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Meet the ‘foreign agents’ Drawing on their own pasts, Russian charity workers at Humanitarian Action are helping thousands overcome drug addiction

Source: Meduza
Artem Leshko / Humanitarian Action Foundation

Russia’s Justice Ministry added “Humanitarian Action,” a charity based in St. Petersburg, to its list of “foreign agents” in late 2020. The organization works mainly with drug users and people living with HIV, but the authorities decided that it is also engaged in “political activities,” including its employees’ criticisms of government policy on HIV and drug dependence. Humanitarian Action helps thousands of people every year, some of whom manage to overcome their substance abuse. Meduza spoke to three people at the group who now use their own experiences with overcoming addiction to help others.

Ilona Keyser

age 46, medical and social support specialist

It was 1989 in St. Petersburg. I was 15. I come from an academic Leningrad family: My mother was a doctor of science and my grandfather was an academic. I grew up a sickly kid — I was very unpopular in school. I was an outcast.

When drugs came into my life, I became “myself” around others. This was great: People thought I was being my own person. But at home, they didn’t understand me. My mom repeatedly put me in asylums because of my drug use. 

When I was 18, I got married. My mother told me to go [live with] my husband. I tried to visit her [and say]: “Mom, look how cool I am. Love me!” I thought motorcycles, rocker parties, and drug use were so cool. Mom’s gonna see how cool I am, and she’s gonna love me. That didn’t happen, of course. It just got worse and worse.

Then I divorced my husband. Remarried, divorced again. I was wandering through life. Tried to study, worked here and there. Looking back, I don’t understand how I was able to work while I was using.

Mom died in 1999. She left everything to my brother, who lives in the United States with our stepfather. He sold her last apartment [where I had been living]. He gave me money to move out. I didn’t really understand, and I agreed.  

Then I married a third time. I lived with my husband from 2008 to 2013. Then I had health problems, went into the regional hospital, and almost died. I never went back to my husband. My aunt took me in for six months, but I started fooling around, and she kicked me out. It was 2014 or 2015. For about two years, I lived on the street.

At first, I stayed at a state shelter — I’d heard about it from some people I knew. It’s like a house with social workers, six beds to a room, and a bedside table. You can only stay there at night (you’re kicked out during the day). They don’t let you in if you’re drunk. I got kicked out for using.  

I tried to survive [on the street]. Every two or three weeks, I had to have surgery — I had a broken arm and a metal plate in it, and my body started rejecting it. My arm was rotting. They couldn’t take the plate out, so they operated on me, and then threw me out on the street without any treatment. They said, “You’re a bum, you should be dead already!”

For a long time, I spent nights at the Moscow train station. I stayed in the front. I was afraid of the heating vents; there were other homeless people gathered around them. I tried not to get close to anyone — to anyone at all. I was so afraid. I didn’t speak to anyone for six months. Why? You live like an animal on the street.  

The police didn’t bother me. They only throw you out of the station if you look bad or drunk. If you look more or less decent, you pretend you’re waiting for a train, and that’s it. Other people were mostly disrespectful and squeamish: “This is not a person.” It’s like being a piece of meat.

Oddly enough, my attitude towards other people was not ruined. A person [under stress] can either run or fight. For example, people are squeamish about the homeless — it’s a defensive reaction. They don’t know the person’s history. They think: God forbid it ever happens to me.

Because of the surgeries, my veins and muscles quickly disappeared. I lost 50 kilos [110 pounds] from my normal weight of about 95 kilos [210 pounds]. There was no question of injecting drugs anymore — there was just nowhere to put them. I was downing sedatives. On the streets, back then, you could buy a bottle for like 50 rubles [about 67 cents]. Sometimes I drank with friends. It was so painful — both psychologically and physically — that I didn’t care anymore. My daily goal was to survive. I didn’t expect anything. I didn’t even manage thoughts of suicide.

I got hit by a car once. The people [knocked me down] and took my ID. I had a broken leg, a broken arm, and a broken collarbone. I couldn’t walk, but I got to one of [the nonprofit organization] Nochlezhka’s shelters. They recovered my papers and took me to the hospital.

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There were people at the hospital who spoke to me sincerely. The staff knew what was going on in my crazy head. I had no one else in my life then.

All my life, I had thought that I had this situation in my life, and that was why I was using. In fact, my life was like this because I was using. That had never occurred to me before.

I [stopped using], I got a job as a cashier, and then I became a saleswoman. Then I worked in a nursing home for the elderly and did babysitting. At the same time, I entered the Institute of Psychology and Social Work, first studying to become a social-work specialist. I recently graduated as a clinical psychologist. The state gave me a rent-free dorm room where I lived for four years.  

And then, one day, a man came from Humanitarian Action and asked if I could help by accompanying one of their clients to court. I was hired soon after. That was in 2018.

At the same time, I was volunteering at the hospital. I had one patient, then two, and then three. I met doctors, and they hired me as a social worker. For example, we admitted an HIV-positive patient with tuberculosis. He couldn’t walk. He had no papers and no relatives. We got his papers restored, put him on the register as a person with no fixed address, and got him a pension and disability benefits. Then he went to a sanatorium. He recently got out. They’ve practically cured his TB. They put him on the waiting list for a place to live. Because he is unable to care for himself properly, he has the opportunity to go to a residential facility. I did all of this for him by power of attorney.  

I can’t do anything else anymore [besides helping people]. I’m sure of this. I’ve been through almost everything that I’ve been doing for my clients. At first, [my job] was a self-affirmation — it was about getting respect and seeing the results of my work. It’s a way of life now.

No one else does this kind of work in Russia. Our clients simply do not have access to government institutions for the help they need. Therefore, I’m puzzled by our being designated as a “foreign agent.”

Because of this designation, we can no longer work with some state institutions. Unfortunately, not everyone understands what “foreign” means: it frightens people. The organization loses influence, it loses face. We’ve transformed into helpful but somehow suspicious types. It’s like we’re good but something’s rotten here. It’s sad.

Photo: Natalya Bulkina

Alexey Lakhov

age 40, director of development

I grew up as a pretty shy kid with a lot of demons. No friends. My parents’ families had a drinking problem. All of these factors seem to have led to my first taste of alcohol at the age of 13 or 14. I didn’t like the feeling very much, but I really liked that it allowed me to connect with people — with my peers who were uninhibited and therefore very cool. I tried marijuana when I was 16. I used it, along with alcohol, for a long time.

I had offers [from friends] to try various intravenous drugs, but I avoided them. I thought I’d never be like that.

After school, I went on to college. Then came the trigger in my life. Looking back, it’s hard to say what it was — some unhappy love story or something — but I tried intravenous drugs. I was 18 years old. Once again, I didn’t like the effects, but I liked being in the company of “non-conformist” people. So I got caught up in it and started using. My parents found out a few weeks later when they saw the marks on my arms.

There’s such a thing as a drug of choice. My choice was heroin. From 1999 to 2006, there was a heroin epidemic in Petersburg. During my first year of heroin use, I discovered the Humanitarian Action bus for the first time. A friend of mine had told me about it. His motivation seemed strange to me: “You can get tested there for hepatitis and HIV infection.” 

Artem Leshko / Humanitarian Action Foundation
Artem Leshko / Humanitarian Action Foundation
Artem Leshko / Humanitarian Action Foundation

But I went and talked to a psychologist on the bus. I was surprised that they didn’t moralize; they just asked if I needed any help. I was surprised because I didn’t realize I was already in trouble. I soon learned that I had hepatitis B and C. At the clinic, I was offered hospitalization at Botkin Hospital, but I thought I would only do that if something bad started happening to my health, so I refused. 

All this time, I was trying to work. My lifestyle was never going to be a good fit with higher education, and I was expelled during my fourth year in 2001. Three years later, I was convicted on drug charges and placed on probation for five years. I was 24 years old. 

When it comes to concepts, there’s also something called dependent thinking. How did it work in my case? [I thought:] “That’s it, there’s nothing left in life. I have to keep using.” To the bitter end, to put it bluntly.

But in 2005, I started trying to kick my addiction. I was influenced by my criminal conviction, being expelled from college, and my divorce (I’d gotten married and divorced after eight months). My teeth had started to fall out. I was 182 centimeters [5 feet, 9 inches] tall and I must have weighed 60 kilograms (132 pounds).

My parents helped a lot. We made a deal: either I would go my own way and wouldn’t expect them to help, or I’d go to rehab. After a month in rehab, I started breaking the rules, arguing with the counselors. I went from being an unmotivated man to being very motivated — I was sure I could handle everything on my own. That’s also a peculiarity of dependent thinking: it goes from extreme to extreme.

I ended up being discharged for breaking the rules. The very same day, I took drugs. Still, in rehab, I’d gotten the idea that I could quit. A few weeks later, I asked to return. They took me back, and I stayed for two and a half months.

Group sessions are held two to three times a week [in rehabilitation]. People are given assignments. For example, think of 100 times when you felt guilt (or resentment or shame) in different periods of your life. Or think of the three most unpleasant episodes of your life. Then you read the answers in a circle of other patients. They give feedback and recall their own cases. When people share things like that, it creates an atmosphere of trust. The counselor then summarizes the session.

Of course, this isn’t to shame people or to show them how bad they are, but for psychotherapeutic purposes. It’s really to show [each person] that such feelings are not theirs alone and that you can live and work with this stuff.

There are other activities, too. For example, in the morning, everyone comes together and shares their plans for the day and their moods, and they do a daily wrap-up in the evening. There are also individual meetings with counselors during the day. They pay attention to studying the “12-step” program [for drug and alcohol recovery]. We’d watch movies about narcotics and then discuss them. For example, Basketball Diaries and 28 Days are about people who overcome addiction. 

After that, I went to a post-treatment outpatient program [at the rehab center]. It also lasted two months. I even started working there, taking phone calls — people can call there and ask: “Where can I find AA groups for addicts and alcoholics?” 

Even so, I relapsed. I used drugs again for several months, but it didn’t feel the same as before because I knew what life could be like without drugs.

I remember one episode from that period. I went with a drug-addict friend to see his grandmother. He told her we needed to borrow her phone for work. She probably understood what was going on, but she gave it to him anyway. We pawned it at a pawnshop. Then we sat on a bench waiting for the dealer. He’d said he’d be back in 10 minutes, but it took two hours.  

It’s such a typical episode for a regular user, always needing money. You bring something to a pawn shop, you borrow, you concoct some sob story. You promise to return it the next day, and you come back in a few months.

For me, this situation has become an example of how quickly you can fall back into it. A week ago, you were on the phone telling people what kind of support groups there are, and you were even being paid some money. Now you’re back on that stupid bench waiting for the dealer. Ready to wait for hours. You feel like shit. You know exactly what’s going on, but the psychological pull is stronger.

The pleasure of the drug passes quickly. You’re using it just to function — to walk, to talk, to remove physical discomfort. It’s like a kind of flu or COVID. The drug becomes dominant; it becomes the most important thing.

At that time, I was attending support-group meetings for addicts. There were people who had gotten out [stopped using] — who had diseases, criminal records, and a lot of other problems. Then the realization came: “Why do I need drugs at all if I can live differently?” Since September 19, 2006, I have not used any drugs or alcohol.

I worked for a long time in the editorial department of a foreign property website and rose in the ranks. It helped me to learn English — as a teenager, I’d been interested in it and studied it. But I kept going to self-help groups. I’d work and then go to group. It’s become a routine, a habit, like brushing your teeth. It is very important when recovering from addiction that you have something to hold on to, no matter how clean you stay.

It’s been five years. I was in my 30s. I realized I wanted to work in the field of charity. You get more confident, more willing to share your experience. I worked for several charities.

I’m generally apolitical, but I noticed that from around the end of the 1990s until 2008, the state was very active in supporting the work of harm-reduction programs [for example, distributing clean syringes to drug users]. After that, everything became like a division between yours and ours: “If you receive foreign funding, we will watch you more closely.” At the same time, the inspectors are completely calm, [saying]: “This is the law, we are simply enforcing it.” 

If you compare the amount of foreign and Russian funding [for such programs now], the ratio is far from favorable to the Russian side. Though getting money from the state wouldn’t be so easy, even if the government offered broader funding. We’re involved in discussing various [legislative] initiatives on the subject of drug dependence, HIV infection, hepatitis — but if a bill is obviously bad and we start to criticize it, then we would be biting the hand that feeds us.

Russian businesspeople could give money. But helping drug users is not very popular in our society. Social media often say about drug users: “Why help them? They made their choice.” It’s perfectly understandable. Our job is to change the public’s opinion. Basically, we’re trying to accomplish what the charity Nochlezhka, which helps homeless people, managed to do.

It’s not only possible but necessary to provide regular assistance to drug addicts — there’s no shame in it. And people are starting to understand. The state is unable to cope with the problem because it acts primarily by force and therefore can’t get access to certain groups of drug users. So let’s help an organization that has direct access to drug users.

So far, the status of “foreign agent” hasn’t impeded us very much, but the whole situation is extremely unpleasant and unfair, of course. We are now in the process of conducting an expert evaluation that we can bring to the courts to challenge the decision.  

Anastasia Elinova

age 28, medical and social support specialist

Drugs came into my life when I was 17. I lived in the United States. My mother had married an American, and for five years I lived with her and my stepfather.

I still think I had a good reason for using drugs. My stepfather was a very aggressive man, and I couldn’t stand up for myself. We had a very bad relationship in the family. As bad as you can imagine: violence, assault.

I knew drugs were bad. I knew it when a classmate at school offered me a pill. I knew I needed it to escape my pain.

As soon as those pills came into my life, everything changed. A month later, I was doing cocaine and stealing money from my mom. It went on for three months. I lost weight and my grades fell apart.

One day, my stepfather beat me up really badly. I went to school without hiding the bruises, and I told the teacher everything. My stepfather was arrested, and they decided to send me to Russia — to relatives in Tolyatti. But my mom told them I was a drug addict, so no one was waiting for me when I got there.

I had no idea where to get drugs in Russia, so I just abused alcohol. I had no steady job and stayed with friends. That went on for a while. I met my future husband when I was 20 years old and got pregnant. It wasn’t a conscious adult decision — our marriage was over by the time I was 23.  

I found out from friends that I could sell drugs. It didn’t even scare me. I thought again it was an escape from pain. So I [began to sell and use] “salts” [synthetic drugs]. That was in 2016.

I thought I was happy. I was distributing “packets,” and I had money. I could support myself and my daughter. I had the fantasy of having lots of money, going to the supermarket with my baby, and buying whatever I wanted.

But literally within a month and a half, I started to lose control, and animal behavior took over. It’s like someone else has moved in. I used to be a mom who never let go of her baby, and then this mom quickly turned into someone else. Somewhere in my heart, I knew that leaving the baby with my grandma and going to the dope store was a bad idea. But I couldn’t help myself.

One night turned into a month. The dealers changed apartments, places, people — but they didn’t run out of drugs. Throughout the month, I kept telling myself, “Another 10 minutes now, and I’m going home.”

I woke up in a house where I didn’t know anyone. I remember the paranoia and the fear of everything I saw and heard. I couldn’t remember the last time I slept or ate.

I began to write to my dad, who at that time lived in St. Petersburg. I confessed to everything. I made my way home, hailing a cab and then taking a train. Every time I remembered that I left my daughter [with grandma], I wanted to take drugs so I wouldn’t have to think about it.

I went to see my dad, and he took me to a drug clinic. It took me a long time to realize that addiction was a disease. The “12-step” program seemed like a sect. [I told myself]: “I’m not shooting up, everything is fine.” 

A month went by. Everyone said it wasn’t long enough. But I felt I’d had enough: I understood everything. I left the hospital, strongly convinced that I was going to get my baby. In fact, I met drug dealers almost immediately. We took a shipment of drugs by car through Chelyabinsk to Yekaterinburg and back, to sell.

I was using even more than before. I was laying out the packets. It was a horror movie. I remember looking at a drug dealer, but thinking I was talking to my dad. I was in a drug house, thinking I was in rehab.  

The Humanitarian Action bus
Artem Leshko / Humanitarian Action Foundation

A week went by. I’d gone nuts. When we got back to Tolyatti, they just kicked me out [of the car] outside my house. My sister and uncle were there. Literally the same night, they put me on a plane to St. Petersburg, and I went back to the rehab hospital.

I was there for a month. Nothing changed: I still didn’t understand that you have to do something with yourself. When I was in the hospital, I hoped the medics would give me a pill, dissect my brain, and I would come out healthy. 

I met a young man there who was also in rehab and soon I went to live with him. I ended up doing drugs again. It didn’t last long and we broke up. With the last of my money, I bought a roundtrip ticket to Tolyatti.

I didn’t do drugs. I went to see my daughter. I wanted to take her with me, but they didn’t trust me. I met a young man in the military. We moved in together, but we saw each other very rarely because of his service. It was lonely. I knew there were support groups for drug addicts, but I still didn’t think that was for me.

Our relationship lasted seven months. I found out I was pregnant, but he demanded an abortion. I said yes. My feelings of inferiority and emptiness intensified. I knew where to go after the abortion clinic — to get drugs. Within 24 hours, everything was back to where it’d been before. I came home high with a packet of “salts” in my pocket. I smashed the dishes and knocked things over. My boyfriend saw it all, packed his bags, and left.

I decided to sell drugs again with my friends. For a month, it was fun: money, evenings, and parties. But the police were already watching us, obviously. They picked me up on the street. I had drugs on me (for my personal use). I told them all about myself and everyone. They used me in a sting operation. I ended up with a year’s probation.

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The court also sent me to a drug clinic. I was there for a month. The treatment was questionable — they give you pills that make you feel like a vegetable. When it was over, I got out. I was shaken up and started acting chaotically. I resumed a relationship with a former boyfriend, and I started getting in touch with drug dealers. Eventually, I started using again. It was bad. I tried to quit a few times, finding support groups, but staying sober was hard.

On New Year’s Eve, I looked at my boyfriend’s cell phone and saw he had been searching online to find out about the side effects of amphetamines. [That he was using] was so hypocritical to me that I asked him to leave. After the holidays, I got another money transfer from my mom, and I spent it all on drugs.

I’d gone completely insane. I was always checking the peephole at the door, I taped newspapers over all the windows, and put my mattress over a big window in the bedroom. I covered the camera on my cellphone. I thought it was very sensible to shave my head.

I overdosed once. Paranoia turned into suicidal thoughts. Then I found some kind of private narcotics treatment service that promised to do it anonymously without the police. A doctor came over and gave me an IV. I slept and recovered, but I kept using.

This craziness ended when I got a call from people at “Drug Addicts Anonymous,” who asked why I didn’t come to them. They invited me to rehab. I said yes, but the addiction made me say, “Let’s move it to tomorrow,” and they said I could come right away. Then they hit me in my weak spot: “You don’t have enough spirit!” That really offended my pride. They picked me up and took me to rehab. I spent three months there. I got to know a lot of good people there — psychologists and counselors.

I didn’t want to do drugs anymore. I wanted to do something good for my child. Dad wrote that she wanted a scooter. I had just been offered a job as a translator at a charity. I sent the money I earned to buy the scooter, and I was very proud of myself.

I decided to move to St. Petersburg. My family helped with this. When I arrived, they gave me my child on my first day. She was five or six years old. I’m very grateful to the father [of my child] and his wife. They took a chance; they gave me my daughter. But I was under constant supervision — they called and visited me regularly.

I borrowed enough money for a month. I got a job at the post office, sitting at a computer, receiving letters, and processing and delivering packages. I worked there for three months. I didn’t like it — the job was boring. So I found a job as a cashier. I was thinking more and more that I wanted to help people — to help people like me. I knew I could do it. I can manage this. I left my job again and became a volunteer at the city narcotics hospital. I was also working as a courier.

At the hospital, I was in the rehab department. I’d join in group sessions. The psychologist could use me to help show others how my perspective had changed. For example, he’d say: “Nastya, you have nine or 10 months of sobriety. How’s everything going?” And I’d tell them.  

The guys [in rehab] have a lot of free time. You start to connect with some of them. But my job, of course, was to help, not just be friends and talk. I wanted to motivate them, to show that there’s a reason to stay sober. I function as a crutch. Here’s the hospital and here’s someone who’s walked the same path, except she’s gone a bit further.

I got acquainted with Humanitarian Action at the hospital. A social worker introduced me to their bus. I immediately agreed to work there. It was love at first sight. Everyone was very kind, they listened to me, and there was acceptance.

Artem Leshko / Humanitarian Action Foundation
Artem Leshko / Humanitarian Action Foundation

There were four people on the bus: a driver, a nurse, and two counselors. We had a questionnaire. HIV and hepatitis testing is anonymous, so everyone was given a unique code. They questioned people and jotted down answers about sex, drugs, and knowledge about HIV. People often don’t know what HIV is, or they [think] that it’s transmitted with a mosquito bite.

The nurse drew blood during the consultation. If the results were negative, they gave out a bag — there were brochures, business cards, handbooks from Humanitarian Action and the AIDS Center, and condoms. We even had some regulars who came in to get tested repeatedly. 

If the test was positive, that was the most emotional. The reactions were different. Some people already knew and just wanted to confirm. Sometimes, people had taken a test in a private clinic, but they didn’t believe it and lied to themselves, moving on until they see this bus and they come in. Some people cried and ran, and we didn’t have a second to stop them and calm them down. We used to pour people a glass of water to wake them up if they fainted. Then I would stay with them, explaining that this isn’t the end and that people can still live and have healthy babies. You just have to do a series of things, and life goes on.

Then I did an internship with the foundation’s senior staff. We did everything: went to court, went to places where homeless people sleep, and went to the AIDS Center.

After the internship, the foundation wanted to assign an employee exclusively to the AIDS Center, to learn how everything is done there, get acquainted with the doctors and the registry, and understand how to resolve different issues quickly. I wanted to try it out.  

Artem Leshko / Humanitarian Action Foundation

I’m at the center every day now. When the pandemic started, I helped by telling people that they could order medication over the phone — that they didn’t have to wait in line and risk getting infected. I regularly got power of attorney to receive shipments of pills for 10-12 people and sent them on to different places. In an emergency, I had to deliver medication myself, for example, to a mother who got COVID and ended up in the hospital. I’m doing that now.

This job first and foremost gives me a sense of fulfillment. I give something — I help someone. It’s important for me to know that I helped at least one person today.

Now I’m thinking that it would be nice to go further — to be educated as a psychologist. I’d like to stay with the foundation for a long time. This is the first and only job in my life where I feel like I’m in a big family, where everyone helps each other and cares and does something useful that fills me with pride.

When I learned that our foundation was included on the list of “foreign agents,” I was afraid. I just didn’t understand. It all sounded like an unreasonable accusation against us because we do so much good for people. It’s a political story, and we’re doing something else.

So far, though, the label hasn’t affected my work. Our leaders [at Humanitarian Action] have not lost heart. In other words, we have what we need. It’s going to be okay.

Interviews by Sergey Kagerazov

Translations by Carol Matlack