Central government authorities are most responsible for reducing discrimination against this group. These institutions should primarily work on their discriminatory attitude towards the group in question, as by means of their behavior they contribute to further stigmatization. The central government is expected to adopt laws and strategies that would be enforced by other state and local institutions. For the addicts, the work of local authorities in the community is of essential importance, but it is conditioned with solid legislative acts and programs adopted by the central government, which has the key role in building the right position on the problem at hand.
“Ministry of Health is responsible for our health status, while the Ministry of Labor and Social Policy should take the leading role in terms of rehabilitation and re-socialization.”
MLSP can do much. It can establish a small start-up business program. The state can provide seed funds for certain social group members to start their businesses.
Sports and Recreation Centers can also be established. One such centre was opened in Ohrid, although it does not function in its full capacity. The opening of a new centre in the settlement “Avtokomanda” was not allowed.
The Mayor disapproved it. In cases centers are opened, they are operated by incompetent
people, thus failing to produce positive outcomes.
“If centers are managed by competent people, they can be turned into self-financing institutions. They can produce various items;
be sustainable.”
The problem with these centers continues on local level, where local authorities’
representatives are not investing enough efforts to convince citizens against such centers in their communities. Due to this, already secured funds obtained from foreign donations fail to be properly used. Another bad example of the local government cooperation is the one regarding the centre in the settlement “Kisela Voda”. Following the example of this municipality, others assume the same position on the issue and would not like centers opened on their territory.
“They are bothered with us coming to the Kisela Voda centre. People are righteously against our visits, because of the careless disposal of syringes by addicts immediately upon obtaining their methadone dose.”
According to focus groups, there are 50 people on the waiting list in Skopje. Some of those receiving therapy and residing in Skopje, have to go to Tetovo or Kumanovo for treatment. Mayors of municipalities falling under the territory of the City of
“Skopje oppose the opening of centers.
There are funds available, but they might go
“down the drain” if no centers are opened.
The funds are provided by the Global Fund Against HIV/AIDS, Tuberculosis and Malaria, in cooperation with the Ministry of Health – the Sector on European Integration.
Governmental approval was obtained for opening centers in the settlements Bit Pazar, Karpos and Cair, but they have not been
established so far. Such units are not operated as parts of health care centers. Mayors do not allow them. On the territory of Macedonia, centers were opened only in Tetovo and Kumanovo. In Skopje, the list has been closed for the last 5 years now. New users are not being admitted on the methadone list. Former inmates are the only ones getting enrolled on the list.
“Addicts do not pay their fines on purpose, so that they would be incarcerated, released from prison and then get in the program. They receive methadone in prison, as well. Some of them commit misdemeanors, just to be incarcerated and receive their therapy.”
Sometimes, problems appear only with individuals holding a central or local government office, due to their personal attitude towards the group. Other times officials play on the card of displeased citizens and are not willing to take any action, so that they would not risk losing political points.
This is not an excuse, since if they are willing to solve the problem they would find ways to convince citizens that a particular initiative is beneficial for the whole community. The current number of centers is insufficient so as to provide care for all addicts.
“They always say - centers will soon be opened.
But we do not see them. We have to go to Tetovo from Skopje, from Gostivar. At the moment Skopje has only one centre, while 3-4 are ready to be opened.”
It is the local community, and not the authorities, that can contribute the most in reducing discrimination. A fine example of this is the Municipality of Strumica, where the whole community was involved in the problem solving, while the church had a major role, as well.
How much do non-governmental organizations help?
One of the interviewed NGO representatives said that - unfortunately - they do the job of the state institutions, as the engagement of the latter ends with the medical (methadone) therapy. NGOs are well accepted by the society and citizens (families of people affected by the problem, but also the directly affected people). Their work is accepted and approved, since their activities are focused on rehabilitation and re-socialization of addicts.
“There are three types of NGOs: the good ones, the single-man organizations, while the third ones are moving back and forth.”
The experience with the NGO “HOPS” is positive. At the beginning HOPS was just a
“cover up”. Within our group there is no NIV/
AIDS because HOPS worked on the field;
people were able to obtain clean packages thus eliminating the spread of HIV/AIDS.
Active work has been undertaken by NGO
“Doverba” (Trust) as well. They work on prevention and consulting. They have an SOS line operated by former addicts. They assist as mush as they can. They also work with self-help groups. They work on the field.
Sometimes they receive calls from family members.
“I am active in HOPS. I was distributing leaflets -information about lectures on AIDS, Hepatitis C. They have a social worker, a medical doctor, and I consult them.”
So far NGOs do not receive any financial assistance from the state, although they have been positively assessed in terms of their work by both - domestic and foreign
institutions. According to them, state bodies are not obliged to finance them, but should assume part of responsibilities and get directly engaged in the process of addicts’
rehabilitation and re-socialization. On the contrary, organizations appear that are more interest- and profit- oriented groups rather than NGOs.
“There are these so called NGOs who completely missed the interpretation of the problem. Most often, they establish commercial programs. You will be cured, but only if you pay. If you don’t have the money, you have to go elsewhere. It all comes down to your parents’ income. Such NGOs charge more than 1000 EUR for monthly regular treatment.”
In general, NGOs operate with funds provided by foreign funds and donations. There is no state money. There is no budget money.
According to the focus groups, there is a general opinion in the state that this group is not worth investing in it. On the contrary, the Government should be the one financing programs. Several things can be done, for example, activities such as the ones undertaken by the People’s University. Re-qualification programs can be established, so that people could at least obtain a certain education level degree. Such programs could address all vulnerable groups, not just the addicts. Employment can also be financed.
Employers can be excused from tax payment.
Businesses could be given incentives for employing such people.
“Such is the situation in Croatia. Business can get loans with grace periods. This should be regulated by a law. On top of it, investments should be made in rehabilitation and
re-socialization programs. Certain groups were addressed with such programs, but not ours. “
The group itself is often faced with lack of special programs for addicts and provision of social assistance and protection. It would be of great assistance when special programs on supporting re-qualification and employment for these people are developed by the state.
This can be done in cooperation with non-governmental organizations.
“Greater engagement on behalf of NGOs is required. But they should be assisted by the state. Funds should be established for that purpose. When I am on 0 with my therapy, I would not know what to do. We are lacking re-socialization under normal conditions.”
The main problem faced by NGOs is the absence of special programs and budget established by the Government that would provide sustainability of projects implemented by NGOs.
“For us, the most important thing is to find something to do. To have some place to go.
We need to get back to life, back to work.
We should not stay at home and think of bad things. This is where NGOs could help.
They should have programs, IT courses, and foreign language courses. They should provide engagement for us for at least 2-3 hours a day.
I spend most of my time at home and that kills me.”