Spal’niy raio, a Russian expression that translates as sleeping area, is often used to describe the district we find ourselves in this muggy Sunday afternoon. A bland, unkempt and culturally vacuous no-mans land that despite its central location isn't served by the city's extensive metro system. We sit in a soulless café on the third floor of a shopping centre with Roman, a heavy drug user who is here to stock up on Methadone. He shifts awkwardly in his seat whilst keeping his eyes fixed on a small screen that is playing endless Romanian pop videos. He is waiting for Konstantin, who is always late; he assures us he is 5 minutes away, every 5 minutes, for an hour and a half.
Konstantin is a Doctor, social worker and bar manager; as a drug user during the 90s he has seen many of his friends die from AIDS. He suffers from Hepatitis C and has now devoted most of his time to helping drug users test, and take the necessary precautions to avoid a similar fate. He is instantly recognizable as he steps outside of a taxi - standing at around 6'5, his jeans hang loose around his emaciated waist; a facial trauma he suffered during the Chechen conflict coupled with regular drug use has left him with one glass eye and a gaunt complexion.
The unsafe use of intravenous drugs was the key driver behind the HIV/AIDS epidemic that blighted Ukraine in the mid 90s. Now, largely due to the side effects of the recent conflict, the country is looking at another sustained period of increased HIV and Hepatitis C transmissions. The conflict with Russia in Crimea and anti-government separatists in the Donbas region has put an enormous stress on the vulnerable groups in society. Many young soldiers – which include conscripts and volunteers – are returning with posttraumatic stress as well as the 1.5 million internally displaced refugees who often find it hard to find a job or suitable housing. The answer, for many of these people, is to seek an escape in the form of cheap, homemade drugs.
We have convinced Roman to show us how the drug scene in Kyiv operates; we are all nervous, including Konstantin, who has brought his girlfriend, Natasha, also a doctor, along for support. We enter an off license; the owner throws a knowing look across at us and goes back to doing nothing. There is a queue for the cash machine at the back of the store; everyone is here for the same purpose - to deposit money to his or her drug dealer.
Roman leads the pack as we walk down one of Kyiv's main roads; the constant drone of traffic drowns out any conversation. A small yellow bus screeches to a halt, breaking far too late and accelerating far too quickly; for locals this is an area that everyone has passed but very few have visited. After 15 minutes in the baking sunshine we turn left into a leafy neighborhood, the tree lined avenues, throw a welcome shadow over the dusty streets. Roman, is fair skinned and now the effects of the sun are showing on his skin, a film of sweat lies across the back of his red hair, it hasn't helped that he has insisted on wearing a hooded sweatshirt despite the heat. He is uncomfortable but appears focused; soon, 17 floors high and overlooking Kyiv's skyline he will find his peace.
The area is not as we had expected, the sound of children playing and the sights of trees in full blossom makes it feel vaguely idyllic. A young girl with pigtails swerves past us on a scooter, heading towards the local playground. Three young men walk behind her, they are all wearing sports clothes, one of them is missing his hand and forearm, his stump appearing just below his sleeve. This is our first exposure to the side effects of Krokodil, an incredibly toxic drug, cooked using household pharmaceutical products. It was first registered in Siberia around 2003, as an alternative to heroine after a government crackdown, and has since spread to Ukraine. If a user misses their vein during use, the surrounding flesh will die and rot; the smell, Konstantin assures us, is unbearable.
The area is divided into two types of buildings; tall modern apartment blocks and low dilapidated buildings built by German POWs after WW2. The cosmetic effect of the spring sun and cherry blossom is wearing off as Roman stops outside a garden of one of the older houses, inviting us to sit on some garden furniture ensnared by the surrounding shrubbery. This is where, amongst 42 drug users who co-inhabit the building, the ‘cook’ produces Methadone. We are later allowed inside; the conditions are appalling, with unlit mould infested communal showers and leaks dripping down the sodden walls of overcrowded rooms. A short, stocky man walks out of the building and into his car; he is wearing a black tracksuit and his gelled fringe appears to seamlessly merge into his sunglasses. The cliché seems too obvious but as he drives off, in his blacked out BMW, Roman confirms that this is one of the local dealers. The garden sits in the cool, dark shadow of a modern uninhabited tower block. A building that, until it finds an owner, will continue to be frequented by drug users who ascend the claustrophobic lift in the pursuit of an elevated state of consciousness. This is the shooting gallery where drug users can use certain sections of the staircase to inject drugs.
Roman stands with a syringe in his hand; he is from a middle-class family and still lives with his parents, unlike Konstantin, his arms are not perforated with holes from needles. He pulls down his shorts and underwear; to the left of his penis is an open wound, this is where he will insert the needle - he uses his groin so that his parents do not notice he is a drug user.
He walks out to the balcony and looks onto the building opposite - its clean exterior simmering in sun-drenched opulence – this, is the District Police Station. The station, explains Konstantin, is every bit as important in the local drugs network as the other buildings we had just visited. The local cook, dealers and users need to know that they are protected, and as long as the right officials are being paid, business can operate uninterrupted. There is a status quo, everyone knows what they can and can’t do. As we leave, Konstantin makes sure all rubbish is cleared “the only rule in this building is not to leave a trace, as long as you do that, no-one will bother you”. The reality however, is that the toxic and unregulated nature of homemade drugs means that things do go wrong and when this happens, there is no-one there to help.
We return briefly to the cook’s house before being led by Roman on a mazy tour of the neighborhood. Natasha has been affected by what she has seen and appears distracted. She is watching Roman who is ‘peaking’ now; we find him standing in various locations with his head raised to the sky and a cigarette hanging out of his mouth. We ask him how he feels “I feel everything is so easy and nice, like someone is massaging me from the inside. Anything you would ask me to do, would make me so happy, I would be so motivated”. He continues down the pavement with an exaggerated gate, swaying from one leg to another, eyes fixed above the horizon as if mesmerized by some heavenly apparition. A policeman, lounging in the driver’s seat of his car, briefly glances at Roman. He is making slow and steady progress down the centre of the sidewalk, forcing two older women to circumnavigate him. They begin to scold him but soon realize their words are falling on deaf ears - Roman’s mind has ascended beyond the grey concrete buildings and left us all behind.
The difference between the situation today and the early/mid 90s when drugs became especially popular is that now there is a greater stigma associated with the habit. Alexei Bobrik, the Technical Officer for HIV/AIDS at the WHO, explains, “ the first HIV epidemic, was driven by people experimenting with drugs, before information was widely available about how the virus could be transferred”. Konstantin describes how he lost many of his friends who he studied with “ they would try it a few times at parties, then stop and move on with their lives having forgot about it”. He explains, “Nowadays the image of a drug user, has shifted from a student experimenting at university or parties to the stereotype of a homeless junkie”. This image has entwined itself with the traditional Orthodox and Catholic values entrenched in Ukrainian society. Father Vasyl of the Russian Orthodox Church in Ukraine describes how “drug users who are ill or desperate are welcome in the church but they will be taught that they are suffering for their sins”. He shows us his Church’s most popular painting that represents hope; a depiction of a miracle in which a man’s hand, which had been severed, regrew thanks to his faith in God – you wonder if the victim of Krokodil use we had passed earlier would appreciate the symbolism. This stigma and discrimination, means it is hard for users to find employment or medical support; like Roman many of them look to hide their addiction making it extremely difficult for the HIV prevention programs to monitor the situation.
Natasha, a doctor for 6 years, who has seen the most graphic effects of drugs, is visibly shaken by what she has witnessed “I knew this happened in my city, but it is different when you witness it first hand”. The unsafe use of drugs is a huge health risk for the young and vulnerable in society, a situation that the authorities appear to protect, rather than combat. Just as drug use in the 90s, the full effects will only become apparent in the years to come; the results could be equally as shocking.