Working with the Marginalized

Until the 1970s, drug addicts didn’t exist in Poland – at least not officially. In those days, drugs were expensive and the supply was limited, so the Polish state could hide the problem by giving a different label to the small number of addicts. But then heroin became more readily available, in part as a byproduct of domestic poppy farming (poppy seeds are a key ingredient in the Polish strudel known as makowiec). And addiction started to grow. By the mid-1980s, heroin use – along with glue-sniffing, marijuana, and speed – had grown to epidemic proportions.

In the 1970s, psychologist Marek Kotanski began a new kind of treatment for drug users that emphasized group therapy and other practices considered innovative at the time. He eventually created the organization MONAR (Youth Movement against Drug Addiction) to address the growing problem. Later, as social problem proliferated in Poland, Kotanski created organizations to address HIV-AIDS and homelessness. He died in a car crash in 2002.

In 1990, I visited MONAR in Warsaw where clinical psychologist Danuta Wiewiora introduced me to the various facets of the organization. When I returned to Poland 23 years later, she was still working for MONAR. I caught up with her on her vacation at the Polish seaside town of Rowy.

I asked her what had changed over the last quarter century in terms of MONAR’s work. “There was a kind of border between society and homeless people or drug users,” Wiewiora told me. “It was a different group. Now, there are plenty of people in our society addicted to something. Some are addicted to drugs, but very few to heroin. The majority of them are addicted to so-called recreational drugs. The level of their problem is rather high. Very often they are students, good workers, managers, your friends, people you pass on the street. Now there is no distinct group of drug users. A lot of people are using different drugs at different levels. Very few use hard drugs. The majority use marijuana, amphetamines, cocaine, Xtasy, a lot of designer drugs. It’s a part of youth culture now.”

With HIV-AIDS, meanwhile, Poland initially made considerable headway in addressing the problem. “For 10-15 years, Poland was seen by other countries as a good prevention policy maker,” Wiewiora explained. “The level of new HIV-infected people was growing only by about 10-15 percent a year. Also, all the doctors were very well trained, with all the new knowledge and drugs for AIDS patients. In Poland, everyone is treated for free even with all the antiretroviral drugs. It’s covered by the ministry of health. The number of AIDS or HIV seriously infected people is growing. Now, close to 20,000 people that we know are infected. But probably it’s two or three times more who are infected and they still don’t know. There are anonymous counseling centers in every big city – free of charge.”

Unfortunately, the situation has changed. “Now the number of HIV infected number is growing again by about 1,000 per year,” she continued. “Last year, it was 1,500 probably. There’s no money for prevention. Everything is spent on treatment, on the medical drugs. Also, and this is happening in other countries, people stopped being afraid of HIV because it could be treated. And so, it’s growing.”

As it did in the 1980s, MONAR continues to employ former addicts as part of its team of psychologists and therapists. MONAR was not supposed to be like a bureaucratic NGO. It wanted to change people’s lives: not just the clients but everyone who became involved with the organization.

“One of my colleagues had been one of the clients in our movement,” Wiewora told me. “He was a heavy heroin drug user. He was infected with HIV, hepatitis C, hepatitis B. Twenty years ago, he was a like a skeleton, just bones and skin. Now, he has a family, and he’s on our board of members. He runs a very good center. He finished his studies and his training. He overcame hepatitis C, which was not easy. Now he’s over 40, close to 50. He’s a mountain climber. He’s a marathon runner. He’s in very good shape, and he gets a lot of respect from other people. He’s come the longest way of anyone I’ve ever seen. He’s also my good friend.”

 

The Interview

 

How did you become involved in this work?

 

I am a clinical psychologist, and I started my training in therapy. I worked for a couple years for a good American project in Warsaw. It ended, and I was looking for work. I never dreamed of working with drug users. But some of my friends came to work at MONAR. One day I went to MONAR and asked if they had work. And Marek Kotanski said yes. Then he asked, “Do you love me?” That was the question he asked everyone. And I said, “Sure, why not?”

I stayed for 30 years. That’s how it happened. At this time there was not so many trained psychologists and therapists cooperating with MONAR. It was 50/50: people coming up through the program and people who were prepared professionally.

 

What was your feeling when you first started working there?

 

I was full of good will. But I didn’t know how to work with that kind of client. I was trained by my colleagues, by the ex-drug users who were working with MONAR. But it took a long time for me to understand what specifically this work was.

 

Did you make any mistakes at the time?

 

A lot! With this group of clients, you have to understand when the drug user is talking to you and when a real person is talking to you. If you believe in some sentences or words produced by the drug user, you’re in trouble. You need to be very careful and understand when the real person is in front of you. This is the real training: to understand these two personalities.

 

Can you give me any examples of these two personalities?

 

The drug user will say almost anything, will promise you anything. They have a lot of hope that the treatment can be done in one day. I would never say that this part of the personality is lying. It’s just another reality for this person. But if you believe them, if you trust the drug user personality, you cannot help this person. But if you try to build up a real relationship that is therapeutic, a good relationship full of trust but that recognizes these two different people, and if you discuss a lot of things, then maybe together you can find a solution. It takes time. But it’s more important to build up a good relationship full of real trust, even if it’s hard for this other person.

Also, I myself need to be as open as I can be. I don’t pretend to be someone who knows better. But it’s takes a long time to feel ready to build up this kind of relationship.

 

When we talked in 1990, the number of drug users and homeless people seemed liked a lot. But now when you look back 23 years –

 

It’s still a great number. What was different: there was a kind of border between society and homeless people or drug users. It was a different group. Now, there are plenty of people in our society addicted to something. Some are addicted to drugs, but very few to heroin. The majority of them are addicted to so-called recreational drugs. The level of their problem is rather high. Very often they are students, good workers, managers, your friends, people you pass on the street. Now there is no distinct group of drug users. A lot of people are using different drugs at different levels. Very few use hard drugs. The majority use marijuana, amphetamines, cocaine, Xtasy, a lot of designer drugs. It’s a part of youth culture now.

 

So, the problem has become much more widespread.

 

Yes.

 

That must make the work of MONAR more difficult.

 

Yes and no. Since the beginning of 1990s, we’ve created a lot of new centers. Now we have over 30 centers for drug addicts. Some of them are also for alcoholics. And there are close to 100 live-in centers for homeless people. But they are not really homeless people like what we saw in 1989-90. These are new homeless people. We reached a breaking point in Poland when we moved from a Communist country to this new capitalism. With these political changes, there were a lot of social changes. Before, even if many people did not have much money, they had safety and stability. You could find work. You were sure of your work, from when you started until retirement. Now, there are plenty of people without work, or they have part-time work or occasional work. It’s hard to manage this. Some of these people are failures rather than homeless. That’s the difference.

 

There are still some homeless at the train station.

 

Yes.

 

Because they don’t want to go to the live-in centers?

 

We have services to visit train stations. But the people there generally prefer to stay there. The major reason is alcohol. In our places, they can’t drink alcohol or use drugs. If they want to do these things they stay on the street. Or they want to feel absolutely free.

 

Are there estimates of homelessness?

 

There are at least 100,000 people who are poor and without homes in Poland.

 

That’s a lot of people. Are they mostly in cities?

 

Almost anywhere. They work part-time, for instance, during the summer, and then move with the seasonal or part-time work. There are also some people from other countries – from the former Soviet countries, like Ukraine. I don’t know if anyone has proper statistics. Before 1989, everyone had an address. Now, are you homeless if you have no address? No. Like in the United States, you are a free person in a free country.

 

Are there any estimates on drug addiction?

 

What I know for sure, it’s a rather low number of people addicted to heroin: real drug addicts. It used to be a couple thousand real addicts before. Now I think it’s hundreds in each city. The majority of these addicts are in centers or in methadone programs. But no one can really count the people who use cocaine at home or on the weekends or do amphetamines and Xtasy in club culture. I think there are many hundreds of thousands of people. Before, a good estimate of heroin users came from the number of deaths from heroin overdose. Now, it’s hard to estimate. Poland is also a great market for drugs.

 

Drugs coming from the former Soviet Union?

 

No, the drugs come from everywhere. Poland is also a great producer of amphetamines. There are open borders. There are some statistics on the website of the National Bureau for Drug Prevention.

 

Open borders change your work a great deal, in terms of people and drugs coming to Poland. It must be more difficult to keep track of the problem.

 

Of course the police do their work. But you can buy any drug you wish.

 

Are you familiar with the decriminalization and drug treatment program in Portugal?

 

Yes, I think it’s a very good idea. For me, always, drug addiction is a problem, an illness or disease, and drugs were only the symptom, or the way to solve some other problems. I never agreed with any kind of punishment. But of course if some people are drug dealers or doing things that are illegal because of drugs, this should be punished. The Portuguese way is very interesting. We should try this kind of policy. But Poland in the last couple of years, mentally, is not really prepared for this kind of policy.

 

Why is that the case?

 

It’s not easy to live in Poland. People are not open and friendly. They are not ready to understand other people. Maybe that’s why these open-minded policies are not too popular among citizens. That’s how I understand this. According to the policy here, it’s better to punish people to stop drug use.

 

Were you surprised by the popularity of the Palikot party and the support for marijuana decriminalization?

 

I was not really surprised. I was happy not only with the decriminalization of marijuana but also the support for people with different sexual orientations. I work all the time in two fields: on AIDS and drug use. For me, the rights of people with sexual orientation are very important. With this I was very happy. But this party, or Palikot himself, he plays some kind of game. He’s not a good leader of this group.

 

When we talked in 1990, there were about 700 AIDS patients. That obviously changed. This was before the antiretroviral medication. How serious did the AIDS crisis become here?

 

In Poland, this problem started in the mid-1980s. In 1985 the first Polish person was infected with AIDS. When we talked in 1990, there were a couple hundred, the majority being drug users. What happened next was that a group of people working on AIDS had a good training thanks to the Open Society Foundation, which I appreciated very much and which provided a good level of funds for prevention. We were young, full of energy and well trained. And it was well funded. Condoms as the first method of prevention became popular and easy to buy. The needle exchange programs began. Also, street services started: street work with drug users, with sex workers. Very quickly the first group of prevention activists trained the next people in even smaller towns. It was a good energetic group with good ideas.

For 10-15 years, Poland was seen by other countries as a good prevention policy maker. The level of new HIV-infected people was growing only by about 10-15 percent a year. Also, all the doctors were very well trained, with all the new knowledge and drugs for AIDS patients. In Poland, everyone is treated for free even with all the antiretroviral drugs. It’s covered by the ministry of health. The number of AIDS or HIV seriously infected people is growing. Now, close to 20,000 people that we know are infected. But probably it’s two or three times more who are infected and they still don’t know. There are anonymous counseling centers in every big city – free of charge.

But now the number of HIV infected number is growing again by about 1,000 per year. Last year, it was 1,500 probably. There’s no money for prevention. Everything is spent on treatment, on the medical drugs. Also, and this is happening in other countries, people stopped being afraid of HIV because it could be treated. And so, it’s growing.

 

Is there money from the EU for this?

 

Almost none. For 15 years at least. In 2005, we became a member of the EU. For the next two or three years, there were some funds given. When we were waiting for membership funds, we had to change everything over to European standards. But in 2005, we stopped getting money from European committees, from almost any international agency.

 

How does MONAR survive?

 

We get money for drug use and prevention as a medical service. A part of it comes from local governments and local funds. But it’s a hard time for AIDS prevention. Medical treatment is done in hospitals and clinics. There’s no money for prevention.

 

There’s also no money for drug addiction prevention?

 

Not so much. There are national campaigns and local campaigns. The rest are services paid from national health insurance. All medical services like counseling centers or rehabilitation and treatment centers are covered.

 

How would you evaluate the national health services in Poland?

 

They’re in very bad condition. It’s very hard to see the doctor. There’s a very long waiting list. The service is okay when you get in. But you have to wait everywhere. For some special kind of help at a particular hospital, you might to wait one or two or even four years. That’s for areas where there are not so many doctors. And in some regions it’s different. But you can also go privately. But if you don’t have much money, you have to wait.

 

What if you have an urgent problem?

 

The emergency services are okay. If something happens, you call emergency, go to the hospital, and get good service. But if you think if it’s better to stay at home and decide to go to the hospital the next day, you get on the end of a long queue.

There’s a big bunch of bureaucrats who try to figure out how many heart attacks will happen next year. And then there can’t be even one more heart attack. Sometimes it’s July and there’s no possibility to see a heart doctor because he could take only 100 people that year. It’s like a Kafka play. There’s no flexibility in the system in terms of bureaucracy. There’s enough money and enough trained people and enough facilities, but it’s a stupid system.

 

Is there any campaign to change it?

 

Not yet. Politicians struggle like little kids. You can’t imagine our politics. They’re out of their mind.

 

Given that the health care system affects so many people, you’d think it would be a major political issue.

 

It should be, absolutely. But the politicians just play around to see who’s better. No comment.

 

Maybe some medical professionals should run for office.

 

Some doctors are in a good position. They have fewer patients, better pay, good working conditions. They don’t want to change the system. And when they finish their duty hours, they can offer private services. It happens a lot. Private clinics. Private doctors. Private hospitals. Like in other counties.

 

Is there a lot of medical tourism here?

 

Yes. For some surgeries: plastic surgery, dental work. It may not be better, but it’s cheaper. The zloty to euro is four to one. If you come to Poland for surgery, it’s four times less.

 

Someone told me that medical students get offers from Scandinavian countries…

 

Many nurses are in England, Ireland, Germany, Scandinavia, Italy even. We have really good trained doctors and nurses. And the nurses are not well paid. Doctors sometimes yes. But nurses have a lot of work and get very bad salaries. I don’t know how this happened.

 

Was it any better at some point over the last two decades?

 

Yes. There were a lot of international and European funds coming from abroad as well as ideas and trainings. It’s not only about money. The exchange programs were very important. Treatment at the moment is okay. But prevention used to be at a much higher level.

 

And MONAR changed as an organization from a real NGO with Marek Kotansky as a real leader.

 

Is he still working?

 

He died in 2002. He was a real strong leader, fighting as an NGO leader. This organization changed much more into a medical institution. Not everyone and everyplace: there is still a lot of energy for social work and more activities. But you have to do what’s paid by the national health services. It’s not up to you. As an NGO, we used to decide what to do and with whom. Now first of all we have to do what’s paid by the national health service, and we have to meet all the standards. I don’t think the standards are bad, but sometimes I don’t know who made these standards. Sometimes they are stupid.

 

These are Polish or European standards?

 

The stupid ones are Polish.

 

Can you give me an example?

 

Back in the good old days, I could meet with a client just anywhere, even at home or in a coffee shop to talk. People could be anonymous or give any name. But now first I have to get your proper name, your address, your personal number (which everyone in Poland has), your last visit to the doctor. And if you visited any other doctor that morning I cannot talk to you, because that’s one of the standards. I have to report in the computer the time you came, your visit, your number. If a care provider that morning registered the same number, I get a blank, so I can’t report it. Can you imagine! We just want to discuss how I can help you. But no way: I can’t help you today, you have to come tomorrow. We are trying to find solutions. But I have to report all the clients if I want them to be paid by national health service.

 

That’s frustrating.

 

Very. I hate it.

 

It’s like other countries. It’s hard for NGOs to do this kind of work.

 

There are fewer and fewer NGOs, and the ones that survive are getting smaller. But MONAR is still getting bigger and bigger. We have thousands of clients every year. We now have at least 500 fulltime workers. In 1990, there might have been about 100, part of them volunteers. There are also plenty of people working now part-time or short-term in different places. A part of MONAR is an institution, but part is still an NGO. I am on the governing board, and we still fight for new ideas and to do the work properly with clients.

 

You still have the NGO spirit.

 

We are getting older and older. I don’t know what will happen with the new generation.

 

I’d like to ask you about the economic changes of the last 23 years and their impact on your work. In 1990, when we talked, the Balcerowicz plan hadn’t yet been implemented.

 

When we met, the reforms had a great impact. In one day, a lot of people lost a feeling of social safety. Before, almost everyone in this country had a place to live even if it was small, plus a little or medium salary with which they could manage their monthly spending. They felt maybe not happy but safe. What happened next was like a big bomb in a little village! Some people became really rich in one or two years, and some people lose their flats, jobs, and feeling of safety.

The whole society changed. Before, people were quiet and friendly, afraid of the secret police or agents. But they didn’t think that way about their neighbors, their managers. Afterwards, people had energy, good ideas to start business or get a good job. But some people are really poor, especially if there are ill or retired. The pension, if you retire, is so small that it’s difficult to pay for your little flat or buy medicine. Medical drugs are expensive.

 

Drugs are not free?

 

Only for AIDS patients. Some people get 800 zloty per month as a pension. Some drugs could cost you 180 or 300 zloty per month. Then it costs 500 zloty for a small flat. So, you have nothing left! Some medical drugs are cheaper. But some are at a very high price. Many medical industries are in Poland and keep the market at a high level in terms of prices, like in the rest of Europe. But in Poland, salaries are four times lower than the rest of Europe.

 

Is there any resentment toward people with AIDS who get free drugs by people who have to pay a lot for their drugs?

 

It just happened. We fought for a long time for free drugs. For people who are getting only 800 zloty per month, they would never be able to afford the medical drugs for AIDS, which cost 4,000 zloty. It was considered prevention because it’s a communicable disease. If you are diabetic or have heart problems, you can buy some cheaper drugs, but some are really expensive.

 

In Britain, there are long lines, but the drugs are inexpensive.

 

In Germany, you pay maybe 5 euro per prescription. Here you can spend all your salary at the pharmacy if you are really ill. You can find some cheaper generic versions. But for some illnesses, it’s hard to find these alternatives.

 

In the United States, more than half of personal bankruptcies are because of sickness. Do people have the same problem here?

 

Yes. It depends what kind of illness, but yes. National health insurance in Poland is not based on personal income. I have insurance up to 100,000 zloty. If I’m insured, I can get any operation, it doesn’t matter how much it costs. If I’m in hospital, I can get any medical drug in hospital. But when I leave the hospital, I pay for it. That’s the difference. Even if it’s a complicated operation, it doesn’t matter.

 

Do you think anything could have been done differently with the economic reform?

 

Yes. I don’t know why but the government is not properly monitoring business, especially international business. In Poland, a lot of people are working just part-time or self-employed, but really all these people help big international companies to save money. These companies are not paying the proper amount of money from their employees to our government. Many people are cheating by saying that they are not working part-time. Many young people have not paid into the national health service or into retirement. They work, they are young and happy, and they are used by these big companies. But I don’t know what will happen after a few years with these young people. Maybe only one-third of people working in Poland are officially working and paying all the taxes. This is a Polish problem. No one wants to tackle this problem.

That’s why there’s no money for social services. The government was not prepared – maybe it’s a function of corruption – to force all these big companies to pay taxes for their employees in Poland.

My daughter is 28. I know all her friends and the friends of her boyfriend. She’s the only one with a proper salary and paying all the taxes – among the 30 people from her circle of friends. They work a lot, but it’s called part-time or self-employed. And they pay very few taxes.

 

They have these so-called junk contracts.

 

And they give the government very little money. Everyone wants railway, transport, public services. But very few people actually pay taxes. This is a huge problem, and it’s growing.

 

Do you think anything could have been done before to avoid this?

 

Better regulations. They could have built good national institutions. The laws were changed a little bit here and there. But it’s like a building. There’s no proper foundation. We have a house now. But it could collapse with the first wind. There were little changes in all the regulations, but after 20 years, there’s no stable national institution built, especially for the next generation. We can survive, because my generation knows how to survive. But I don’t know how it will be for the others. After 20-30 years, my daughter and all her friends will have no proper pensions and will make less than 150 zloty per month. The government knows this. It’s discussed in the newspapers plenty of times. And nobody knows what to do! And no one really cares. This is the time to ring the bell and change everything. It’s not enough to say, “You will have no pension after 30 years. Poor girl, now just play and do what you want.”

 

Maybe the whole idea of pensions is disappearing?

 

But it’s not. Not from the mind. Fulltime workers like me pay a lot of taxes, and I pay my whole life. Maybe they should put money in the bank, but they are too young. Even if they have money in the bank, what does it mean for my daughter, her boyfriend? They wouldn’t build a new hospital, a new school. They might feel safe for some time, but not everyone. It’s a real social problem now.

 

Was there a moment in the past when Poland started off on this wrong path or do you think it was inevitable?

 

There was a moment when everyone understood the message that they were alone and had to take care of themselves. But a lot of people understood it to mean just play, drink alcohol, take drugs, work on the weekdays, play on the weekends, do what you want, like a bunch of children with no mommy or daddy. Some people were reasonable enough to build businesses, but some live just in the here and now. It’s a good idea but only for some time. It was even fun. Nobody cares for you, for better or worse. Nobody keeps an eye on you. But for some people, they have a problem with being grown up and responsible. Maybe it will be okay, I don’t know, but I’m worried.

 

What differences do you notice between your daughter’s generation and your own?

 

In 1987-8, I was for almost one year on an exchange project in California. I went half a year, stayed a little big longer, and was invited to stay in United States. My friends would have been my official sponsors. My daughter was three, staying with her father. I was thinking about my life decisions. In 1987-8, I could have tried to stay and hope to bring them over to me. It was not easy to do that at that time. This training was in San Francisco, and I was thinking about a life in California. It was not a bad idea. I had a lot of friends who were going to help me, even some rich friends who were very helpful.

But I decided to come back to Poland. I feel much more Polish than international, even though I traveled a lot before. It was not so common in Poland, but I had this opportunity to travel a lot. I spent more than a year in England. I traveled around Europe. But I feel more Polish than anything else. It was not a bad decision. My daughter travels a lot, has a good job, has a good flat. She doesn’t know what the problems were 25 years ago. She’s open-minded. She will have her wedding next year in Italy. They are European now, she and her partner. There are no borders. They are a part of this world, just as we were for a long time a poor neighbor of other countries.

Which decision would have been better? I don’t know. Maybe California would have been better. But you had some economic problems in America a couple years ago. No one knows. Now I see that these two ways were equal for her. Maybe not for me, but for her.

 

You talked about the importance of security before 1989.

 

People had time in those days for friends, real ones, not so-called friends from the Internet. There was time for meetings at home, time for theater, cinema, books. Now everyone works overtime – just to manage. Before, I started at 10 am and worked until 3 or 4 pm. I could easily go home, then later on meet friends, go to cinema, or prepare a nice supper for people at home. Now I start at 8 am and finish at 8 pm.

 

You work for 12 hours!

 

With some breaks. I don’t know how much work I will have. I move from one place to another. I work for MONAR. I also teach. I train. I do a lot in the AIDS field. I also work on Saturday and Sunday, not every weekend, but very often. I teach in Lublin on weekends. I’m a supervisor. Maybe this is a question of age and experience. But nowadays, to get by you need to work a lot of hours. This is a difference for people working on drug addiction. Almost everyone works in a lot of places.

 

When I lived here in 1989, there was always time to meet people. The cafés were crowded even in the middle of the day.

 

You could easily go and meet your friends. You could go to a shop and buy a new shirt. No one kept track. You had clients. But there was no registering of each minute.

 

That computer knows where you are all the time.

 

You’re paid only for the time you spend with clients, not for the whole three hours. Each client and each hour is counted.

 

Have you been anywhere where the work set up is better?

 

No. I’ve gone on some exchange conferences. A couple years ago, I taught in Moldavia and Kazakhstan for a training on AIDS. At the beginning of 1990s, I almost lived on the plane – Sweden, Finland, Greece, Ireland – all these exchange programs and international conferences. But there is not much interest in Poland any more.

We had a great exchange program with an NGO in France. We were flying back and forth to Paris. We go to Morocco, Tunisia, Moldovia. Then one day it just ended. We thought we were friends. But we were just a market. Some people were friendly. But we were just a market, really. And we’re not any more.

 

When you think back to the way you looked at the world in 1989, has anything major changed in the last 23 years?

 

I had much more hope and belief in people before. Now I still keep this hope and belief with me. But it’s getting harder and harder. I don’t want to but I’ve become more realistic.

 

People you work with or people in general?

 

People I talk to about funding, about what would be best for our clients. But also people in general. There’s not so many well-socialized people. I used to believe in many social ideas. Now I see people as individuals, minding their own business. I feel like an old dinosaur.

 

Because everything has become private?

 

Social ideas are not so popular right now. By social I mean being a part of this world, not helping everyone but not thinking only about myself.

 

What do you think about Krytyka Polityczna?

 

I share some ideas and smile at them. They’re young and energetic. Like I was some years ago. But they are not right in some ideas. They need time. They are fighters, not thinkers. But this is the time for young people to fight for their rights. I don’t share every idea, but some. But it’s an interesting movement. There’s a lot of energy in this group, and they’ve done a lot.

 

You’ve been working for MONAR for 30 years. Are there any success stories, on an individual basis, you can talk about?

 

A lot of them had big changes in their life. One of my colleagues had been one of the clients in our movement. He was a heavy heroin drug user. He was infected with HIV, hepatitis C, hepatitis B. Twenty years ago, he was a like a skeleton, just bones and skin. Now, he has a family, and he’s on our board of members. He runs a very good center. He finished his studies and his training. He overcame hepatitis C, which was not easy. Now he’s over 40, close to 50. He’s a mountain climber. He’s a marathon runner. He’s in very good shape, and he gets a lot of respect from other people. He’s come the longest way of anyone I’ve ever seen. He’s also my good friend.

Some people became our colleagues after training and working. At least three young women, former clients, received psychology degrees over the last couple years. They’re very interesting people doing interesting things in their work, bringing friends from clubs for therapy. It used to be that they’d become part of MONAR. Now, they are just ordinary happy people with their own lives. One young lady, four or five years after treatment, did her master’s degree exam in psychology. She put a special personal dedication for me not on the first page but on every page of the exam.

I’ve had children, even grandchildren of some of my clients. Just before I came here to Rowy, I had a phone call from the daughter of some clients. First I treated her parents. Then she came with her partner, who had some problems with drugs. And now she just called me that her 16-year-old son started smoking marijuana. It’s a third-generation problem. We don’t always have just happy endings. The grandparents are okay. She’s okay with her husband. But her son has just started. But she might come in with him.

 

When you look back to 1989 and everything that has changed since then, how would you evaluate that on a scale of 1 to 10 with 1 being most dissatisfied and 10 most satisfied?

 

9.

 

Same scale, same period of time: but your own personal life?

 

9.

 

And when you look into the near future, how would you evaluate the prospects for Poland on a scale of 1 to 10, with 1 most pessimistic and 10 most optimistic?

 

8.

 

 

Rowy, August 25, 2013

 

 

Interview (1990)

 

MONAR (or Movement of Youth against Drug Addiction) was founded ten years ago in 1980. At the time there was no talk of drug addiction. Marek Kotanski, the founder of MONAR, was the first to talk about the issue publically. He established a center in Glockow and from there, the movement grew. There are now twenty centers for rehabilitation around the country and eighteen centers for consultation.

I was conducting my interview with Danuta Wiewiora in one of these “points of consultation” in the center of Warsaw on Jerozolimski Ave. As we talked, several young people walked in and out of the room, talking, drinking tea. Wiewiora sketched in the history of MONAR and talked a little about the new range of problems that the organization has begun to address.

The method they rely on in the fight against drug addiction involves not so much psychologists or therapists as ex-addicts. These are the people that predominantly staff the centers. There are on an average 30 people who live in the center, creating a sort of family atmosphere. The purpose of the method is a re-shaping of values, undertaken by the individual–not forced upon them–so that they will be able to live without narcotics. She pointed out that MONAR’s work was quite unique in Eastern Europe, since Poland was one of the few countries to acknowledge the drug problem. They hope, through contacts with other countries, to help establish centers in USSR, Czechoslovakia and so on.

In August 1988, AIDS officially became a problem in Poland when the first case was diagnosed. Today there are roughly 700 people in Poland with the disease. Between 60-70 percent are drug addicts. Therefore MONAR decided to start working on this issue and established a center solely for AIDS sufferers who are also addicts. They also established contacts with Lambda, a group devoted to gay rights that was registered officially this past March.

Over the past half year, MONAR has also begun working on the issue of homelessness. The office on Jerozolimski happens to be located near the central train station. A lot of homeless people come to this station, don’t know what to do, don’t have any money, their families don’t want them. For a fifteen-year-old homeless kid, for instance, present day Poland is incomprehensible with its joblessness and rising prices. MONAR therefore arranged to house people in the barracks surrounding the metro station (which is under construction) in Ursynow. A dozen or so people now live there. But, she points out, the train station is still filled with homeless people: every empty seat occupied. A movement has spontaneously begun among such people because they are, in general, young and healthy.

What are the institutions that such people can fall back upon? Not many. The Ministry of Health and Labor have helped out with special funds and there are also private charitable institutions. But, she pointed out, there are no foundations for social purposes.

I asked about the outcry in Gloskow over the AIDS patients there. She of course was not particularly happy about the situation. But she understood the reaction of the townspeople. After all, there just was a lack of information. In some respects, then, the severe reaction was good since it attracted news coverage and provided a lot of necessary publicity.

Where do the drugs come from? Most of it is homemade heroin, she said. It is called “puppystraw” and “kompot.” It is not as expensive as it is in the West. Many addicts prostitute themselves in order to pay for the drug. Was the use of the drug growing? Probably not. The AIDS scare was keeping the younger generation from the drug; twelve year olds seemed to prefer glue-sniffing these days. As for other drugs, there doesn’t seem much market for crack, amphetamines and so on. These drugs are still too expensive for the average Pole. With the large fortunes beginning to appear today in Poland, she feared that the rich might decide that drugs were fashionable and the drugs of preference from the West might take hold. Alcoholism, meanwhile, is still very strong. “It is so bad now, that it can’t get any worse.” New work environments will probably decrease alcoholism however.

 

 


2 Comments

  1. Bruce E. Woych

    https://www.chip.uconn.edu/chipweb/bio.php?id=112
    Merrill Singer, PhD
    Professor of Anthropology
    University of Connecticut
    From his site:
    “Merrill Singer is a medical anthropologist with a focus on structural and biosocial factors in health, drug use and HIV/AIDS, global warming and health, disease interactions, and the elimination of health disparities. In addition to CHIP, he is affiliated with the Institut Interuniversitaire de Recherche (Haiti), the Global Health Research Center of Central Asia (Columbia University), and the Center for Interdisciplinary Research on AIDS (Yale), and is the former Director of the Center for Community Health Research at the Hispanic Health Council (HHC) in Hartford, CT. He has been the PI/Co-PI on a series of basic and applied federally funded drinking, drug use, and AIDS prevention studies and related health research dating to1984”
    (a listing of his publications is available at the link above);
    at Amazon:
    http://www.amazon.com/Merrill-Singer/e/B000API5KC/ref=sr_tc_2_0?qid=1422130007&sr=1-2-ent
    A dozen titles that are relevant to this crisis happening now in Poland and elsewhere.

Leave a Reply

Your email address will not be published. Required fields are marked *