This report is based on research conducted between March 2010 and 2011, including field visits to Ukraine in April and October 2010. Field research was conducted primarily in the Kharkiv and Rivne provinces and in Kiev. Research in these provinces and Kiev was conducted jointly with the Institute of Legal Research and Strategies in Kharkiv and the Rivne and Kiev branches of the All-Ukrainian Network of People Living with HIV. We chose these locations for research because of their geographic diversity. Additional research was conducted in the cities of Lviv and Cherkassy. We also conducted desk research regarding palliative care availability in various other parts of the country.
During four weeks in Ukraine a researcher from Human Rights Watch and each partner organizations conducted more than 67 interviews with a wide variety of stakeholders, including 20 people with cancer, HIV/AIDS, and other life-limiting health conditions, or their relatives; 35 healthcare workers, including oncologists, AIDS doctors, anesthesiologists, palliative care doctors, and administrators of hospitals, hospices, and palliative care programs; and a dozen drug control and health officials.
Most interviews with patients and their relatives were conducted at their homes. Interviews were conducted in private.
Interviews were semi-structured and covered a range of topics related to palliative care and pain treatment. Before each interview we informed interviewees of its purpose, informed them of the kinds of issues that would be covered, and asked whether they wanted to participate. We informed them that they could discontinue the interview at any time or decline to answer any specific questions without consequence. No incentives were offered or provided to persons interviewed.
We have disguised the identities of all patients, relatives, and healthcare workers interviewed to protect their privacy, except when they specifically asked for their identity to be used. Similarly, we have disguised the names of the districts we visited to protect healthcare workers who, as government employees, may have legitimate concerns about a possible negative official response to their speaking out about problems with pain treatment.
All interviews were conducted in Russian by the Human Rights Watch researcher, a fluent Russian speaker. Most interviewees had no difficulty speaking Russian. Researchers from partner organizations provided translation where necessary.
In October 2010 Human Rights Watch presented preliminary findings to the Ministry of Health, the National Drug Control Committee, the section for the licit circulation of narcotic drugs of the Ministry of Interior, and the State Expert Center of the Ministry of Health. In March 2011, Human Rights Watch wrote a detailed letter summarizing the report’s findings to the pharmaceutical company Zdorovye Narodu, inviting it to respond to the findings and to present comments in this report. A copy of the letter is included in this report in Annex 1. No response had been received by the time the report went to print in late April 2011.
All documents cited in the report are publicly available or on file with Human Rights Watch.