Sex Work under Conditions of War in Ukraine: Observations and Recommendations

By Agata Dziuban

[During the war] sex workers go through the same hardship and deprivation [as everyone else], only their burden is multiplied by criminalisation, economic and social vulnerability, legal insecurity, stigma and lack of state support. (Legalife-Ukraine)

This blog post consists of extracts from the “Regional Assessment of the Impact of the War in Ukraine on Sex-Workers and Sex-Worker-Led Organisations in Central and Eastern Europe and Central Asia” developed by CrimScapes team member Agata Dziuban with and for the Sex Workers’ Rights Advocacy Network (SWAN). Analysing the impact of the war in Ukraine on sex worker communities, this policy brief builds on desk research, community research, and direct consultations with sex worker-led organisations in Ukraine and other countries of the CEECA region. Excerpts presented in this blog post focus, specifically, on how the war has affected the living and working conditions of sex workers in Ukraine contributing to various economic and work-related precarities. Additionally, this post explores the continuities and shifts in policing and law enforcement strategies sex workers in Ukraine are exposed to under conditions of war. Eventually, it looks into sex worker community-driven responses to the humanitarian, economic and socio- political crises caused by the war, and explores efforts undertaken by Legalife-Ukraine and individual sex workers with the aim to challenge criminalisation of sex work in Ukraine. The full version of the report can be found here.

Dziuban, A. (2023) Regional Assessment of the Impact of the War in Ukraine on Sex-Workers and Sex-Worker-Led Organisations in Central and Eastern Europe and Central Asia. SWAN. http://dx.doi.org/10.13140/RG.2.2.32405.91363

The War in Ukraine – An Overview

The launch of the large-scale armed attack by the Russian Federation on Ukraine on February 24th 2022 has heavily impacted the safety and security of Ukrainian citizens. As of October 9th 2023, 27,768 civilian casualties were recorded in the country, among them 9,806 killed and 17,962 injured – with the actual toll estimated to be higher.[1] In many cities, infrastructure facilities, residential buildings, and other institutions have been destroyed, and residents do not have access to food, running water, and heating; many have also lost their homes. The war has also forced many people to flee their homes in search of safety. An estimated 5.1 million Ukrainians are internally displaced and more than 6.2 million have crossed into neighbouring countries in the European Union and globally.[2]

The war has significantly impacted the overall economic situation in Ukraine, leading to a drastic deterioration of the living conditions of its citizens. In 2022 Ukrainian GDP declined by 29.2 per cent, with the poverty rate increasing from 5.5 to 24.2 per cent pushing 7.1 million more people into poverty.[3]  This contributed to the sharp rise of unemployment rates, up to 35 per cent at the end of 2022, leaving many people without livelihoods and means of survival. As reported by the UN, 17.6 million Ukrainians are in need of life-saving and life-sustaining humanitarian aid and protection.[4]  

The War’s impact on sex workers in Ukraine

Even before the outbreak of war, sex workers in Ukraine had been subjected to criminalisation, discrimination, and harsh policing.[5] The Ukrainian state penalises people providing sexual services and imposes criminal sanctions on third parties managing, organising and facilitating sex work.[6] Sex workers working online are also subject to prosecution under laws criminalising the production and distribution of pornographic content. These unfavourable policies and pervasive stigma compromise sex workers’ well-being and safety, health, and access to essential services. Criminalisation and exclusion from the state’s duty to care puts sex workers at disproportionate risk of abuse, violence, and harm, also on the part of law enforcement agencies.[7]

The humanitarian crisis caused by the full-scale Russian military attack on Ukraine exacerbated these pre-existing inequalities, greatly affecting marginalised and underserved communities, including sex workers. As reported by Legalife-Ukraine, the war has further increased the level of vulnerability among sex workers in Ukraine, exposing them to further violations and precarity. […]

Sex work under conditions of war

War hostilities have adversely affected the living and working realities of Ukrainian sex workers, as well as the overall situation in the sex industry. According to Legalife-Ukraine,[8] 71,5 per cent of sex workers surveyed in April 2022 did not stop providing services following the outbreak of war. Despite increased war-related dangers, sex workers reported huge economic pressure and greater reliance on income from sex work as the main factors that kept them at work. In turn, 19 per cent of surveyed sex workers left sex work in the first months of the war due to forced migration, war-related risks, decreasing income, and deteriorating working conditions. Many of them, however, resumed sex work later on. Simultaneously, conditions of war and the resulting economic situation have also contributed to an influx of women into the sex industry. As reported by Legalife-Ukraine, 9,5 and 11 per cent of respondents – in April 2022 and April 2023, respectively – declared they had taken up sex work after the outbreak of the war.[9] […]

Simultaneously, sex workers reported a significant worsening of their working conditions and a decrease in income:

There is less work, earnings have dropped, the risks are greater, it’s scary to go out to work. (respondent from Ukraine)

[…] Forced migration, rising unemployment, high inflation rates, and drastic increases in prices of food, housing, and other essential products and services, left many sex workers across Ukraine in destitution, without money to meet their basic needs and secure their livelihoods. As indicated by the Legalife-Ukraine survey report, 98 per cent of sex workers questioned in April 2023 reported a sharp deterioration of their financial situation,[10]and almost all sex workers interviewed for this study noted that their earning from sex work has decreased significantly due to reduced working hours, lower number of clients, and war-related challenges to the provision of sexual services.

Since the beginning of the war, the average income level in most sex workers’ families has fallen by 25-50 per cent. The economic pressure is particularly great for single mothers and those whose husbands or partners lost jobs or were drafted. Becoming the sole breadwinners and carers for their families, they are facing a heavier burden to provide for their children or elderly parents.

Deterioration of working conditions

Direct war hostilities, air strikes, shelling, and rocket attacks have exposed sex workers to imminent dangers at work:

Before the war, sex workers worked individually, looking for clients on the street, more often in the evening and at night. When rocket attacks, frequent air raids, and curfews began, the work became more dangerous and difficult to organise. (Legalife-Ukraine)

Additionally, since the introduction of martial law on February 24th 2022,[11] a night curfew has been in effect in most parts of the country. Depending on the region and the security situation, citizens are not allowed to be outside from 11 or 12 p.m. to 5 or 6 a.m., and public transport and other facilities do not operate at this time. As a result, many sex workers have been forced to change their working routines.

Sex workers who used to work outdoors cannot work anymore. They try to limit their work and not to move around during curfew, they try to finish work before curfew, irrespective whether they have had a client or earned anything. The same with sex workers working indoors, they try to finish work early, because otherwise they would be stuck in their workplace. That is why some sex workers try not to work at night, although previously they would choose working at night due to child care and other obligations. (Legalife-Ukraine)

The introduction of restrictions on movement has contributed to a decrease in sex workers’ mobility, making it more difficult to travel to other cities or regions of Ukraine to work and to travel to outcalls within their cities. This translates into shorter working hours, fewer clients and a drastic reduction in earnings.

As a result of the curfews and war hostilities, many sex workers interviewed had to change their work settings. Several women previously working in collective workplaces decided to work on their own, individually, in their flats or trusted venues (cafes/hotels/saunas) to avoid encounters with the police and to increase their safety. Some gave up outdoor work and started to arrange meetings with their clients indoors, primarily at their homes. For some, this decision has been motivated by the greater influx of women providing sexual services from other regions of Ukraine, in particular IDPs [internally displaced persons], and rising competition among sex workers. It has been reported that in some regions of Ukraine, the increase in the number of people selling sex has led to a decrease in the prices of sexual services.  Some sex workers previously working indoors or outdoors, have taken up online work, such as webcamming or posting content on dedicated websites. This allowed them to secure safer working conditions and combine work with care obligations:  

I went online, it’s safer, on my own territory, quiet, with fewer clients. Of course, my earnings have halved, but at least I can look after my mum and grandmother. (respondent from Ukraine)

However safe, online work proves challenging not only because of decreases in income but also due to power outages and blackouts that have become common in Ukraine since the outbreak of the war – a consequence of the targeted destruction of critical infrastructure by the Russian army. Moreover, sex workers working online risk criminal charges under laws banning the production and distribution of pornography, a provision actively challenged by the Ukrainian sex worker community.

While the demand for sexual services decreased due to the war hostilities and economic hardship, many sex workers reported an increased presence of soldiers and military personnel among their clients, particularly in the regions near the frontlines or stationing the army. Interviewed sex workers had varying opinions on working with soldiers and draftees. Some praised them for their sympathetic and caring attitudes, and for providing financial support to them and their families. Others pointed to challenges related to, in particular, mental health issues, including post-traumatic stress disorder, problematic alcohol use, tension and aggression among soldiers and other military personnel directly exposed to atrocities of war. To reduce risks, most sex workers spoke about undertaking various safety measures at work: they are more careful in choosing clients, do not accept clients on drugs or alcohol, negotiate details and prices in advance, and try not to use alcohol or drugs with clients and at work.

Policing in times of war

Even before the war, sex workers across Ukraine were subjected to harsh policing, penalties (usually in the form of monetary fines) and various abuses from law enforcement agencies. As noted by Legalife-Ukraine, the war did not have a significant impact on sex workers’ interactions with the police. While police presence in sex workers’ venues might have been reduced in some regions of the country, sex workers working in different parts of Ukraine declare being exposed to contact with the police on a daily basis. These interactions – following the “rules” established before the outbreak of the war – usually involve paying a fine/bribe for the provision of sexual services and receiving a receipt (in the form of a protocol) confirming that the payment has been made. One interviewee from Ukraine explained:

Most of them know us, they charge us 100-200 UAH per day for protocol. We do not fight with them, we use the protocol as a receipt, a proof that we paid today. When others [police officers or law enforcement agents] come, we show them these protocols as a proof that we have already paid to others today. (respondent from Ukraine)

Additionally, Legalife-Ukraine reported that police raids targeting third parties, such as venue owners, managers and others organising sexual labour, are continuously carried out in sex work venues, with a noticeable increase in the number of raids in some regions of the country. Police interventions push many sex workers to work individually and alone in fear of prosecution under third-party charges. As mentioned above, cases of pornography-related charges against sex workers working online have also been reported since the outbreak of the war.

One of the key issues highlighted by sex workers taking part in this study is the increased presence of military administrations in all regions of Ukraine. Established to implement martial law, military administrations are given special powers and prerogatives in providing defence and ensuring public safety and order. Many sex workers expressed uncertainty and fear about potential encounters with military personnel and administration, as their powers, as well as jurisdiction over sex workers, are not entirely clear and differ from those granted to the police:

Sex workers know how to engage with the police, because they have long-standing relations with them, but they don’t know how to engage with the military. They have slightly different jurisdiction, they have different entitlements than the police. They have different obligations and it is not quite clear what the military can do when they check your documents. Will they detain you to clarify who you are? Or will they do something to you? That is why people are saying that they are afraid of engaging with the military, because they don’t know what the consequences are. (Legalife-Ukraine)

As noted in the quote above, this is particularly relevant for sex workers lacking identification documents (national or international passports) that were lost, for instance, during forced displacement. Deprived of resources to restore their documents, sex workers fear going out, also during the day, as they might be stopped and interrogated by the military.

Trans women providing sexual services have another reason to fear encounters with military personnel, as they might be drafted due to wrong gender markers in their legal documents. As a result, they often try to avoid public places and working outdoors where they could be apprehended. Trans sex workers seeking refuge abroad also risk being stopped and drafted at border crossings if they have the wrong gender marker on their passports.   

Additionally, sex workers working outdoors or travelling for work at night risk being subjected to financial penalties for breaching curfew restrictions. While Ukrainian legislation does not impose legal liability for violating curfew, Legalife-Ukraine noted that some sex workers were subjected to financial punishment by the police or military personnel, and these penalties are much higher than fines for the provision of sexual services. […]

Community response to the war

Following the war’s outbreak, Legalife-Ukraine promptly mobilised to assist Ukraine’s sex worker community, assessing the immediate needs of sex workers and adapting their priorities to address the challenges posed by the conflict.

Their primary focus was ensuring sex workers’ survival during wartime and providing humanitarian aid. The United Front of Ukrainian Sex Workers was established early in the conflict, uniting the remaining community leaders and activists who had not fled Ukraine. By April 2022, the organisation had surveyed 12 regions, pinpointing the most critical needs of their communities. Consequently, they concentrated on distributing food, water, medicines, hygienic products, warm clothing, and essential resources.

Legalife-Ukraine  […] delivered 780 food kits, 780 hygienic product kits, and 370 essential medicine kits to sex workers. Those in war-affected regions received additional support, including power banks, generators, flashlights, heaters, sleeping bags, and water purification tablets. The organisation also secured temporary shelter and housing for displaced sex workers and covered transportation expenses for evacuation and healthcare access.

To assist sex workers in restoring legal documents and applying for state benefits, including child support and IDP support, Legalife-Ukraine offered financial and logistical support. They addressed the mental health needs of sex workers affected by the war, providing psychological consultations through a hotline and online chats. Local activists ensured access to healthcare, HIV services, harm reduction, OST programs, and legal aid.

Throughout the war, Legalife-Ukraine has supported internally displaced sex workers and those leaving Ukraine. They facilitated connections with sex worker-led organisations and service providers in neighbouring states, helping sex workers find housing, protected status, healthcare enrollment, and educational opportunities for their children.

The organisation has also been engaged in providing essential and up-to-date information to sex worker communities across the country via its website, social media and communicators. Legalife has been informing its constituencies about the social and political situation in Ukraine; legal security, rights and entitlements under wartime conditions; possibilities of obtaining humanitarian assistance (e.g. location of aid and distribution points, legal services and support schemes available to IDPs and victims of war); evacuation procedures on territories affected by the war hostilities or occupied; obtaining refugee status abroad, etc. […]

Advocacy and Decriminalisation Efforts in Ukraine

Members of the All-Ukrainian Union “the Council of Leaders of Sex Workers of Ukraine” actively contribute to advocacy and information strategies for decriminalising sex work in Ukraine. They collect data on sex worker needs and represent the community at local and national levels. They’ve developed an intervention plan for the Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria and collaborate with HIV/AIDS Coordination Councils and Country Coordination Mechanism to assess the Global Fund’s programs in the context of the Russian military aggression and post-war period.

Despite challenges due to the socio-political climate and the war, the organisation achieved success in repealing criminal sanctions against sex workers operating online. Previously, sex workers engaged in online activities faced criminal charges for producing and distributing pornography. Criticism of the Ukrainian pornography ban, particularly in light of the OnlyFans fundraiser for Ukrainian war efforts, played a pivotal role. In March 2023, sex workers initiated the “TerOnlyFans” (Territorial Defence OnlyFans) charity project, collecting approximately $800,000 in donations for Ukrainian defence forces and IDP support in exchange for nude photos and erotic content.[12] This initiative ignited public interest and mobilisation for decriminalising pornography in Ukraine.[13]

Over recent months, Legalife-Ukraine, alongside partner organisations like 100% LIFE NGO, Institute for Legislative Ideas, Better Regulation Delivery Office (BRDO), TerOnlyFans, DEJURE Foundation, and the Centre for Economic Strategy, actively challenged Ukraine’s pornography ban. They participated in policy meetings and public hearings aimed at revising the Penal Code. Their efforts bore fruit as a legislative proposal to remove provisions criminalising consensual provision and distribution of erotic content has been submitted to the Supreme Council of Ukraine, awaiting a vote in the near future. […]

Conclusions and recommendations

The Russian invasion of Ukraine, as well as the resulting cost-of-living crisis, have severely affected sex worker communities and organisations in Ukraine and other Central and Eastern European and Central Asian countries. As demonstrated by this report, sex workers across the region are facing dire poverty, deterioration of working conditions, rampant policing, and severe barriers to accessing essential services, including healthcare and existing support schemes. Subject to structural and institutional violence and abandoned by the state, sex worker communities across the region can often only count on support provided by sex worker-led organisations and dedicated service providers. All of the groups included in this research mobilised to provide humanitarian aid and all the necessary services to ensure sex workers’ survival in times of war-related crisis. However, sex worker-led initiatives and organisations themselves are facing significant political and funding challenges.

The following recommendations have been developed by organisations contributing to this report. Their fulfilment would reduce sex workers’ vulnerability to the crisis caused by the war and war-related economic pressures, strengthening sex worker-led collectives in providing their communities with apt and lifesaving support:

For policymakers:

  • Decriminalise sex work and recognise sex work as work. Only full sex work decriminalisation can guarantee sex workers’ access to their human, civil and labour rights and can protect sex workers’ communities from rights violations, exploitation and violence.
  • Adequately address the vulnerability of women and girls to gender-based, war-related sexual violence and trafficking. Do not introduce legal measures that contribute to the criminalisation and policing of sex worker communities.
  • Remove all the harmful and discriminatory narcophobic, homophobic, transphobic and anti-migrant legal provisions that hinder rights access for the most vulnerable and marginalised communities. Secure functional human rights protective mechanisms against discrimination, violence and institutional exclusion. 
  • Remove all legal measures that target civil society organisations and restrict their ability to operate […]. Create a favourable environment for NGOs, service providers and community-led organisations providing services to vulnerable and marginalised communities.
  • Sex worker-led groups and organisations providing direct services to sex workers should be involved in the planning, development, implementation and evaluation of policies that affect sex worker communities, including humanitarian aid and war-related relief, prevention and support schemes.
  • Sex workers’ health, social, and economic vulnerabilities should be recognised and addressed in governmental relief programming, including war-related and economic crisis-related support schemes. Sex workers and other marginalised communities, including LGBTQIA communities, people who use drugs, people experiencing homelessness, and those operating in informal economies should be granted access to state support, benefits and protections.
  • Newly emerging trends in war-related migration and mobility should be monitored and adequately addressed. All people fleeing war and prosecution should be included in relief schemes and granted support regardless of their nationality, citizenship, and legal status. Undocumented persons have a right to cross borders and seek shelter and protection in case of war or other humanitarian crises.
  • All legal barriers and discriminatory provisions preventing refugees and both internal and international migrants from accessing healthcare and other support services should be removed. Both undocumented and documented migrants should be granted unconditional access to the same primary and secondary healthcare services available to all citizens.
  • Policing strategies should not single out marginalised communities, including sex workers, and ought not to be enacted in an arbitrary, discriminatory and  disproportionate manner. Police using unjustified and illegitimate violence based on profiling and prejudice should be held accountable and adequately prosecuted.  Police violence should be recognised as a structural issue and addressed by the state. […]

[1] https://ukraine.un.org/sites/default/files/2023-10/Ukraine%20-%20civilian%20casualty%20update%20as%20of%208%20October%202023%20ENG.pdf

[2] https://www.unrefugees.org/emergencies/ukraine/; https://data.unhcr.org/en/situations/ukraine

[3] https://www.worldbank.org/en/country/ukraine/overview#3

[4] https://www.unocha.org/ukraine

[5] SWAN (2019), Sex Work Legal Frameworks in Central and Eastern Europe and Central Asia. Briefing paper. https://www.swannet.org/files/swannet/SWLegalFrameENG_web_0.pdf; SWAN (2015), FAILURES OF JUSTICE State and Non-State Violence Against Sex Workers and the Search for Safety and Redress, https://www.swannet.org/files/swannet/FailuresOfJusticeEng.pdf

[6] SWAN (2019), Sex Work Legal Frameworks in Central and Eastern Europe and Central Asia. Briefing paper. https://www.swannet.org/files/swannet/SWLegalFrameENG_web_0.pdf;

[7] Legalife-Ukraine (2018), Обнаружение барьеров в доступе и оценка качества услуг для секс-работников, изучение их потребностей с целью повышения эффективности программ уменьшения вреда, профилактики и лечения ВИЧ/СПИДа в Украине», 2017-2018гг., Аналитический центр «Социоконсалтинг», при поддержке AFEW Интернешнл).

[8] Legalife-Ukraine (2023), Aналітичний звіт За результатами оцінки потреб сп в умовах війни Та впливу проєктів з надання підтримки сп (в рамках реалізації проєкту за підтримки ACTIONAID).

[9]  Legalife-Ukraine (2023), Aналітичний звіт За результатами оцінки потреб сп в умовах війни Та впливу проєктів з надання підтримки сп (в рамках реалізації проєкту за підтримки ACTIONAID).

[10] Legalife-Ukraine (2023), Aналітичний звіт За результатами оцінки потреб сп в умовах війни Та впливу проєктів з надання підтримки сп (в рамках реалізації проєкту за підтримки ACTIONAID).

[11] https://ukraineinvest.gov.ua/en/response-to-war/helpdesk/martial-law/

[12] https://www.euronews.com/2023/09/05/nudes-for-war-effort-campaign-backs-ukrainian-parliaments-porn-legalisation-bill

[13] https://www.kyivpost.com/post/20650; https://www.euronews.com/2023/09/05/nudes-for-war-effort-campaign-backs-ukrainian-parliaments-porn-legalisation-bill; https://lgbti-consortium.org.ua/en/media/legalizatsiya-pornografiyi-v-ukrayini-shho-potribno-znaty/

In this country, you can die four times while waiting for detox: The pandemic, drug use and chronicity of crises in Poland

By Justyna Struzik

The CrimScapes project[i], in which I explore the experiences of opioid users in the context of drug possession criminalization in Poland, began at the peak of the restrictions imposed by the coronavirus pandemic (COVID-19). The regulations enacted in response to the COVID-19 pandemic not only shaped and constrained the context in which ethnographic research was conducted, but they also influenced the topics of my interviews with people who use drugs. Interviewees invariably referred to their experiences during the pandemic.

The pandemic, according to my interviewees, was not always unambiguously negative. Accustomed to the persistence of difficulties resulting from, among other things, the criminalization of drug use and perceiving themselves as a relatively “invisible” group to the Polish public discourse[ii], they did not anticipate the additional difficulties posed by the pandemic nor the specialized care provided in response to it. The chronicity of crises this group has experienced over the years has, in some ways, bolstered their resilience, or perhaps “indifference,” to the changes, crises, and difficulties that have occurred. Police violence, a lack of access to high-quality, non-stigmatizing health care, and the paucity of harm reduction programs, along with the dominance of abstinence-only programs, have shaped and continue to shape the social landscape of drug use in Poland.

 However, some of the narratives I have gathered emphasize the repercussions of the pandemic (and imposed restrictions) on drug users’ lives and experiences, particularly regarding access to health care, the availability of treatment, and social support. Following Jarrett Zigon (2018), who encourages us to deconstruct the ‘fantasy world’ of the drug war locally in order to demonstrate how specific components of this world translate into the lives of drug users, in this blog post, I want to look at the experiences of people who use opioids in Poland during a specific period – the pandemic. I do so, among other reasons, because there are so many voices in public debates about the adverse effects of the pandemic and its restrictions, but this group’s experiences remain primarily unrepresented. Notably, I do not consider this blog post to be exhaustive in its coverage of the complexity of drug users’ experiences during the pandemic. Rather, utilizing two narratives gathered during the course of my research, I wish to highlight specific inequalities in access to certain public services that were a part of my interviewees’ experiences. I want to exemplify how the individuals I interviewed navigate and frame these inequalities, either by emphasizing the catastrophic impact of the pandemic on their own lives or by highlighting the chronicity of crises and the continuity of the decades-long drug war.

Klara’s story

At the end of March 2022, I met 35-year-old Klara in Warsaw. Klara was in an intimate relationship with another heroin user at the start of the pandemic; they lived together. They both tried several times throughout their relationship to break the cycle of heroin use they had been in for a while and return to substitution treatment. Because of the risk of experiencing withdrawal symptoms a few hours after taking heroin, Klara mainly worked remotely from her home at the time. She also desired to devote more time to her ailing dog. Her partner worked for a transportation company and was frequently absent from the home.

“The main thing I remember from that period is that I felt quite alone. In the sense that I just spent a lot of time alone. Because also the social life died down a bit. And with my parents, we didn’t see each other […]. It was this sense of increasing isolation. And it was very [acute]. And it wasn’t conducive to handling our life, especially because we were already in the throes of using. “

To maintain financial stability, Klara kept a close eye on the amount of heroin they both were using. She describes her experiences during this time as “acutely repetitive.”

“It was kind of a black hole in general. In the sense that there was just nothing happening, especially nothing good for a long enough time. I wondered how the pandemic would affect the availability [of drugs], because there were actually some voices saying …’ and maybe there won’t be drugs available on the market…’. But the availability hasn’t changed a bit, at least in Warsaw.”

The repetitiveness mentioned by Klara was also, in her opinion, something that kept them from quitting heroin and returning to substitution. Moreover, their relationship was becoming increasingly difficult, and violence began to emerge. During a holiday they spent together in the summer of the first year of the pandemic, they decided that they would both go to addiction treatment centers. Her partner decided to go into detox. He returned to Warsaw intending to seek further treatment for his addiction. However, new admissions were halted at the time due to the pandemic; the center’s staff advised him to wait and call every week to see if anything had changed. As a result, they were both in limbo for a while. Klara, on the other hand, was supposed to go to another center, but the number of beds available for women who use drugs was reduced due to the pandemic. The facility gave her the option of arriving the next day or waiting three months for a spot to become available. Due to the need for detoxification, the first option was not feasible. Klara, therefore, waited for the center for a few more months, which was especially challenging as it involved obtaining a new referral for treatment at the center from a doctor. During this time, her partner chose another center where new patients were being admitted. He first went to detox at a place that, ironically, she described as ‘not cool’ when she recalled the conditions there. When he returned, his admission date was again postponed by a few days. Eventually, Klara managed to drive him to the treatment center before going for treatment herself.

“I waited for detox for 3 weeks+. This is one of the wonderful features of the Polish healthcare system. In this country, you can die four times waiting for detox. The only opioid detox in Warsaw at the moment is the Nowowiejski center, where there were plenty of empty beds when I was there, but it doesn’t pay them [financially – author’s note] to have patients. In any case, when I finally got there, of course not without adventures, I was surprised that I got there at all, that it worked out after all, and I had this brief feeling that something had worked out and that [my boyfriend] was in the center and that I had survived. I was in a very bad physical state. And also, mentally, it was bad, but also physically. I had 45 abscesses, and in general, I was all swollen, at least on my legs. Throughout the detox, no one managed to take my blood, unfortunately. “

Her partner left the center where he was staying after a few days. Then, while waiting for the next one, he overdosed and died in Warsaw while Klara was still in the center. She was unable to attend the funeral due to pandemic restrictions.

“We were both aware that it would end up that way eventually, that it would be like one of us would eventually go down, and the fact that it happened to be him, I think it’s more of a coincidence; it probably didn’t have to be that way.”

Klara’s narrative is grounded on the category of waiting and her constant navigation of Poland’s complex treatment system. Their struggle to get into the center, to survive, was dependent not only on their own agency (e.g., trying to get into detox, planning a leave of absence from work for treatment, saving money for a more difficult time) but also on a volatile and unpredictable system in which the rules for accepting new patients were frequently changed.

The social landscape depicted in the interview demonstrates how drug users, specifically opioid users, are positioned as “less-than-human Others” (Zigon 2018, 59) – as someone who is constructed as an “incomplete subject,” as an addict who deserves less assistance and support than full citizens. This conception of drug users is sharpened to some extent by the pandemic, which makes some lives worth saving while condemning others to death (Agamben 2017[1], Caduff 2020).

Ryszard’s story

I met Ryszard in June 2022 in Warsaw. He’s 42 years old and has been undergoing substitution therapy since 2006. During his first ten years on the program, he used a variety of other psychoactive substances (amphetamine, clonazepam, and mephedrone). Currently, he only consumes alcohol, which he tries to limit as much as possible. Due to the fact that he faced incarceration for drug possession, he decided to enroll in a substitution program. As he had already had a negative experience with abstinence-only programs, he started taking methadone to avoid prison. He has had non-healing wounds on his leg for the past sixteen years. Due to his Hepatitis C and HIV co-infection, he is automatically referred to a hospital for infectious diseases, where no effective treatment to heal these wounds has been undertaken to date.

“As I have had these wounds for 16 years, I have not been to any other hospital for 16 years. They [infectious disease hospital’s staff – author’s note] treat poorly other than your main infectious disease issues. In other hospitals they didn’t want to treat me at all. For example, these wounds they didn’t want to treat at all. […] In the Prague hospital I was with this leg and fuck, and they told me to fuck off to this infectious hospital. I lay there for two days, I went on Friday afternoon, and on Monday a head doctor came and [says to me]: ‘fuck off to the infectious hospital’.”

Ryszard currently resides with his partner, who is also enrolled in a methadone substitution program and awaiting surgery for a fractured spine. According to Ryszard, the impact of the pandemic on their lives has been minimal. He temporarily stopped taking antiretroviral treatment for HIV, but he does not directly attribute this to the pandemic. Rather, he attributes it to a sense of alienation and stigma in the infectious disease clinic and the medical staff’s lack of concern for people who inject drugs.

“But they [the doctors – author’s note] do, they really approach us like…I tell the doctor that here I am starting to have some pain with these legs. And he says: ‘Ah, these legs, well yes. ‘ And he prescribes me cream as standard; I even already know I’m not going to heal it that way. I tell him I have vein problems because I do, and they’re huge. The nurses couldn’t take my blood, but I found a deep vein in my hand and took blood myself. I’m like, ‘doctor, we did it!’ And he says to me, with such a snarky tone, ‘how can you still get your blood drawn, what kind of drug addict are you?’. And as I’m thinking: ‘retard, I told you, I haven’t been taking that many years’. Fucked up, right?”

From Ryszard’s perspective, the substitution program has not changed significantly during the pandemic. He relied on taxis for the majority of his and his girlfriend’s two-week advance methadone dosage due to his leg wounds. His narrative, similar to Klara’s, demonstrates the ways in which people who use opioids are systemically constructed as disposable subjects (Wang, 2018) – as a group that the system, including the health care system, willingly pushes beyond what it is intended to address. Patients living with HIV and other infectious diseases or opioid users become invisible, unnecessary, and unprotected by the system, particularly in a criminalized context or during a ‘state of exception’ (Agamben 2005). Looking at the experiences of drug users, on the other hand, gives the impression that the pandemic is merely another crisis – part of a complex, multi-layered social world in which the criminalization of drug use and the emphasis on abstinence-only approaches translate not only into continued stigma, but also into poor housing and the threat of homelessness, difficulties in finding work, a lack of access to health and social care, and social isolation. When viewed through the lens of these experiences, the pandemic appears to be less of a unique process bringing social chaos and fear and more of a component of chronic crises, felt most by vulnerable groups.


Agamben Giorgio. (2005). State of Exception. Chicago: University of Chicago Press.

Agamben Giorgio. (2017). The Omnibus Homo Sacer. Stanford California: Stanford University Press.

Caduff, Carlo. (2020). What Went Wrong: Corona and the World after the Full Stop. Medical Anthropology Quarterly, 34(4), pp. 467-487.

Wang, Jackie. (2018). Carceral Capitalism. South Pasadena (CA): Semiotext(e).

Zigon, Jarrett. (2018). A War on People: Drug User Politics and a New Ethics of Community. Oakland: University of California Press.


[i] I would like to warmly thank all the people who agreed to talk to me and share their stories. I would like to thank Kasia Urbaniak for discussing a possible theoretical framework for the stories described in the post and Bardh Lipa for helping me express myself better in English.

[ii] For more on the invisibility of opioid users in the Polish context, see the interview with Magdalena Bartnik, ‘Niewidoczne populacje [Invisible populations]’ in the book ‘HIVstorie. Żywe polityki HIV/AIDS w Polsce [HIV-stories. Living HIV/AIDS Politics in Poland]’, edited by Justyna Struzik and Agata Dziuban, published by the NOMOS publishing house in 2022.

Requests, Memes and Networks: Transgressing the national boundaries in the context of criminalization of abortion in Poland

The Polish embassy sent a letter to Czech officials demanding, that the Czech parliament does not pass a law clarifying that Polish women can obtain abortions in Czech Republic. In the March 2021 letter a Polish diplomat warned that passing such a law would be “unfortunate” for the Czech-Polish diplomatic relations, since the law would be “openly motivated by an intention to circumvent the Polish law, which protects the unborn human life” and that this propositions “are aimed at encouraging Polish citizens to break Polish law” (p.mal 2021).

The Polish abortion ban, tightened in January this year to exclude embryopathological indications, forces Polish women to travel for abortions, often to neighboring countries. The Czech Republic has long been one of those destinations, and the planned legislation is supposed to update the current 1986 law to adjust it to the new context of EU membership. The new law is only supposed to formalize an ongoing practice of providing medical care to Polish women in Czech Republic, but it still stimulated Polish officials to take a stand.

The voice of the Polish official might seem comic and it has, in fact, given rise to many a meme. The strangeness of this request to prevent women from having abortions in Czech hospitals stems from an elementary legal rule: jurisdiction. The law of a certain country only applies to this country’s territory. The desire of the Polish politicians to foil any woman’s attempt to escape the criminalization of abortion in Poland, even outside Poland’s territory, goes against the rule of jurisdiction. The officials are acting as if the Polish law could be binding even outside Poland. We might call this ambition, expansiveness or a bid for ultra-sovereignty.

Ultra-sovereignty is an effort to expand the binding force of certain laws beyond a country’s territory (by means other than international treaties), or at least to create an illusion of such power. This illusion, creating a perception among the Polish public, that abortion is illegal for Polish women everywhere, might prove crucial, as criminalization comprises of so much more than just the legal order. Public perception, popular understanding of rules, laws and their implementation, as well as the effects of stigmatization of a certain criminalized act or issue, all constitute the functioning social reality of criminalization.

The Polish official’s letter seems to be aimed at creating an illusion, however contrary to legal rules, that Polish women cannot find help anywhere, and cannot escape the Polish law. Legally, these claims are empty, but on the level of public perception, their role is to increase the impression of illegality, the unacceptability of abortion travel, and feelings of loneliness and helplessness. While legal debates will continue, the public understanding of the issue might only retain the vague information about the ambitions of the Polish state to stop Polish women from going abroad to terminate a pregnancy. On the other hand, the news brought about many satirical responses, including memes, showing the Polish embassy’s efforts as comic and delusional.

“The Czechs after finding out the Polish don’t like their law. Hello!”

Source: Średnio Się Przejęli 2021; Polska to Oficjalnie Mem 2021
“Polish ambassador in Czech Republic: Don’t let Polish women have abortions in your country, because it is illegal in our country. The Czechs: Thank you very much for this piece of invaluable information, but I really don’t give a shit.”

The increased visibility of abortion tourism (or abortion migration) is a new phenomenon in Polish abortion debate. I hypothesize it is a result of a new type of pro-abortion activism. New activist groups seem to adopt a strategy, in which organizing, facilitating and popularizing at-home pharmacological abortions and abortion tourism is prioritized over strategic litigation and facilitating legal abortions in Poland. These new activist groups choose to center the conditions and costs the abortion ban imposes on women, while directing public attention away from monstrous-fetal imagery of the anti-choice movement. Most of these groups were founded between 2016 and 2021 (e.g. Aborcyjny Dream Team, Ciocia Czesia), although some go back as far as 2006 (Kobiety w Sieci).

One of the results of this strategy is a dissemination of knowledge on how to safely circumvent the abortion ban. A recent interview in Newsweek reveals, that it was in fact one of such groups that initiated the legislative update that is being processed by the Czech parliament (Pawlicki 2021). Ciocia Czesia (“Auntie Czesia”) is a group of Polish women living in the Czech Republic, who facilitate contact between Polish women seeking abortions and two Czech clinics (one private, one public). Thanks to online crowdfunding, the group can also provide financial assistance to those who cannot afford the trip. Ciocia Basia activists point to other similar groups in Austria and Germany as inspiration and source of know-how (Ciocia Basia and Ciocia Wienia) (ibidem). An important part of this activism lies in its openness and the rejection of secrecy, a conscious effort to combat abortion stigmatization and fear around facilitation – crucial components of criminalization.

These developments demonstrate how criminalization of abortion is a constant negotiation and struggle between different actors (national states, citizens, clinics, public opinion) and that new, surprising strategies are being formulated to address it. Transgressing national borders seems to be a growing feature in the debates and practices around abortion criminalization.

  • Pawlicki, Jacek. 2021. “To z Jej Powodu z Polskiego Dyplomaty Śmieją Się w Czechach. „Ciocia Czesia” Pomaga Polkom Zorganizować Aborcję Za Granicą.” Newsweek, May. https://www.newsweek.pl/swiat/aborcja-w-czechach-polki-pomagaja-polkom/ynqb794.
  • p.mal. 2021. “Ambasada Do Władz Czech: Nie Ułatwiajcie Aborcji Polkom.” Rzeczpospolita, May 2, 2021. https://www.rp.pl/Dyplomacja/210509961-Ambasada-do-wladz-Czech-Nie-ulatwiajcie-aborcji-Polkom.html.
  • Polska to Oficjalnie Mem. 2021. Mem. https://memy.jeja.pl/759450,polska-to-oficjalnie-mem.html.
  • Średnio Się Przejęli. 2021. https://kwejk.pl/obrazek/3763313/srednio-sie-przejeli.html.

Article written by Dr. Agata Chełstowska.