Just over two months ago, on 17 June 2009, Kostya Proletarsky’s exhausted, cadaverous body finally gave in to the ravages of TB and AIDS. He died just a few days short of his 35th birthday.

A heroin addict for most of his adult life, Proletarsky’s life of petty crime and intermittent prison spells was unexceptional for those amongst his circle of friends.

It seemed though that things might at last change for the better when, just over three years ago, having been caught and convicted one too many times, Proletarsky was sent to the Segezh Rayon Medical Correctional Facility in Karelia, just south of the Arctice Circle. Despite the punitive nature of the internment, he was hopeful that in this ‘medical facility’ he might find the support to wean him off heroin and receive the necessary treatment for his already advanced TB.

The two years he spent here were, however, nothing less than a living hell, a time during which he endured all forms of invented and sickening torture, and accounts from which bear more than a passing resemblance to the stories of Sobibor, Dachau or Bergen-Belsen.

Fortunately for posterity, the hellish details of Proletarsky’s incarceration have not been lost amidst the countless records of other luckless victims of Russia’s ‘drug rehabilitation programme’.

Proletarsky was released in time to recount his gruelling story to new-found friend and associate Anya Sarang, President of the Andrey Rylkov Foundation for Health and Social Justice.

As a campaigner for health and social justice, Anya thought she was already familiar with the brutality of Russia’s treatment of drug addicts. But it was only in forming a close bond with Proletarsky that she began to fully understand the horrors of what was taking place behind closed doors.

When I caught up Anya over the telephone some weeks back, she was still audibly shocked and reeling in anger, not least because her close friend and confidante Proletarsky, about whom we mostly spoke, had just passed away.

I asked Anya to describe to me the severity of the situation. A wry smile from Anya followed by a sigh said it all. ‘Where can I possibly begin’ she seemed to be saying.

‘Well, first came the starvation’ she told me. The daily soup was nothing more than green pickled tomatoes in water. A calorie diet filled with fresh fruit and vegetables was in fact what the TB-infested inmates would have required to escape the worst ravages of the disease. “You need to feed the TB so that it eats the calories, and not you” she explained. Without the necessary sustenance, the inmates morphed over time into skeletal figures.

Despite its own name, healthcare at the Segezh Rayon Medical Correctional Facility was almost non-existent. Proletarsky recalls that he was moved temporarily to Onda, a TB colony within the prison, in order supposedly to receive specialist care. On arrival, however, he found himself having to explain to the so-called doctor the basics of treating TB. “I talked him through viral load, ARV and the like and when finally I had finished the doctor exclaimed ‘Wow, I’ve learnt a lot from you. You must be from St Petersburg with all that information you have’”. Proletarsky left the TB colony and was sent back to the main prison having received no treatment whatsoever.

Where medication was offered it was done arbitrarily with no apparent interest for the health of the patient. Proletarsky recalled one man who suffered a flare up of hepatitis. ‘They stuffed him with TB drugs, which themselves are toxic and appropriate only for the treatment of TB. His stomach kept swelling and he turned increasingly yellow”. The patient understood that to refuse his ‘medication’ would result in being sent to the dreaded isolation chamber and so he kept silent and continued with the treatment until he contracted Ascite (or ‘drum belly’) and died.

In one particularly perverse ritual that seems to come directly from the witness accounts of Nuremburg, Anya told me how inmates would be herded en masse into tight enclosed spaces, such as bathrooms and toilets, wherein gallons of noxious liquids – bleach and ammonia, being the favoured choices – were poured onto the floor. Once in, the doors were sealed shut and the poisonous vapours began to do their work, causing severe burns to the mouths, eyes, throat and lungs of the victims inside.

‘They pour it and you just can’t breath’ recalled Proletarsky in his account to Sarang. ‘People started suffocating right away. Many fainted and fell down’. On that particular occasion when Proletarsky found himself inside he recalled the desperate efforts of the inmates to try and break down the door. They eventually succeeded.

Whether this served as a punishment, a ‘treatment’, or was simply the machinations of some sick-minded individuals, remains unclear. What is clear is that barbaric cruelty of one form or another was a daily feature of life inside a centre that was, so the name suggests, intended primarily as a centre for medical treatment and care.

Asked how common such cruelty was across Russia’s mainstream prisons and drug treatment facilities, Sarang told me that investigations of her own were revealing that it was far from unique.

Indeed, there are plenty of sources to corroborate Proletarsky’s story. A combined report from Human Rights Watch, USAID and Yale University has exposed widespread institutionalized abuse, degradation and torture of drug addicts across the country both inside and out of prison.

“The Gulag is alive and well in Russia’ the report states. ‘The [penal] system is designed in such a way that any person can be grabbed and annihilated in prison. As long as society tolerates it, it will continue to happen’.

Outside of prison the police enforce a brutal regime for those even suspected of drug use, or not as is often the case. To meet their daily quota of arrests, the police will often plant drugs on unsuspecting people. Drug selling areas, the report states are ‘like pastures on which they [the police] graze’.

Once taken in, the police will ensure they gain a guilty confession whoever the person may be. The report gives the account of one young male from Moscow who refused to sign a fabricated confession. “They didn’t hit me at first. I was surprised. They even suggested I go for a smoke” the source recalls. “They led me down some gloomy passageway, where I light up, then a door opens and in come two men and it starts: bang, bang, bang until finally I shout, ‘okay, okay I admit to everything”.

Others describe having acid poured onto their genitals, having their stomach cut with piano wire bound tightly around the body, whilst another recalls having his fingers and hands broken when ropes were attached to different fingers and then pulled in opposing directions.

But, the police contempt for drug users does not stop them allying themselves with them in order to line their own pockets, according to another report, Policing Drug Users in Russia: Fear and Structural Violence. It is common practice for police to set themselves up as doormen to drug dens, charging an entrance fee for those wishing to enter. This motive to make money also seems to be behind the reason why so few senior-level drug dealers are taken into custody. ‘Who then would be able to pay their bribes’, the report speculates.

The egregious treatment of drug users across Russia finds little sympathy with a public which has been spoon fed a media narrative of punishment and ostracism over inclusion and treatment.

But it is seems to be partly due to this ‘sweep it under the carpet’ attitude that Russia now finds itself sliding into a heroin epidemic. Addiction to the drug in Russia is eight times the EU average and four times the global average. Even so, methadone and buprenorphine – substances which, though not free of controversy themselves, are placed on the Essential Medicines List for drug rehabilitation by the World Health Organisation – are outlawed. Even advocating their use has been enough to land some people in prison.

The troubling offshoot of this dependency is a ballooning of associated diseases, such as TB and HIV/AIDs. Craig McCLure, Executive Director of the International AIDS Society, accused Russia of almost willing the spread of HIV/AIDS by doing virtually nothing to impede its uncontrolled spread when speaking at the Harm Reducation Association Conference this year in Bangkok.

Proletarsky would surely have to agree. In his conversations with Sarang, he claimed that of all the 180 inmates who were suffering from HIV/AIDS he knew only of one receiving any kind of treatment. Asked why that was, Sarang told me that admitting to the existence of AIDS would require state authorities to provide more funding for specialist treatment and diets. If the money was not there to treat AIDS, then it was simpler just to deny its existence.

Listening to Proletarsky’s account juxtaposed with the government’s abnegation of the problem makes the whole scenario itself seem like some drug-induced dream. So long as these drug-addicted people are removed from the purview of society, then a facade of life as normal can continue seems to be the thinking. Not so, unfortunately. The statistics show a groundswell of addiction, strife and victimhood. Surely a country such as Russia would appreciate that at some point this cause a breakdown. Better surely to deal with a manageable problem now than a seismic shift further down the line.