SARATOV, Russia -- For more than three decades, the nongovernmental Saratov Regional Organization For Diabetics has provided vital practical and informational assistance to the more than 80,000 people diagnosed with diabetes in Russia's mid-Volga region.
"Recently a woman came to us and said she hadn't eaten for several days because she had no insulin," organization head Larisa Saigina told RFE/RL recently. "When we hear of such cases, we appeal to the Health Ministry. If the Health Ministry ignores us, we ask Roszdravnadzor" -- the state health inspectorate -- "to look into it. Very often as a result, people get their insulin and other necessities."
But that work may soon come to an end, as local prosecutors have filed charges accusing the group of acting as a "foreign agent" without having registered as such with the authorities.
Court proceedings against the NGO are scheduled to begin on January 15. Since the controversial foreign-agent law, which requires NGOs receiving foreign funding and engaging in political activities to register and to regularly proclaim their status, was adopted in 2012, three organizations from the Saratov region have been prosecuted under it and all three were closed down shortly afterward.
"I think they are getting revenge on us because we work too well," Saigina concluded.
Formally, the pressure against the Saratov diabetes organization began in August, when prosecutors received a denunciation from local medical student Nikita Smirnov, an activist with the youth wing of the ruling United Russia party and now the head of a local student organization supporting President Vladimir Putin for reelection in the March presidential ballot.
Smirnov, who declined to be interviewed for this story, told Novaya Gazeta in December that he'd read "on the Internet" that the diabetes society received funding from foreign pharmaceutical companies. "I considered it my civic duty to alert the authorities so that they could look into it, that's all," he said. "If you suspected something like that, you'd most likely do the same thing."
After a public outcry on social media, Smirnov announced on the VKontakte social-media site that he "withdraws" his complaint and is ready to support the organization "in any way possible."
That statement, however, is unlikely to have any effect on the case. "The machine is already working," Saigina said. "The case is already before the courts, so there is no way to avoid a trial. Nikita is just a puppet in someone's hands."
In reality, however, the organization's troubles began last spring. Its former president, Yekaterina Rogatkina, was hounded at her place of work to such an extent that she had to resign from the diabetic society to avoid being fired. Shortly afterward, the organization was kicked out of the space it had been allocated in a regional hospital. It moved to another building, but local officials have so far refused to sign off on the lease.
"We could be thrown out on the street at any moment," Saigina said.
The pressure comes with reports of insulin shortages and other problems on the rise as regional authorities cope with a severely strained budget.
A key part of the upcoming trial will be the "expert analysis" commissioned by prosecutors from local historian Ivan Konovalov, who also manages a project called Civic University for the Saratov branch of United Russia.
Konovalov's report, which was seen by Novaya Gazeta, concludes that the Saratov diabetes organization "gives information to foreign partners about so-called sore spots in the region, particularly in the area of health care, that could be used to inflame protest tendencies in society."
The organization also allegedly "creates preconditions for discrediting the authorities by groundlessly making claims" about problems securing medications. "This can be considered political activity," Konovalov concluded.
In 2016, Konovalov wrote the "expert analysis" in the foreign-agents case of an NGO called Sotsium, which worked to prevent the spread of the virus that causes AIDS. Although Konovalov's report stated that Sotsium "does not picket or protest or call for the resignation of the government," it could still be considered "a participant in a hybrid war against Russia, the goal of which is the destruction of the foundations of traditional culture and family values by promoting its own understanding of human rights." Sotsium was declared a foreign agent in April 2016 and closed down shortly afterward.
Saigina said she worries that the same fate awaits her organization because of the onerous costs of fighting the case and the possibility of heavy fines. Saigina readily conceded that it had received contributions from the Russian branches of foreign drug companies to hold seminars and carry out educational work on living with diabetes.
"They have factories in Russia -- some of which have operated since the 1950s," Saigina said. "All the medications and equipment are produced in these factories, not imported. The heads of these factories are members of the Russian Pharmaceutical Association and their products are sold in our pharmacies. They are purchased by the Health Ministry."
"The money we get from sponsors is for specific projects," she added. "We have nothing in our account except member contributions and operating funds. Now I have 150 rubles ($2.60) in the account. I can't even pay the phone bill. We have no money for lawyers."
'You Need To Fight'
The Saratov Regional Organization For Diabetics received grants from the Russian presidential administration in 2014 and 2015.
Vladislav Tkachenko, 40, was diagnosed with diabetes when he was 2 years old.
"Before I came to this organization, I really didn't care about anything," he told RFE/RL. "The days just went by. I hardly ever left the house because I was afraid I'd have an episode."
But then he attended a society conference in 2010 and heard doctors discussing how to live with diabetes.
"I understood that I could control my lifestyle so that I would feel better," he said. "It is awful that this patients' organization which protects their rights, is being dragged into political games. I am not white or red or blue -- because all politics are temporary. But the disease I have is forever. I need to learn how to live with it and to help others learn this through my example."
Saigina said that, if her organization is declared a foreign agent, she will appeal.
"The patients support us," she said. "They say they will come to the court. They are even ready to protest in our defense. The people that we help are confused and don't know what is going on. For their sake, we will fight to the end and will not shut down our organization."
"I'm one of those people who think you need to fight," she added. "You need to defend your rights and to make noise when they are violated."
Written by RFE/RL senior correspondent Robert Coalson in Prague on the basis of reporting by RFE/RL Russian Service correspondent Darina Shevchenko in Saratov