Officials in Kyrgyzstan have expressed alarm in recent weeks over blood shortages in hospitals. The problem has become so acute that parliamentarians are discussing new laws to encourage citizens to donate. But, as I experienced recently, there are some basic reasons people are unwilling to give blood, and they cannot be addressed by legislation.
On January 22, parliament began considering a bill that would encourage military personnel to donate by giving them an extra day off.
But, even if I were given such an incentive, I would think twice before visiting the aggressive and offensive people running our nation’s Republican Blood Center, which is managed by the Ministry of Health.
In late December, an appeal was circulating on a popular local social network: a two-year-old boy was very sick and needed blood. The next morning my friend and I visited the Republican Blood Center, eager to help.
After answering a few questions about my health in a written questionnaire, I was called to speak to a middle-aged woman at the reception desk. “What did you eat over the last three days?” she asked through a small window in a glass wall. I answered that, to be honest, I couldn’t really remember. “Who are you? A princess?” she yelled. “Quickly, tell me what you ate and don’t waste my time!”
Rude service is nothing new in Kyrgyz government agencies, but next the woman said something that all but guaranteed any young woman in this conservative country would not return to the Blood Center.
Officials in Kazakhstan are struggling to understand a wave of suicides that has horrified the country this year. One MP says “alien” western subcultures are to blame.
Galina Baimakhanova, a member of Kazakhstan's lower house of parliament, called the punk and emo movements “alien to our mentality” as she addressed parliament about adolescent issues this week. She blamed the subcultures for targeting emotionally unstable teenagers and said that punks were aggressive and emos preached “depression, withdrawal and general suicidal behavior.”
Defenders of emo – which grew out of the punk movement and is often characterized by expressive and emotive lyrics and writing – dismiss stereotypes that they are overly emotional or angst-ridden just because they sometimes wear black and can express an interest in morbid topics.
The suicide rate is high in Kazakhstan. A 2011 World Health Organization studyranked Kazakhstan third-place globally with 31.06 suicides per 100,000 people in 2008. Baimakhanova proposed setting up a nationwide project to combat the problem of teenage suicides and called for “a special ombudsman to protect the rights of children and teenagers in Kazakhstan.”
Kazakhstan was stunned earlier this year when two teenagers threw themselves off a twelve-story building in the commercial capital Almaty on May 28. Classmates said the couple had planned their double death and were members of online groups that discussed suicide.
Kyrgyzstan’s Health Ministry has denied any new cases of bubonic plague after a 15-year-old boy died of the disease last week.
Citing an unnamed government source, AFP reported on August 27 that three more people who had had contact with the deceased were exhibiting signs of the disease and had been hospitalized.
The Health Ministry denies the three have contracted the disease. "Preliminary results are negative,” Health Ministry spokeswoman Elena Bayalinova told EurasiaNet.org on August 28.
A total of 148 people believed to have had contact with 15-year-old Temirbek Isakunov
shortly before his death on August 22 in northeastern Ak-Suu district have been quarantined and are receiving prophylactic antibiotics, the Health Ministry said in a statement. The ministry says an epidemic is unlikely and authorities are said to be controlling movement in and out of the district.
A boy tries to sell a dead marmot in Tajikistan. Marmots are often hunted for their meat in mountainous parts of Central Asia. But in Kyrgyzstan, health officials suspect a teenager died from bubonic plague after coming into contact with a flea that had lived on a marmot.
Kyrgyzstan’s Health Ministry has confirmed the death of a teenager from bubonic plague, an infectious disease most famously known as the Black Death that killed approximately one-third of Europe’s population in the 14th century.
On August 26 the ministry said an autopsy on 15-year-old Temirbek Isakunov had confirmed the boy had contracted the disease. Isakunov died in Issyk-Kul province on August 22 after being admitted to a hospital with a high fever and swollen lymph nodes in his armpits and on his neck. Doctors suspect Isakunov contracted the disease from a flea living on a marmot that his family had cooked. Marmots are common in Central Asia's mountains and are sometimes hunted for their meat.
Kloop.kg quoted Health Minister Dinara Saginbaeva saying at a press conference this morning that the teenager had been buried and 105 people who could have been in contact with him during his last days are being given antibiotics. The Ministry of Emergency Situations says that more than 700 people in Issyk-Kul province have been examined for symptoms, the 24.kg news agency reports.
Kazakhstan has extended its smoking ban by prohibiting the use of the shisha pipe in enclosed public spaces including bars, nightclubs and restaurants.
The ban came into force on March 14, sparking an outcry among entrepreneurs warning of widespread job losses.
According to the calculations of the Association of Shisha Pipe Industry Entrepreneurs of Kazakhstan, reported by Bnews.kz on April 1, up to 20,000 jobs stand to be lost since each of the 5,000 premises where the shisha is smoked employs three or four people to clean and light the pipes.
The pipes are hugely popular in bars and restaurants in Astana, Almaty and other cities. One pipe, which is shared by groups of friends out socializing, costs around $30-$50. Establishments breaking the new rules face fines of just over $1,100.
Shisha – also known as kalyan or hooka – pipes had been exempt from a smoking ban in enclosed spaces introduced in 2009, when officials said some 30,000 people per year were dying from tobacco-related diseases. Implementation is patchy, with most establishments respecting the ban but some openly flouting it.
According to a World Bank report published in 2010, 40 percent of male adults in Kazakhstan smoke – fewer than Russia’s 59 percent, but almost double the 22 percent smoking in neighboring Uzbekistan.
Remarking on a topic not often discussed openly in Kyrgyzstan, a deputy health minister said last week that abortion is the number one form of birth control in the country and the numbers are rising.
Back in the Soviet Union, after 1955, abortions were legal and free, while access to birth control was difficult and highly unreliable. (One study estimates there were almost 6 million abortions in the Soviet Union in 1988 alone.) These days, borders are open and pharmacies are well-stocked. Yet a lack of education and youth-friendly medical services means abortions -- still legal in Kyrgyzstan if performed in a clinic – are a highly popular method of family planning.
While good statistics are hard to come by, experts have no doubt the numbers are staggering. According to some estimates, “on average, by the age of 22, a woman in Kyrgyzstan has had one abortion. By the time she is 30.7 she has had two. By the time she is 36, she has had three,” says the United Nations Development Program (UNDP) in its 2009/2010 National Human Development Report.
“I would say the real number of abortions in the country is much higher. There are many abortions that are performed in private clinics and are not registered,” Dr. Meder Omurzakov, the assistant representative of the United Nations Population Fund (UNFPA) in Bishkek, told EurasiaNet.org.
The UNDP study cites a local professor claiming that 70 percent of pregnancies end in abortion.
As the quality of medical services in the post-Soviet era declines, the procedure is also getting more dangerous.
The study finds that Uzbekistan, Turkmenistan and Kyrgyzstan have made huge strides in reducing child malnutrition. It singles out Uzbekistan (alongside Angola) as one of “two priority countries that have made the fastest progress in reducing child malnutrition – both cut stunting rates in half in about 10 years.”
Uzbekistan topped the list of states that have made the greatest strides. Kyrgyzstan and Turkmenistan came fifth and sixth respectively.
As The Economist pointed out, half of the top six success stories identified by Save the Children are in Central Asia (while number six is North Korea). “This finding is – how can one put it politely? – counter-intuitive,” The Economist commented.
“Number one on the list is Uzbekistan, a vicious dictatorship which imprisons political opponents and has been the site of mass killings,” it continued, while Turkmenistan “had for many years one of the world’s stranger dictators [Saparmurat Niyazov] who renamed the days of the week after himself and his family.” (Turkmenistan is still run by a dictator who is fostering his own personality cult.)
Being a doctor in Turkey carries with it a certain amount of prestige. But, increasingly, the job is also proving to be one that comes with a high level of danger. The last month has seen a string of violent attacks against doctors and health professionals in Turkey, from the murder of a doctor by the 17-year-old relative of a patient of his who died to attacks against ambulance crews that were accused of arriving late. Things have gotten so bad that Turkish doctors went on a nationwide strike earlier this month to protest the violence they are facing, while the Health and Justice ministries have been forced to step into action and come up with a plan to protect the country's medical workers.
So what's behind this upsurge in violence against doctors? Some suggest that because of a recent expansion of universal health coverage in Turkey, the country is now facing a severe shortage of doctors, resulting in poorer care and more angry patients and relatives. Some doctors, on the other hand, believe that they are the victims of government rhetoric that they say portrays them as lazy elitists. Reports the Financial Times:
Everything is fine, no need to look here, we don’t secretly cut out our women’s wombs.
That’s the message from Uzbekistan’s state-run Uzdaily.uz, which has decried as the work of the “yellow press” a recent BBC report on how Uzbek doctors are secretly sterilizing tens of thousands of women.
Only women who wish to be sterilized are having the procedure, says Uzdaily. The BBC, however, reported that doctors are convincing women to give birth by Caesarean section in order to gain access to their internal reproductive organs: "Rules on Caesareans used to be very strict, but now I believe 80 percent of women give birth through C-sections. This makes it very easy to perform a sterilization and tie the fallopian tubes," a senior surgeon at a Tashkent hospital told the BBC. Uzdaily reiterated the government claim, which doctors ridicule, that only 6.8 percent of Uzbek women have C-sections.
The controversial sterilizations are not new, but the BBC report – which suggested officials are concerned with Uzbekistan’s ranking on international maternal mortality indices – appears to have gotten Tashkent’s attention. The Associated Press reported in 2010 on the “Uzbek women who have been surgically sterilized without their knowledge or consent in a program designed to prevent overpopulation from fueling unrest.”
The doctor “never asked for my approval, never ran any checks, just mutilated me as if I were a mute animal," one mother, who had part of her uterus removed during a C-section, told the AP, shortly after the death of her first, and last, baby.
Stories have been leaking out for years about doctors secretly performing hysterectomies on women who have given birth in hospitals. The surgeries are described as “voluntary,” but EurasiaNet.org has reported how increasing numbers of women are choosing to give birth at home, fearing doctors will tie up their fallopian tubes or cut out their uteri without their consent.
The UN Committee Against Torture and the US State Department have both expressed concern. Nevertheless, it appears Tashkent is issuing doctors quotas for the procedures.
"Every year we are presented with a plan. Every doctor is told how many women we are expected to give contraception to; how many women are to be sterilized,” a gynecologist from Tashkent told the BBC’s Natalia Antelava.
Several doctors I spoke to say that in the last two years there has been a dramatic increase in Caesarean sections, which provide surgeons with an easy opportunity to sterilize the mother. These doctors dispute official statements that only 6.8% of women give birth through C-sections.
"Rules on Caesareans used to be very strict, but now I believe 80% of women give birth through C-sections. This makes it very easy to perform a sterilization and tie the fallopian tubes," says a chief surgeon at a hospital near the capital, Tashkent.
One local expert estimated tens of thousands of forced sterilizations have happened in the past few years across Central Asia's most populous nation, a vast country of, officially, 28 million.