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Notes from the Field: Uzbekistan and Kyrgyzstan

  • December 14, 2006

Recently, AmeriCares Program Managers Jim O’Brien and Kathleen Oldaker visited our partners in Uzbekistan and Kyrgyzstan.  While there,  they recognized an ongoing need for basic health care in the region. Read Jim’s account below.

 Jim O'Brien and Sergei Albert in Uzbekistan
 AmeriCares caseworker
 Jim O’Brien, right, and Sergei Albert

After two flights and more than 22 hours in the air we landed in Bishkek, Kyrgyzstan and were met by AmeriCares Central Asia consultant, Sergei Albert.  Many of the buildings, built during the Soviet era, lacked heat or running water and provided limited electricity. Residents, proving resilient, adapted by getting water from a road-side pump and carrying it up six stories to bring it home. They also found other means to keep warm, searching garbage bins for wood to burn.   In fact, one of the Soviet regional hospitals was literally reduced to rubble because the people in Kyrgyzstan had picked it apart to use as fire wood.  The only thing left was a pile of foundation stones.  I have been to very poor areas, but nothing like this.

In Kyrgyzstan more than half of the people live in poverty.  In neighboring Uzbekistan, where we traveled next, 28% of the population lives in poverty.   A doctor there earns just US$40 a month.  As a result, most of the people in these two countries have limited access to basic medical needs. 

Despite these conditions, the people in Uzbekistan remain in high spirits, thankful that their living and health conditions have already improved from where they were a decade ago and hopeful that they will continue to get better.  We heard the sound of children’s laughter emanating from the streets and their warm welcoming smiles beckoned us to join family gatherings.

We traveled to this all-but-forgotten part of the world with a clear purpose:  to assess the health conditions; verify that AmeriCares is sending the appropriate medical aid; ensure that this aid is reaching the proper clinics, and ultimately the people in need.

The two-year old boy shown in the photograph to the right is a burn victim at the Tashkent Regional Hospital Burn Center in Uzbekistan.  He had been burned along his arm when a pot of boiling water fell on him, a common occurrence in a place where families are forced to find unconventional ways to cook food and heat their homes.  The need to care for burn victims is so great, and the conditions at the health care facilities so desperate, that the hospital here is reusing gauze.  The boy in the picture is bandaged in gauze recycled through a washing machine.  And yet, his was not the most serious case we came across. 

Another boy, just 5-years old, lay in an adjacent unsanitary hospital room.  He suffered from burns that covered 65% of his body.  He had no skin left on his torso.  A 1970’s hot-air machine feebly attempted to keep the flies off his severely traumatized body.  Strapped to a mesh crib, his hands and legs tied to each post, wrapped in re-washed gauze, and isolated from human contact, this five-year old lay crying as flies nested on his injuries.  He had been in this position for six months.

While the medical conditions were grim, the staff of highly qualified local doctors and nurses was extremely dedicated, sometimes sleeping at the hospital when a patient needed constant attention.  I was impressed with their undying will to care for their patients without the many basic tools necessary for proper care.  Day in and day out, these doctors and nurses administered care to each patient they saw, offering not only help, but also hope.

Still, complicating the best efforts of the various medical professionals we met was the deterioration of the Soviet infrastructure.  Blackouts are endemic.  In Kyrgyzstan, doctors routinely perform surgery by candlelight.  In Uzbekistan, hospitals in the Aral Sea region may be without fresh water for days.  The determination and commitment of the Uzbek and Kyrgyz medical professionals is admirable and awe inspiring.  But even determination has real-life limitations. 

 Doctor Ernst Akramov
 Dr. Ernst Akramov

Dr. Ernst Akramov, the chief surgeon at Chui Oblast United Hospital in Kyrgyzstan told us he was in dire need of more supplies, “We don’t have anything, so we need anything that you can provide.”  In his hospital, Dr. Akramov uses old equipment and outdated medical instruments to perform surgery.  He lacks sutures, monitors, and gowns.  Needles are “resterilized” in old mineral water bottles.  Soda bottles act as drain bags.  Dr. Akramov has a single anesthesia machine, which means his hospital can only perform one surgery at a time.  We discovered that his story is not unique.  In Central Asia a chronic lack of supplies has led to the loss of hundreds of thousands of lives.

AmeriCares regularly sends basic supplies, including gauze, syringes, drain bags, rubber gloves and acetaminophen to facilities like Tashkent Regional Hospital Burn Center and Chui Oblast United Hospital. We also send medicines to treat hypothyroid disease and hypertension. The doctors and medical staff we met with thanked us repeatedly for these much needed drugs that they do not have but desperately need for their patients, many of whom suffer from these chronic illnesses. After witnessing the need for more hospital supplies during this visit, AmeriCares is now making plans to increase the number of shipments it sends to Uzbekistan each year so that we can better meet the needs of this struggling health care system.