WELCOME TO IWPR'S REPORTING CENTRAL ASIA, No. 458, July 28, 2006 HIV SCARE AT CHILDREN'S HOSPITALS IN SOUTH KAZAKSTAN While health officials try to track down the cause of 15 HIV cases affecting young children, parents are staying away from hospital. By Olga Dosybieva and Daur Dosybiev in Shymkent for IWPR
KYRGYZSTAN: RISING LAKE THREATENS SHORELINE Beaches and basements are disappearing under water as Kyrgyzstan's huge lake Issykkul rises inexorably. By Mavluda Japarova in Issykkul and Sultan Kanazarov in Bishkek UZBEK CHILDREN MISS OUT ON KINDERGARTEN Unemployment and poverty means a pre-school education is beyond the means of many families. By IWPR staff in London TURKMEN STUDENTS FLEE ABROAD Endless propaganda and bribes to pass exams are just two of the disincentives to going to university in Turkmenistan. By IWPR staff in London ****************** VISIT IWPR ON-LINE: www.iwpr.net *************** PLEASE NOTE IWPR'S NEW ADDRESS & PHONE NUMBERS: 48 Gray's Inn Road, London WC1X 8LT, UK Tel: +44 (0)20 7831 1030 Fax: +44 (0)20 7831 1050 RSS: http://www.iwpr.net/en/rca/rss.xml FREE SUBSCRIPTION. Readers are urged to subscribe to IWPR's full range of electronic publications at: http://www.iwpr.net/index.php?apc_state=henh&s=s&m=p ****************** VISIT IWPR ON-LINE: www.iwpr.net *************** HIV SCARE AT CHILDREN'S HOSPITALS IN SOUTH KAZAKSTAN While health officials try to track down the cause of 15 HIV cases affecting young children, parents are staying away from hospital. By Olga Dosybieva and Daur Dosybiev in Shymkent for IWPR Southern Kazakstan has been rocked by news that 15 small children have been found to be infected with the HIV virus at two hospitals. The government has moved fast to find the source of the infection, but nothing has come to light yet. Prosecutors in the South Kazakstan region launched a criminal investigation on July 14 after doctors at three paediatric hospitals found 15 children under three years of age who tested HIV-positive. Apart from the fact that young children are involved, these cases also amount to a huge spike in the incidence of HIV in South Kazakstan. They take the total number of new cases since the beginning of the year to 78, compared with 44 for the same period of 2005. Such is the seriousness with which the authorities are treating the matter that a government commission led by Kazakstan's chief doctor Anatoly Belonog and National AIDS Centre director Isidora Erasylova was sent in to look into the cases, and a regional-level health commission is conducting its own investigation. Despite this activity, the authorities are remaining tight-lipped about how the children were infected, and officials have been reluctant to talk to the media. Doctors cannot say for certain what the source of infection was, and warn that more cases may yet emerge. The deputy director of the regional health department, Nagima Joldasova, said all the children affected had been treated at least once and had received blood transfusions at the hospitals - two located in the provincial centre Shymkent and one elsewhere in the region. Hospital blood stocks, donors, and the children's parents have all been tested, but nothing has come to light, she said. The health department's director Nursulu Tasmagambetova agrees with her deputy's assessment, but suspects that the parents may eventually be found to be the source. "I have data from infectious disease doctors in Russia showing that HIV-infected women may remain in a so-called negative grey zone for a long time - up to 10 years. When they're examined, no infection is found, but they may still be carriers," she said. Dr Belonog and his commission have not come up with definitive conclusions yet, but they appear to believe the hospitals are to blame. "In the hospitals we've looked at, we found a lack of control over the use of sterile medical instruments, and cases where the sterilisation regulations had been broken," he said. "These children were probably infected by donor blood, or as a result of non-sterile medical instruments being used." The commission's findings to date have led to three senior health officials being sacked: Tashmukhan Taibekov, head doctor at the regional children's hospital in Shymkent; Kelesbai Jumagulov, chief doctor at the regional AIDS centre; and Shora Seidinov, the head doctor at the regional blood centre. The head doctors of children's hospitals in Shymkent have received formal reprimands. Seidinov is unhappy with what he seeks as a knee-jerk reaction, and intends to appeal against his dismissal. He points out that Belonog's commission did not find fault with the blood centre. "Of the 91 donors whose blood was given to recipients, all have undergone repeat testing, except one who was away, out in the steppes working as a beekeeper. And I'm sure this man is not the source of the infection, as he's been examined several times in the past," said Seidinov. He noted that a recommendation made by the commission for blood plasma to be quarantined for six months has been enforced since January, but only for ten or 15 per cent of the blood in stock since his centre does not have the 130,000 US dollars it needs to buy the 35 extra refrigerator units required. "I reported to my superiors that neither the money nor the equipment had been provided," he said. There is some disagreement about the number of donors involved. While Seidinov spoke of 91, of whom one had not yet been tested again after the HIV scare, regional health officials said three of them had not undergone repeat tests. Meanwhile, a national health ministry official, Ualikhan Akhmetov, told reporters that all the donors had been checked, but that there were 105 of them. This contradictory information has only added to the rising sense of panic among Shymkent resident. A health officials who asked not to be named said there are more and more cases where people refusing are refusing medical assistance and hospitalisation, especially when it comes to their children. The number of children visiting doctors at Shymkent clinics has halved. Many parents are taking their children out of hospital even though their course of treatment has not ended, the official said. "After this outrageous incident, how can you trust doctors to look after your child?" asked one mother with a five-year-old son. "If my child falls ill, then I will try to go to a doctor I know personally, and he will be treated at home. I don't trust hospitals at all." The majority of doctors interviewed by IWPR were doubtful that the 15 children had been infected while in hospital. But one senior doctor with 24 years' experience said the possibility could not be ruled out for certain. "I fear that the official information we've received is just the tip of the iceberg, and we'll never know how many children actually received this fatal infection," he said. "It's also possible we're dealing with 'professional terrorism' here - in other words, some medical staff member is intentionally infecting people." As parents watch and wait nervously, the regional health department has taken action to reassure the public. A July 25 instruction requires all medical staff whose work has any connection with blood to undergo HIV testing. All children who have received medical treatment this year will also be tested. Olga Dosybieva and Daur Dosybiev are independent journalists and regular IWPR contributors in Shymkent. KYRGYZSTAN: RISING LAKE THREATENS SHORELINE Beaches and basements are disappearing under water as Kyrgyzstan's huge lake Issykkul rises inexorably. By Mavluda Japarova in Issykkul and Sultan Kanazarov in Bishkek Kyrgyzstan's Lake Issykkul is rising, swamping the shoreline and threatening the environment, but experts disagree on why it is happening and what should be done about it. What is clear, however, is that after nearly 150 years of declining water levels, the huge lake in the country's north is now rising fast. Since 1999, levels have increased by almost 12 centimetres a year, leading to fears that existing hotels and those currently under construction along the lakeside could one day be unusable. Damage has already been done to garages and saunas near the lake. Some sandy beaches are submerged and the rising water is washing away plants along the shore. Basements and boiler rooms have also been flooded, allowing fuel to seep into the lake and contaminate the water. The head of the Cruise yacht club, Olga Ilchishina, says the club's pier has been submerged and a canoe shed has sunk into the water. Scientists have mixed views about the reason for the sudden rise, with many suggesting that it is connected with global warming. Vladimir Romanovsky, head of the water resources laboratory at the Institute for Water Problems and Hydroelectric Energy has studied Issykkul for over 30 years and is one of those who believes warmer temperatures are causing the glaciers on Kyrgyzstan's massive mountain ranges to melt into Issykkul. His colleague at the institute, Vladimir Matychenkov, agrees. "There are many reasons for the rising level of Issykkul. The main one is global warming, which has caused glaciers on the northern ridge of the Kungei Alatoo range to melt by 25 per cent," said Matychenkov. According to data from the observation station at Cholpon-Ata on the north side of the lake, ambient temperatures in the area around the lake have risen by between one and 1.5 degrees Celsius in the last 45 years, while the area of the lake that freezes over in winter is shrinking year by year. Some groups such as the Gottfried Merzbacher Ecological Foundation, a group dedicated to preserving the glaciers, blame gold mining for causing the ice to melt. They say mining, particularly at the Kumtor gold seam which is located high in the mountains, fills the atmosphere with dust which then covers the glaciers, creating a darker surface that absorbs more sunlight, speeding up the melting. "Every year, the problem of glacier melt will assume increasingly global proportions," the foundation's head Chingiz Aitmatov - the country's most famous writer - told journalists recently. A youth group called Baisoorun Jashtary distributed a statement early in July alleging that neighbouring Kazakstan and China were the real culprits. They called for the two countries to pay Kyrgyzstan compensation for industrial emissions which, they said, contribute to glacier melting. Not everyone believes such explanations, however. Glacier specialist Murat Koshoev disagrees that gold mining, heavy industry or indeed melting glaciers are to blame for the swollen lake. "Even if you were to blow up ten mines like Kumtor, there would still be less dust deposited on the glaciers by the explosion than the natural yearly dusting they get from sandstorms in China and Kazakstan," he said. "If one takes the total water flow into Issykkul, then the percentage that comes from glaciers is very small; it's just an additional component. People who say that intensive melting of glaciers raises the water level are just speculating." Koshoev said that historically, water levels in the lake have always varied depending on how much rain falls, how much water evaporates, and tectonic shifts which alter the shape of the lake bed. For example, even though levels are rising, about a metre of water is still lost to evaporation every year. What makes it harder to predict what the lake will do next - either recede as part of a natural fluctuation in level, or continue its advance to swamp hotels and homes - is that Kyrgyzstan cannot afford to fund the amount of research that is needed. Gennady Shabunin, who heads the Kyrgyz Hydrometry Service's observation station at the lake, said cutbacks in staff make it hard for his agency to contribute to the debate about why the water is rising or what will happen in future. He is sure about one thing, however, "The water level has risen significantly and continues to rise." Mavluda Japarova is an IWPR trainee. Sultan Kanazarov is a correspondent for Radio Azattyk, the Kyrgyz service of RFE/RL. UZBEK CHILDREN MISS OUT ON KINDERGARTEN Unemployment and poverty means a pre-school education is beyond the means of many families. By IWPR staff in London Four-year-old Utkir plays in the ruins of a former collective farm kindergarten in his village in Uzbekistan's Fergana Valley. Nearby, his sister looks after two sheep as well as Utkir, while their mother Sharifakhon works in the fields, toiling for farmers for 1,500 sums per day, about 1.20 US dollars. Unlike his sister, Utkir has never been to kindergarten and has little chance of doing so. His family is too poor to pay the fees. Sharifakhon, whose husband went to Russia to work and never returned, says her main priority is not pre-school education but feeding her children. "Even if he only eats bread, at least he does not go hungry," she said. "In the past, I worked as a milkmaid on a collective farm, but I soon found myself out of a job. It is good that I have a chance to work as a labourer. The work is hard, we bend our backs in the sun all day, but at least I am able to feed my children myself. Of course we do not have enough money for clothes and other things, but my relatives help out with hand-me-down stuff from the kids' cousins." Sharifakhon's position is far from unique. The collapse of the agricultural system and unemployment in the countryside has doomed many rural families to poverty, making education for young children a low priority. Even if Sharifakhon and others like her could find the money to send their youngsters to pre-school, the number of kindergartens is in decline in Uzbekistan, while conditions are poor in those that do exist. A local government official in a rural district of Namangan province said that although things were not perfect in Soviet times, there was a reasonably sophisticated system of free pre-school education. But many kindergartens have been forced to close in recent years because parents cannot afford the monthly fees of 5,000 sums. "Last year, the district education department decided to close three more kindergartens. As a result, there are now 18 kindergartens in a district which used to be 30," he said. "Mass unemployment and poverty in the countryside... has directly affected our children." Urban areas also face problems with pre-school education. An expert on children's issues described how urban kindergartens are in an impoverished state, most with poor sanitation and many too poorly maintained for children to attend in winter. Part of the problem is that the state funding allocated for to repair and maintain the kindergartens is rifled by unscrupulous bureaucrats. "Education officials receive large bribes for ordering foodstuffs from businessmen, and then the cooks and chief accountants sell off the food that was supposed to go to the children," said the expert. Despite their problems, these kindergartens are difficult to get into. Ravshanoi from the city of Fergana told IWPR that she had to pay a 40,000-sum bribe to get a place in a kindergarten next door to her house. "It's regarded as the best kindergarten in the area," she said. "It's got experienced teachers and relatively good food. But all the same, before and after my child goes to kindergarten I feed him well. We only need the kindergarten so that someone looks after the child, because I have to work." Besides the bribe and monthly fees, Ravshanoi must also find money for school trips, festival and contribute to birthday presents for teachers and the kindergarten head. "This has already become the norm, and so few parents show their anger openly, although when we talk amongst ourselves we always complain that we have to pay bribes for a person starting from childhood. But you can understand the teachers: their [monthly] salary is 20,000-30,000 sums, and it's difficult to live on that." A kindergarten teacher confirmed this, saying her dream of working with children was jolted by the harsh reality of how little she got paid. "I didn't think teachers were valued so little in our society. Just think about how to live on a salary of 25,000 sums. I have to pay 18,000 just for utilities." Like the parents, the school itself has to pay bribes in the form of treats and presents to municipal officials. "Otherwise our kindergarten may be closed. So we have to do something, and we ask for help from parents. But we do not force them to help us," said the teacher. (Names of interviewees have been changed or withheld for reasons of security.) TURKMEN STUDENTS FLEE ABROAD Endless propaganda and bribes to pass exams are just two of the disincentives to going to university in Turkmenistan. By IWPR staff in London Educational reforms introduced by Turkmen president Saparmurat Niazov are forcing students seeking a university degree to go abroad. Far from home, students from Turkmenistan face numerous difficulties but most agree that studying in Turkey, Russia, Ukraine, Belarus or Kazakstan is still far better than staying at home. "I don't regret receiving my education here," said Alisher who graduated from a university in the Belarussian capital Minsk two years ago and now works for a Russian company. "Thanks to that, I have a good job, and I can help my parents who live in Turkmenistan." Restrictive measures on access to higher education have made getting a decent university education in Turkmenistan almost impossible. In 2003, President Saparmurat Niazov signed a decree saying that school leavers must do two years' work experience before they can attend university. With jobs hard to come by even for skilled workers, this restriction alone has helped cut the number of students enrolling in Turkmen universities to 3,000-3,500 per year, compared with 30,000-35,000 in the past. That's a tiny fraction of the around 150,000 young people who graduated from secondary school this year. Studying in Turkmenistan is costly. The starting rate for bribes to enrol at an average university is 3,000 US dollars, rising to 15,000 dollars for more prestigious faculties. And if students do manage to register, there are still more bribes to pay - this time to the poorly-paid lecturers running the exams. Aina, a Turkmen studying in Russia, explained: "After graduating from school, I wanted to enrol in the Makhtumkuli Turkmen State University. But my parents were told that they would have to pay 6,000 dollars. Instead of paying this sum, my parents decided to send me to Russia." Getting an education is especially difficult for ethnic minorities. Most subjects at universities are now taught in the Turkmen language, forcing ethnic Russians and other groups like Tatars and Armenians who use Russian as their lingua franca to go abroad. "I studied at a Russian-language school, and I also spoke Russian at home," says Ruslan, a second-year student at a Moscow university. "I can't imagine studying in Turkmen, as I can barely speak it." The reforms also reduced the quality of education by cutting teaching courses to two years from four or five years previously. Two more years are spent working in the student's chosen profession. "Not only does my daughter spend days attending useless concerts and subbotniks [voluntary work days], but the theoretical element has been reduced to two years," said Mehrijemal, the mother of a student at the Azadi Institute of World Languages. Jeiran, who attends an Ashgabat university, complains she is forced to spend much of her time studying the Ruhnama, the "Book of the Spirit" which was penned by the president himself and forms the basis of the country's official ideology. "We studied the Ruhnama in enough detail at school, and now we are forced to study at here as well," said Jeiran. "To be quite honest, we've been studying the same thing for several years now." Male students are particularly keen on studying abroad because it releases them - temporarily at least - from compulsory army service and the harsh life of a Turkmen soldier. "The exam period will soon be over, but I'm not going home," said Bairam, in his third year at a university in St Petersburg. "I'm afraid that I will be forced to serve in the army." Like Bairam, many who go abroad have no plans to return as unemployment is so high in Turkmenistan, and many recent graduates there cannot find work. Also complicating the return home is the fact that most foreign degrees are not valid in Turkmenistan. Berdymurat, a fourth-year student in Samara, plans to stay on and eventually apply for Russian citizenship. "Many of my friends also plan to live and work here, because there are no jobs in Turkmenistan," said Berdymurat. Arzuv, 25, went to Turkey to study, and will not be returning home because she has got married. "Initially my parents were opposed to my marriage, especially as international marriages are frowned upon there [in Turkmenistan]. But after a while they agreed. Now I have a job, education and a loving husband." A former history lecturer at a Turkmen university who now lives in Russia predicts dire consequences if the country's educational policy continues along the current path. "Turkmenistan can expect an entire generation of uneducated people, which will lead to economic and social crises." (Names of interviewees have been changed or withheld for reasons of security.) ****************** VISIT IWPR ON-LINE: www.iwpr.net *************** IWPR's Reporting Central Asia provides the international community with a unique insiders' perspective on the region. Using our network of local journalists, the service publishes news and analysis from across Central Asia on a weekly basis. The service forms part of IWPR's Central Asia Project based in Almaty, Bishkek, Tashkent and London, which supports media development and encourages better local and international understanding of the region. IWPR's Reporting Central Asia is supported by the UK Community Fund. The service is published online in English and Russian. All our reporting services are also available via e-mail subscription. For further details on this project and other information services and media programmes, visit IWPR's website: www.iwpr.net Editor-in-Chief: Anthony Borden; Managing Editor: Yigal Chazan; Senior Editor: John MacLeod; Central Asia Programme Manager Saule Mukhametrakhimova; Editor in Bishkek Kumar Bekbolotov. The Institute for War & Peace Reporting is a London-based independent non-profit organisation supporting regional media and democratic change. 48 Gray's Inn Road, London WC1X 8LT, UK Tel: +44 (0)20 7831 1030 Fax: +44 (0)20 7831 1050 The opinions expressed in IWPR's Reporting Central Asia are those of the authors and do not necessarily represent those of the publication or of IWPR. ISSN: 1477-7924 Copyright © 2006 The Institute for War & Peace Reporting REPORTING CENTRAL ASIA No. 458
