WELCOME TO IWPR'S REPORTING CENTRAL ASIA, No. 587, August 27, 2009 ECONOMIC CRISIS CITED IN TAJIK SUICIDE CASES Indications that people overwhelmed by financial burdens taking their own lives. By Bakhtior Valiev in Khujand
UZBEKISTAN: BLOOD SHORTAGES CAUSE CONCERN Doctors say lives at risk because people have no incentive to give. 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For more information about how you can support IWPR go to: http://iwpr.net/donate **** www.iwpr.net ******************************************************************** ECONOMIC CRISIS CITED IN TAJIK SUICIDE CASES Indications that people overwhelmed by financial burdens taking their own lives. By Bakhtior Valiev in Khujand Economic hardship resulting from the global financial crisis is to blame for a spate of suicides in the northern Tajikistan region of Soghd, victims relatives and experts say. A mother of three who lives in the provincial capital Khujand said her car-dealer husband committed suicide after some of his clients failed to pay him. He was in the business of buying and selling imported cars. He took loans, a lot of money. He did not tell me about his problems but I understood that he had been simply let down, she said. On top of her bereavement, the woman has had to deal with some of her husbands creditors, Now they come to me and demand that I repay his debts. Where do I get this kind of money? If I had been working I would have tried to pay it back little by little. It is good that others have cancelled his debts. A mother of two from Bobojon Gafurov district not far from Khujand lost her husband of 11 years. They shared a house with his two brothers and their families. While her husband was working they managed to make ends meet but things changed when he lost his job. His brothers did not like it and told us to move out. My husband did not see any way out and hanged himself, she said. After the 40-day mourning period, they [the brothers] threw me out of the house. It was a terrible time for me. I went to live with my relatives, and then with my sister. Kind people gave me a helping hand and found me a place in a hostel. I found a job to feed my children. The Soghd region, traditionally better off than other parts of the country thanks to its industry, has been hit hard by the economic downturn. The crisis has not only cut local incomes and the number of jobs but also remittances from thousands of labour migrants. Some 150,000 seasonal workers from Soghd are working abroad, mostly in Russia but also in Kazakstan, according to official figures. Najiba Shirinbekova, who heads a non-governmental group called Law and Prosperity, told IWPR, The latest information indicates a particularly high level of poverty in the region. This is because factories are standing idle because of the financial crisis and the winter energy crisis. In the first six months of the year, labour migrants from Soghd sent home more than 200 million US dollars, compated with last year, when the figure for the same period was more than 300 million dollars. There are no official records of how many suicide cases are directly caused by the economic crisis, though police sometimes note financial problems when recording deaths. From January till the end of June, the number is given as 15. However, the figures do not distinguish between those living in long-term poverty and those whose dire financial situation has been compounded by the economic slowdown. The interior ministry office in Soghd said that in the first six months of the year police registered 92 cases of suicide and 52 attempted suicides, 25 more than the figures for the same period last year. Despite a lack of clarity in suicide statistics, there are some indications that people are taking their lives under the stress caused by the economic crisis. There are more men than women who committed or attempted suicide - 84 and 78 respectively. Many men are of working age and the country has more women than men because of the numbers working abroad. An expert in gender issues, Rano Bobojonova, said financial problems are often the cause of suicide in men whereas among women the leading cause is domestic violence. Men carry the responsibility of being the breadwinner and are expected to be able to provide for the family, Society is used to seeing in a man a strong, brave person who takes care of his family. But in times of economic crisis they struggle to fulfil this role and that can make them depressed, according to Bobojonova. They are not supposed to cry or show weakness. They have nowhere to turn and that is why they may take such a radical step, she said. Six suicide cases in the last month involved unemployed men aged between 22 and 60, the local interior ministry office said. Commenting on suicide statistics, the coordinator of the crisis centre Gulrukhsor, Mavzuna Hokimboeva, said there is a widespread perception - and law enforcement bodies are no exception that suicide is linked with mental illness. According to our information, to a large extent it is financial difficulties in the family that lead to the rise in this phenomenon, Hakimbaeva said. Medical doctor Malika Saidalieva said that psychological illnesses tend to emerge against the backdrop of various factors including financial problems, This could be the loss of a loved one, losing a job and a number of other reasons. She explained how the economic hardship could lead to suicidal thoughts, Constant stress, a weakened immune system and nervous breakdown will lead to neurasthenia. [This brings] persistent thoughts including a desire to commit suicide. Neurasthenia is a condition whose symptoms include fatigue, anxiety and depression. A 45-year-old resident of Khujand who gave his name as Samad told IWPR how he was driven to the brink of suicide when he lost his job. He tried to find work but failed to get a stable job and earnings from temporary work were meagre. In his desperation, Samad turned to alcohol. He and his wife quarrelled constantly. I was ready to take my own life and even pictured in my mind how to do it. But one evening my youngest daughter sat on my lap and said, Daddy, I love you very much, he said. I felt reborn and realised that there are more important things than one's own worries. The decline in remittances puts a strain on people who have used funds sent by family members working as labour migrants as collateral to take out loans. Microcredit organisations accept a banks letter confirming monthly transfers from a relative abroad as a guarantee for repayment. The head of crime prevention among minors and young people at the interior ministry, Lieutenant-Colonel Rahimjon Abduvaliev, told IWPR that this years suicide statistics included cases of men who took their own lives because they had problems repaying a loan. He was not able to give the number. Barbara Kreuter, a consultant with the German Development Service advising the Tajik Association of Microfinance Organisations, confirmed that many people are struggling with loan repayments. This year delays in repayments have risen four times compared to 2008, she said. The rise in suicides has been noted in the Soghd region over the last couple of years but the latest increase in attempts has attracted the authorities attention. The local government in the northern region of Soghd last month decided to set up a special commission to work on how to prevent suicide attempts. The head of the department for social and cultural affairs and interethnic relations in the city administration of Khujand, Zulfia Umarova, said the commission plans to organise meetings and talks. Members of the commission will include a deputy of the Tajik parliament, a psychologist, a cleric, a police officer and a writer. The administration is enlisting the help of mosque leaders. They will be asked to talk in their sermons about being patient and thinking of responsibility towards the family, Umarova said. Bakhtior Valiev is an IWPR-trained journalist in Tajikistan. UZBEKISTAN: BLOOD SHORTAGES CAUSE CONCERN Doctors say lives at risk because people have no incentive to give. By Yana Sergeeva in Tashkent Uzbekistan will have to start paying more donors to ease a major shortage of blood that is costing lives, say medical professionals despite official denials that there is a problem. Students are effectively being forced to donate en masse, getting paid for their blood in bags of sugar. Some, from the impoverished countryside, are being made ill by the process, they say. There is money for a few donors to be paid 25 or 30 US dollars a time but mostly the Uzbek system relies on voluntary donors. The director of the Scientific Research Institute of Haematology and Blood Transfusion, SRIHBT, of the Uzbek health ministry, Hamid Karimov, said over the last decade the number of volunteers has fallen dramatically to four or five per 1,000 people compared with what is regarded as the norm of ten times that number. He said there had been an increase in donations in the first six months of the year compared to last year but did not give details. This followed a government programme aimed at encouraging blood donors adopted last February. More than 1,000 SRIHBT staff members volunteered to give blood. The overall number of volunteer blood donors over [the last] six months exceeded 5,500 people, said Karimov. The head of the administrative department at the same institute, Zair Saidvaliev, said the problem of blood donor shortages is common in many countries and is not unique to Uzbekistan. Saidvaliev believes that putting the emphasis on volunteering is the way forward, In our country there is a tendency to give blood for free and in the foreseeable future we will fully switch to voluntary blood donations. Medical professionals say that the shortage is caused by a combination of the governments reluctance to pay blood donors and a lack of publicity to encourage voluntary contributions. Also, unlike the Soviet government in the past, the Uzbek authorities are no longer able to order a vast army of public sector workers to give blood for free. Medical staff say people most at risk include those with blood cancers, oncology patients, women giving birth, patients undergoing operations and victims of accidents. The shortage covers reserves of fresh blood and blood components such as plasma - the liquid in which the blood cells would normally be suspended - and thrombocytes, the cells that promote clotting. The head of haematology at SRIHBT, Mamura Nigmatova, said, We have 65 patients with leukaemia. One female patient has a nose bleed from yesterday. Her blood does not clot. She urgently needs plasma but we are still waiting for it to be delivered. There is a shortage of donor blood and its components in our country. Her colleague from the department, haematologist Eldor Iskhakov, who is in charge of scientific research, confirmed that the shortage had reached a critical level, In extreme situations we loose the patient due to a lack of donor blood. Iskhakov said that doctors themselves give blood up to five times a year, Unfortunately the majority of our citizens are not conscientious enough. Most people only donate when their relatives fall ill, Iskhakov said. At the department, IWPR was told that in July, a 25-year-old woman named Malika died from an acute form of leukaemia after doctors failed to secure the transfusions of thrombocytes and plasma that she needed. Another doctor at the department who wished to remain anonymous said, The death toll among our patients [with leukaemia] is very high: two or three out of ten die from bleeding. What triggers their death is that they are not given timely transfusions of blood or blood components. They were just not there when patients needed them. He said available reserves of blood and its components were a fifth of what was required, Many patients with advanced blood disorders might need up to two litres of blood components equalling four litres of blood. Over the course of treatment they could require blood from 60 donors. The shortage can be more acute for particular blood types. Sapura Ibrahimova, who heads the childrens department of the same institute, said, Sometimes we dont have enough group A blood and plasma of all types and have to look for it at all the blood transfusion centres. If a patient arrives with an advanced condition, we dont have time to find a supply of the right blood group and he dies. She said that sometimes they face the difficult choice of who should get treatment first, There are 50 children being treated in our department. At least ten of them need daily transfusions of blood and its components. We order it from our blood transfusion centre but receive only half of what we need. The City Oncology Hospital in Tashkent has been forced to delay even urgent cancer operations, said the head of the blood transfusion department, Ilhom Hokimov. Due to a shortage of funds our department is not functioning for one and a half months, so we have to place an order at the city blood transfusion centre and at the institute for haematology, he said. The governments programme targeting student donors brings its own problems, students and university teachers point out. University students are considered easy prey for the governments campaign. Gone are the days of the Soviet Union when authorities were able to rely on employees of state enterprises and other public sector workers to donate blood en masse. These days the private sector that employs a majority of the people is reluctant to allow blood donors to take paid time off to give blood. In addition, unlike the Uzbek authorities, the Soviet government was known for allocating huge sums to the country-wide promotion of voluntary blood donations. According to the head of the blood donor promotion team, Mashhura Muhamedova, All the universities in Tashkent have been divided between the citys five biggest blood transfusion centres. In the last campaign, the most donations came from students at the Paediatrics Institute 350 people. The University of World Languages and the Institute for Chemical Technology supplied 300 students each and IT University provided 250 people, said Muhamedova. She said that each student volunteer donates 420 grammes of blood and receives two kilogrammes of sugar in recompense. The students also have to undergo blood tests to detect infections such as HIV-AIDS and hepatitis C and B. But the giving is not as voluntary as the authorities suggest. According to a second-year student from the IT University, just before the summer holiday all students from his group - with one exception were ordered to give blood. He said that they did not even get what they were promised, Last year we were given two kilos of sugar; this year only one kilo. I dont know why. Instead of having two days off we had to attend lectures and take notes with a bandage on one arm. Some felt unwell. Some teachers point out that many students come from the countryside where living standards are worse than in the city. They tend to have a weakened immune system and suffer from anaemia due to their poor diet. These students were also forced to give blood although they are supposed to be excluded. An anonymous teacher from the same university confirmed that some students fainted after giving blood. She said many students come from poor families and do not eat well. Medical professionals say that the best way to tackle the problem is to provide financial incentives for giving blood. The head of a blood transfusion centre in Tashkent, who refused to give her name, said that although some donors are paid, a lack of funds means she turns many away. Donors can get 25 dollars for giving 280 millilitres of concentrated thrombocyctes or 30 dollars for plasma. Other measures that the government is partially implementing include media campaigns to raise awareness of voluntary blood donations and publicising the profiles of individuals who regularly give blood. Yana Sergeeva is the pseudonym of a journalist in Uzbekistan. **** www.iwpr.net ******************************************************************** 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. 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