WELCOME TO IWPR'S REPORTING CENTRAL ASIA, No. 602, February 10, 2010 UZBEKISTAN: ALARM AT RISE IN CANCER CASES Medical staff complain of shortage of specialist care, medicines and hospital beds. By Bakhtior Rasulov in Tashkent
KYRGYZ REWRITE LEADERSHIP SUCCESSION RULES Parliament devises compromise to ease passage of constitutional amendments. Pavel Dyatlenko in Bishkek KYRGYZSTAN: CONCERN OVER JOURNALISTS SAFETY Violent attacks prompt media community to act. By Asyl Osmonalieva in Bishkek **** NEW ************************************************************************************ IWPR PROJECT REVIEW: OCTOBER/NOVEMBER 09 http://iwpr.net/EN-oth-f-359098 VIDEOS OF THE 2009 KURT SCHORK AWARDS CEREMONY http://iwpr.net/kurtschork09 VACANCIES AVAILABLE http://iwpr.net/vacancies CENTRAL ASIA HUMAN RIGHTS REPORTING PROJECT http://iwpr.net/centralasiahumanrights **** IWPR RESOURCES ****************************************************************** CENTRAL ASIA RADIO: http://iwpr.net/centralasiaradio CENTRAL ASIA PROGRAMME HOME: http://iwpr.net/centralasia IWPR COMMENT: http://iwpr.net/comment SAHAR JOURNALISTS ASSISTANCE FUND: http://iwpr.net/sahar BECOME A FAN OF IWPR ON FACEBOOK http://facebook.com/InstituteforWarandPeaceReporting FOLLOW US ON TWITTER http://twitter.com/iwpr **** www.iwpr.net ******************************************************************** REPORTING CENTRAL ASIA RSS: http://www.iwpr.net/en/rca/rss.xml RECEIVE FROM IWPR: Readers are urged to subscribe to IWPR's full range of free electronic publications at: http://iwpr.net/subscribe GIVE TO IWPR: IWPR is wholly dependent upon grants and donations. For more information about how you can support IWPR go to: http://iwpr.net/donate **** www.iwpr.net ******************************************************************** UZBEKISTAN: ALARM AT RISE IN CANCER CASES Medical staff complain of shortage of specialist care, medicines and hospital beds. By Bakhtior Rasulov in Tashkent Doctors in Uzbekistan say cancer treatment facilities are failing, with poor provision for early diagnosis, inadequate hospital facilities, and medicines that are unobtainable in the state healthcare system and unaffordable on the open market. The warnings come at a time when a leaked internal report says the incidence of cancer is rising dramatically in this Central Asian state. The report, based on a study conducted last year, showed a leap in the number of people with cancer in the first half of 2009, 17.9 per cent more than in the same period of 2008. Over the five years from 2003 to 2008, the incidence of cancer increased from around 14 cases to 25 per 100,000 of the population. The study drew comparisons with other countries around the world, where it said the annual growth rate ranged between six and 8.5 per cent. The Uzbek health ministry says that in 2009, there were 90,000 people with cancer, about a third of one per cent of the population. The internal report was based on data collected by doctors from all over Uzbekistan. The highest rates of cancer were discovered in Fergana, Bukhara and Khorezm regions. Khorezm lies close to the Aral Sea, which has dried up over several decades, causing harmful dust in the air and other environmental problems. The study made a link between the Aral disaster and cancer rates, although it did not place the seas location Karakalpakstan among the regions with the highest incidence, while Fergana, one of the top three, is a long way away from the sea. A more general cause was, said the report, the use of harmful pesticides on cotton plantations, where much of the work is done by hand by adults and often children. A number of experts expressed concern that almost nothing was being done to prevent cancer or detect the early signs among children, young women, and people who work with chemicals or other hazardous materials. Uzbekistans state health system appears to be in no shape to cope with such a high, and rising, incidence of the disease One cancer specialist in the capital Tashkent, who was involved in the study, summed up what he saw as the main problems, a lack of highly-trained experts and inadequate state funding for cancer centres. Nationwide, this doctor said, There are only 1,104 beds for cancer patients. People have to wait their turn for months on end. According to a haematologist also from Tashkent, The majority of cancer sufferers are admitted in the final stages of the disease. They cannot be treated, and were simply forced to watch them die. A doctor involved in gathering data for the report said Uzbekistan should have at 30 large cancer clinics instead of the current 19, and also hospices where the terminally ill could receive qualified care. In addition to the inadequate number of specialised medical centres, many forms of treatment are in short supply. A health ministry adviser said the lack of radiotherapy and other treatment was causing a lot of deaths. The cost of medicines used to treat cancer or alleviate the symptoms is a focus of many complaints. The Tashkent cancer specialist said the health ministry had refused a request to buy in 1,000 bottles of an advanced drug known as MabThera to be dispensed by state doctors. At 6,000 US dollars a bottle on the open market, the drug was beyond the reach of people who might considering buying it themselves, since the average wage in Uzbekistan is between 70 and 80 dollars a month. Doctors say that the combined treatment including modern chemotherapy and new drugs helps one recover, said a 39-year-old woman who has stomach cancer. But such drugs arent available here and I dont have money to buy them abroad. Officials say the problems are exaggerated. Bakhtior Niozmatov, first deputy prime minister of Uzbekistan and the countrys chief doctor insists that state funding is adequate and the system is getting better all the time, with drugs and treatment methods available. Every year, several million soms [upwards of one million US dollars] is allocated to purchase of drugs for those who need cancer treatment, he said. A wide-ranging programme is under way to prevent serious diseases, including cancers. Last year a haematological stem cell transfer centre opened now its become much easier to treat serious forms of leukaemia. That will be little consolation to one woman, who told how she had brought her son to Tashkent the hundreds of kilometres from Navoi to Tashkent in hope he would get better treatment. For the last six months, we havent been able to get the medicines we need even though we have an official prescription from the cancer centre, she said. They say there arent any drugs. But the drugs they do have get divided up among those whore able to pay over the odds, and they dont have to wait in the queue. Our 27-year-old son is simply melting away before our eyes, and theres nothing we can do to save him. Bakhtior Rasulov is the pseudonym of a journalist in Uzbekistan. KYRGYZ REWRITE LEADERSHIP SUCCESSION RULES Parliament devises compromise to ease passage of constitutional amendments. Pavel Dyatlenko in Bishkek Kyrgyzstans parliament has been forced to rethink plans to change the rules on who steps in if the head of state cannot continue in office. Deputies were forced to reconsider the reform, which was proposed by President Kurmanbek Bakiev, after the countrys constitutional court rejected it on a technicality. At the moment, should the president step down unexpectedly, for example due to illness, the constitution says the speaker of parliament can fill in as head of state until an election is held. If for some reason the speaker cannot do it, the prime minister is next in line. President Bakiev wanted to change this to a system where the choice of interim replacement would fall to the Presidential Institution, a new administrative structure which he unveiled late last year, but which has yet to come into being. Doing so would have reduced the certainty that the temporary president was in some way a representative of the public, like the speaker or prime minister, since the Presidential Institution made up of non-elected executives might make some other choice. The bill, which consists of a package of changes to the constitution to bring it into line with governance reforms announced by the president last October. Tasked with checking the legality of the amendments, the constitutional court ruled on the emergency appointment issue on January 21, rejecting it on the grounds that the Presidential Institution is an advisory rather than a decision-making body, and consequently lacks the authority to pick a temporary head of state. Court chairwoman Svetlana Sydykova said this provision needed revision, and sent the bill back to parliament. This created a dilemma for a legislature that is dominated by the presidents party Ak Jol, as members now had to get their leaders reform package through while at the same time accommodating the courts objections. Ak Jol members came up with a new arrangement designed to kill both birds with one stone. The parliamentary committee tasked with redrafting the bill produced a proposal to that would, as Bakiev wants, abolish the automatic delegation of power to the speaker or premier. Instead, a new entity called the State Council will be set up, and it will be its job to appoint an interim president. The details have yet to be worked out, and separate legislation will be needed to constitute the new body. It is known, though, that the State Council will include the prime minister, the speaker as well as members of the Presidential Institution. In remarks made on February 2, opposition parliamentarian Roza Otunbaeva indicated that the latter were likely to include the head of the presidents office, his communications chief, the State Adviser for Defence, Security and Law and Order and the director of the Central Agency for Development, Investment and Innovation. These last two posts were created as part of Bakievs governance reforms and give the Presidential Institution strategic oversight of security and economic policy and planning. Placing such an important decision in the hands of a narrow group of unelected officials would be a major change to the constitutional system. The Presidential Institution includes some elected officials like the president himself, who acts as its chairman, and the speaker of parliament. The cabinet is represented by the prime minister and foreign minister, but the rest of the Presidential Institutions members are directly appointed by the head of state. The net result is to place more power in the presidents hands at the expense of the prime minister and his cabinet. Under his control, the Presidential Institution has wide-ranging powers, including some that previously belonged to the government, for example foreign policy and control over security and economic policymaking. In turbulent times, it is important to have clear legal procedures in place for the transfer of power, so that this happens promptly and effectively. The current system, where the leadership role temporarily goes to one of two officials, is simple and logical and has stood the test of time. It was put to the test during the Tulip Revolution of March 2005, when mounting popular unrest put an end to the rule of the then president Askar Akaev. He left the country, his prime minister resigned, and Kyrgyzstan seemed to be facing a parliamentary vacuum as the old legislatures mandate was expiring and the new one had yet to form. At that critical moment, the speaker of the old parliament was able to step in as head of state for less than 24 hours and facilitate the appointment of a prime minister. The latter post went to Bakiev, who ex officio assumed the role of interim president until he was elected to the job in July 2005. This experience, of a system that worked under stress, is one that should be remembered when the terms of the new constitutional arrangement are being worked out. The next stage now is for President Bakiev to approve the proposed State Council, after which the entire package of changes can be put to a vote in parliament. Once that happens, the bill will get its second hearing in three months time, after which it could become law. Pavel Dyatlenko is an expert at the Polis Asia Centre, a think-tank in Bishkek. KYRGYZSTAN: CONCERN OVER JOURNALISTS SAFETY Violent attacks prompt media community to act. By Asyl Osmonalieva in Bishkek A wave of brutal attacks on Kyrgyz journalists has sparked alarm among journalists and local and international media watchdogs Media representatives have also expressed concern about what they say is the Kyrgyz authorities failure to investigate crimes against journalists and to bring those responsible to account. According to the Association of Journalists in Kyrgyzstan, at least 58 journalists from Kyrgyzstan have been attacked over the last four years. The Kyrgyz interior ministry, meanwhile, says that between 2005 and 2009, there were 28 reported cases of attacks on journalists, 23 of which led to criminal cases. In the other five cases it was decided not to prosecute. The latest attack on a journalist from Kyrgyzstan involved Gennady Pavlyuk, who died in hospital on December 22 after he was thrown out of a tall building with his hands tied behind his back. Pavlyuk was on a visit to Almaty, the financial capital of neighbouring Kazakstan. Kazak police said they were treating the case as murder. The Kazak TV station KTK has reported that the officers from the Kyrgyz National Security Service had a meeting with Pavlyuk in the Almaty apartment in Almaty from which later he fell to his death. The press office of the Kyrgyz security service denied the allegations, dismissing them as disinformation. Pavlyuks supporters and campaigners have linked his death to his work in Kyrgyzstan, where he was setting up a website. The leader of opposition party Ata-Meken, Omurbek Tekebaev, told Radio Free Europe/Radio Liberty that he and Pavlyuk had met shortly before the latters death to discuss plans for the website project. Tekebaev insisted that atameken.kg was to be an independent website, not an official party mouthpiece as some media have reported, the RFE/RL website said. "I think this is a politically motivated crime," he was quoted as saying. "It's yet another attack in order to restrict freedom of speech in Kyrgyzstan." Tekebaev also said Pavlyuk had recently published several articles and interviews in which he criticised the Kyrgyz authorities, explaining the real meaning of their newly initiated reforms". Akmat Alagushev from the Media Representative Institute in Kyrgyzstan, a non-government group, said the countrys law-enforcement agencies needed to solve crimes involving attacks on journalists. Freedom of expression in this country will depend on how crimes are investigated and how those responsible are punished, he said, adding that impunity would hinder any improvement in journalists safety. The Committee to Protect Journalists, a New York-based watchdog group, has taken up the Pavlyuk case. Its Europe and Central Asia programme coordinator, Nina Ognianova, said in a statement, This investigation will not succeed without bilateral cooperation. We call on Kazak investigators to coordinate efforts with their Kyrgyz counterparts, and we urge the government of Kyrgyzstan to assist to the fullest extent. Asked to comment on the number of attacks on Kyrgyz journalists, presidential spokesman Ilim Karypbekov told IWPR the authorities support freedom of expression. We are building a state on principles of democracy and freedom of expression, he said. We have an interest in seeing that the safety of journalists is assured and that all attacks on representatives of the media are resolved. Karypbekov said all attacks on journalists were being dealt with by law enforcement agencies, and the presidents communications department was watching how this was being handled. We try to inform the public about the progress of investigations and, at the same time, we urge all interested parties to join efforts to solve the problem, he said. We await a response from the media community and we are hoping above all for constructive proposals and solutions, instead of accusations directed at the authorities. The death of Pavlyuk was the third incident involving journalists working in Kyrgyzstan in December alone. Alexander Yevgrafov, a correspondent for Russia's Rosbalt news agency in Bishkek, was beaten up in the Kyrgyz capital earlier in the month. Days later, an envelope carrying a threatening message and a bullet casing from a Kalashnikov was sent to the Osh Shami newspaper in the southern Kyrgyz city of Osh. Others have been murdered. Freelance journalists Alisher Saipov and Almaz Tashiev were killed in 2007 and 2009, respectively. Saipov, a prominent journalist working in Osh, was shot dead in the street by an unidentified gunman. An ethnic Uzbek, he was the founder of an Uzbek-language newspaper called Siyosat known for its critical coverage of human rights in neighbouring Uzbekistan. Tashiev, a freelance journalist who worked for a number of news organisations including the Kyrgyz-language newspaper Agym, was beaten by a group of policemen when he went to a police station to obtain a new passport. No one was brought to justice for these murders. Other recent attacks include those on Syrgak Abdyldaev, a correspondent for the Reporter newspaper, the victim of a multiple stabbing in March 2009; Kayrat Birimkulov, a reporter for the state broadcaster, who was assaulted; NBT television journalist Gulmira Umetalieva, who was injured and had her camera broken; and political commentator Alexander Knyazev, who was mugged and had his notebook and money stolen. At least six journalists have left the country since 2005 to seek political asylum abroad because they feared for their lives. According to the head of the Association of Journalists, Marat Tokoev, the most worrying trend is the brutal character of the attacks. I cant say that the number of attacks is on the increase but what is definitely changing is the manner in which they are done... Attacks are becoming more brutal and cynical, and as a result journalists end up in hospital or even die, he said. Tokoev said that his organisation was working with experts from the Organisation for Security and Cooperation in Europe, OSCE, and with lawyers, police and journalists to uncover the real number of attacks and find out whether they were connected to the victims work. The situation prompted the OSCE centre in Bishkek to make journalists safety one of its priorities for 2010. In an interview with IWPR, Lilian Darii, deputy head of the OSCE centre in Bishkek, said the organisation aims to contribute to an environment in which journalists can perform their crucial work responsibly and safely, without fear of reprisal or intimidation. She said the OSCE mission planned to provide legal assistance to journalists and to support public debate on the issue. The OSCE therefore renews its calls on the Kyrgyz government to address the current situation, which the OSCE representative for the media has described as a crisis, said Darii. Tokoev welcomed the OSCE statement making the safety of journalists a priority, but said the problem could only be solved if all the parties involved joined forces. Whats needed to withstand the pressure and the threat to journalists is to unite and work together, he said. Asyl Osmonalieva is an IWPR-trained journalist in Kyrgyzstan. This article was produced under IWPRs Building Central Asian Human Rights Protection & Education Through the Media programme, funded by the European Commission. The contents of this article are the sole responsibility of IWPR and can in no way be taken to reflect the views of the European Union. **** 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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