Wednesday, 24 April 2002

INFECTIOUS DISEASES IN KAZAKHSTAN GIVE CAUSE FOR CONCERN

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By Marat Yermukanov, Kazakhstan (4/24/2002 issue of the CACI Analyst)

Some years ago “cholera” was used merely as a swearword in Kazakhstan. Hardly anyone at the time gave much thought to the real meaning of the word at the time. The true epidemic proportions of cholera became known to local people only last year when to the awe of the self-assured medical officials, 29 residents of the Mangystau region contracted the disease within a few days.

Some years ago “cholera” was used merely as a swearword in Kazakhstan. Hardly anyone at the time gave much thought to the real meaning of the word at the time. The true epidemic proportions of cholera became known to local people only last year when to the awe of the self-assured medical officials, 29 residents of the Mangystau region contracted the disease within a few days. The same year, 15 cases of anthrax were registered in southern Kazakhstan. Foot-and-mouth diseases have also been frequently reported from southern parts of the country last year.

What worries the general public more is not the threatening spread of the disease, but the obvious inability of the medical institutions to combat the diseases effectively. Last year, for example, the government allocated 15 million tenge (an equivalent of US$100,000) to prevent the spread of epidemic diseases. The sum is, of course, inadequate to carry out any serious project or to provide medical centers with antibiotics and modern medicine. But the worst thing, as was revealed at the international conference on prevention of the contagious diseases in Kazakhstan, held on April 15 in Almaty, is that the health-care system of the country is still lagging behind the others.

According to the statistics of the National Heath Department, 2 million cases of infectious diseases were reported last year. What is more alarming, 70% of the affected are children under the age of 15. Every year, 22,000 additional cases of tuberculosis are registered in the country. Last year, about 1,000 HIV-infected people received medical treatment, while more than 500 of the patients had to be hospitalized.

Some speakers at the conference pointed out the problems which reduce the results of measures taken by medical institutions of Kazakhstan to combat contagious diseases. According to the director of the Center for Disease Control in Central Asia Michael Favoroff, Kazakhstan should concentrate more on the prevention of the diseases, and not on the treatment of them. Actually, the health-care system of Kazakhstan has long declared the prevention of disease as a priority, but in reality nothing has been done to implement this strategy which would achieve much more considerable results at lower cost. Instead, as it was revealed at the conference by the general director of the National Center for Promotion of Healthy Way of Life Aykan Akanow, the government is still spending money on the costly treatment of the diseases.

The spread of such diseases as AIDS and tuberculosis are understandably attributed to the low standard of living conditions, poverty and drug abuse. It is officially admitted that almost every one of the overcrowded prisons in Kazakhstan is infested with tuberculosis. The recent amnesty of people serving prison terms for minor crimes added to the problem. The continuing migration of unemployed people from rural areas into the cities also contributes to the spread of the disease. For many of these people, even the cheapest medicines are not affordable. Added to this, the low quality of drinking water in most regions, particularly in the South, compounds the problem.

Medical workers in Kazakhstan are among the lowest paid. Many see no other ways of filling their stomach than taking bribes. That erodes public confidence in medical workers. Many people in case of illness therefore turn to quack doctors with doubtful reputation. Not long ago, the government had to issue a decree to stop the practice of quackery. But this warning fell on deaf ears of the “folk healers”.

Since the beginning if the economic reform, the health system of the country underwent several stages of reforming, yet these efforts turned to be futile for the lack of a clear concept. It was also noted at the conference, that Kazakhstan has a greater role to play serving as a positive example for other Central Asian countries in combating infectious diseases. To be up to that mark health-care system of Kazakhstan should adopt new, internationally recognized approaches.

Marat Yermukanov, Kazakhstan
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