In the last few years, Kyrgyzstan has faced a dramatic tuberculosis epidemic. In spite of measures taken by the Kyrgyz government, the number of people infected with tuberculosis is increasing day by day. The government adopted a National Tuberculosis Program in 1995, Tuberculosis II in 2001, and a Law on Tuberculosis in 1998. The poor economic conditions, growing poverty, and low living standards of the majority of the population have contributed to causing the rapid spread of this disease.
According to the Ministry of Health Care, in 1999 the number of infected people with tuberculosis per 100,000 people was 114,4; in 2000 it was 121,8. If in 1999 the registered number of infected children under the age of 14 was 824, in 2000 the number increased up to 998.
The Kyrgyz Minister of Health Care Tilekbek Meymanaliev recently said that the outbreak of tuberculosis is closely related to rising poverty. In Kyrgyzstan, a country living with poverty and unemployment, people can neither prevent nor afford proper treatment of the disease. According to Meymanaliev, apart from the poor economic situation, growing poverty and lack of nutritious food, and the deteriorating conditions in overcrowded prisons have greatly contributed to the outbreak of tuberculosis in recent years.
Prisoners live in severe conditions and they are not fed properly. Prison authorities lack resources to fight and prevent the outbreak of tuberculosis in prisons. As the Times of Central Asia reports, prisoners constituted 30 percent of 7000 registered cases of new infections in 2000. Meymanaliev said that the Ministry of Health Care has adopted a joint program together with the Ministry of Internal Affairs to deal with infected convicts after their release. However, the program has not been very effective. In spite of all efforts, more than half of the infected convicts did not visit medical institutions for treatment after their release. The prison population continues to be a threatening source of tuberculosis.
The Kyrgyz government and the Ministry of Health Care have been addressing this issue seriously. A National Tuberculosis Program was adopted in 1995. As Meymanaliev mentioned, foreign aid and grants have been used under the program and several international donor organizations have been assisting in the struggle against tuberculosis. Medical drugs and equipment were bought for $2 million given by the World Bank and thousands of new patients have received free treatment. Last year, a new program called Tuberculosis II was adopted to continue and further the efforts against this infectious disease. The program is supported by the German government, which gave 5 million German Marks for its implementation.
Kyrgyzstan also passed a law on the Protection of the Population from Tuberculosis. The law defines the rights and responsibilities of each citizen, health worker and the government in the struggle against tuberculosis. The law states that “people infected with tuberculosis, who refuse to get treatment and follow proper sanitary-hygienic norms, should be forcefully hospitalized by court decision. Those infected people, who threaten to deliberately spread the infection, must bear administrative and criminal responsibility in accordance with legislation of the Kyrgyz Republic.” However, the law is not bringing about the desired results. This is partly due to the absence of a special anti-tuberculosis medical institution of a closed type, where patients could get full treatment. The treatment in the hospitals is on voluntary basis and patients can leave the hospital whenever they want. Forceful treatment can be imposed only through the court. The court decides whether the patient should be forced to get treatment or not, after having considered the case appealed by the patient’s relatives. However, relatives do not normally appeal to the court and in some cases they even try to hide the patient from health workers.
Although the poor economic situation, poverty and insufficient nutrition are the main causes of tuberculosis, its spread has been in recent years highly exacerbated also by deteriorating conditions in prisons. Kyrgyzstan is under-resourced to deal with the problem alone. In spite of the lack of funds, the government has managed to channel some foreign aid and it has been taking measures to prevent the further spread of this infectious disease. However, as experience has shown so far, in order for the government’s attempts to succeed, there should be some joint efforts from the part of the people as well.Gulzina Karim kyzy