HIV/Aids in Kyrgyzstan
Welcome to the first of what will hopefully be a series of New Eurasia country blogs universal posts. The idea is that all of the individual blogs will post on a particular topic – in this case on the HIV/AIDS situation – on the same day, collectively providing an overview of the given issue in the region. If you have ideas for a topic you’d like to see covered as a universal post, drop the New Eurasia team a line.
Thinking about HIV/AIDS in Kyrgyzstan, several things become very clear very quickly: so far, registered cases of HIV/AIDs have been relatively low, but numbers are rapidly increasing; secondly, IV drug use, especially in the south and in prisons, is the major cause of infection, but there are an increasing proportion of people who have been infected by sexual contact, and the growth in the number of commercial sex workers is contributing to this rise; thirdly, prevention programmes are being hindered by a basic lack of funding, as well as more emotive and problematic issues brought on by a perceived clash of traditional morals and values and the unavoidably explicit nature of much of the information being given out. It is this final point that is most worrying, since HIV – and other STDs – will not wait for societal attitudes to change.
This is not to say, however, that simply providing more information is the answer, as a recent article in the Vechernii Bishkek highlighted:
Several respondents noted that existing legislative loopholes must be closed, including those that permit officials to use grants for their own interests. NGOs should be open and transparent. It is vital to make information on the distribution of financial resources at all levels, from the national to target groups, accessible. After all, AIDS doesn’t sleep, but nor do corruptioneers.
What this means in practice is that efforts on paper to curb the spread of HIV and STDs, including the government’s 5-year (2000 – 2005) State Programme on the Prevention of AIDS and Intravenously and Sexually Transmitted Infections”, have not translated well into practice, despite the best and often incredibly impressive efforts of many individuals and NGOs.
To take a step back, let’s start with some basic facts and figures:
Not looking good, especially when one considers there is still a significant lack of accurate information available about sexual matters in general, and many people still feel extremely uncomfortable discussing such things – even when it is, literally, a matter of life and death.
The so-called Healthy Lifestyles Controversy surrounding a sex education book, written by head of the National AIDS Centre, Boris Shapiro, showed the degree of influence the country’s “moral majority” wielded when their protests that the book “disgraced ethnic Kyrgyz” in May 2003 (three years after the book’s publication) resulted in the Ministry of Education and Culture withdrawing the book from all schools. Aside from the nastily nationalist and xenophobic tone of some of the articles published in the Kyrgyz-language newspaper Agym, opponents of the book called for strong national ideology to replace teaching “shameless things such as how to put on a condom, how to avoid pregnancy, how to have sex”, arguing that the approach in the book does “not lead to good morals”. The following year, 2004, the same group tried to sue one of the books authors for US $ 100,000 in damages.
As usual with the moral majority, they don’t necessarily represent the majority view, they just make the most noise. To put so-called “morals” above people’s health is downright criminal, but then I would say that as a Westerner with no shame… Even so, many teachers and parents in Kyrgyzstan are in favour of the book, not least as parents often feel unable to talk to their children about sex but they are nonetheless concerned that young people need to receive accurate – and timely - information.
Fortunately, even with the book’s official withdrawal, sources of information and education have not stopped working, even if it means taking an up-front approach that can initially feel a little embarrassing all round, as Bryan Schubert found out at a sex education seminar - he’s been based at the NGO Rainbow in Osh since December when he swore in as a Peace Corps volunteer having completed his training. His blog follows his experiences training and with Rainbow, and currently has a nice set of photos of his colleagues and Rainbow’s office.
One of the most effective ways of educating young people about both HIV/AIDS and drugs has been peer-to-peer approaches, as John Sparrow of the British Red Cross describes. Actively involving young people and utilising informal networks helps to avoid the awkwardness of an inter-generational exchange and provides a far freer environment for information to be distributed using workshops, seminars and events in informal settings – for example the Youth to Youth about HIV/AIDS. The internet is also a valuable source of information for those with access to it, with sites like Stop SPID including a FAQ page and programmes such as the Joint Programme on Expanded Response to HIV/AIDS in the Kyrgyz Republic producing a wide range of materials and leaflets. Other projects include the joint UNICEF-Kyrgyz Soccer Federation initiative started in 2004, as RFE/RL reported.
An arguably bigger obstacle to combating the spread of HIV/AIDS in the republic is the role of narcotics and the narcobusiness. Kyrgyzstan is a transit zone for narcotics from Afghanistan, and there are a significant number of local users – up to 2% of the general population and over 50% of the prison population - being IV users according to some estimates, with the situation being exacerbated by the easy availability of heroin and poor conditions in prisons. In such circumstances, sex education is only half of the battle, as evidenced by the approach many NGOs take, targeting drug addicts, many of whom see little point in getting tested just to become a statistic: Kyrgyzstan may have started to address the issue of rapidly rising HIV infection rates, but providing sufficient medical care, either maintenance or palliative, is an issue that is looming ever larger on the horizon and with no immediate answer in sight.
A further complication in tackling the spread of HIV/AIDS is prostitution. There is a perception that the number of commercial sex workers (CSWs) in Bishkek has increased over the last few years, possibly in connection with the presence of the US airbase, and may be as high as 3,500 now. Many of these women have been forced into selling sex as the only way they can find to earn an income as job prospects remain bleak and the absence of documents make it impossible to work officially. Inevitably, many of these women are also drug addicts, further increasing the danger to both their own health and that of their clients, who may then pass infections on to their wives or other sexual partners.
All in all, the situation remains serious, and it is vital that the work of individual NGOs and projects is backed up on a governmental level to ensure everyone is as informed as possible about the risks of HIV/AIDS. Talk about morality is empty when the health of the country is at stake. One is left to hope that more people will start to echo the words of pop star Maksat Begaliev, who performed at a concert to mark World AIDS Day last December in Bishkek: “We have to live, it is our city, it is our country, and it is our world, we have to stop AIDS.”
Further information:
on February 24th, 2006 at 1:56 pm
“but numbers are rapidly increasing;”
Well of course it starts from low levels. But it is indeed increasing rapidly, and therefore it’s maybe time to bust a little taboo…
Dunno if it was noticed, but the title of the Vechernii Bishkek article (first link above) is:
“?????????? ??????? ????????: ?? ??????? ?? ?????????? ????? ??????? ? ??????????? ???????? ?????????.”
[”Priorities have to shift from promoting safe sex to the rebirth of spiritual values.”]
Yes.
See, much is the result of the perverted form of ‘westernization’ that thoroughly screwed up Kyrgyz society along with IFI-promoted jungle capitalism over the last decade; the de facto promotion of prostitution, drugs, alcohol, homosexualism and sex tourism in the name of ‘freedom’ and ‘secularism’. Vot – rezultat!
I’m not into primal West-bashing but a large part of the guilt lays with the expat community and the behavior of its sleazy fringe. And young, naïve do-gooders who don’t realize what they’re doing.
Scuzi but that is the reality!
on February 24th, 2006 at 3:55 pm
Thanks for your response Ataman Rakin.
You have a point - but only to a certain extent, and laying the blame with the expat community or with the West without considering other factors is similarly naive. Sure, there are certain groups that have contributed to the rise in the number of commercial sex workers, as is unfortunately the case is much of the developing world and which undoubtedly does contribute to the spread of HIV and other STDs. But to say that that is “the reality” is very one-sided.
On the issue of narcotics, on can only partially blame the West insofar as it creates a market. But you must also consider the socio-economic situation many of these people find themselves in that leads them to start using.
Similarly, I would argue strongly that the West has not “promoted” homosexuality; homosexuals and transgender people have always been present in every society - what is different now is that an entirely normal and natural phenomenon has at least started to enter the public sphere. Much of the backlash about homosexuality is caused by ignorance and fear; it may not comply with “traditional values”, which is unfortunately sometimes a term for rigid intolerance of difference, but that doesn’t mean that seeking to repress homosexuality will work - it hasn’t done yet!
The title of the Vecherka article was noticed; but the “spiritual values” referred to (at least, as I understood it) was more to do with trying to eliminate corruption than moving towards more general “moral” standards and values. I entirely agree that encouraging good “spiritual values” can only be a positive development, but not if it is at the cost of openness and education. Denying a problem, be it drug use/abuse, homosexuality or HIV infection does not make it go away - and that is also a reality.
I’m afraid that despite your claim not to wish to West-bash, your comments do make me think you are that way inclined, without looking at some of the damage that so-called “traditional” values do - keeping women ignorant of their sexuality and treating it as though it belongs to their husbands - often resulting in domestic violence or rape, the turning a blind eye to men taking mistresses or extra-marital sex, allowing the practice of bride kidnapping (which is consensual only part of the time at best) to continue and encouraging absolutist, closed and intolerant attitudes that seek to keep people ignorant.
HIV/AIDS affects us ALL and failing to address this issue will make things far, far worse. Trying to encourage spiritual values undeniably has a role to play, but humans are inherently prone to making mistakes. Thus education on prevention and risk reduction is also a vital part of tackling this issue without resorting to overt and narrow-minded moral judgements.
Peace, CXW
on February 24th, 2006 at 5:44 pm
Thank you for the feedback CWX.
I am perfectly aware that local attitudes are fundamental as well, in particular a widespread culture of masculinity that revolves around a) heavy drinking and b) treating women like shit (which of course also includes bragging with lots of prostitutes etc.).
The reasons why I lash out at ‘the West’ and the expats are two-fold:
1) the notorious, conspicious behavior of a certain portion of the expats (every reader who is from or has spent any substanial amount of time in Bishkek knows what I mean) has definitely *encouraged* local vices and the sort of attitudes outlined above, for Westerners were long, and naively so, considered as ‘role models’ by many locals;
2) the Soviet collapse was followed by an invasion of all sorts of Western/international organisations and -consults who came to tell the Kyrgyz how to live and – often with the best intentions – started to promote all sorts of values and concepts to which these societies indeed paid lip service to (if only for the $$$ and jobs attached) but that could as well come from another planet/that theses societies can basically not handle; the result is more corruption, uprooting/dislocation, confusion and, thus, more vulnerability for all sorts of vices and abuses.
“homosexuals and transgender people have always been present in every society - what is different now is that an entirely normal and natural phenomenon has at least started to enter the public sphere.”
That is always existed in most societies or civilizations is true. I’ll take your point that it is ‘an entirely normal and natural phenomenon’ with irony — as it was intended, I suppose?
on February 24th, 2006 at 6:08 pm
I broadly agree with your first two points, and thank you for taking the time to clarify your argument and contribute to the discussion.
On the point of homosexuality and transgender being entirely normal and natural, there was absolutely no irony intended - all we can do is agree to differ on this one.
Pax, CXW
on February 25th, 2006 at 3:06 pm
“all we can do is agree to differ on this one.”
Guess that’s what we have to do, my friend.
Honestly, reg. transsexualism of whatever it is called I can not see anything else than depravity, period.
As for homosexuality, I accept it as a given in society that has always been there and can be accommodated
I have this question though: everything in nature has a function, otherwise it does no exists; as such, sexuality, being part of the human nature, has one too, i.e. reproduction and transfering ones genes (at the end of the day, that’s what it comes to); yet homosexuality does not serves that natural function; so: can it be natural?
We als have to admit that homosexual*ism* (i.e. not homosexuality by itself but the mass hyping and promotion of homo- or bisexual lifestyles by media, pop culture, do-gooders etc.) is typical for highly developed societies that have entered an irreversible phase of decline (like Europe and Japan today).
on February 25th, 2006 at 5:32 pm
We are more than our biological functionality is my reply to the question of human sexuality - various scientists have argued that female orgasm has no functional purpose; does this mean it is unnatural? What about masturbation? Surely following your logic, this can also be seen as “unnatural” as it does not directly further the goal of reproduction? Human sexuality is far more complex than this sort of biological “logic”, particularly once emotion and the human capacity for pleasure are brought into the equation. Is it natural - yes, undoubtedly.
You may not see transgender as anything more than “depravity”, but this is more a reflection of your world view than on any transgender people, in the same way my classification of people who are strongly religious as bigots is a reflection of mine. Since neither of us is likely to change our beliefs, the ONLY thing to do is to agree to differ, rather than pointlessly come into conflict.
I hope that regardless of your personal views you can at least see that compassion toward difference, rather than condemnation, is the only way societies are going to make progress; you cannot expect others to respect your opinion and values if you do not respect theirs - this is something many fundamentalists, be they religious, political or any other sort, have not realised. In their determination to impose their views on the rest of the world, these few zealots are in danger of dragging the rest of us down with them, which would be tragic.
I do not believe “highly developed societies that have entered an irreversible decline” have ever promoted so-called “alternative” lifestyles - unless this is classed as actually daring to acknowledge their existence, presence and place in society. It is also very questionable whether Europe and Japan have entered “irrevocable decline” - who is setting the criteria? Granted, values and social structures are being challenged as never before, but change is not the same as decline and is necessary for progress, both individually and societally.
I do not feel that this debate can go any further constructively; you have stated your case eloquently and I can agree with you on certain points and vice versa, on others we will simply have to respectfully agree to differ.
Rakhmat, Pax, CXW
on February 27th, 2006 at 11:46 pm
BISHKEK, 27 February (IRIN) - A film highlighting the plight of people living with HIV/AIDS in Kyrgyzstan is becoming increasingly popular in major urban areas of the former Soviet republic, where the virus is on the rise.
http://www.alertnet.org/thenews/newsdesk/IRIN/d7d1a4d2ef9feb3e54cc88cec5d78d02.htm
on March 1st, 2006 at 5:29 pm
I’d like to see this film and especially the role models and its core message. Perhaps parts of it are/will be online?
CWX:
“We are more than our biological functionality is my reply to the question of human sexuality”
Let’s put it this way: we are able to *sublimate* it in the form of love, romantics, pleasure etc. The latter, in turn, have been completely commercialised over the last couple of decades leading to depravity and decadence and the destruction of the family as society’s core component — and, thus, the unraveling of society itself.
“You may not see transgender as anything more than “depravity”, but this is more a reflection of your world view”
Look, my friend, it’s pointles too go for a yes/no/yes/no discussion but you can not deny that the whole transgender thing is rooted in a mental crisis of the afflicted individuals — a crisis whose root causes can be hormonal deficiencies or social, but a crisis in any case.
“I hope that regardless of your personal views you can at least see that compassion toward difference, rather than condemnation, is the only way societies are going to make progress”
I do not condemn, I’m just being realistic.
on June 11th, 2006 at 12:33 am
I think seriously you people are great ,but westernization will corrupt your society more and more.To be democratic always brings a price and this feee dom of choice has it’s responsibilties but seldom we do take the these responsibilities seriously.I do have my sweet heart in Kyrgyzstan and she is a real example of women in Kyrgyzstan ,her liberity is evident but more importantly she has refused to be stero typed in any way,shape or form.Thanks
on May 2nd, 2007 at 4:32 am
The HIV epidemic in Kgz may be largely hidden now, smoldering underground, but it can flare up at any time. As everyone knows, the only way to reduce its eventual impact is to implement a serious treatment and prevention program now. What is being done? Who can answer this question?