Kyrgyzstan: “Huge mistrust between communities leaves many without essential medical care”

Médecins Sans Frontières doctor Dmitry Donchuk examines a patient, who was beaten on his way to the food marketin Osh, Kyrgyzstan. © Alexander Glyadyelov

Andrei Slavuckij is heading Médecins Sans Frontières programs in southern Kyrgyzstan. He describes the situation in Osh, two weeks after violent clashes killed hundreds of people.

Andrei, is the situation still tense on the ground?

You can still feel a high level of tension among the population. At the beginning of last week, a hospital supported by Médecins Sans Frontières in Osh received 25 wounded in one day, many of whom had been beaten. There are still many rumours going around, and there is a lot of fear. But in general, the situation has returned to calm. On Sunday, a national referendum took place peacefully and the majority of the people, who had fled to Uzbekistan or to places inside Kyrgyzstan near the border, have now returned. Many of these people have found their houses burned down…

What do these people need most urgently?

They have lost everything, so they basically need everything. Those who lost their house are trying to stay with neighbours or in schools. In these often overcrowded conditions, they lack clean water and basic hygiene conditions. In response, we have distributed hundreds of hygiene kits containing soap, towels and shampoo and have also handed out kitchen utensils, blankets and jerrycans to these families. It is also important to provide them with access to medical services so we are supporting 12 health facilities throughout Osh and Jalal-Abad regions, mainly by donating drugs, medical equipment and training. On top of this, we are also seeing mental health problems. In a clinic in Onadyr, Médecins Sans Frontières doctors are seeing more and more patients suffering from mental disorders. When we arrived at the clinic, medical staff told us that many pregnant women had suffered from miscarriage, which is probably another tragic consequence of stress.

Mental wounds are deep and will take time to heal…

Many people we meet are still in deep shock. Mothers tell us that their children don’t sleep at night and don’t play outside anymore, that any single noise scares them and they rush into the house. Last week, we went to Suratash, a village located on the border, to carry out consultations for thousands of refugees who were returning to Kyrgyzstan. We saw lots of people crossing the border in tears. We asked them ‘how are you?’ and they just cried and started talking and talking again. Our nurse cared for an old man who had a serious leg injury. When I accompanied him to the Médecins Sans Frontières supported clinic in Onadyr, in the outskirts of Osh, he told me he had been building his house for four years after it was destroyed in an accidental fire. He started to cry like a baby. But all of a sudden his glance turned really firm and he told me: “It’s ok, we’ll do it again.” Then I understood this man would never move from here, that he would stay here.

What is the atmosphere between the different communities after the recent events?

It is difficult to answer this question. But within the medical services, we see a huge lack of trust between communities, leaving many without essential care. Despite the significant efforts of Kyrgyzstan authorities to send medical assistance to southern regions, many people won’t actually have access to it. Among the Uzbeks, there is still a lot of fear and mistrust towards governmental services, which are mainly perceived as Kyrgyz. In addition, the presence of armed personnel in health facilities adds to the Uzbek people’s fear of seeking specialised care. On several occasions, Médecins Sans Frontières doctors have faced the problem of patients who, given these circumstances, have refused to be referred to hospitals. In Nariman hospital, we even had reports of a man with diabetes who was twice arrested by armed men on his bed, removed from the hospital and then beaten. We informed the relevant authorities, talked to armed personnel and called for respect of medical ethics. We hope this will bring positive change.

What can be the role of Médecins Sans Frontières in this situation?

Our is to go where there are unmet needs. The latest violence and the subsequent mistrust and fear have exacerbated existing medical needs. On the one hand, small clinics have been overwhelmed with patients and, on the other, most of the official health facilities remain inaccessible to a significant part of the population. Médecins Sans Frontières has therefore decided to support several medical structures, with a focus on those that had received very little assistance, for instance in Onadyr where our doctors and nurses are working alongside local staff. We are liaising with personnel from all the facilities, we are accompanying patients during referrals to offer some reassuring presence, and we will hopefully ensure continued medical care for all patients. But there is still a long way to go.

Médecins Sans Frontières activities in southern Kyrgyzstan

In the regions of Osh and Jalal-Abad, Médecins Sans Frontières continues providing medical and psychological care, as well as distributing relief items to the many people who have been affected and displaced by violence.

In Onadyr, a neighbourhood of 50,000 inhabitants located southeast of Osh, Médecins Sans Frontières doctors and nurses have also carried out 169 dressings for wounded people as well as 535 consultations during their first week at the local clinic. In addition to psychological and mental health disorders, the main pathologies seen were respiratory tract infections, high blood pressure and diarrhoea. Médecins Sans Frontières has also set up a surgical facility inside the clinic and has worked on water supply and sanitation.

In the past days, thousands of people who had fled violent clashes have returned to their neighbourhoods, where many houses have been burnt. Some people have sought refuge with neighbours, relatives or in schools. Some people, mainly women and children are still staying on locations near the Uzbekistan border, too scared to return.

During these returns, a Médecins Sans Frontières nurse carried out 86 consultations at a medical point on the border village of Suratash.

In several neighbourhoods in Osh and Jalal-Abad, as well as on sites located on the border, Médecins Sans Frontières has so far distributed 714 hygiene kits (with soap, shampoo, towels, and various hygiene material), 1898 blankets, 149 sets with kitchen utensils, 470 jerrycans, and 450 boxes of nutritive biscuits.

Many people are deeply shocked by the extreme violence they have been through. Four Médecins Sans Frontières psychologists are setting up a significant mental health support programme throughout southern Kyrgyzstan. They are providing individual consultations and are training counsellors to implement group support within the communities.

A last Médecins Sans Frontières team – made up of a medical doctor, a nurse, a psychologist and a logistician – is also conducting needs assessments in various areas across southern Kyrgyzstan.

To date Médecins Sans Frontières has assisted 12 medical facilities by donating medicines, medical material and surgical equipment.

64 Médecins Sans Frontières employees, including 38 international and 26 national staff, are running program in southern Kyrgyzstan. Teams are made up of doctors, surgeons, nurses, psychologists, logisticians and water-and-sanitation experts. Since 2006, Médecins Sans Frontières has been running a tuberculosis programme Kyrgyzstan’s penitentiary system since 2006.

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