Health services struggle to cope with high level of respiratory diseases

Uultay Smilova, 63, is one of many patients undergoing treatment at the National Cardiology Centre's pulmonary department in the capital, Bishkek. She cannot speak, is partially deaf and requires constant treatment. The reason is a respiratory disease that began some 20 years ago. But, according to her daughter Anarkul, it was not the disease but a faulty diagnosis that undermined her health from the very beginning. "When we first went to a doctor in [the northern] Kara-Balta city polyclinic, he diagnosed my mother as suffering from bronchial asthma. However, this turned out to be a faulty diagnosis," she told IRIN. Therefore the wrong treatment ruined her health, Anarkul maintained. Uultay's health gradually worsened and she had to be taken to Bishkek from Kara-Balta. But after better specialist care and treatment in the capital, her health improved within six days. However, she still has to undergo treatment every three months. Uultay's case highlights the dire need for such specialists in the country, with health officials saying that only 20 pulmonary specialists are working in four departments with 105 beds, mainly located in Bishkek. The World Health Organisation (WHO) contends that the death rate from respiratory diseases in Kyrgyzstan was the highest among the former Soviet republics, and much higher than the average European level for the past 20 years. According to official statistics, over 40,000 patients with chronic respiratory diseases were registered in 2002. "There are currently 45,000 sick people," Talant Soronbaev, head of the pulmonary department at the National Centre of Cardiology, told IRIN. Health officials note that respiratory diseases were the second leading cause of death after cardiovascular complaints in 2001. However, respiratory tract diseases were at the top in terms of prevalence rates, with that level reaching 40 percent among children. The main reasons for this were increasing rates of smoking, especially among adults and women, environmental pollution and a lack of awareness on the issue, Nurilya Davletalieva, a coordinator for the Kyrgyz-Finnish Lung Health Programme (KFLHP), operating in Kyrgyzstan since 2003, told IRIN, adding that the absence of any proper control of the illness was also contributing to the problem. Unconfirmed reports claim that at least 12,000 to 15,000 people a year die in the country because of respiratory tract diseases caused by smoking. Kyrgyzstan has not yet signed the Framework Convention on Tobacco Control adopted in May 2003, apparently due to a powerful lobby of tobacco producers in the impoverished republic. In an effort to address the issue, work to train family doctors and establish specialist departments are under way in the former Soviet republic. "First of all, we plan to train those personnel who are the primary link [with patients] - groups of family doctors. We have already trained 84 specialists in the country. Also, we plan to train and equip specialist pulmonary departments at the national level", Nurlan Brimkulov, the KFLHP's national project manager, told IRIN. But some technical problems related to the issue remain. The issue of vital equipment for treating respiratory diseases in pilot districts remained unresolved, he maintained. However, it is planned that part of what is required will be financed by the compulsory medical insurance fund and another part by patients themselves. As for medicines, humanitarian aid is going to meet that need to some extent, Brimkulov added. However, "the best preventive measure against lung diseases is the fight against smoking", Davletalieva said.