Health care for refugees

Kyrgyzstan hosts 11,000 refugees, mostly from Tajikistan, Afghanistan and Chechnya, who benefit from legal protection, education and free medical care. However, there are big differences between various communities. "All officially registered refugees going through our centre are treated free of charge, which is unique in Central Asia", Dr Lyudmila Pachaevna, coordinator of the Bishkek Medical Care Centre for Refugees, told IRIN on Thursday. The Bishkek centre is open from 0800 to 1700 five days a week, and employs 11 people, including doctors, nurses and technical staff. "Such centres are operating not only in Bishkek but also in Osh, Kara-Balta and, recently, in Ivanovka, thereby covering therefore most of the country," Bazarkul Kerimbaeva, head of the Refugees Office of the Kyrgyz Migration Department, told IRIN on Wednesday. These medical care projects are financed by the UN High Commissioner for Refugees (UNHCR) and implemented by the Bishkek Red Cross/Crescent Society. At all the four centres, patients can receive general diagnostic treatment and medical drugs. If necessary, they are sent to the nearest hospital for analysis or operations, which are paid for by UNHCR. "On average, we receive 15 to 30 patients a day, but we also go on field visits, and on each trip we check about 50 people," said Pachaevna. The field visits are carried out three times a week by two doctors in order to reach isolated refugee families living around the cities from which the centres operate. Most of the 1,000 officially registered Afghan refugees live in Bishkek in relative comfort. Most of them were educated, with their children attending Russian and Afghan schools and, in spite of facing some difficulties, able to earn some money by way of business activities, Karimbaeva said. "Tajik refugees, of whom there are about 8,000, and some 250 Chechens live mostly in villages on farms. They are less educated, do not always send their children to school, and have serious health problems," Kerimbaeva noted. Pachaevna concurred with this view. "They all work very hard in the fields - men and women. All the women and children suffer from anemia, and many have internal infections," she said. Family planning is also a major concern. Tajik families have an average of five to six children, but quite often up to 12. By comparison, Afghan families normally have about three. The medical centres first tried to tackle the problem by distributing contraceptives to men, but the effort proved a failure. Instead, the centres are now promoting contraceptives for women. "In the beginning, refugees didn’t even want to take oral pills from us. Now, however, they have begun trusting us, and some women even come to us for abortions. The decision to opt for abortion requires an enormous change in mentality," the Bishkek centre's gynecologist, Bupai Sofi, told IRIN. Sofi is an Afghan. She studied medicine in neighbouring Uzbekistan, and joined the centre five years ago. Her language skills are particularly useful for dealing with Afghan and Tajik refugees unable to speak Kyrgyz nor Russian. The main issue now at stake for relief workers is a possible influx of refugees. "If the number of refugees increases, then we will need more field visits to check them all, but in order to do so we will need more money, staff and transport facilities. This would be impossible under present circumstances, because our budget for this year is smaller than last year's," said Pachaevna.