Wednesday, 22 October 2003

THE STATE OF MENTAL HEALTH IN KYRGYZSTAN

Published in Field Reports

By Aisha Aslanbekova (10/22/2003 issue of the CACI Analyst)

In hospitals, patients live in dreadful conditions and are poorly fed, not to mention of being properly taken care of. The rooms in hospitals are overcrowded, holding up to 10-15 patients in a room. Lack of hospital staff forces a single nurse to supervise 10-15 people.
In hospitals, patients live in dreadful conditions and are poorly fed, not to mention of being properly taken care of. The rooms in hospitals are overcrowded, holding up to 10-15 patients in a room. Lack of hospital staff forces a single nurse to supervise 10-15 people.

The rights of the mentally ill people in Kyrgyzstan have been systematically violated. According to the leader of the NGO “Mental health and society” Burul Makenbaeva, the principle of the voluntary appeal for psychiatric help is often ignored. For example, in Osh center of mental health, one of the few psychiatric institutions in the country, there have been cases when patients were hospitalized without their written consent. Methods of physical constraint are often used toward patients. There have also been cases of ungrounded hospitalization or in other words of medically unjustified long-term hospitalization of patients. Another practice, which grossly violates the right of the mentally ill people and has been evoking concern, is using patients as free labor force. The use of patients of psychiatric hospitals for manual labor on private farms of hospital staff or of local farmers has become a common phenomenon.

As a way of preventing abuses of patients’ rights, the program manager of a British organization “Hamlet Trust” Paul Carter during his visit to Kyrgyzstan in summer suggested to set up a system of permanent monitoring of what is going on in the psychiatric hospitals by international organizations and NGOs. He also called local human rights activists to work out and realize projects directed towards protecting patients’ rights in psychiatric hospitals. Kyrgyz NGO leader Burul Makenbaeva recently stated in an interview to journalists that it is necessary to create a special service for protecting patients’ rights, which would be independent from the Ministry of Health. However, this suggestion has not drawn support yet. Another local activist, Karamat Abdullaeva, representative of the Women’s Congress, says that in order to solve the problems of the mentally ill people, it is necessary to raise the issue on the national level.

A national program dedicated to the issue of mental health already exists in Kyrgyzstan. The National program “Mental health of the population of the Kyrgyz Republic for 2001-2010” was adopted several years ago, but did not improve the situation. As local observers note, although this program by itself provides a good basis, it has been ineffective as its main provisions have still not been realized. A system of rehabilitation of patients has not been worked out. In some places, psychiatric service has not even been staffed. Besides, financing for this program has not been envisaged yet.

Indeed, the present state of the mental health service in Kyrgyzstan has much to do with such factors as lack of funding. For example, last year the Republican centre of psychiatric health received only one fourth of its funding. According to the Chief Director of the centre Suyutbek Nazarkulov, today the state budget allocates 6 som ($1 is ca. 42 som) for medical treatment of one patient while the amount of needed medicines constitutes 60 som. 13 som is spent for one patient as a daily food allowance. For the first nine months of this year, the Republican centre of psychiatric health was underfinanced by 846,000 som on “food allowances” and 203,000 on “medicines”. For renovation of the hospitals, transportation and communication expenses, no funding was provided.

This is made worse by the fact that there is a tendency of growth of mental sicknesses in Kyrgyzstan. Only in Osh province, the number of mentally ill people has increased by several thousand people. The issue of mental health appears to be beyond the priority area for the Kyrgyz government, for whom providing even basic social and healthcare services has been an uphill task. But still this issue should trouble not only the activists of international organizations or local NGOs but the Kyrgyz leadership as well, especially when it wants to promote Kyrgyzstan as the “country of human rights”.

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The Central Asia-Caucasus Analyst is a biweekly publication of the Central Asia-Caucasus Institute & Silk Road Studies Program, a Joint Transatlantic Research and Policy Center affiliated with the American Foreign Policy Council, Washington DC., and the Institute for Security and Development Policy, Stockholm. For 15 years, the Analyst has brought cutting edge analysis of the region geared toward a practitioner audience.

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