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Saturday, 27 August 2005
Soviet ghosts haunt Kazakh Aids policy
Jill McGivering
By By Jill McGivering
BBC News, Kazakhstan
Sex worker in Kazakhstan

Some of the sex workers are ill-informed about HIV and Aids
Sex worker in Kazakhstan
Some of the sex workers are ill-informed about HIV and Aids
As midnight approaches on Sina Street in Almaty, one of Kazakhstan's main cities, groups of young female sex workers stand in the shadows by small hotels, giggling, swigging beer from bottles and smoking.
Every time a car slows down, they push forward into the light from streetlamps in the hope of being chosen by a client.
Some charge as little as $3-4 (£1.60-2) for an hour.
Some of the young women are from Kazakhstan itself.
Others have travelled here from neighbouring Kyrgyzstan or Uzbekistan.
Although some we spoke to were well informed about HIV and said they always made sure that clients used a condom, others were confused about what HIV was and how it was transmitted.
"I'm very afraid of getting HIV," said one young woman with vivid blonde curls.
"Everyone says it's possible to get Aids from talking to someone.
Men having sex with men are a really stigmatised and marginalised group of people... it's really hard to get access to them
Kanat Shakenov
UN HIV project manager
"Or, you never know, you might get Aids from lying in a dirty bed or something."
In Kazakhstan, more than 5,000 people are formally registered as having HIV-Aids, but officials say the actual total is more than 13,000, in a population of about 15 million.
So far infections have been concentrated in specific groups, including drug users, sex workers and men who have sex with men.
But the fear now is of rapid spread into the general population.
Reaching out
But one of the difficulties in addressing this is that most people in Kazakhstan still have very conservative attitudes to these marginalised groups, a legacy in part of the Soviet era.
These attitudes make these communities more difficult to reach, as Kanat Shakenov, the HIV project manager for the United Nations Development Programme, explained.
"For instance men having sex with men," he told me, "are a really stigmatised and marginalised group of people so they don't reveal themselves to the general public and it's really hard to get access to them."
Late at night, I visited one of the few places in Kazakhstan where gay men can socialise, a gay nightclub.
The sign outside just reads "restaurant."
Because it's such a hidden community, it's hard to get... basic information across to everyone
Anatoli
Volunteer HIV worker
A guard sits at the locked door, restricting entry, and upstairs all the windows are carefully blacked out.
At the moment there are only two non-governmental groups for gay men.
They hand out condoms and leaflets about HIV in clubs like these.
One of their volunteers, Anatoli, told me that recent surveys suggested about half of all gay men still did not have basic information about HIV, about how to protect themselves from it or even how to use a condom.
"Because it's such a hidden community," he said, "it's hard to get that basic information across to everyone."
Access problems
Isadora Eraselova, director of the Republic Centre for HIV

The government just doesn't have the same access to everyone who is affected, the way non-governmental organisations do
The government just doesn't have the same access to everyone who is affected, the way non-governmental organisations do
Isadora Eraselova
Republican Centre for HIV
Kazakhstan still has few non-governmental organisations (NGOs), especially working with high-risk groups.
HIV programmes — and most of the funding now pouring in — are largely controlled by government ministries.
Linara Akhmedzyanova works for the international non-governmental group, the Aids Foundation East-West.
In neighbouring Kyrgyzstan, she said, NGOs work very closely with the government to reach sex workers, drug users, prison inmates and gay men and women.
But in Kazakhstan it is very difficult to have access to these people, she said.
The main government-funded body dealing with HIV-Aids is the Republican Centre for HIV, which provides a range of educational and support services nationwide.
I visited its headquarters, on a high floor of a Soviet-style block in Almaty.
Its director, Isadora Eraselova, said there were now people officially registered as HIV positive in cities, towns and villages all across Kazakhstan — a country the size of Western Europe.
"This is a big country, and we have to reach all areas," she told me.
"The government just doesn't have the same access to everyone who is affected, the way non-governmental organisations do."
Progress
So there are signs the official line is starting to change.  Kazakhstan realises its old attitudes do not sit well with this new problem of HIV.
But moving away from a heavy-handed government approach is taking time.
The government is slowly turning its face towards people infected with HIV
Nurali Amanzholov
Support group president
Nurali Amanzholov is the president of a grassroots support group for people with Aids — and is himself HIV positive.
He admitted there were some positive changes.
"The government is turning its face towards people infected with HIV," he said.
"Slowly, but it is turning."
But although officials were trying, he went on, they did not always handle things well.
"Sometimes you can see the government doing something for people who are HIV positive that they don't actually want," he said.
"They try to help but end up making things worse."
Monday, 29 August 2005
Kazakhstan's battle with heroin
The BBC's Jill Mcgivering
By Jill McGivering<
BBC News, Kazakhstan
Douglas Boyle counsels Kazakh addicts

Douglas Boyle, a former addict himself, now counsels Kazakhs
Douglas Boyle, a former addict himself, now counsels Kazakhs
There is a rambling building in Kazakhstan which now functions as a temporary home to some 600 drug addicts.
These men and women — as well as some children — are going through a rehabilitation programme run by the non-government organisation Teen Challenge Kazakhstan, led by Douglas Boyle.
Mr Boyle, an addict himself many years ago in his homeland of Australia, has been helping drug addicts here since the collapse of the Soviet Union.
Nowadays, he says, many children who used to live in orphanages live out on the streets in the summer months.
Too often they are becoming drug users, he says — partly because they frequently survive by helping people sell drugs, and partly because many of their parents are addicts too.
Mr Boyle now treats addicts as young as eight years old.
Huge stigma
One of the residents, 38-year-old Raoshan, tried to put into words the impact of heroin addiction on her life.
"It's just horrible.  I wouldn't even compare it with the worst sickness or worst misery," she said.  "You are constantly in fear and in pain.  You are desperate.  There is no hope at all."
My family and friends rejected me.  I didn't belong anywhere.  I couldn't find a job
Raoshan, a recovering heroin addict
The stigma associated with drug users in this highly conservative society added to her misery.
"People are aggressive towards drug addicts," she said.  "Straightaway my family and friends rejected me.  I didn't belong anywhere.  I couldn't find a job."
Kazakhstan has about 200,000 drug addicts, and heroin is easily available and relatively cheap.
One gram costs about $35 — about a tenth of the street price in London.
Most of it comes from Afghanistan, and after the fall of the Taleban the US set up a special programme with the government of Kazakhstan to try to stem the flow over the border.
Trafficking crossroads
One US official in Almaty, who asked not to be named, described Kazakhstan as being right at the crossroads of illegal trafficking routes.
Drugs move through Central Asia from China and Afghanistan on their way to markets in Russia, Western Europe and points beyond.
The Kazakhstan government, well aware of this rising social problem, has set up a series of programmes to support drug addicts, including special clinics where addicts can get free needles, blood tests and counselling.
Anti-drug poster in Kazakhstan

Despite campaigns, Kazakhstan is struggling to curb its heroin problem
Anti-drug poster in Kazakhstan
Despite campaigns, Kazakhstan is struggling to curb its heroin problem
Support groups are also encouraged to establish contact with drug users, particularly because about three out of four drug addicts are also HIV positive.
But these efforts are hampered by a general climate of lingering mistrust.
Alexander Kossukhin of UNAids says many drug users are afraid to contact healthcare institutions for fear of being arrested for buying or possessing drugs.
Another problem, he says, is the changing attitude to drugs amongst young people.
A gap needs to be closed, he says, between the official prevention message in schools and what young people actually believe.
"It's a sign of masculinity — a sign that you're part of the same community, that you use drugs jointly with your friends," he said.
"Teacher is one thing.  Street and yard is another thing.  They don't take seriously what teachers are saying."
Douglas Boyle insisted the main emphasis must be on curbing availability.
Heroin in Kazakhstan, he said, "is as easy to buy as alcohol and cigarettes."
Clearly Kazakhstan has many battles to fight, including tackling punitive attitudes to addicts that prove an obstacle to accessing drug addicts.
But the larger war on availability needs international help.  The growing tide of drugs across its borders is a threat the Kazakh authorities cannot counter alone.
SEE ALSO:
Kazakhs 'not ready for democracy'
14 Jun 05 | Asia-Pacific
Country profile: Kazakhstan
26 Oct 04 | Country profiles
Timeline: Kazakhstan
09 Jan 05 | Country profiles


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For archives, these articles are being stored on TheWE.cc website.
The purpose is to advance understandings of environmental, political,
human rights, economic, democracy, scientific, and social justice issues.