In a middle school in Burghandy village in the south of Kyrgyzstan, pupils come to school with their own bottle of boiled water or tea, labelled clearly with their names.

This is no ordinary school regulation but one that is crucial to public health as part of attempts to prevent children from falling ill from belly typhus, which is the most common infectious disease due to dirty water in the south of this Central Asian country.

The most recent episode of belly typhus in Burghandy occurred in December, and it also affected two other villages — Mombekov and Dostuk — in Jalal-Abad province. There are more than 16,000 people in these villages.

Due to polluted and unsafe water from the Majluusuu River that residents use for drinking and cooking, 65 inhabitants ended up in hospital and many others were treated by doctors at home. Children made up 77.5 percent of patients up to 14 years old.

This why the Burghandy middle school has taken steps to prevent another outbreak. Two years ago, 25 of its pupils had fallen ill with belly typhus.

«Now we have taken all steps so that children don’t drink dirty water from canals,” Rabia Dovlatova, head of the middle school, said, pointing to the students’ water containers. “Also, doctors often come to our school. Teachers and doctors constantly explain to parents and pupils the rules of hygiene,” Dovlatova added.

Experts say it is time for better preventive measures and improvements in the quality of water. Already, the number of rural residents who are usually hospitalised due to belly typhus has risen from 30 in previous years to 95 people in 2005, according to Umsunay Nazaeva, a doctor at the infectious diseases branch of the Jalal-Abad province united hospital.

«The main reason for the occurrence of this illness is infected water. People are compelled to use water from open reservoirs and channels for drinking and cooking. Only 20 percent of them have access to water pipes,” Nazaeva explained.

“Other peasants are compelled to drink dirty water from irrigation channels. Old water lines in any way do not meet the requirements of sanitary, hygienic and technical rules,” Nazaeva added.

In the case of Burghandy, Dovlatova said, «Old water lines work only two hours per day.” Those who not get to access water from these lines are compelled to use water from irrigation canals, she adds.

Local administrations do not have enough means to repair and construct new water supply systems, according to Bektur Umarov, head of the Jalal-Abad branch of the department of rural water supply under the ministry of agriculture and water management.

While there is a state programme, supported by international donors, called ‘Taza Suu’ (‘Pure Water’), this is being “carried out very slowly”, Umarov said. The water lines in 277 out of 423 villages in Jalal-Abad require improvement.

“Last year, only 16 villages received new water lines. This year, we plan to construct new water networks in 27 villages. It is not enough,” Umarov pointed out.

But pricing is also an unresolved issue. The requirement from international donors is that 5 percent of the cost of water services under the Taza Suu programme should be paid for by users. But Umarov reports that the collection of fees from residents is far from ideal.

«We have collected 39.4 million soms (961,000 U.S. dollars), but this is only 59 percent. The basic problem (in paying) is the poverty of the population. People lack money for living expenses,” he added. “Many peasants consider that the money (they pay) will appear in the pockets of officials. They do not trust that money will go to the construction of water pipes.”

“The level of corruption in Kyrgyzstan is very high. People do not trust the authorities any more. It is very difficult to break this stereotype,” local resident Ibraghim Askarov said.

According to the constitution of Kyrgyzstan, citizens have the right to free health services, which should theoretically make it easier for them to get treated when illnesses like belly typhus occur.

But the government and the Ministry of Health are unable to provide such services for all.

«Apart from belly typhus, there are also other infectious diseases,” stressed Dr Nazaeva. We (already) lack medicines and doctors. If you count all the infected patients, you will understand that the situation is catastrophic. The provincial sanitary and epidemiological services do not have sufficient financial assets.”

In the event of a epidemic from dirty, polluted water or other causes, Nazaeva says the country would be hard put to rely on its own resources to cope. “There is a constant danger of new epidemics,” Nazaeva said.

By E. Kabulov

Source: Asia Water Wire, 13.02.2006

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