In order to reach the southern region one has to cross these breathtaking mountains. 80% of the country is a mountainous area.
Osh, a city of 250.000 people in the southern region of Kyrgyzstan at the border of Uzbekistan. In 2010, riots erupted in Osh, a harsh conflict between the Uzbek and Kyrgyz ethnic groups, killing at least 400 and injuring thousands of others. One of the reasons of the WHO support is to handle the psychological consequences of the conflict.
Meeting with the local psychiatrist and mental health nurse in Kara-Suu at the outpatient center of the small town. This team will be extended by a psychologist and one more nurse and the new staff members will act as a mobile team in the region. Their office has been equipped with modern ICT tools in order to run eConsultation between professionals in Bishkek and Osh Region. Kara-Suu has 20.000 inhabitants.
The waiting room of the local health center in Kara-Suu.
Meeting with local social workers in Kara-Suu. They will be important co-operation partners of the new mobile team. Their office is only a few steps away from the outpatient center.
We also made efforts to meet the relevant stakeholders of the town. We had a meeting with the local police officers who were very supportive and we discussed how the new mobile team can co-operate with the local police units in case of crisis situations connected to suicide attempts. According to the chief police officers only last month, 3 similar crisis events have occurred in the town.
We also tried to build a connection to the local Muslim priests and natural healers (shamans). Research revealed that majority of Kyrgyz people prefer to turn to religious leaders or to natural healers instead of medical services. If we want to improve mental well- being in the region we need to get connected with these people.
On the picture one of the local mosques is visible. We attempted twice to get connected with the imam but he escaped from the meeting. Islam radicalization is a serious problem in the region. Savay, small village with 3000 inhabitants at the Uzbek border. The local team will visit places like this. Meeting with the local VHC team in Savay. VHC means Village Health Committee. Their members are local village people who volunteer to help to solve basic health problems in local communities. There are more than 50 voluntary teams in the region and they have an extremely important role to deal with tuberculosis, HIV or to support newborn babies and their families. Our mobile team will also rely on their activity, these people are extremely important in local communities with zero health infrastructure. As they do not have resources their office is together with the local police forces and it turned out to be a very fruitful co-operation. Meeting wth local psychologists in Osh. They are the applicants who has applied for the positions working in our mobile team. They were very impressive: Highly trained, enthusiastic people who speak Uzbek, Kyrgyz, Russian and English and who keep using their skills and knowledge to help their people in disadvantaged regions. After the meeting with the applicants, it really gave an impression that this pilot will be work beautifully...
Zsolt Bugarszki also said he had a similar very positive impression when he met the voluntary health workers in the village. Sketching the Kyrgyz Mental Health system at the office of Kyrgyz Soros Foundation. The main point is to shift capacities to the community level, strengthening outpatient centers and family doctors with mobile teams, mobilizing available community resources on the very local level.
"I am very honored to be part of this program. Next semester at Tallinn University I will run a special development project to support this pilot with different eConsultation tools bringing the advanced Estonian ICT solutions to local colleagues. ICT is a relevant part of the project and I was surprised that internet penetration and access to devices and other tools are much better than I expected, even in the smallest villages I visited. At the endpoints, local professionals and volunteers all have smartphones and access to the internet. Modern technology can bypass a lot of disadvantages. This will be the contribution of Estonia to this wonderful Kyrgyz development project." - Zsolt Bugarszki
This was the beginning. It was a meeting at the Ministry of Health in Bishkek. New Mental Health Strategy has been developed in Kyrgyzstan, the pilot project is part of this new strategy.