Page last updated at 11:35 GMT, Thursday, 26 June 2008 12:35 UK

Central Asia's child Aids tragedy

By Natalia Antelava
Central Asia correspondent, BBC News

Dilfusa and her son, Bekhruzbek
Doctors who treated Bekhruzbek are now accused of infecting him with HIV
Dilfusa wept as she rocked her baby, Bekhruzbek, to sleep.

She had taken her son to hospital near their village in southern Kyrgyzstan because he had heat stroke.

Eight months later he was diagnosed with HIV. "I thought my life was over," she said.

The doctors who treated Bekhruzbek are now on trial, accused of infecting him.

There are 78 other babies who have contracted HIV inside hospitals in Kyrgyzstan. Three of them have died, and new cases continue to emerge.

Most of their parents do not want to talk - so great is the stigma.

"My husband left me, he is in Russia now. The night when we got the test results he slept on the other side of the bed. I accidentally touched him and he kicked me," said Dilfusa.

Dilfusa, in her early twenties, is now also HIV positive. Like 16 other mothers in Kyrgyzstan, she contracted the virus through breastfeeding.

It is rare, but it happens - yet no-one warned her, she says, that she should not have nursed.

Fourteen medical workers in Kyrgyzstan have been accused of negligence, malpractice and corruption.

The prosecution alleges that doctors charged parents for equipment which they had used again and again.

Crumbling system

But it is not just individual doctors, it is the entire medical system in Kyrgyzstan and across Central Asia that is on trial.

This system is part of the region's Soviet legacy.

Soviet healthcare - just like much in the USSR - was huge, centrally managed and inflexible.

The situation in hospitals is similar everywhere, it just happened that it was discovered in Shymkent
Bahit Tumeneva,
former Kazakh health official

Doctors followed the orders of the Communist Party, but they were well paid and had plenty of resources.

As the USSR fell apart, so did its health system. Hospitals lost funding, many doctors left for better paid jobs overseas, leaving the crumbling medical system unprepared for new challenges like HIV/Aids.

As the international community began to pour tens of millions of dollars into HIV/Aids prevention, very little was spent on reforming the health system itself.

Donors are beginning to realise that this was a mistake.

"I think trying to address the problem of HIV/Aids without investing in health systems is inefficient use of resources," says Gabit Islmailov of the World Health Organisation.

"I think this is a realisation that is coming to the mind of many donor agencies."

But it has come too late for the growing number of children already affected, and not only in Kyrgyzstan.

Drug users

Across the border lies Central Asia's richest nation, Kazakhstan.

It boasts one of the former Soviet Union's most successful economies. But away from the buzz of the capital, the country's health system is in ruins.


One year ago, an unprecedented trial took place in the southern city of Shymkent.

Twenty-one medical professionals were found guilty of infecting more than 70 babies with HIV. The number of infected children now stands at 149.

Most of the babies were infected through blood transfusions as doctors made money by prescribing unnecessary transfusions and selling blood to parents.

Court documents show one child received more than 50 transfusions during just one treatment.

It is not clear where the infected blood came from. But the prosecution suggested drug users could be one possible source.

They are the biggest HIV risk group in Central Asia. In Shymkent three drug users said it had been standard practice for them to give blood for money, and that when they did they were not checked for HIV.

The government says this is no longer the case and that all blood donors are now carefully screened, but the problem, some believe, is that the underlying cause of the outbreak still exists.

"Corruption is a particularly dangerous infection for society," says Bahit Tumeneva, a former senior Kazakh health official who left her job several years ago to protest against corruption in the medical sector.

"The doctors have to bribe in order to get jobs or to get a place for their children in school, and then they start taking bribes too. When the power of law is substituted by the power of money, all of us become hostages to situations like the one in Shymkent," she says.

Ms Tumeneva, like many, is convinced that the Shymkent and Osh outbreaks are part of a larger regional trend.

"The situation in hospitals is similar everywhere. It just happened that it was discovered in Shymkent," she says.

Wasted lessons

More than a year after he was first diagnosed with HIV, two-year-old Syatt now lives with his grandmother, Salima, in the outskirts of Shymkent.

Syatt and Ruslana in Shymkent
Both Syatt and Ruslana face an uncertain future

The government provided accommodation for 10 of the 149 families. Their houses stand on the edge of a landfill. The air reeks of rotting rubbish, and their neighbours want them out.

"When the neighbours found out that Syatt was ill, there was a big scandal - there was even fighting. They wanted to evict us," she said.

When Syatt was seven months old, Salima took him to hospital to check a swelling on his knee. It was inside the hospital, she says, that he got sick with pneumonia and doctors administered several transfusions

"I'm heartbroken. None of our relatives want to know us. They told me to abandon him, to put him in an orphanage. But it's not his fault, it's the state's fault and the doctors' fault," she said.

As she speaks, Syatt is playing with his only friend, Ruslana.

She is another of the HIV babies. Salima hopes that maybe one day the two will get married. No healthy girl will ever marry my grandson, she tells me.

But Ruslana is already very sick and only one stage away from getting full-blown Aids.

Fifteen babies have died of Aids in Shymkent, killed in places that are built to cure.

Salima has heard of the new outbreak in Osh.

Syatt and Ruslana's tragedy, she says, is all the more pointless because elsewhere the painful lessons of Shymkent have already been wasted.

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