Osh Hepatitis Crisis

Cases of viral hepatitis have almost tripled in the southern Kyrgyz oblast of Osh over the last year, as a result of the authorities' failure to enforce the most elementary sanitary and hygiene standards.

The source for many of the infections are the new snack-bars and restaurants which sprang up in Osh, Kyrgyzstan's second largest city, in the run-up to its 3000th anniversary celebrations in early October.

Historically a trading city, catering establishments have flourished in recent years and would have done so, with or without the anniversary, as demand for roadside helpings of local popular dishes like pilau, samsa, manty, lagman and shashlyk ensures constant custom.

Such has been the growth in street trade, local authorities have failed completely to regulate the outlets. Meat, fish, fruit and vegetables vie for space on streets in every town and village amid piles of litter and traffic-choked streets.

On the rare occasions inspectors come calling, stallholders produce easily available stamped forms attesting to the sound health of their businesses.

However, street vendors are only one reason behind the growth in the number of infections. Doctors, decrying the lamentable state of general hygiene levels, are particularly concerned about the state, or even absence of drinking water.

From the suburbs of Osh to the more isolated regions of the oblast, there is still no clean water supply. Consequently, there are outbreaks of intestinal illnesses. Two years ago over a hundred cases were reported in Zhapalak after an outbreak of typhoid.

Those lucky enough to have running water are still advised to boil it when preparing food. Also, the danger of infection increases when it rains as tap water runs brown.

Despite attending training programmes on the latest water purification techniques in the US and elsewhere, city officials seem powerless to prevent the seeping of river water into the system.

This is because construction of the central water treatment plant on the banks of the Ak-Bura river was botched. Special dirt filtering sheets for the lining of reservoir basins were not available, so the builders simply used roofing material which lets unpurified river water leak into the basin.

Due to a shortage of funds the city council was unable to complete the job, only managing to replace one of the sheets which cost up to $1000 a piece.

Insufficient financing also affects the work of the city's health department. Inspectors are limited for the most part to merely noting infringements. Their recommendations are usually ignored and fines are rarely paid.

This summer, for example, milk infected with the hepatitis virus was found in one of the refrigeration units on Osh's main thoroughfare. Trading continued. Business as usual.

At the end of every day rubbish piles up on the streets. But municipal authorities complain that they haven't even the funds to fuel garbage trucks never mind invest in new equipment.

Children have always been the most vulnerable to hepatitis and other infections. In the post-Soviet era, even more so.

Before, one ill child would set alarm bells ringing. The kindergarten or school concerned would be shut down and quarantine restrictions imposed. Nowadays, staff are more likely to try hiding any evidence of, say, jaundice, concerned that the parents might demand the school be temporarily closed, depriving them of their salary. It's not uncommon for poorly paid teaching staff to take food, intended for pupils, home with them

The state has implemented various programmes in its struggle against infectious diseases. But there are ever-increasing numbers of sufferers.

At the last meeting of the Emergency Anti-Epidemic Commission of the Osh oblast, it was noted that the situation concerning infectious illnesses, including viral hepatitis, was indeed a very complex issue. Yet another in a long line of decrees was adopted and all health services alerted that it's time they put their affairs in order. Time will tell.

Alla Pyatibratova is a regular IWPR contributor.