Combining efforts to secure people’s health in Karakalpakstan

Jun 1, 2015

The UN Volunteers (UNV) of UN Joint Programme “Sustaining Livelihoods Affected by Aral Sea Disaster” have been working for several years on raising awareness of tuberculosis and other respiratory diseases common to the Aral Sea disaster area. In 2014 1,730 community volunteers were trained to help the authorities to bring TB message to the rural areas of Karakalpakstan. Last week volunteers organized a workshop with local partners to discuss the results of volunteer activities at the conference hall of the Ministry of Health of Karakalpakstan. Representatives of educational and health institutions, international and local NGOs and Ministry of Health of Karakalpakstan gathered to hear about the activities and results of community volunteer work and to ponder next steps.

The workshop shared information on epidemiological situation of respiratory diseases in Karakalpakstan, MDR-TB burden in the area, impact of volunteerism and knowledge of the population of respiratory diseases, training TB knowledge for students, community involvement in TB care and sustaining current volunteer pool. All partners agreed that wide and intensive cooperation as well as strong community involvement are key issues when tackling infectious diseases like tuberculosis.  Health is determined by many social, economic and environmental factors and those living in the areas with restricted access to water are in danger to drop out of same health equity with others. UNDP and WHO have acknowledged the importance of cooperation in disease control and signed an agreement stating that health should be addressed in partnership. The UN Joint Programme in the Aral sea disaster area have already joined forces of 5 UN agencies (UNDP, UNV, WHO, UNFPA and UNESCO) and intensifying cooperation with other partners in the field continues by applying the human security approach that ensures the holistic approach for development to address multidimensional consequences of the Aral Sea crisis.

“Combining the efforts of national and international organizations is the crucial in achieving common goals when securing people’s health, so the focus should be on continuation of stabile cooperation that will increase opportunities to improve the health system”, Deputy Minister of Health KuralKamalov stated.

According to MDG report 2015, the TB situation has improved since the peak level of morbidity and mortality that occurred in 2002 in Uzbekistan. In 2002-2013 the incidence of tuberculosis in Uzbekistan has decreased from 79.1 (per 100,000 population) to 50.8 (per 100,000 population) and in Karakalpakstan from 182.8 (per 100,000 population) to 106.3 (per 100,000 population) accordingly. In 2014 the incidence rate in Karakalpakstan was 106.0 (per 100,000 population).

Last year the community health volunteers reached 32,000 households in the rural areas and helped the authorities to increase TB case detection, diagnosis and starting of proper treatment. However, there are concerns of diagnosed TB patients that do not finish treatment or refuse of medication due to its hard side effects.  According to Doctors without Borders, as many as one fourth of the patients are lost in follow-up or do not finish the treatment. TB treatment takes 20-24 months and strong medication causes severe side effects that scare patients. Removing stigma and strong psychological support from the community would help the TB patients to take treatment and eventually get cured.

“We need wider community cooperation in TB care to reach the patients that are lost in follow up or do not start the treatment”, Dr. Cormac Donnelly from Doctors Without Borders says.

Even though the trained health volunteers succeeded to achieve proven results and increase population’s knowledge of respiratory diseases to a very high level, there is still a lot of work to be done. The awareness campaign of UNV reached 91,5% of the inhabitants of the five districts where the work was done. The campaign underlined the importance of community support and targeted affecting people’s attitudes towards TB patients and the disease. The campaign managed to double the amount of people who were willing to help TB patients. However, according to recent UNV study, one third of the population still feels afraid or helpless in front of tuberculosis patients.

“Self-medication of common cold with non-prescribed antibiotics has dropped from 33% to 14% due to volunteer work”, UNV Project Coordinator Ruslan Dauletnazarov explains.

The workshop pondered ways to increase community involvement in TB care and medical culture of population. Simple and continuous messaging would reach the most vulnerable people in the rural areas. With the help of volunteers, media, workshops, basic education and local and international NGOs and by involving healthcare workers, teachers, volunteers and students to activities the word would spread wider. Educational institutions that were represented in the workshop promised to increase and intensify teaching of tuberculosis in their valeology studies.

“The volunteers introduced community-based disease control, and volunteerism to us. Now it is part of our valeology studies”, Docent of Valeology Turdibay Saparov from the Pedacogical Institute says.

Legalizing the status of volunteers, continued integration of free-willing volunteerism in the governmental scheme and solving the question of modalities and procedures for introducing amendments to existing legislation was seen as an important part of the future steps. The workshop also highlighted the importance of creating healthy environment, free from air and water pollution so that people could live healthy lives.

To learn more about the UN Joint Programme and UN Volunteers in Uzbekistan and their work, please visit the project website, Facebook page of UN JP or UN Volunteers in Uzbekistan


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