Wake Up Call

If I’ve been delinquent in my blogging responsibilities, it is because my summer in Almaty has kept me very busy. So busy, in fact, that I drove my body into the ground, and I am now laid up at home on antibiotics and painkillers, recovering.

Falling ill precipitated my first interaction with healthcare since I came to Kazakhstan. I’ve written before about my hesitations regarding medical facilities and knowledge in the country, and for this reason I confess to having gone to the fancy, expensive foreign clinic to be looked over. But I feel I had good cause. I learned earlier this month in a cocktail party conversation with a USAID employee that Kazakhstan, similar to the other Central Asian countries, has among the highest rates of HIV transmission in hospitals anywhere in the world. This is because of bad practices with syringes and blood. Supposedly (again, this is a ‘fact’ coming from a casual conversation, but with a professional in the field) only 50% of blood slated for transfusion is screened for blood-borne diseases.

I was prescribed my medications without any jabs or transfusions, so I’ve avoided the major risks of my hospital visit. However, the facts above, in conjunction with some other statistics I’ve learned from various sources and conversations over the last few weeks (and not all independently verified, by the way), have served as a wake up call for me about: first, the gap between Almaty and Astana and the rest of Kazakhstan; and 2, the unseen problems challenging even the ‘developed’ parts of Central Asia.

The other statistics I heard were:

  1. Kazakhstan has the third highest young adult suicide rates in the world, behind only Russia and Belarus, and, according to Wikipedia, as of 2010 (although some figures are older) had the fourth highest absolute suicide rate in the world, trailing Lithuania, South Korea and Guyana.
  2. Supposedly heroin is cheaper per dose than a new syringe in Central Asia, leading to lots of shared needle use in among drug addicts. This explains the fact that…
  3. Kazakhstan, along with its regional neighbors, is one of the few places in the world in which the HIV/AIDS infection rate is still growing, and in fact has one of the fastest growing HIV populations in the world. This superlative is mitigated somewhat by the fact that the infected population is relatively low to begin with (a fast rate of expansion is easier: 75% growth in a population of 4 is only 3 new cases; the same rate in a population of 160 requires 120 new infections), but is shocking nonetheless.

I am shocked because these statistics do not resonate with the city and country as I’ve experienced it, which appear to be on the up and up even outside of Central Almaty. What the facts tell me, though, is that I’ve been somewhat complacent in my explorations and adventures. I’ve become very comfortable in Almaty, and I take for granted the creature comforts that this city – which I heard a US Foreign Service type refer to as “the best kept secret” – offers to foreigners with disposable income. But it comes as no great revelation that expats, including myself, mistake the city’s superficial and cosmetic accomplishments for real improvements in quality of life and social welfare. While they were still in Kazakhstan, the Peace Corps folks liked to tell Fulbright grantees living large in Almaty like myself that we didn’t know or hadn’t really experienced Kazakhstan. This is preposterous on one level because, well, if I’m not in Kazakhstan, then I don’t know where I am; but on another level, I am sympathetic with their frustration at people confusing the part for the whole, and perhaps misjudging the part at that. Even after the better part of a year here, it is very hard for me to say what is going on here, where the country is going, how people feel about their circumstances, etc.

It is unlikely that, in my last month in the country, I’m going to strap on my hiking boots and set out for the “real Kazakhstan” (perhaps an imaginary analog to Sarah Palin’s “real America,” but you get the idea). I say “unlikely” not because it would be hard, but because I really have come to appreciate my creature comforts, and I don’t want to set off on an expedition in the summer heat. Instead, I am taking comfort in the idea that I’ll be back after my Fulbright research is over. That I raise these (and many other) doubts about my experience now means that I have questions to answer in the future.

1 comment
  1. Aigul Sultanbekova said:

    Paull, you do have sence of humor! 🙂

    Being serious though, Almaty and Astana are indeed dramatic stand-outs among all other areas in Kz. But I think that it could be the case in many-many countries. Though the difference is not that vast as in India, for example.

    I agree on your argument on HIV growth rate, though it coud look frightening in percentages it is low in absolute terms. There have been some UN projects on HIV prevention in Kz in the past as far as I remember.

    Idea that heroin dose costs less than syringe sounds too much. I am not sure about prices for heroin 🙂 but new syringe costs nor more than max 1.4 USD (200 KZT).

    I am sure that all of your friends in Kz are ready to investigate any of your hypotheses with you, so come back!

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