Kyrgyzstan struggles with deadly shortages of medicine

Kyrgyzstan struggles with deadly shortages of medicine
A man asks for donation for medicines in Bishkek, Kyrgyzstan. (AFP)
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Kyrgyzstan struggles with deadly shortages of medicine

Kyrgyzstan struggles with deadly shortages of medicine
  • The five Central Asian countries are highly dependent on pharmaceutical imports and patients are often left to fend for themselves
  • Shortages, high prices and the poor quality of medicine affect many of the region’s 80 million inhabitants

BISHKEK: Like many people affected by serious illness in ex-Soviet Central Asia, Almagul Ibrayeva is having trouble finding medicine in her native Kyrgyzstan.
“Women are dying because of a lack of medicine,” Ibrayeva, who is in her 50s, told AFP.
In remission from breast cancer, Ibrayeva needs a hormone treatment called exemestane after having a mastectomy and her reproductive organs were removed.
She said she “often” faces difficulties.
“I order it from Turkiye or Moscow, where my daughter lives,” she said.
“There are many medicines that are simply unavailable here. The patient has to look themselves and buy them.”

Shortages, high prices and the poor quality of medicine affect many of the region’s 80 million inhabitants.
The five Central Asian countries are highly dependent on pharmaceutical imports and patients are often left to fend for themselves.
There are often cases of expired or adulterated medicine such as the cough syrup imported from India which killed 69 children in Uzbekistan in 2023.
The costs of high-quality medicine are often prohibitive.
“Some people sell their homes, their livestock, get into debt just to survive,” said Shairbu Saguynbayeva, a uterine cancer survivor.
She created a center called “Together to Live” in the Kyrgyz capital Bishkek which hosts women who have cancer, offering accommodation and help for treatment.
“Here they can get organized. When someone is receiving chemotherapy, they fall ill, not every loved one can handle it,” Saguynbayeva said.
Women at the center sew and sell traditional Kyrgyz ornaments — funding the treatment of 37 patients since 2019.
Saguynbayeva says she is grateful to the Kyrgyz state for “finally” starting to supply more medicine but says the quantity is still “meagre.”
One patient, Barakhat Saguyndykova, told AFP that she received “free anti-cancer medicine only three times between 2018 and 2025.”
At the National Oncology and Haematology Center, doctor Ulanbek Turgunbaev said that sourcing medicine was “a very serious problem for patients” even though medicine supply has increased.
He said the best way of reducing therapy costs was “early detection” of serious illnesses.

Material deficits and a shortage of 5,000 health professionals in Kyrgyzstan mean that the most urgent needs have to be addressed first.
President Sadyr Japarov has promised to eliminate corruption in the medical sector, which cost the health minister his job last winter.
While medicine factories have finally been opened, the situation in the short term remains complicated.
The Kyrgyz Chamber of Commerce and Industry said that “around 6,000 medicines could disappear from the market by 2026” because of the need to “re-register under the norms of the Eurasian Economic Union” — a gathering of former Soviet republics including Kyrgyzstan.
The government in 2023 created a state company called Kyrgyz Pharmacy which is supposed to centralize medicine requests and bring down prices, according to its head, Talant Sultanov.
But the organization has been under pressure because of a lack of results.
Sultanov said he hoped medicine prices could be lowered “by signing more long-term agreements with suppliers through purchases grouped on a regional basis” with other Central Asian countries.
Kyrgyz Pharmacy has promised steady supplies soon but many women in Bishkek are still waiting for medicine ordered through the company months ago.
Recently a mother of three “died simply because she did not receive her medicine in time,” Saguynbayeva said.
“It is better to save a mother than to build orphanages,” she said.


One man’s 30 years of toil to save Sierra Leone’s orphaned chimps

Updated 5 sec ago

One man’s 30 years of toil to save Sierra Leone’s orphaned chimps

One man’s 30 years of toil to save Sierra Leone’s orphaned chimps
TACUGAMA: Bala Amarasekaran has never felt like running his world-renowned sanctuary for orphaned chimpanzees in Sierra Leone was truly work, having come to his calling only after several unexpected twists of fate.
Standing in his Tacugama Chimpanzee Sanctuary not far from the capital Freetown, he tenderly patted a young ape’s nose and stroked its cheek, whispering a few words of encouragement into its ear.
A nearby adolescent, visibly jealous, grabbed at Amarasekaran’s hand, pandering for his attention with an intense gaze.
The chimps are not just Amarasekaran’s life and work, but his family too. Since 1995 he has fought for them, nurtured them and preserved the oasis he created for them against an onslaught of dangers.
“I never feel I come to work because the chimps are a part of my life,” Amarasekaran told AFP. “It’s my passion, I come to see my family.”
In the face of armed rebel attacks during the country’s civil war, mass deforestation and even Ebola, Amarasekaran has ensured the chimps’ safety.
In the midst of it all, Tacugama Chimpanzee Sanctuary has become the country’s leading ecotourism destination and a model for environmental conservation in west Africa.
The little apes in the enclosure visited by Amarasekaran had only recently arrived following traumatic life experiences.
Members of the critically endangered Western chimpanzee subspecies, the orphans are often malnourished or otherwise wounded by bullets or machetes, sometimes after being sold by poachers and kept as pets.
At the sanctuary, located inside the country’s Western Area Peninsula National Park, they will first be rehabilitated then freed into its dozens of hectares of protected tropical rainforest, already home to 123 primates.


Amarasekaran, a 64-year-old accountant by training, was by no means destined for a life protecting young apes.
“Well it all happened by accident,” Amarasekaran said, green eyes twinkling.
Amarasekaran first arrived in Sierra Leone at age 17 from Sri Lanka.
In 1988, while traveling in the countryside with his wife, Sharmila, the newlyweds were shocked to discover a baby chimpanzee tied to a village tree, malnourished and dehydrated.
“We took the chimp, otherwise he would have died,” Amarasekaran said, and once home “we actually looked after him like a child.”
Bruno, as he was named, would live with Amarasekaran for almost seven years until the sanctuary was built.
The couple was astounded by the ape’s emotions, and discovered that chimps had “the same kind of demands in terms of affection” as humans, Amarasekaran said.
The interspecies family grew as the Amarasekarans took in up to seven chimpanzees at a time.
Despite all the love, there could be “a lot of destruction,” Amarasekaran said.
Sometimes the chimps would escape from the house, causing damage to neighbors’ properties or stealing bread from passersby.
“I was public enemy number one,” Amarasekaran said with a laugh, often returning home to find bills for repairs from neighbors.


After a decisive meeting with renowned primatologist Jane Goodall in 1993, Amarasekaran secured funding from the European Union and a green light from the Sierra Leone government.
At the time, Amarasekaran thought he would commit one to two years to the project and then hand over the sanctuary.
But that never happened.
“I didn’t realize the chimps would become a very important part of my life,” Amarasekaran said, his voice breaking with emotion.
Thanks to his awareness campaign, the government declared the chimpanzee the “national animal of Sierra Leone” in 2019.
Over the years the sanctuary has endured many challenges. During the country’s civil war, which lasted from 1991 to 2002, the sanctuary was attacked twice by rebels and completely looted.
Amarasekaran had to negotiate with the fighters to spare his staff and chimps’ lives.
Later, the Ebola epidemic posed an existential threat to humans and chimps alike. The center closed for a year and caregivers moved into the facility.
The same system was also put in place for several months during Covid-19.


Faced with an alarming increase in deforestation and illegal encroachment on the national park where the refuge is located, Amarasekaran is taking drastic measures.
Since late May he has kept the sanctuary closed in a protest meant to shock the government into action.

So far however, the government has not responded, and the financial consequences for the sanctuary, which depends on tourism and donations, are weighing heavily.
As a keeper it is easy to develop a special bond with a few favorite chimps, just like among humans, Amarasekaran said.
He had been particularly close with Bruno, Julie and Philipp, now deceased.
These days, he likes to visit with Mac, Mortes and Abu: “These are my friends,” he said while smiling.
As AFP accompanied Amarasekaran around the sanctuary, a roar of excitement arose from an enclosure where some of the adults were gathered.
The adoring screeches seemed proof that the unique love Amarasekaran professed for his chimps goes both ways.

Toxic Balkan wildfires ignite in poorly managed dumps

Toxic Balkan wildfires ignite in poorly managed dumps
Updated 5 min 44 sec ago

Toxic Balkan wildfires ignite in poorly managed dumps

Toxic Balkan wildfires ignite in poorly managed dumps
  • According to the 2024 poll, in Kosovo, less than 20 percent of households separate their trash. Montenegro, Bulgaria, Bosnia and Serbia all closely follow in the rankings, with households recycling at rates lower than 40 percent

BELGRADE: As blistering summer heat sweeps across the Balkans, poorly managed and illegal dumpsites are bursting into flames, sparking wildfires and smothering towns and cities with toxic smoke.
The municipal Golo Brdo dump, deep in the lush forests of southeast Serbia, burned for days after it ignited under the scorching sun in early July.
In the small town of Lukare, about seven kilometers (4.3 miles) from the blaze, the air became foul and unbreathable.
Local children were kept indoors for fear of the deadly diseases that many people nearby already suffer, resident Haris Ibrahimovic told AFP.
“Honestly, no one cares whether we’re exposed or not,” Ibrahimovic said, frustrated by the inaction and poor monitoring by the local government.
This fire was just one of hundreds of blazes that have torn through parts of Serbia since the start of summer.
Authorities said many fires started at landfill sites, where the improper disposal and management of waste is a long-standing issue.
Although Golo Brdo is a government-run site, Ibrahimovic said what is dumped there was “absolutely uncontrolled,” and it caught fire several times since opening in 1999 — each time burning for around two weeks.


When piles of organic waste aren’t stored properly, they can create pockets of methane that ignite under intense heat and burn through the dump’s readily available fuel, Aleksandar Jovovic, professor at Belgrade’s faculty of mechanical engineering, told AFP.
Jovovic said the issue had grown over decades, and fixing it would mean reforming the entire waste management system to sort and process trash safely.
According to Serbia’s environment ministry, less than half the country can access just a dozen properly managed, or “sanitary,” landfill sites.
Most waste instead ends up either at an unsanitary site like Golo Brdo, with the unsorted trash piles described by Jovovic, or in one of the 2,500 illegal dumps.
The issue is region-wide, with research by Lloyd’s Register finding that Balkan households separate their trash at the lowest rates in the world.
According to the 2024 poll, in Kosovo, less than 20 percent of households separate their trash. Montenegro, Bulgaria, Bosnia and Serbia all closely follow in the rankings, with households recycling at rates lower than 40 percent.
The impact of poorly managed waste extends far beyond those near a dump, Ibrahimovic said.
Fumes from last month’s fire reached two cities around 10 kilometers (5 miles) from Golo Brdo, while the runoff into a local river is “literally black.”
“We have a series of cases around the landfill where people are getting lung cancer,” he said.
“We’re not claiming that it’s all because of the landfill, but it certainly has an impact.”
Former director of the World Health Organization’s European Center for Environment and Health, Elizabet Paunovic, said that the impacts of garbage fires on local communities were well-documented.
These blazes belch toxic gases, leach microparticles and pump heavy metals into the atmosphere, while fumes from burning plastic were “highly toxic,” Paunovic told AFP.
For people living nearby, these toxins, which can cause congenital disabilities, will often go unnoticed due to poor monitoring by authorities, she said.


Balkan nations, bolstered by foreign investment, are intensifying their efforts to address waste management, but they still lag behind the rest of Europe.
In 2021, Belgrade’s Vinca, then one of Europe’s largest open dumps, was redeveloped.
Elsewhere in the region, new landfills are planned or have recently opened.
In response to the series of fires at landfills this summer, the government asked local authorities to increase monitoring as an emergency measure.
But progress remains slow, often hindered by aging infrastructure and a lack of accountability.
In Albania, three long-promised incinerators never arrived, despite millions of euros invested in a project now mired in corruption allegations.
At the proposed site, mounds of garbage burned for almost a week in June, blanketing parts of the nearby city of Elbasan in noxious fumes.
“The way this waste is managed is a real corruption case that goes against all the functional safety standards,” local environmental expert Ahmet Mehmeti said.
Around 20 people have been charged in a vast scandal linked to the incinerators, but little has changed at the landfill sites.
For those like Ibrahimovic living in the shadow of smoke clouds, promises to fix or even close landfill sites are not new — he said authorities first vowed to close Golo Brdo in 2018.
After years of protesting, including by blockading the dump, he is now preparing a lawsuit to force change.
“It can only be closed on paper, not through agreements, not through promises.”


Thailand accuses Cambodia of second ceasefire violation in two days

Thailand accuses Cambodia of second ceasefire violation in two days
Updated 2 min 56 sec ago

Thailand accuses Cambodia of second ceasefire violation in two days

Thailand accuses Cambodia of second ceasefire violation in two days
  • Thailand’s military accused Cambodian forces on Wednesday of breaching a ceasefire agreement
  • The allegations come less than two days after both governments agreed to a ceasefire brokered in Malaysia

BANGKOK: Thailand’s military accused Cambodian forces on Wednesday of breaching a ceasefire agreement at three separate locations along the disputed border, warning that continued aggression could compel Thai forces to respond more decisively.
The allegations come less than two days after both governments agreed to a ceasefire brokered in Malaysia, which came into effect at midnight on Monday, aimed to stop fighting and prevent escalation of their deadliest conflict in more than a decade following five days of intense fighting that has killed at least 43 people and displaced over 300,000 civilians on either side. The truce came after a sustained push from Malaysian Premier Anwar Ibrahim and US President Donald Trump, with the latter warning Thai and Cambodian leaders that trade negotiations would not progress if fighting continued. Thailand and Cambodia face a tariff of 36 percent on their goods in the US, their biggest export market, unless a reduction can be negotiated. After the ceasefire deal was reached, Trump said he had spoken to both leaders and instructed his trade team to restart tariff talks.
On Wednesday, Thailand said Cambodian forces fired on positions in northeastern Thailand’s Sisaket province on Cambodia’s northern border. “Cambodian forces used small arms and grenade launchers, prompting Thailand to respond in self-defense,” Thai army spokesman Maj. Gen. Winthai Suvaree told reporters.
“This was the second incident since the agreement and reflects a behavior that does not respect agreements, destroys de-escalation efforts and hampers trust between the two countries.”
Cambodia rejected the allegations, saying it was committed to the ceasefire and called for observers.
“Cambodia strongly rejects the ceasefire accusations as false, misleading and harmful to the fragile trust-building process,” Cambodian Foreign Ministry spokesperson Chum Sounry told reporters at a press conference, adding the government supports a monitoring mechanism and independent observation.
The ceasefire, which also agreed to halt troop movement, paves the way for a high-level military meeting that includes defense ministers on August 4 in Cambodia. There have been no reports of any exchange of heavy artillery fire but also no reports of troop withdrawals by either side.


UN investigator says US sanctions over her criticism of Israel will seriously impact her life

UN investigator says US sanctions over her criticism of Israel will seriously impact her life
Updated 21 min 9 sec ago

UN investigator says US sanctions over her criticism of Israel will seriously impact her life

UN investigator says US sanctions over her criticism of Israel will seriously impact her life
  • An independent UN investigator and outspoken critic of Israel’s policies in Gaza says the sanctions recently imposed on her by the Trump administration will seriously impact her life and work
  • Francesca Albanese, is tasked with probing human rights abuses in the Palestinian territories and has been vocal about what she has described as the “genocide”

ROME: An independent UN investigator and outspoken critic of Israel’s policies in Gaza says that the sanctions recently imposed on her by the Trump administration will have serious impacts on her life and work.
Francesca Albanese, the UN special rapporteur for the West Bank and Gaza, is a member of a group of experts chosen by the 47-member UN Human Rights Council in Geneva. She is tasked with probing human rights abuses in the Palestinian territories and has been vocal about what she has described as the “genocide” by Israel against Palestinians in Gaza.
Both Israel and the United States, which provides military support to its close ally, have strongly denied that accusation. Washington has decried what it called a “campaign of political and economic warfare” against the US and Israel, and earlier this month imposed sanctions on Albanese, following an unsuccessful US pressure campaign to force the international body to remove her from her post.
“It’s very serious to be on the list of the people sanctioned by the US,” Albanese told The Associated Press in Rome on Tuesday, adding that individuals sanctioned by the US cannot have financial interactions or credit cards with any American bank.
When used in “a political way,” she said the sanctions “are harmful, dangerous.”
“My daughter is American. I’ve been living in the US and I have some assets there. So of course, it’s going to harm me,” Albanese said. “What can I do? I did everything I did in good faith, and knowing that, my commitment to justice is more important than personal interests.”
The sanctions have not dissuaded Albanese from her work — or her viewpoints — and in July, she published a new report, focused on what she defines as “Israel’s genocidal economy” in Palestinian territories.
“There’s an entire ecosystem that has allowed Israel’s occupation to thrive. And then it has also morphed into an economy of genocide,” she said.
In the conclusion of the report, Albanese calls for sanctions against Israel and prosecution of “architects, executors and profiteers of this genocide.”
Albanese noted a recent shift in perceptions in Europe and around the world following an outcry over images of emaciated children in Gaza and reports of dozens of hunger-related deaths after nearly 22 months of war.
“It’s shocking,” she said. “I don’t think that there are words left to describe what’s happening to the Palestinian people.”
The war began on Oct. 7, 2023, when Hamas-led militants stormed into Israel and killed some 1,200 people, mostly civilians, and took 251 people captive. Israel’s retaliatory campaign has killed over 60,000 Palestinians, according to Gaza’s Health Ministry, which does not differentiate between combatants and civilians but says more than half the dead are women and children.
Nearly 21 months into the conflict that displaced the vast majority of Gaza’s 2.3 million people, the United Nations says hunger is rampant after a lengthy Israeli blockade on food entering the territory and medical care is extremely limited.


Female tour guides in lead women-only groups as some travelers return

Female tour guides in lead women-only groups as some travelers return
Updated 17 min 43 sec ago

Female tour guides in lead women-only groups as some travelers return

Female tour guides in lead women-only groups as some travelers return
  • Deadly attacks have dropped sharply after the Taliban returned to power, and the improved security is attracting an increasing number of tourists after decades of war

KABUL: They wandered through the museum, listening attentively as their guide explained the antiquities in display cabinets. It could have been any tour group, anywhere in the world. But there was something unusual about this one.
The group of foreigners visiting the National Museum of Afghanistan was made up only of women. Its guide was a woman, too — one of the first Afghan female tour guides in a country whose Taliban rulers impose the severest restrictions on girls and women anywhere in the world.
Somaya Moniry, 24, hadn’t known that tour guides existed, as a profession or even as a concept. But while browsing the Internet for help on improving her English language skills, she stumbled upon Couchsurfing, an app where travelers connect with locals and stay in their homes.
After hosting a traveler, “I became very passionate about it and it was very interesting for me,” Moniry said. “It was very unique. I have never heard about it before, so I said: ‘Why not (do) this?’”
Looking for the positive
As she showed that first visitor around her hometown in western Afghanistan, she saw a new side to her country.
“Most of the things that we have heard (about Afghanistan) was just … negativity. The focus of the people, focus of the media, focus of headlines, all of them were just the negativity. And definitely we get influenced by that,” Moniry said.
But for her, Afghanistan is far more nuanced. While there are undoubtedly problems in a place recovering from decades of war and chaos, there is also another side to the complex, stunning country. Her love for her homeland runs deep, and she is eager to share it. She hopes to gradually change people’s perceptions.
“Whenever … I saw all of that natures, all those beauty, all those positivity, it changed my view totally,” Moniry said in her enthusiastic English. “And definitely this can be also for other people.”
One of those visitors is Australian Suzanne Sandral. She originally wanted to see Afghanistan in the 1960s but the pressures of having a family kept her away. Now at 82, she was part of Moniry’s women-only tour group in Kabul.
Afghanistan surprised her.
“It’s not what I expected at all. I expected to feel rather fearful. I expected to be given a lot of ... accusatory looks. Not at all,” she said during a pause in sightseeing. “Wherever you go in the streets, if you smile at someone and give them a little nod or say hello, you get a terrific response. So it’s very different.”
Jackie Birov, a 35-year-old independent traveler from Chicago who was not part of the tour group, called the Afghan people “unbelievably hospitable.”
However, “I’m very aware that I have a lot more freedom than local women,” she said.
A fledgling industry
Four decades of war have kept tourists away from Afghanistan. But while the Taliban’s takeover of power in August 2021 sent thousands of Afghans fleeing and shocked the world, the end of its insurgency against the previous US-backed government also marked a sharp drop in violence.
Attacks still occasionally occur, mainly by a Daesh affiliate, and Western countries advise against all travel to Afghanistan. Still, the improved security is increasingly attracting foreign visitors drawn by the dramatic scenery, millennia of history and a deeply ingrained culture of hospitality.
Tourism is a fledgling industry, with annual visitors in the low thousands. Most are independent adventure travelers. But guided package tours are increasing from countries as diverse as China, Greece, the Netherlands and the United Kingdom.
Afghanistan’s Taliban government is keen to welcome them. Isolated on the international stage — officially recognized only by Russia, which did so in July — the government sees how potentially lucrative tourism could be.
Tourist visas, typically single-entry ones valid for stays of up to 30 days, have become relatively simple to obtain from the few embassies that issue them. Regular flights connect Kabul with major transit hubs such as Dubai and Istanbul.
A question of ethics
For some, the idea of visiting Afghanistan as a tourist is morally abhorrent, particularly given the government’s treatment of women.
Girls are banned from education above primary school level, and women live under myriad restrictions. The government dictates what they can wear in public, where they can go and who they can go with. They cannot walk in parks or eat in restaurants. Beauty salons are banned. A very limited number of professions, such as teaching and carpet weaving, are open to them.
And the rules can change quickly.
But those involved in tourism point to the positive effects that visiting Afghanistan can have.
“I truly believe in ethical tourism,” said Zoe Stephens, 31, a British tour leader at Koryo Tours, a company specializing in unusual destinations. “I believe that you can divide politics and people, and that is the main thing for me. … A country is not a sum of its politics. It’s a sum of so much more, it’s a sum of its culture, its history, its food, and especially in Afghanistan, its people.”
Glimpses into the women’s world
Of the three recent tours Stephens led in Afghanistan, two were women-only. Working with local female guides, including Moniry, they combine key attractions with visits to women’s centers and cooking and embroidery classes from local women — worlds that are closed to male travelers.
“We always try and do something a little bit different that really makes our tours unique, as well as something that kind of gives back to the community,” Stephens said. “So I felt that working with the female tour guides does both of those things really well.”
The groups are small — one had eight women, the other three — but the company is looking to build a network of female guides across Afghanistan.
“What we try and do with this tour, especially the women’s tour, is conquer those ethical concerns,” Stephens said. “The idea is to learn about the lives of Afghan women in context.”