Tourism has exploded in the Central Asia region.  The exquisite mountains, closed for many years to the West, now attract growing numbers of foreign visitors who are drawn by their natural and unspoiled beauty.  Government officials, hungry for the revenue that tourism generates, are fearful of international scandal.  As a result, there is little transparency when it comes to disclosing failures in infrastructure, including health care systems.

The announcement this week by authorities in Uzbekistan that at least 14 children had died and that another 133 are infected with HIV from contaminated medical equipment is a sober reminder that health care in underdeveloped countries remains perilous. Reports of similar incidents in Kazakhstan and Kyrgyzstan, should make anyone travelling to the former Eastern Soviet bloc wary of the medical treatment they might receive.

Complicating matters further, the government of Uzbekistan is widely believed to have covered up reports in 2007 that HIV contaminated needles and syringes were used to immunize toddlers in the city of Namangan.  Indeed, the details only came to light this week when news broke that 12 doctors and nurses at two hospitals in the city were convicted of using contaminated equipment.  Moreover, Uzbek activist Maxim Popov, who distributed brochures saying condoms and disposable syringes could help prevent HIV, was convicted of corrupting minors by promoting homosexuality, prostitution and drug use. He was sentenced to seven years in jail.

The United Nations says Uzbekistan has one of the world’s fastest-rising HIV infection rates. About 16,000 cases of HIV/AIDS were reported in 2009 — more than an eleven-fold increase from 1,400 cases in 2001, a World Health Organization report said.  Not all of the increase can be attributed to transmission through contaminated needles, however, as the rate of illegal drug use and sexually transmitted diseases has skyrocketed in recent years. 

American tourists must prepare before travelling to Central Asia. As in many underdeveloped regions of the world, most health care remains substandard.  However, risks may be minimized with the proper vetting of medical providers – hospitals and doctors – prior to departure. If you are heading for Tashkent, Almaty or Dusanbe, ask your travel health plan or assistance company for a contingency plan.

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About The Author

Frank Gillingham, M.D. serves as Chief Medical Director for HTH Worldwide. Frank has led HTH Worldwide's international business development efforts in Europe and Canada and has been a guest speaker at international business conferences and has authored a series of articles on travel medicine, including pieces on travel information available on the Internet and the role of physicians working with travel insurers. Frank is a Board-Certified Internist and Emergency Medicine Specialist. He is also a private emergency physician in Southern California and a former emergency department director and member of the UCLA emergency department staff. Frank completed residency training at Los Angeles County/USC Medical Center, received his M.D. from Albert Einstein College of Medicine and his B.A. from the University of Pennsylvania .

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