������Ƶ

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.

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.”