Dear colleagues,
The Uzbek mass media has recently reported about series of trainings
organized in different areas of the country with the goal of raising
awareness of the male population in reproductive rights. The project
is supported by the UNFPA.
In this regard the Expert Working Group draws attention to the
HIV/AIDs situation among the Uzbek labor migrants and their families.
The attached paper highlights this problem and puts forward
recommendations.
The paper is distributed in English and Russian. Thank you in advance
for your attention.
Kind regards,
Sukhrobjon Ismoilov
Director, the Expert Working Group
TEXT IN ENGLISH
Uzbekistan: Migration activity and situation with HIV/AIDs among Uzbek
labor migrants and their families
The Uzbek mass media has recently reported that the Uzbek authorities
began involving male population in the issues of reproductive health.
This project supported by the UNFPA (United Nations Population Fund)
has organized a series of training on reproductive health for
representatives of mahalla committees (the lowest self-governance body
in Uzbekistan) in Andijon, Namangan, Fergana, Surkhandarya and Khorezm
regions. Trainings focused on ways of involvement of male population
in reproductive health and rights. As to the plan of the organizers
the advisors and activists of local mahalla committees are expected to
organize similar workshops for the target groups from their
constituencies. All in all more than 100 representatives of the
mahalla committees from five provinces of Uzbekistan have participated
in those trainings.
Traditionally men play a leading role in decision-making process in
the Uzbek families. Therefore the organizers of the trainings have
aimed at involving at representatives of male population in their
events. The training participants have studied issues of reproductive
health, major reproductive rights, prevention of infections
transmitted through sexual intercourse, including the HIV, creation of
healthy families, gender equity and equal partnership.
In this regard the Expert Working Group draws attention to the Uzbek
labor migrants, their role in implementation of reproductive rights
and prevention of HIV-infection in Uzbekistan. The Uzbek population,
in particular the rural population, has a high migration activity, and
therefore the Uzbek labor migrants are very often in the groups of
risk as carriers and distributors of HIV-infection. The existing
government policy lacks a clear approach to dealing with mobile groups
of the population (Uzbek labor migrants, migrating groups of risk –
i.e. consumers of injection drugs, persons providing sex services for
remuneration, men having sex with men, drivers to long distances,
etc.)
A serious problem is absence of a clear system of monitoring and
record of the Uzbek citizens engaged in labor activities abroad.
Unfortunately there is no reliable information on the numbers of Uzbek
citizens working abroad and places of their dislocation. At the moment
the Uzbek customs declaration tends to fulfill the function of
collecting such information although it is not the task of the customs
body to do so. The Uzbek customs declaration form T-6 which every
person coming in and out of Uzbekistan should fill in has a section
(Section # 3 of the customs declaration form) which requests
information on purposes of visit with a response “Work”. In practice
there is no a clear system of monitoring and information on locations
and work of the Uzbek labor migrants abroad. Very often neither the
Uzbek government nor the family members of the Uzbek labor migrant has
information on the work and living conditions of the Uzbek labor
migrant. The existing consular system of Uzbekistan obviously fails to
meet the current needs . For instance, Uzbekistan maintains its
diplomatic representations only in two places of Russian Federation –
the Uzbek Embassy in Moscow and a general consulate in Novosibirsk. At
the same time the geography of the Uzbek labor migrants throughout
Russia is rather dispersed and covers almost the whole territory of
Russia. It is physically impossible for the Uzbek labor migrants
working for example in the Russian Far East to apply for a consular
registration because of a long distance to the Uzbek consulates in the
territory of Russia. Special procedures which could enable a distance
consular registration of the Uzbek labor migrants do not exist yet.
In this regard the tendency of spreading for HIV among the labor
migrants temporarily living and working in the Russian territory
raises serious concerns. According to Ivan Mironyuk, a chief doctor of
the Center of Prevention and Fight against HIV/AIDs in Zakarpatye
region of Russia in 2011 about 78 % of new cases of HIV in this region
were registered among male labor migrants from foreign countries. In
60 % of cases the wives of the labor migrants were also found as
HIV-positive. In 2008 the Russian authorities tested 1,088,761 foreign
labor migrants in Russia to HIV/AIDs and found 1,579 persons with HIV
status. In 2007 – 2008 the highest rates of HIV cases were registered
among the labor migrants from Ukraine (798 cases), Uzbekistan (773),
Tajikistan (322) and Moldova (167). The Russian authorities which
annually accept up to 4 million Uzbek labor migrants recognize the
increasing negative consequences of the HIV-infection epidemics in
this country. Each year about 60 thousand people in Russia are found
as HIV-infected. The total number of HIV-infected persons officially
registered in Russia on 25 January 2012 made up 647,578 persons.
The Russian authorities and legislators have already started
discussions on setting restrictions against entrance to the country
for foreign labor migrants with serious infectious diseases (HIV/AIDs,
TB) and also drug-addicts. Requests obliging the prospective foreign
labor migrants to undergo a medical diagnostics before they enter the
Russian territories and get a medical certificate are also in the
center of discussions. Those suggestions only sound radical but they
might reflect real concerns of the Russian authorities over this
issue.
The above mentioned numbers compared to the existing official data in
Uzbekistan provide a serious ground for concerns. According to the
official statements by 1 January 2012 there were 21,542 persons with
HIV-positive status in Uzbekistan (72,3 persons per 100 thousand
population) although the mentioned official data might be understated
to many times. The most popular way of spreading the HIV in
Uzbekistan is parenteral. At the same time the number of cases of the
HIV-infection transmitted through sexual contact has been on the rise
which coincides with the general tendency in the world. For the last
several years the number of women among the officially registered new
cases of the HIV-infection in the country has also been growing (women
made up to 47,6 % of the new cases of the HIV-infection in 2011). 67,7
% of newly registered cases of the HIV-infection in 2011 related to
the population between 25-49 years old. It can be suggested that at
present the external labor migration serves as one of the major
sources of intervention and spread of different inflectional diseases,
including the HIV/AIDs in Uzbekistan. This problem in particular
raises special concern in the case of returning labor migrants when
the returning Uzbek labor migrant infects his family members thus
pushing further spread of the infection.
From time to time the Uzbek authorities distribute on the board of the
Uzbek Airlines brochures and demonstrate video-programs with awareness
raising materials on HIV/AIDs prevention. This project is supported by
the AIDs Control Program for Central Asia. However there is no a
unified control system to monitor the health of the Uzbek labor
migrants who are returning home. The measures of prevention of
intervention and spread of different inflectional diseases in
Uzbekistan should also include all citizens and non-citizens from
Uzbekistan, and not only the labor migrants, who haven’t in the
country for a long period (for instance, for six months and more).
The existing legal and institutional system of fighting against the
HIV/AIDs in Uzbekistan fails to prevent spread of this disease among
the Uzbek labor migrants and their families. There are Decrees of the
Uzbek president # PP-1023 (adopted on 26 December 2008) “On
additional measures of raising the effectiveness of fighting against
the spread of the HIV-infection in the Republic of Uzbekistan” and
Cabinet of Ministers # 1 (adopted on 5 January 2009) “On measures of
improving organizational structure and activities of Centers for
Fighting the AIDs”. The official statements mention that the
government has already implemented a Strategic Program on Fighting the
HIV-infection Spread in Uzbekistan in 2007-2011. At the moment the
Uzbek authorities are reported to be developing a new National Action
Plan on Fighting HIV/AIDs in 2012-2016. The government has also
created a National Commission responsible for coordination of all
measures in the field of fighting against spread of the HIV-infection.
According to the official reports the authorities also maintain a
regular work of the National Epidemiological Patrol on Spread of the
HIV-infection which carries out regular monitoring of the situation
with the HIV-infection in the country since 2005. The Uzbek
authorities claim that the Epidemiological Patrol regularly monitors
the HIV situation among the major risk groups of the population in all
regions of the country – injection drugs consumers, persons providing
sexual services for money, men having sex with men. But to our
knowledge the Epidemiological Patrol doesn’t work with the Uzbek labor
migrants leaving and returning to the country.
In this way the Uzbek labor migrants are practically excluded from the
social groups vulnerable to HIV-infection and special prevention
programs. Due to a variety of factors the Uzbek labor migrants face
the highest risks to catch the HIV-infection. Those factors include a
complicated access to necessary information on ways of prevention and
medical aid because of cultural and language barriers in the accepting
countries; being apart with family members and permanent partners;
increased demand for temporary sexual services.
The situation with HIV/AIDs and other types of infections transmitted
through sexual contact among the Uzbek labor migrants will
deteriorate. Facing high risks of catching HIV-infection during sexual
contacts the Uzbek labor migrants demonstrate low level of awareness
on safe sexual practice. Independent observers conclude that it would
be the Uzbek labor migrants who will influence the tendencies of
epidemiological situation in the country for the coming years.
In this regard the Expert Working Group recommends the following:
The Uzbek government should immediately take measures to effectively
prevent spread of HIV-infection among the labor migrants;
The existing National Epidemiological Patrol on Prevention of the
Spread of HIV-infection should include the Uzbek labor migrants as
well;
Every Uzbek labor migrant leaving or returning to the country should
undergo HIV-test;
The access of the Uzbek labor migrants and their families to
awareness raising information and medical services helping to decrease
the HIV risk should be increased;
The employers of the Uzbek labor migrants should be widely involved
in implementing tasks of fighting the epidemics of the HIV/AIDs;
The access of the Uzbek labor migrants to medical services, in
particular diagnostics and medical treatment of the HIV/AIDs, other
types of infections transmitted through sexual contact and TB should
be increased;
The access of the Uzbek labor migrants and their families to social,
psychological and legal assistance and services should be increased;
Wide distribution of means of HIV prevention and prevention of other
infections transmitted through sexual contact, first of all condoms
among the labor migrants;
Creation of a clear system of monitoring and registration of the
Uzbek labor migrants working abroad;
Adopting Law “On external labor migration”.
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