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Bishkek

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OVERVIEW

Bishkek.jpg

In Kyrgyzstan, you will find a complex picture regarding sexual and reproductive health care. On the one hand, birth control pills are legally sold over-the-counter in urban environments, and a large percentage of women use intrauterine devices (IUDS). Emergency contraceptive pills (morning after pills) are available, though a prescription may be required. Furthermore, abortion is legally available upon request and there are no travel restrictions related to HIV status. On the other hand, Kyrgyzstan is still very much a traditional country. Women tend to use contraceptives at lower levels than the Central Asian average, and sex education is not currently taught in schools (as of May 2018), though this may soon change. Bride kidnappings are rather common, and many bride kidnappings are nonconsensual. There is no nationwide HPV vaccination program and we are unaware of any programs related to Pre-Exposure Prophylaxis (PrEP). There are also limited resources related to STI education and support. In 2017, the UNFPA also completed a contraceptive distribution program in the country, and the local government has not yet filled the gap created by this loss of program. Overall, Kyrgyzstan is a country where certain sexual and reproductive health care options are available to some women, particularly if they tend to be wealthier and live in urban environments, but accessibility, affordability and choice remain an issue for many women in the country.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Kyrgyzstan, you can purchase condoms and oral contraceptives (birth control pills) without a prescription at pharmacies.[1] You can also access longer-lasting contraceptive methods, such as IUDs, at clinics and hospitals in the country.

Generally speaking, women in Kyrgyzstan are expected to marry and have large families. However, women are increasingly trying to space out their births at least three years apart,[2] leading to a larger demand for contraceptive options. In 2015, it was estimated that 42% of women (who are married/in unions and of reproductive age) in Kyrgyzstan use some form of contraception, and about 17% of women have unmet family planning needs. This is below the average rate of contraceptive use in Central Asia, which is 57%. The most common contraceptive methods were found to be IUDs (22%), male condoms (10%) and birth control pills (4%). There were low usage rates for traditional methods (2%), female sterilization (1%) and withdrawal (1%). Meanwhile, less than 1% of women used contraceptive injectables or the rhythm method, and there was no recorded usage of male sterilization, female barrier methods or contraceptive implants.[3]

For women in Kyrgyzstan, contraceptive access depends on many factors, including location, income status, and personal autonomy. While wealthy women in urban centers, like Bishkek, can find contraceptives in pharmacies and clinics, women from low-income or rural backgrounds often struggle to access and afford contraceptives. In the 1990s, the Kyrgyz government launched a program to promote family planning and reduce the infant mortality rate, but the majority of women still could not access birth control pills. During that time, the most common family planning methods were IUDs and abortion.[4] In the 2000s, UNFPA launched a temporary program that provided free birth control pills to Kyrgyz families from impoverished backgrounds. However, the program ended in 2017 and the Kyrgyz government has not done enough to fill the gap left by UNFPA's departure. While the government has begun to offer a 50% discount for birth control pills, this only applies to people who hold medical insurance policies, which excludes many rural women.[5]

Generally speaking, Kyrgyzstan is a socially conservative country. The majority of Kyrgyz citizens are Muslim (75%) followed by Russian Orthodox (20%). The Kyrgyz people (who make up about 71% of the population) are not extremely religious on average, but they can be considered very traditional.[6] Frank discussion of sexuality is typically considered taboo,[7] and bride kidnappings (“ala kachuu”) are common. In fact, it was estimated that up to 40% of ethnic Kyrgyz women were married after being kidnapped and nearly two-thirds of bride kidnappings are unplanned. While bride kidnapping has been technically illegal since 1994, it is still widely practiced.[8] [9]

In 2015, Parliament passed a bill that established the legal basis to teach sexuality education in schools. While the bill was controversial and opposed by some people, it was also welcomed by others. In fact, it was found that 80% of parents in Kyrgyzstan wanted their children to receive sexuality education, and many stated that they did not know how to talk about sexuality with their children.[10]

What to Get & Where to Get It

  • In Kyrgyzstan, you can find condoms available in pharmacies and online stores. For example, on the website for Neman, a leading wholesale and retail company in Kyrgyzstan, you can find Durex, Masculan, Sico, Vietex, and Viva condoms sold in local currency.
  • You should be able to purchase oral contraceptives (birth control pills) without a prescription at pharmacies.[11] Some of the brands you may see are Belara, Jess, Ovidon, Microgynon, Regulon, Rigevidon, and Yarina.[12] [13] While there are many pharmacies, some of the ones that you can check out are Central Pharmacy (Address: 127 Abdrakhmanov (former Sovetskaya) st. crosses Moskovskaya st.; Tel: (312) 901011, 665500) and Prestige (Address: 95 A Kievskaya St.; Tel: (312) 621462).
  • For Kyrgyz women, intrauterine devices (IUDs) are the most popular contraceptive option. For this reason, if you are interested in obtaining one in Kyrgyzstan, particularly in urban areas like Bishkek, you should not encounter too much difficulty. For example, at NEOMED Clinic, you can get IUD insertion for 1080 KGS (without the cost of the IUD), as of April 2018. This general clinic has a number of specialists, and some staff speak English. Address: 46 Orozbekov str., Bishkek, Kyrgyzstan 720040. Phone: +996 312 906 090. They're also on Facebook..

Costs

  • Here are the prices you can expect to see for pills at Bishkek pharmacies (as of April 2018): Belara pills - 970 som, Jess - 990 som, Rigevidon - 686 Som, Regulon - 940 Som, Yarina - 920 Som, [14]

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Kyrgyzstan, it appears that you may need a prescription to obtain emergency contraceptive pills (morning after pills) at pharmacies.[15]

What to Get & Where to Get It

  • In Kyrgyzstan, you can obtain emergency contraceptive pills (morning after pills) in pharmacies, certain clinics and IPPF-affiliated programs, but a prescription is required. Some of the brands you can expect to find available are Escapelle, Postinor and Dvella.[16]
  • If you cannot access dedicated emergency contraception, you can use regular birth control pills as replacement ECPs. Talk to your local pharmacist or physician about how this can be done.
  • If you cannot access dedicated emergency contraception, you can get an IUD, which can sometimes prevent pregnancy up to five days after unprotected sex.

Costs

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

If you're a foreigner who is visiting Kyrgyzstan for a short-term stay, you will not be asked about your HIV status. However, if you plan to stay in Kyrgyzstan for a month or longer, the laws around HIV status and foreigners are a bit murky. Technically speaking, if you're a foreigner and you stay in Kyrgyzstan for over 30 days, you must show proof that you are HIV negative. However, according to sources, this law does not appear to be actively enforced. It is important to note that enforcement can begin at any time.[17]

While the HIV infection rate is relatively low in Kyrgyzstan, it has grown in recent years, according to the Republican AIDS Center Ulan Kadyrbekov.[18] In 2016, it was estimated that 8500 adults (ages 15-49) were living with HIV in Kyrgyzstan, which accounted for about 0.2% of the adult population. It was estimated that 61% of people living with HIV knew their status. Only 28% of people living with HIV were on ART and only 18% had suppressed viral loads. Some of the populations that were most heavily impacted by HIV were injection drug users (12% infection rate), prisoners (11% infection rate), men who have sex with men (6% infection rate) and sex workers (2%).[19]

People with HIV face stigma in Kyrgyzstan. According to a 2012 survey, 57% of adults (ages 15-49) would not buy vegetables from a shopkeeper or vendor if they knew that person had HIV. Furthermore, only 23% of young people (ages 15-24) knew how to prevent HIV.[20]

Testing Facilities

  • NEOMED Clinic: This general clinic has a number of specialists, and some staff speak English. They provide ELISA and PCR methods for STI tests, and the average cost is 480 KGS per test, as of April 2018. Address: 46 Orozbekov str., Bishkek, Kyrgyzstan 720040. Phone: +996 312 906 090. They're also on Facebook.

Support

  • If you're in Bishkek and have HIV-related questions/needs, visit the center at Logvinenko Street no. 8. If you're outside Bishkek, contact your local hospital to find the nearest center in your area that can provide help.
  • UNAIDS Krygyzstan: Meerim Sarybaeva, UNAIDS Country Manager. Phone: +996312611232. Email: sarybaevam@unaids.org
  • Asteria: "Asteria Public Foundation was founded in 2006 by group of former women drug users. Asteria aims at providing psychosocial services to women drug users, sex workers, formerly incarcerated, HIV-positive women and their partners and relatives." Email: asteria.pf@gmail.com

Costs

Medications & Vaccines

Laws & Social Stigmas

What to Get & Where to Get It

  • If you have a yeast infection, you can go to the pharmacy for medication. You can ask the pharmacist for Fluconazole, which is the type of medication used to treat fungal infections. While they may not specifically have Fluconazole, they may have similar products that you can use.
  • If you have a urinary tract infection (UTI), we're not sure what is normal protocol in Kyrgyzstan. You may want to contact a local clinic or physician for details. Also, if you know how to get UTI treatment in Kyrgyzstan, please update this section.
  • There is no nationwide HPV vaccination program in Kyrgyzstan, as of July 2017. However, cervical cancer is the second leading cause of cancer for women in the country, and it is the first most common cause of female cancer for women ages 15 to 44 years old in the country. To learn more about cervical cancer and HPV prevalence in Kyrgyzstan, click here to read a report from the HPV Information Centre.
  • There is currently no Pre-exposure Prophylaxis (PreP) program in Kyrgyzstan, as of April 2018.[21] However, the Ministry of Health of Kyrgyzstan has stated that it plans to begin evaluating its possible introduction into the country, as of 2017.[22]

Costs

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

Laws & Social Stigmas

In Kyrgyzstan, menstruation is a taboo subject, and many young girls and boys are not properly educated on menstruation.[23] However, there are local and NGO-sponsored initiatives that aim to reduce the stigma and shame in the country.

What to Get & Where to Get It

Costs

Gynecological Exams

Laws & Social Stigmas

What to Get & Where to Get It

  • Asymbekova Clinic: This clinic focuses on gynecology.
  • “Kamek” Private Surgical Clinic: Address: 225, Moskovskaya street, Bishkek. Tel. +996(312) 640055, 640101. Polyclinic address: 45, Aynee str. Bishkek Tel. +996 (312) 490000
  • "Яна Тешебаева is a great doctor and very gentle. She works in Neomed (46 orozbekova) and Nadejda (moskovskaya/ sovietskaya)" - Bishkek local, April 2018
  • NEOMED Clinic: This general clinic has a number of specialists, and some staff speak English. A consultation and pap smear costs 2400 KGS, as of April 2018. Address: 46 Orozbekov str., Bishkek, Kyrgyzstan 720040. Phone: +996 312 906 090. They're also on Facebook.

Costs

Pregnancy

Laws & Social Stigmas

In Kyrgyzstan, new mothers are entitled to maternity leave, but the Labor Code does not specify any paternity leave. Generally speaking, mothers can take 70 days before delivery and 56 days after delivery. For women who work in the highlands, they are entitled to a total of 140 days of maternity leave (70 days before delivery and 70 days after delivery). If there are complications with delivery, women can take 186 days of maternity leave, and if they experience the birth of one or more infants, they can take 180 days of maternity leave. For the first ten days, the women are paid 100% of benefits from employer funds. After that time, the payment comes out of state benefits. After her maternity leave is complete, a woman may take an additional eighteen months off as part of childcare leave.[24]

What to Get & Where to Get It

  • "In Upper Dzal,right before the traffic light towards South Magistrale (южная магистрал),it's a building on the right side.You will see a big billboard on the building of a woman and child.I was happy with their attitude,nice and clean environment.It's a private clinic." - Recommendation from a local, April 2018

Costs

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Kyrgyzstan, abortion is legally available upon request[25] in the first twelve weeks of pregnancy. This means that people can obtain an abortion for any legal reason during the first trimester. After this period, abortions are legally permitted in certain circumstances. Between twelve and twenty-two weeks of pregnancy, abortion can be legally performed at the request of the patient, which may often be due to physical or economic reasons. Furthermore, an abortion is always legally available if the pregnancy endangers the life of the pregnant person.[26]

The abortion laws in Kyrgyzstan are based on the Soviet Decree of 23 November 1955 and Decree in 1982, which declared the right for women to obtain abortions. These laws were further expanded upon in Ministry of Health Order № 249 in 1998, after Kyrgyzstan had become an independent state.

What to Get & Where to Get It

  • In Kyrgyzstan, abortion is legally available to people upon request. According to some sources, only surgical abortion is available and medical abortion (i.e. the "abortion pill") is not available[27], but this may no longer be the case (this fact needs to be confirmed).

Costs

Advocacy & Counseling

Laws & Social Stigmas

To read a report on violence against women in Kyrgyzstan, click here.

What to Get & Where to Get It

  • Bishkek City Ambulance: Dial 103
  • Commercial Ambulance Services: Dial 139, 548666, 549999, (0554) 548666; Dial 151 or 439151; Dial 1130 or 577115
  • Sezim 24/7 Helpline: +996 (312) 51-26-40
  • There are homeless shelters open in the Pervomaisky district (Kolomto Center), Oktyabrsky district and Sverdlovsky districts of Bishkek. "Hot meals are served daily, and a medical examination is carried out once a week."[28] However, homelessness is a difficult condition for many people in Kyrgyzstan, particularly in the winters. Click here to learn more.
  • Crisis Center “Sezim”: Established in 1998, this is one of the first crisis centers and non-profit organizations in Kyrgyzstan, and it's the only crisis center in the country that receives governmental support.[29] They provide legal, psychological and social services, including: safe houses for victims of gender-based & domestic violence and trafficking, assistance in getting housing and employment, lawyer consultations, legal protection in court, document preparation, psychological consultations, family consultations, support groups, intervention, art therapy, etc. Address: Tabyshaliev str., #3 Bishkek, Kyrgyzstan. Phone: +996 312 31 64 66. Email: centersezim@gmail.com
  • Aryyjan Karakol: We don't know how active this NGO currently is (their online presence seems to have stagnated around 2013), but they do seem to have a hotline: 0773-660-220/0550-026-288. Here's information on the NGO from their Fundly page: "Aryyjan Karakol is a local community-based NGO in Karakol, Kyrgyz Republic... What originally started as a women’s rights organization that provided counsel (a 24-hour crisis hotline) to women who are victims of domestic abuse, bride kidnapping and property rights violations; and trainings to local village women on their rights as citizens, has since expanded its overall scope and evolved into a gender equality organization, inclusive to youth and men in its training sessions."

Costs

List of Additional Resources

  • Click here to learn about LGBTQ rights and laws in Kyrgyzstan. As of April 2018, homosexuality is legal and there are laws that protect LGBTQ people from housing discrimination and employment discrimination. However, gay marriage is unrecognized and conversion therapy is not banned.
  • Forum of Women’s NGOs of Kyrgyzstan (FWNGO): "Forum of Women’s NGOs of Kyrgyzstan (FWNGO) was set up in 1994... Main areas of the Forum’s activity are included joining of the activities of women’s NGOs, development of women’s networking and training in Kyrgyzstan and in Central Asia, advocacy and lobbying women’s issues, provision of the complex of consultative services to all organization and private individuals dealing with gender issues, publication of newsletter for women, protection of women’s human rights, development and holding educational training effective programs, promoting women’s advancement, their adaptation to new social conditions, organizations and holding of conference, workshop, seminars."
  • UN Women - Kyrgyzstan: "UN Women in Kyrgyzstan prioritises initiatives and programmes in these areas that are fundamental to women’s equality and that can unlock progress for both women and men: Economic empowerment, Ending violence against women, Peace and security and engendering humanitarian action, National planning and budgeting and UN system coordination."
  • Women Support Center: "Women Support Center works to encourage gender equality in Kyrgyzstan through the advancement of human rights and active participation in democratic reforms. It was established in 1995 to promote a democratic society through understanding the role and capacities of each individual." Address: zip 549, Bishkek, 720044, Kyrgyz Republic. Phone: +996312547416. Email: kyrgyzwomen@gmail.com
  • Kyrgyz Women’s Leadership Development and NGO Capacity: This program ended in 2011, but certain elements may still be active. "Kyrgyz Women’s Leadership Development and NGO Capacity – Building is a two-year, multi-phase program. The project is designed to positively impact emerging professionals (community leaders, political leaders, educators, and youth workers), to strengthen grassroots organizations in the Republic of Kyrgyzstan, as well as the mutual understanding of the role of civil society in the U.S. and Kyrgyzstan."
  • Human Rights Movement: Bir Duino-Kyrgyzsta: "Human Rights Movement: Bir Duino-Kyrgyzstan, is the successor of the NGO “Citizens Against Corruption” (CAC ), which was founded in May 2000. The mission of Bir Duino is to protect human rights, particularly freedom of association, to defend the political space for Human Rights Defenders (HRDs) in Kyrgyzstan through culture and arts, and to facilitate practical implementation of humanitarian articles, international legal instruments, and other obligations of Kyrgyzstan in the field of human rights and fundamental freedoms."
  • Law and Human Rights Department (Tian Shan Policy Center)- American University of Central Asia: "The promotion and protection of human rights is a key thematic priority of the TSPC, based on the firm belief that “All human beings are born free and equal in dignity and rights”. Therefore, working to enhance the compliance of institutions with international and national legal obligations is considered an absolute necessity by the TSPC, especially in a young democracy like Kyrgyzstan." Address: 7/6 Aaly Tokombaev Street, Bishkek, Kyrgyz Republic.
  • Voices on Central Asia: Feminism through Pictures: How Girls of South Kyrgyzstan Fight for Women’s Rights
  • Asteria: "Asteria Public Foundation was founded in 2006 by group of former women drug users. Asteria aims at providing psychosocial services to women drug users, sex workers, formerly incarcerated, HIV-positive women and their partners and relatives." Email: asteria.pf@gmail.com
  • Global Research Institute Foundation: "The Global Research Institute (GLORI Foundation) explores solutions to a whole range of globally significant health and social issues such as gender-based violence, HIV/AIDS, STIs, TB, issues specific to elderly population, Hepatitis C, drug use, malnutrition, mental health and others." Email: danilst.nikitin@gmail.com

References

  1. [Conversation with a Bishkek pharmacist, April 2018]
  2. End Of UN Contraceptive Program In Kyrgyzstan A Bitter Pill For Many
  3. Trends in Contraceptive Use Worldwide 2015
  4. Kyrgyzstan: Abortion Believed to be Most Common Form of Birth Control
  5. End Of UN Contraceptive Program In Kyrgyzstan A Bitter Pill For Many
  6. CIA World Factbook: Kyrgyzstan
  7. Kyrgyzstan: Women and children from Kyrgyzstan affected by migration
  8. GRAB AND RUN: KYRGYZSTAN'S BRIDE KIDNAPPINGS
  9. Little Is Being Done To End Kyrgyzstan’s Bride Kidnapping Crisis
  10. Sexuality education comes to Kyrgyzstan
  11. [Conversation with a Bishkek pharmacist, April 2018]
  12. Princeton EC Website
  13. [Conversations with a Bishkek pharmacists, April 2018]
  14. [Conversations with Bishkek pharmacists, April 2018]
  15. EC Status and Availability: Kyrgyzstan
  16. EC Status and Availability: Kyrgyzstan
  17. KYRGYZSTAN - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  18. Number of HIV-infected through sexual contact increases in Kyrgyzstan
  19. UNAIDS - Country factsheets, KYRGYZSTAN 2016
  20. UNAIDS - Country factsheets, KYRGYZSTAN 2016
  21. PrEPWatch World Map
  22. PREP: EFFECTIVE AND EMPOWERING
  23. In Kyrgyzstan, girls lift shroud of shame on menstruation
  24. International Labour Organization - WORK AND FAMILY: THE REPUBLIC OF KYRGYZSTAN
  25. World Abortion Laws
  26. Abortion law Kyrgyzstan
  27. Abortion law Kyrgyzstan
  28. Shelters for Homeless People Opened in All Districts of Bishkek
  29. Report to the UN Special Rapporteur on Violence Against Women