HIV Outbreak Leaves Kyrgyz Families Struggling

APMustafakulova, left, and Shamshiyeva visiting the Rainbow center with their children, who were infected in hospitals.
OSH, Kyrgyzstan -- Dilfuza Mustafakulova was a contented wife and mother who helped support her family by working as a teacher in the village school.

Last summer, her life was overturned. Her youngest child contracted HIV while being treated at local hospitals. And then she found out she had been infected, too -- through her son, who was breastfeeding.

Since then, her husband has left her and she has lost her job. With little government support, she struggles to feed herself and three children.

A total of 72 children have been infected with HIV in the two southern Kyrgyz hospitals, and 16 mothers also contracted the virus, health authorities said, in a scandal that has rocked this impoverished Central Asian nation. The numbers are a dramatic jump from earlier figures of 41 children and six mothers infected.

In some cases, the mothers likely were infected by nursing their children, said Uchkun Karimov, the prosecutor overseeing the case. Charges were filed last month against 14 medical personnel accused of negligence in administering injections and blood transfusions.

Although infection through breastfeeding from child to mother is unusual, it is possible, according to AIDS specialists. Mustafakulova, whose son was 7 months old at the time, said her breasts were cracked and bleeding.

Since the first cases were discovered in July, hundreds of children and their parents have been checked in southern Kyrgyzstan, a corner of the country squeezed between the Fergana Valley and China.

Health Minister Marat Mambetov announced recently that the infections, which began in the summer of 2006, had been contained. Investigators suspect they were caused by tainted blood and the multiple use of needles at the two hospitals.

Some 1,600 people are now officially registered as having HIV in the country of 5 million people -- 15 times more than in 2002. AIDS experts estimate the real number is closer to 6,000. The majority of cases stemmed from intravenous drug use.

The HIV-positive children are getting antiretroviral drugs, but their mothers are being denied treatment.

Erkin Bakiyev, deputy director of the national AIDS center, said they were not entitled to the drugs if they are in the first clinical stage of infection, as Mustafakulova is. And they have no money to buy the drugs themselves.

"These women are having huge financial difficulties. They should be getting nutritious food, but they are not able to get jobs or to provide decent food for themselves or their children," said Fatima Koshokova, director of Rainbow, a nongovernmental agency helping Mustafakulova and other infected mothers.

Mustafakulova's troubles began in June, when her son developed a high fever. She took him to the Nookat hospital, where she said doctors put him on an intravenous drip. When he did not get better, she took him to the hospital in Osh, the country's second-largest city.

After more than a month in the hospital, her son still was not well and she was also feeling weak, so they returned to their village of Zhani-Nookat, about 75 kilometers southwest of Osh. In October, they both tested positive for HIV.

Her husband and two older sons, aged 6 and 12, tested negative.

It has not been established where the infection originated. Of the 72 children infected, some were treated only in Nookat and others only in Osh, so both hospitals are suspected.

"Where else could my child and I become infected if I don't use narcotics and don't live an immoral life," Mustafakulova said during a recent visit to the Rainbow center. "This could only be the irresponsibility of doctors."

She was abandoned by her husband, who like many Kyrgyz men spends much of his time in Russia, where he can find work. No longer welcome in her in-laws' home, she and her children moved in with her parents. She sold her only possession, a small plot of land, to pay for her son's medical treatment.

"I have no faith in the future," said Mustafakulova, who looked exhausted and thin, her eyes vacant. "What will become of my sons?"

The story of Mustafakulova's fellow villager, Zarifa Shamshiyeva, is remarkably similar. She took her daughter to the Nookat hospital in June 2006, where her little girl, then about 1, was put on an intravenous drip before later being transferred to the bigger hospital in Osh. She and her child both tested positive in November. Her husband, who tested negative, left her, though he occasionally sends money for food.

She has hidden her infection from her neighbors and even from her two teenage daughters, 14 and 16. The eldest is of marriageable age. "How could she find a good husband if our neighbors and everyone else knew about our diagnosis?" asked Shamshiyeva, 34.

Both women get antiretroviral drugs for their children from the Nookat hospital. But Shamshiyeva said the doctor told her: "You're strong. You'll live as long as God wills."

Their case has been taken up by Rainbow's Kairat center, which provides free legal assistance to people living with HIV/AIDS.

"The husbands of many of these women leave when they learn the diagnosis, and these women are left alone with their grief," said Fatima Khabibullina, a lawyer at the center.