by Simon Forrester, UNV Programme Officer, Almaty, Kazakhstan

11 March 1999

Bonn, Germany: To be fair, it has to be said that Temirtau is not a pretty sight. From its location, flat bang in the middle of the Kazak steppe, anyone approaching the city will see a grey skyline of mostly redundant smoke-stacks, blast furnaces, residential apartment blocks made from untreated concrete, and the ubiquitous, Soviet, above-ground utility supply pipes. Even for the most loyal of citizens, of whom Igor is one, "compared with Temirtau, Pittsburg is probably a paradise". However, sadly for Temirtau and for Igor and its 120,000 other residents, a dodgy skyline is the least of their worries. The worsening socio-economic situation in Temirtau, inflated by the down-sizing of its main employer the steel-producing combinat, and the virtual collapse of the former Soviet welfare state, is being tragically aggravated by a relatively cheap and well organised supply of illicit narcotics. Kazakhstan is a well-known thoroughfare for drug traffickers, moving opium and marijuana products from the south-east to their clients in Moscow, Berlin, London and beyond. Such ruinous products are easily found in cities like Temirtau, where a ready-made syringe full of tayan, a local drug mix, costs less than a bottle of vodka. Indeed, the abuse of drugs is so wide-spread in Temirtau that unofficial reports suggest that up to 15% of the population are, or have been, intravenous drug users(IDUs).

The damage done by endemic drug abuse is well documented: the damage done in Temirtau not only follows a familiar pattern, but is further tainted by an incidence of HIV infection which has led to the city being dubbed Kazakhstan's AIDS capital. The statistics from 1997 show that approximately 85% of all cases of HIV infection (465) in the entire Republic are to be found in this one city. Furthermore, the epidemic is only just beginning.

Valentina Knyazeva , the head of the 'Mothers Against Drugs' NGO, herself a direct victim of the crisis, having suffered the murder of her son in a drugs-related crime, says, "the whole community is sick. The whole community needs material, medical and psychological help."

There is definitely a sense of desperation on the streets of Temirtau, but the city is not helpless. There is a Government funded AIDS Centre - part, in fact, of a national strategy to combat HIV/AIDS. A number of local NGOs support those touched by the consequences of drug addiction. And the private company which took over the combinat, Ispat Karmet, is funding a number of initiatives to fight the infection rate and bring about a decline in drug abuse.

The United Nations Development Programme, along with partner organisations (UN AIDS, UNESCO, UNDCP, UNFPA) and with cost-sharing from Ispat Karmet, is attempting to elaborate a multi-sectoral AIDS prevention project in the city. Amongst its many activities, since April of 1998, the project has utilised the inputs of a UNV Specialist from the Ukraine, Dr. Nikolai Gagarkin. He works with NGO and Government colleagues, with suppliers and end-users (and potential users) to raise awareness of HIV infection and to reduce the harm that drug abuse inflicts.

As Sholpan Baimurzina, the Project Co-ordinator explains, "volunteer inputs into community development are paramount to this project's success. People like Nikolai and our local NGO volunteers can reach all elements in the community." NGOs like 'AntiNar' have improved their application of 'peer-to-peer' measures to raise awareness of drug abuse amongst youth groups. The staff of the AIDS Centre are finding means to offer more support to the community - not just a 'testing facility', but an 'open house' providing services such as advice on safe sex, medical assistance to IDUs, and psychological counselling. And a programme of Drug Harm Reduction has increased its impact with more effective location and running of Needle Exchange Centres. Even the criminal elements in the district, largely responsible for the supply of narcotics and controlling commercial sex, have been coaxed "into the loop" in an attempt to build up trust and a willingness to support anti-HIV/AIDS activity.

The city and people of Temirtau certainly have a tough future. But the community does have some strength left at its heart and the stakeholders must make the most of this. Igor, one of the IDUs who regularly visits the AIDS Centre, said that he is happy that someone cares, that "I am not forgotten". This might be a perverse happiness, and indeed much more is needed than 'caring', but a change in attitudes is one step toward changing the city's blighted landscape.