The FRESH AIR project in the Kyrgyz Republic is led by Prof Talant Sooronbaev of the Ministry of Health. There is a very high smoking prevalence rate of 47.4% of men. Indoor biomass for heating is used extensively in the high altitude areas. Here in the highlands people live indoors 8 months a year, with the ventilation hole in their yurts closed to retain the heat created by burning dung. Public awareness of the hazards of smoke is very poor.
Summary - for clinicians and researchers
The Kyrgyz Republic has the highest respiratory mortality of all countries in the European Respiratory Society “White Book”. Studies will be conducted in two administrative territorial units of the Kyrgyz Republic. The lowland population of the Chui Region live at 730 m above sea level. The area has a continental climate with hot summers and moderately cold winters. In the area there is the Ore Mining Factory, Concrete & Slate Factory, and Glass Factory. Most people live in rural areas, in private houses and work in agriculture and the highland of the Naryn Region. The population of the Naryn Region lives at 2,200–3,200 meters above sea level and is continuously affected by negative extreme conditions (exogenous hypoxia, cold, strong winds, low humidity) and indoor air pollutants caused by the use of biomass fuels for heating homes and cooking as well as a very high tobacco smoking rate.
Professsor Talant Sooronbaev - Ministry of Health Kyrgyz Republic
Prof Sooronbaev is a physician specialising in lung diseases. In addition
to his role as Chief Pulmonologist of Ministry of Health Kyrgyz Republic,
he is the Kyrgyzstan National Coordinator of GARD (WHO).
Results from the FRESH AIR project featured heavily in the programme of the first IPCRG Euro-Asian Scientific Conference in Bishkek, Kyrgyzstan in October, 2018.
Project partners shared their experiences and recommendations for dissemination within other countries in the Euro-Asian region. The conference also presented the opportunity for the first showing of a project film on pulmonary rehabilitation in Kyrgyzstan showing feasibility and acceptability of introducing it in remote and rural areas for people who are breathless from COPD and TB.
380 primary care delegates from medicine and nursing backgrounds attended from Kyrgyzstan, Kazakhstan, Uzbekistan, Tajikistan and the Russian Federation. There was a huge interest in the results of the project, with several full sessions covering the learning outcomes from FRESH AIR.
Sian Williams, Chief Executive Officer of the IPCRG and WP7 lead for FRESHAIR, said:
“The conference represented a wonderful opportunity to show frontline workers and policy makers why FRESH AIR was important, and to share with them our experiences and successes in Kyrgyzstan. We hope that through this important dissemination work, the project can leave a lasting legacy, not only in our partner countries but also in the wider region. We ran three parallel programmes: one for nurses, one for GPs and one for clinical teachers.
“We were also delighted to have the opportunity to talk to colleagues from the Swiss and Finnish governments about their work in Kyrgyzstan to tackle the burden of non-communicable diseases – in particular looking at clinical recruitment and education and rolling out a nationwide tobacco control programme including treating tobacco dependence. It has been very rewarding to meet and discuss with a wide variety of primary care professionals how the results of the project can be utilised now FRESH AIR has drawn to a close.”
The Kyrgyz Republic has approximately 6 million inhabitants. Part of the country is at high altitude, with areas located 3,000m above sea level. In these highlands, above the treeline, where people live in yurts, locals burn animal dung for fuel for cooking and heating. They live indoors for about 8 months per year. During these months the ventilation hole in their yurts is kept closed to retain the heat, but this also increases their exposure to indoor pollution.
In the highlands, clinical centres are not easily accessible by the population, especially during winter months. The rate of smokers is alarming; nearly half of all the men smoke. More resources are needed to effectively support quit attempts.
FRESH AIR researchers from Leiden University Medical Center (LUMC) visited the Kyrgyz Republic in May 2016. The purpose of the visit was to carry out research to ensure that the implementation of evidence-based interventions that will be carried out during the project will be as suitable as possible for the area.
The delegation was joined by a multidisciplinary team of researchers from the Kyrgyz National Center of Cardiology and Internal Medicine.
During the 3-week expedition, the delegation visited eight villages and six GP centres. Before starting the research activities, the LUMC team delivered a 2-day workshop on rapid assessment to local researchers. Rapid assessment is a qualitative research approach aimed at gathering a vast amount of in-depth information in a short period of time.
The study included community members, healthcare professionals (nurses and doctors) and leaders of rural villages. The team held numerous one-on-one interviews, group interviews and observations with nurses working in the clinical centres. The team also visited rural primary care practices to observe consultations. An impressive stakeholder engagement group has been set up across the entire country who will help advise on all stages of the project, from implementation through to sharing of any findings, so that the impact of the project lasts beyond the project end. The trip was a real success and the data collected will be analysed in the next months.
Link back to FRESH AIR 1st Newsletter - December 2016
Hilary Pinnock and Beraki Ghezai were invited by our colleague Talant Sooronbaev to Bishkek to the Euro-Asian International Primary Care Respiratory Group (IPCRG) Symposium as part of the Kyrgyz National Congress of Respiratory and Allergic Diseases and the 3rd Congress of the Kyrgyz Thoracic Society. This builds on the relationships we have been building through FRESH AIR. In addition Katrina Flannigan, Respiratory Specialist Nurse in the Scottish Highlands kindly stepped in to deliver a Skype presentation on the role of nurses in COPD. Our Treasurer Kristine Whorlow attended on behalf of the National Asthma Council Australia. There is a real appetite to develop services for people with chronic lung disease, and to strengthen primary care across the EuroAsian region and we are delighted to help colleagues in this endeavour.