COVER STORY

Surveyors on the New Silk Road

Columbia social workers are pulling back the curtain on AIDS in Central Asia, where the epidemic is spreading faster than anywhere else in the world.

by David J. Craig Published Fall 2010
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Barakholka Market / Photo: David TrillingBarakholka Market is a place where you can buy anything. Nestled in the foothills of Kazakhstan’s Tian Shan Mountains, three miles northwest of the city of Almaty, it is a noisy, congested, and chaotic emporium at the edge of the desert. When you first enter its maze of zigzagging aisles that tower overhead with sneakers, pirated DVDs, fake leather handbags, fur hats, stereo speakers, generic Legos, black-market pharmaceuticals, and dirty magazines, you wonder: How will I find my way out? There are no maps or directories, and Barakholka is enormous, occupying some 100 acres. Locals navigate the place by remembering where specific types of merchants are situated — all 170 cosmetics vendors are crammed together, as are all 200 jewelers, and so on. Dozens of languages are spoken here, so urgent messages get communicated by volume alone. “Out of the way! Out of the way!” shouts a man in Russian, sticking his elbow in your back, and storming past with a refrigerator on a dolly.

For the tens of thousands of Kazakhs who shop here daily, Barakholka is a junk shop, a department store, a farmer’s market, and a red-light district rolled into one. For the 30,000 men and women who work here, it is also home. They come from Kazakhstan’s poorer southern neighbors — Tajikistan, Uzbekistan, Kyrgyzstan, and Turkmenistan — and sleep in dilapidated concrete tenements that encircle Barakholka. They awake at three every morning to prepare their stalls, and by late afternoon, after the shopping ends, they hit the cafés and gambling dens on the outskirts of the market.

“Over there is where they get girls,” says Sholpan Primbetova ’09SW, a Kazakh woman who studies life in this market. She points to two teenagers at an outdoor café wearing halter tops and blank stares. “A man soon will sit down next to one of them, offer to buy her a drink, and things will proceed from there,” says Primbetova. “The men tend not to think of women they find this way as prostitutes, but as friends who need money.”

For the past three years, Primbetova and other social scientists at Columbia’s Global Health Research Center of Central Asia (GHRCCA), which is based in Almaty, have been studying the sex lives and drug habits of men who work in this market. They want to know if Barakholka is a hot spot for the transmission of HIV, which is spreading faster in Central Asia and Eastern Europe than anywhere else in the world. The researchers worry that migrant workers temporarily away from their families are having sex with prostitutes or shooting heroin, contracting HIV, and then infecting their wives when they return home.

Primbetova demonstrates how she recruits study subjects. She walks up to a Tajik shoe seller, a man of about 25 in a sleeveless tee. He seems nervous. Within seconds, half a dozen other shoe sellers have surrounded her. They prod Primbetova’s arms in a way that expresses more curiosity than aggression. “This is typical,” she whispers. “Immigrant men, particularly the Tajiks, are very protective of one another and tend to stick close together. It’s tough to get them to speak to you one-on-one.”

Primbetova, speaking in her native Russian, introduces herself as a researcher and asks the men if they’re familiar with AIDS. They chuckle, but say little. She asks if they use condoms. “But I’m married,” says the first shoe seller, striking a defiant pose. One of his friends chimes in: “Still, we all have girlfriends here.” The first man grins bashfully. “Yeah, we have girlfriends, and we use condoms.”

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