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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A Kazakh couple learns HIV-prevention skills as part of Columbia’s Project Renaissance, which helps heroin addicts.

On their own

To date, nearly 1000 people have participated as subjects in GHRCCA research, and in doing so they’ve received HIV-prevention tips and have been screened for sexually transmitted diseases. But El-Bassel doesn’t intend for GHRCCA to deliver these services on a large scale. Rather, she hopes that the Kazakhstani government, or perhaps an international aid agency, will step in to provide services based on her team’s successful experiments.

This is already happening. The Kazakhstani government recently launched a nationwide program inspired by Project Renaissance. The new program doesn’t involve HIV prevention, but rather emergency care for IV drug users: Project Renaissance has shown that large numbers of heroin deaths can be avoided if addicts are given a personal supply of Naloxone, a stimulant that counteracts the effects of overdose. By the end of the year, the government will make Naloxone available in drug-treatment clinics across Kazakhstan.

El-Bassel’s work soon may kick-start new AIDS programs, too. Kazakhstan’s Republican AIDS Center, which oversees all of the government’s HIV-prevention and treatment efforts, this summer announced an ambitious five-year plan to control the disease’s spread. The center’s director, Baurzhan Baiserkin, still has to convince the government to cover the plan’s huge price tag. When he makes his pitch to lawmakers later this year, he says, he’ll be armed with lots of GHRCCA findings and recommendations.

“I need Columbia to help justify my programs,” says Baiserkin, “because we don’t have the capacity to do research on our own.”

El-Bassel hopes to see that change. She envisions training hundreds of Kazakh researchers and eventually transferring GHRCCA’s projects to locals. (She also wants to help Columbia faculty from across the University launch similar projects in Central Asia. Several professors from the Mailman School of Public Health, including Wafaa El-Sadr, Joseph Lee, and Ezra Susser already have plans to collaborate with GHRCCA.)

On a hot afternoon in late June, as El-Bassel took coffee in Columbia’s small field office in Barakholka, and as her young colleagues bustled around her, anything seemed possible. Out the second-story window, the Tian Shan Mountains were faintly visible through a fog that had settled after a rain shower, and the rusty ribbons of corrugated steel sheets that cover the marketplace glistened. “This is a country that’s being built by young people,” she said. “Many of them have been educated in the West, and now they’ve come back to implement new approaches to education, health care, social services, and politics. On the ground here, everything is shifting, transforming, moving. For me, it’s the most fascinating laboratory.”

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