The road from Naryn to Bishkek is long, first tracing along the winding Naryn River before weaving through vast open valleys and rugged mountain passes.
Herds of horses and flocks of sheep dot the landscape, with small villages appearing intermittently in the distance. Eventually, the air fills with the movement and noise of the bustling capital city.
For residents of Naryn town, this five-hour journey is often a costly and arduous barrier to health care.
Nestled in the mountainous central Kyrgyz Republic, the town sits over 2,000 metres above sea level, making it one of the highest settlements in Central Asia. Its scenic isolation comes with real challenges for health access.
According to Gulzat Masymbaeva, cardiovascular diseases and cancer are the most prevalent illnesses in the Kyrgyz Republic. Breast cancer is one of the most common diagnoses for women and stomach cancer the most common for men.
In Naryn, the mortality rate from breast cancer is high, with up to 50 percent of newly diagnosed women not surviving beyond their first year. In contrast, five-year survival is over 90 percent in high-income countries, according to the World Health Organization.
“With early detection, there can be up to a 95 percent recovery rate. But most people come in when it's at a later stage… And the specialists are located in Osh [a city over 400 kilometres away] and Bishkek,” says Gulzat.
For many families, financial constraints, limited specialists, and cultural barriers around seeking care further compound these challenges.
But with support from Canada and in partnership with the Aga Khan Health Services, health facilities like the Naryn Oblast Unified Hospital are now equipped with new medical supplies that allow for quality care, closer to home.
New health equipment, like ultrasounds and colposcopes, help local providers screen, diagnose, and support patients directly, so they no longer have to travel to Bishkek.
“Not everyone can afford to travel to Bishkek,” says Dr. Tukan, who has been working as an obstetrician-gynecologist at the Naryn Oblast Unified Hospital for 43 years.
“In some cases, it is very difficult to make a diagnosis, especially when patients have multiple conditions. In such situations, with the help of telemedicine, they invite professors and specialists online, and decide together how to help a patient, either to refer them to Bishkek or treat locally. This helps greatly.”
The new equipment has also made it easier for healthcare workers to bring care to people unable to visit the hospital. “Before receiving a portable ultrasound machine, there was only one machine in the hospital,” recalls Dr. Tukan. “All seriously ill patients with injuries or trauma had to be brought here on stretchers and then taken back, in winter too. Now, for seriously ill patients in cardiology, we can take the portable machine and go to them ourselves.”
Professional development is also a challenge, according to Dr. Tukan, as many public healthcare workers often must fund their learning and take unpaid leave from work. Support from Canada provided fully funded training for staff to learn how to use the new equipment, in addition to training on topics like adolescent health, psychological health, and nutrition.
“For me, it was my first training… I’ve just completed a course on cervical pathology, on its diagnosis and treatment. It was very useful for my work,” says Dr. Tukan. “There is also a room for remote learning [at this hospital],” adds Gulzat, which supports the ongoing learning and professional development.
Outside the hospital, health education campaigns, led by local providers, are helping communities adopt healthier habits — like scheduling regular check-ups or eating more wholesome foods — to support long-term well-being.