After seven years as a volunteer aid worker in Krygyzstan, Rhonda Hodgkinson considers herself ‘cured of adventuring’ – at least for now.
Settling into her new role as programme coordinator and lecturer for EIT’s health promotion programmes has been really exciting, Rhonda says.
‘I’m utilising a lot of skills and experience gained in Krygyzstan, and I’m looking forward to the certificate and diploma classes starting next month.’
It was in 2003, while teaching EIT’s Bachelor of Nursing programme, that Rhonda started thinking about coupling an adventure with helping those in need overseas.
Weighing up opportunities, she found herself fascinated by the ancient history and rich cultural mix of Krygyzstan – a landlocked Central Asian country that many Kiwis might struggle to spell or pronounce, never mind locate on a map.
Rhonda felt drawn to help the people of Krygyzstan as they continue adjusting to the independence thrust upon them following the collapse of the USSR in the early ‘nineties.
A democratic republic, Krygyzstan had no real borders before becoming part of the USSR. Ninety percent of the country is mountainous and many of its people are semi-nomadic, tending sheep, small sturdy horses and sometimes yaks on high summer pastures. These herders typically winter over in their village homes.
Developing a sense of national unity presents another challenge for a population that includes Russians, Uzbeks, Kazakhs, Tatars and Tajiks as well as the indigenous Krygyz.
Rhonda went to Krygyzstan with a small, American-based charitable organisation that does aid and development work, and for a year she taught in the nursing programme in the capital city, Bishkek.
Krygyzstan is committed to reforming its health services, and improving primary health care is a priority. Employing more general practitioners is proving difficult, however. A new doctor only earns around the same as a trolley bus driver in Bishkek – the equivalent of about $US50 a month.
‘To put that in perspective,’ Rhonda points out,’ it would be difficult to rent an apartment for less than $US100 a month.’
People in the cities live very differently to those in rural areas. Housed in Communist-era apartment blocks, most city-dwellers would view New Zealand’s modest-looking houses as palaces.
Rhonda says her three-roomed apartment was comfortable, although a ‘wealthy’ family of five shared the same square footage in an apartment upstairs.
The collapse of the USSR was a huge economic shock for Krygyzstan, and the social upheaval was compounded by Russian residents leaving the country in droves.
‘Suddenly the country had to govern itself where previously everything had been dictated from Moscow.’
Rhonda came back to New Zealand for 18 months after a year of teaching but returned as a student, attending the Krygyzstan National University in Bishkek to learn Russian, a language generally understood and spoken throughout the country.
‘I wanted to get involved at a more grassroots level,’ she explains, ‘I felt that changes to health care were going to come from the community.’
The organisation she worked for selected villages, and a health committee was set up in each. These comprised mainly women – teachers, nurses and interested community members – who identified major concerns that usually centred on health and well-being.
‘Many endemic diseases can be attributed to poor nutrition and lifestyle,’ Rhonda says. ‘As an example of that, high blood pressure is a widespread problem that leads to strokes, even in men and women who are early middle-aged and in their most productive years.’
All the indicators for developing the condition are present – excessive alcohol consumption, a high salt intake, smoking, a sedentary lifestyle and a high fat diet.
Anaemia is common among women who don’t regularly eat meat.
‘A lot of the populace live on bread, black tea and perhaps a broth made with potatoes and pieces of meat. The staples of the Krygyz diet are potatoes and rice. Herders milk their mares to make a sour fermented drink that is very popular and considered particularly refreshing in summer. I found it to be an acquired taste.’
While less than 10 percent of the land area is arable, beautiful orchards produce apricots and apples for export and local consumption. But in winter, temperatures are too low for growing food.
‘People store carrots, onions and potatoes for the cold times of year, but there are no leafy vegetables available.’
Rhonda’s group worked with the village communities to come up with solutions. An agronomist, for example, advised on caring for trees and producing better crops.
‘There are issues that will take time to work through, and some processes will be more difficult than others. The higher you are in a social structure, the harder it is to make change. It is at the community level that people are suffering, and they are motivated to make change.
Rhonda says there were times when she felt lonely and homesick, but she found the people very warm, friendly and hospitable.
In April 2010, her last week in Krygyzstan, a people’s revolution overthrew the government – for the second time in four years.
‘I wonder if the people feel it is the only way they can bring about change. A curfew was imposed, and I was concerned I wouldn’t be able to leave the country. I did manage to get out, but it was hard leaving knowing the country was in such turmoil.’
Rhonda worried about abandoning her friends, although her departure date had been determined long before the uprising. Finally, she accepted that the people’s resilience would see them through.
An election was held recently, she says, and UN observers helped to ensure the results weren’t fraudulent.
‘A coalition government was elected. From what I could see, it was one of the most positive and fair elections held in a long time.’
Rhonda looks back on her experience feeling she has benefitted from her time in Krygyzstan.
‘There was so much I gained by going. In some ways, I feel that was more than I was able to help. It was an amazing adventure.
Now she is fully immersed in her ‘next chapter’, ensuring her students at EIT are able to work with competency and confidence in diverse health promotion fields.
‘There is Ministry of Health funding available for those who work in health promotion, so I am hoping that motivates people to enrol.’
Krygyzstan is not unique in facing problems with its population’s health, she adds – ‘there are huge gaps in people’s health status here in New Zealand’.