Back in December, at my HIV/AIDS Stigma Reduction Training, a crowd descended upon me as we finished the training.  These women were the heads of the regional Health Promotion Units (HPUs) around Osh Oblast.  Each was hoping to meet me to find out if I could come give additional trainings at their respective clinics for them and their staff.

After four months trying to get it off the ground, I’m happy to say that the project is moving fast, and we’ve already done two full-scale day-long trainings, with more to come as we move on.  Today I’ll walk us through the project from its genesis, focusing on the most recent training, and how we’re modifying it moving forward.

As I discussed in the sort of precursor post to this one about Kyrgyzstan’s Health Promotion System, we actually have a very robust health infrastructure here, and it reaches out to many if not most of the smallest villages here.  Plus, people generally actually have a very good understanding of many of the key diseases here, and the health misconceptions that do exist generally aren’t harmful (for instance, that sitting on concrete will make you infertile, or that kymyz can cure all ailments).  But, with so many people working at the volunteer end of the many-tiered knowledge distribution network, that can make it difficult to ensure that everyone has all of the skills they need to accomplish the goals of the network, especially for the volunteers who haven’t worked outside of their houses prior to joining the network.

This is where my counterparts and I come in.  Peace Corps Volunteers are often placed out in these villages or regional centres, where we are generally well equipped to help people learn many of these skills.  I’m placed in a city, one level above that, so the people I work with here in the city generally already are good at their jobs and don’t have much that they can learn from me.

But, combine these requests from the regional centres with the areas of need, and combine that with the fact that in January, I began working with the organization that oversees Heath Promotion for the entire southern half of Kyrgyzstan (called the Republican Centre For Health Promotion, or the RCHP for short), and we found a path forward: using the connections of the RCHP, I would travel out to give TOT’s at the regional level on job skills and health topics.  I piloted a few of the sessions within Osh City at my HPU and with others in the city to get things polished.

The project got stalled for about four months, but finally I was able to run a full-scale pilot of it up in Uzgen back in May.  It went really well – two weeks after a planning meeting, I traveled up there and spent the day training 7 staff from 3 Uzgen-area HPU’s in a basic curriculum of job skills, including goal-setting, time management, lesson planning, and project planning, before moving on to earthquake preparedness, animal-derived diseases (brucellosis and echinococcosis), and a quick overview of non-communicable diseases.  It took a whole day of me teaching and team-teaching with them, moving between Kyrgyz, Russian, and Uzbek, but it was fun and productive.  I got some good feedback on how to modify the training, and so I returned to Osh excited, and revised the plan for the second round.

I had planned to make Gulcho in the Alay region my second stop, but by coincidence, I happened to be headed out to Daroot-Korgon in Chong-Alay region with the American Corner Book Caravan before then.  I had a great meeting with the polyclinic while I was there, and we set a date for my training.  But, as soon as we set it, my counterpart there said to me, “you know, you can come do the training on July 15th.  But if you can come on June 27th, we will have 27 VHC staff members here, and you could train all of them too if you came then.”  I really appreciated her frugality and creativity (since paying them myself to come would have cost tens of thousands of som), and thanks to that we were able to add immense value to an already-planned training.

The next day, I headed to Gulcho to meet with the polyclinic there about training staff in Alay region.  To my surprise, I learned that they actually manage several large grants at that polyclinic from the Aga Khan Foundation and other international organizations, and that they regularly go on a caravan to train and bring new information and materials to their villages.  I could immediately see that my training would not really be the most useful to them, since they already were doing such amazing work.  But they did ask for materials and resources.  Since Uzgen also asked for that, I’m working on developing materials to meet this requested need, materials that can benefit all the villages in this oblast.

So, with the training planned for Daroot-Korgon, I hopped on the marshrutka there (after spending an hour trying to find its quite hidden departure zone), and by 6pm, was gazing in awe upon the massive Peak Lenin (7134m) which towers over the Alay valley there.

I met up with my counterpart there, and she showed me to my guesthouse, which wasn’t far from the polyclinic and the bazaar, which in rural areas like this, is a small collection of converted shipping containers, each containing a shop.

It was a quick night’s rest before I was off to the polyclinic at 9am to meet our guests and get started on the training.  We had 26 VHC staff travel in from villages across the rayon, which was really exciting for me, and we also had a few guest speakers who came in from other offices in town.

Unlike Uzgen, I didn’t have 8 hours to myself, so I had to move quickly through my trainings.  I did my same block of goal setting, time management, and lesson planning, then also did the earthquake preparedness.  One thing I learned from Uzgen is that these women all know the health information very well, and so it didn’t make sense for me to train them in health topics.  Instead, I am focusing now more on giving them the tools they need to train and teach more effectively with their limited time since they are volunteers.

This time, I also prepared printouts of lesson plans so that my counterpart and I could co-teach rather than me teaching it all myself.  Not only did this take a lot of stress off my shoulders, but because she’s a native speaker of Kyrgyz and Russian, she can explain concepts with much more nuance than I can.  I realized very quickly my hubris from when I was in Uzgen.  I also left a bunch of electronic lesson plan resources with her so that she may use them in her own work and lessons.

Again, these women requested physical resources, which is why I’m beginning work on an updated lesson plan book that I may be asking for some support for soon.  These are the kinds of resources they need to help use their time more efficiently.

After a long long day (many of these women were even fasting during this time!), our training concluded with a few other sessions from other trainers.  I was exhausted, but it was well worth it.  Very few volunteers have ever gone this far out into rural Osh oblast before, and there’s so much opportunity to help in many different ways there.  I was honored that they even invited me to give another training there at the end of September, which is the next time that they will all be in Daroot-Korgon again for a group training.  This is a partnership I’m absolutely thrilled to continue!

One really cool thing that I saw in the polyclinic was this sign:

This is a list of the rights guaranteed to people in the 1978 Alma-Ata Declaration, which was a landmark international agreement made in Almaty, then-Kazakh SSR.  It was the first major international agreement about Universal Health Care/Coverage, which says that all people have a right to things like health information, proper nutrition, clean water, family planning (yes, this placard in the middle of nowhere in a Muslim-majority country in the former Soviet Union says that women are entitled to family planning), breastfeeding, drugs and treatment, and other things.  I studied this agreement in college extensively, and in my previous job, worked on a project with the Rockefeller Foundation doing advocacy work around the anniversary of this declaration.  So it was really cool to see that this is something that is still embraced as a foundation of healthcare justice in the offices where I work.  You can learn more about the declaration at its Wikipedia page and with some googling.

After a delicious satisfying dinner, and a bit of catching up on the news, I called the driver of my marshrutka to reserve a seat for the return trip (the marshrutkas to Sary Mogul, Daroot-Korgon, and points between and beyond all usually require an advance reservation so the drivers who organize them know how many buses they need to operate the route properly).  And at 6:00am, I was up and packed.  At 6:30 sharp, the marshrutka pulled out, and I was back in Osh before lunchtime.

But the drive back wasn’t without its memories…

The high mountains are renowned for having some of the finest kymyz, the fermented horse milk that is one of the most famous products of Kyrgyzstan.  Families brew it, then put it in recycled bottles and sell it on the side of the road.  As we drove along between Sary-Mogul and Sary-Tash, a few passengers in the bus motioned to the driver that they wanted to stop to buy some.  Well, we cleared out the entire stock of one stand, but one woman didn’t get as much as she wanted.  So, we drove to the next stand (which was less than a kilometer ahead), and instead of getting out, the man in front of me just slammed open his window, passed out some money, and passed back in several liters of fresh kymyz from the boys outside.  A drive-through kymyz stand.  Definitely one of the funniest memories from my time here so far.

And, if that wasn’t enough, after sitting and watching a movie and listening to some podcasts for a few hours, some of the other passengers began to get curious.  As I mentioned in my previous blog about Chong-Alay, it’s a small and highly homogeneous region – out of 25,000 people, only 11 aren’t Kyrgyz.  When I walked down the main street there, I got a few confused looks, and one man even asked me if I was Kyrgyz!  Because of this homogeneity, there is almost no Russian known, let alone spoken.  So I was also surprised when the man sitting on the stool in the aisle next to me (we had a few more people than hard seats) turned to me and asked me, in Russian, where I was from.

Now I enjoy telling people that I’m from Osh, which is technically true, but it always shocks them when I speak in Kyrgyz.  His eyes and his companions eyes broadened, and they began asking me all about myself and what I’m doing.  Within less than a minute, they all had turned to the people sitting next to them and, right in front of me, as though I were not there, said to each other, in Kyrgyz, as though I could not understand, “wow, it turns out he speaks, Kyrgyz, did you hear?” using the discovery mood that I explained in my most recent language lesson (practice time! what word do I add to the end of each sentence?).

As fate would have it, I had earlier noticed several people in the bus talking about me and questioning who I was and what I was doing.  We had a good laugh when I told them that I had heard them and understood every word!  And soon, the entire marshrutka was turned towards me listening to me talking about Peace Corps, my work, and the training I had just given in Daroot-Korgon.  It was really cool, and a wonderful community event for all of us, since they almost never see foreigners riding in their personal express marshrutka that crosses all of Osh oblast.

But, by lunch, I was back in Osh, and headed home to relax, plug into some Netflix, and some much needed celebratory microwave popcorn.  And to sit down and plan the next group of these trainings.

Thanks for reading!  Got questions?  Want to know more?  Let me know in the comments!