1. July-December 2010

2. Kyrgyzstan has been in turmoil since the overthrow of then-President Bakiyev on April 6, 2010. In early June, brutal violence and widespread burning, looting, and forced evictions occurred in Osh City and throughout southern Kyrgyzstan. First thought to be an angry symptom of economic crisis, attacks quickly turned to ethnic-based violence. Estimates indicate that hundreds were killed, and nearly 100,00o people fled their homes into neighboring Uzbekistan.

3. Internally displaced persons (IDPs) face a host of health hazards. With limited shelter and uncertain access to clean water, risk of communicable disease is high. Because of the violent, targeted nature of the uprisings, many Uzbeks fear going to local, Kyrgyz-run health facilities…or going anywhere at all. Mental health is another huge concern for these IDPs.

4. Even before the violence had ended, USAID/CAR Project Specialist Fatima Kasmahunova reached out to the CHI-Bishkek team, asking CitiHope to present a plan to address four critical health areas for IDPs. CitiHope staff in Bishkek and the US developed a proposal for this program, which was funded in mid- June.

5. CitiHope is maintaining two in- country offices for this program – the principal office in Bishkek, and a ‘field office’ in southern Osh. The program focuses on four locations: Cheremushky, On-Adyr, Navoy, and Furhkat. These areas were determined to have some of the highest rates of destruction and displacement. The program serves approximately 12,000 IDPs, predominantly ethnic Uzbeks. CitiHope is addressing four specific critical health needs.

6. Successes: Voucher system developed to guarantee services for IDPs Secure transport established for IDPs to health facilities Multi-lingual brochures describing program activities distributed

7. Procurement (local and US) of medicines and medical supplies for primary health care facilities

8. Successes: Weekly disease monitoring system established Regular water supply monitoring, testing Hygiene kits assembled and distributed

9. In progress: Local procurement of sanitation supplies

10. Task 3 Sub-Contract: Joy Masters Successes: 20 counselors deployed to communities 6,000 IDPs counseled 600+ referred to psychologists, 125+ to psychiatrists

11. In progress: Mental health educational brochure to be developed Gender-based violence assessments Group/community counseling sessions

12. Task 4 Sub-Contract: Kyrgyz Alliance on Family Planning Successes: 60 outreach workers deployed 5,186 women of reproductive age counseled Hygiene and reproductive health kits distributed

13. In progress: Training on antenatal care standards Monthly training on seasonal illnesses

14. Focus sites have changed, as many IDPs quickly relocated back to regions of origin. Many IDPs have lost jobs or suffered destroyed businesses, leaving most unable to pay for basic health care services or medications. Ethnic Uzbeks remain afraid and untrusting of majority ethnic Kyrgyz populations, including medical professionals. Reconstruction of houses is slow, and most IDPs will not be in completed permanent shelter before winter weather sets in. There is ongoing concern for reported human rights abuses related to unlawful loss of jobs, harassment and intimidation, inhumane detention, and forced confessions. Large numbers of ethnic Uzbek men are leaving for Russia to find jobs. There is ongoing concern for the nutritional status of IDPs, considering living conditions, inability to can vegetables for coming winter, and limited financial resources.

15. CitiHope is employing Kyrgyz, Uzbeks, Russians, and Americans together, in the larger work of building trust and peace among destroyed communities.

16. At several camps, memorial walls stand to the men killed in the violence.

17. Translation: “From this, the sun is also sad”

18. Health outreach workers standing in front of a fellow worker’s destroyed home. “We were chosen for such a time as this” Feruza (right) and her daughter are reproductive health workers with CitiHope. Both are also IDPs.