without documents, or for those who have difficulty in establishing their national identity. In
Ashgabat, however, UNHCR spoke with someone who had been born to a stateless single mother
without a passport. Delivery and post-natal care had been administered to this person, free of charge,
in a state medical facility.
In Kazakhstan, the rules for providing health care to people documented as stateless, and to other
foreigners, are set down in Government Instruction No 997 of 2006.375 Stateless persons are entitled to
a selection of free medical services at the state clinic nearest to them, for a prescribed list of illnesses.
Beyond that, they can also pay for medical help at commercial rates at any clinic in the country.
Among the free services available to stateless persons are emergency ambulance transport for acute
illnesses or exacerbation of a chronic condition, medical and sanitary assistance in an epidemic,
consultation, diagnosis for in-patients and follow-up treatment in a rest home.376 Treatment for other
complaints is to be paid privately by the patient, by employers or by private voluntary insurance.377
The list of free medical care available to the registered stateless in Kazakhstan seems to exclude
surgery. Stateless persons who took part in Participatory Assessments with UNHCR reported no
unequal medical treatment. Some, however, noted the difficulty of receiving such treatment without a
valid document identifying them as a stateless person.
In Kyrgyzstan and Tajikistan, the lines are drawn less clearly between the medical care on offer to
nationals and to registered stateless persons. The same is the case for the distinction between services
that are free and those that must be paid for by stateless persons.
In Kyrgyzstan, children and their parents interviewed in the UNHCR surveys confirmed they were
included in all immunisation and vaccination programs undertaken in the area where they lived. Some
25% of the individuals surveyed in northern Kyrgyzstan said they could not get medical help because
their documentation was inadequate – but they did not specify exactly what range of services was
inaccessible to them. People interviewed in the south had similar problems with documentation.
Clinics were also said to have refused to treat children without birth certificates, which meant they
could not get skilled diagnosis or surgery. According to the UNHCR surveys, 3% of undocumented
stateless children surveyed in north and south Kyrgyzstan did not have birth certificates.378
5.4
HIV / AIDS
No study on HIV/AIDS in Central Asia has thus far looked at how the disease affects stateless persons
in the region. Since the late 1990s, each of the four Central Asian States dealt with in this section has
been working with international agencies to combat HIV/AIDS infection. Each has adopted a national
programme and set up an inter-agency body to manage it.379 The programme has included education,
monitoring, and confidential testing and the adoption of laws on AIDS-prevention. Identification of
the virus has risen steadily in Kyrgyzstan, Kazakhstan and Tajikistan – although UN experts estimate
the figures are only a fraction of the real total. Data is not available in Turkmenistan.380
375
This Instruction was replaced in part by the 2009 Health Code.
Article 1, 2006 Instruction No 997 ‘On Rules for Receiving Medical Services for Foreigners and Stateless Persons’.
377
Ibid, Article 9.
378
UN High Commissioner for Refugees, A Place to Call Home. The Situation of Stateless persons in the Kyrgyz Republic:
Findings of Surveys Commissioned by the UNHCR, UNHCR Bishkek, 2009, page 23.
379
Since 1999, a National Programme on HIV/AIDS in Tajikistan, under a National Coordination Committee for HIV/AIDS
Prevention; in Turkmenistan, since 1999 a National Programme on HIV/AIDS and STIs Prevention under an InterMinisterial task Force led by the Ministry of Health, the National AIDS Centre and STIs Dispensary, now on a plan for 20052010; in Kyrgyzstan since 2000 A Strategic Plan of national response to the Epidemic of HIV/AIDS; and in Kazakhstan,
five-yearly National Programmes, most recently from 2005-2010. Data provided by the World Bank Central Asia AIDS
Control Project in November 2004, available at
http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/ECAEXT/EXTECAREGTOPHEANUT/EXTECAREGTOP
HIVAIDS/0,,contentMDK:21081679~pagePK:34004173~piPK:34003707~theSitePK:571172,00.html.
380
According to Epidemiological Country Survey Profiles for 2008, compiled by UNAIDS, World Health Organization
(WHO) and the FAO, inter alia. Appendices to WHO reports, available at www.apps.who.int.
376
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