The Implications of the War in Ukraine on Healthcare Disparity in Kyrgyzstan
After severe economic sanctions and the temporary collapse in the value of the Russian ruble earlier this year, Kyrgyzstan, among other members of the Eurasian Economic Union (EAEU), is attempting to regain its pre-war socioeconomic standing. In Kyrgyzstan, a disparity between work opportunities and healthcare expenditure has emerged as a roadblock in this effort. Because of this, those who seek proper healthcare are incurring economic hardship within the Central Asian nation.
A 2021 study indicated that between 2012 and 2018, out-of-pocket payments (OOPPs) in Kyrgyzstan increased by about $6.00 USD, and inpatient costs placed the highest cost burden on users ($13.60 USD). Alternatives include self-treatment ($10.70 USD) and outpatient costs ($9.00 USD). This rising trend in the cost of healthcare expenditure in Kyrgyzstan threatens the socioeconomic wellbeing of its primarily low-income population. As of June 2022, the average monthly earnings in Kyrgyzstan sat at $365.00 USD, with 25.3 percent of the nation living at or below the national poverty line. Between the declining job market, less opportunities to produce sufficient wages, and increasing healthcare expenditure, families seeking healthcare that are supported by the remittances of migrant laborers are vulnerable to further economic hardship.
In the past, the solution for domestic economic woes in Kyrgyzstan was often employment in Russia. Several million Central Asian migrant laborers look to Russia for work opportunities, sending the money they earn back to their families abroad, with most workers emigrating from Tajikistan, Uzbekistan, and Kyrgyzstan. Kyrgyz migrant laborers in particular represent approximately 650,000 migrant laborers in Russia, making up nearly one-tenth of the population. Due to the ease for EAEU citizens to secure a work permit in Russia, Kyrgyz citizens have had access to the Russian healthcare system and the job market. These opportunities are as essential to the Kyrgyz economy as they are to the families receiving their remittances abroad, which ultimately equate to approximately 31 percent of the Kyrgyzstani gross domestic product (GDP).
However, because of the ongoing conflict in Ukraine and the Western sanctions imposed on Russia, these healthcare and job opportunities have diminished for these migrant laborers. As a result, 60,337 migrants returned to their families in their respective nations. In a series of polls conducted among these Central Asian laborers a month after Russia’s invasion of Ukraine, of those 60,337 migrants, approximately 40 percent of these Central Asian migrants who originated from Uzbekistan and Kyrgyzstan only returned after losing their jobs or income. As the War in Ukraine raged on, the largely Kyrgyz migrant worker population was effectively forced to return home in search of economic and social security as the value of sending home remittances decreased by 33 percent.
With the share of remittances from Russia constituting 83 percent of all remittances to Kyrgyzstan, Kyrgyz households were placed in a unique predicament that threatened their well-being. Kyrgyz citizens are facing an uphill battle against not only job insecurity, but during a pandemic in a nation with a lack of healthcare resources. Even in the life of an average Kyrgyz citizen making a monthly wage of $365.00 USD, a hospital visit for a single individual equates to 3.7 percent of the average monthly wage. In a sick household of four, especially in a nation where 20.3 percent of the overall population is fully vaccinated, relying on the average cost for an individual, it would cost 14.9 percent of the average monthly income to go to the hospital and recover from sickness. Living expenses, such as electric and water bills or grocery expenses, are not considered in this case, making it even more arduous to live on in aggregate.
The rising costs of health expenditure are disproportionate to that of the average monthly wage of Kyrgyz citizens. Recently, however, a collaboration between the government of the Republic of Kyrgyzstan and the Saudi Fund for Development (SFD) announced a project to address this issue and provide further healthcare expenditure relief. Sadyr Japarov, the president of Kyrgyzstan, and Sultan Abdulrahman Al-Marshad, the CEO of the SFD, endorsed this project to expand the General Children’s Emergency Hospital in the capital, Bishkek, which intends to contribute to the development of the health sector in the Kyrgyz Republic. This silver lining may provide the much-needed relief Kyrgyzstan has needed during this troubling time. Beyond this, world leaders need to consider not only their own self-interests but the negative implications these egocentric ideals may impose on the rest of the world, as it has in Ukraine, Russia, Kyrgyzstan, and many other countries around the world.
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