This summer, I had the opportunity to intern at the United Nations Population Fund (UNFPA) in Kyrgyzstan, a former Soviet Republic of five million in Central Asia. I worked at the United Nations building in Bishkek, the capital city of almost one million people, approximately half of whom are Russian.

Kyrgyzstan is a heterogeneous country situated at the literal and ideological crossroads between Europe and Asia. It is a nation of many contrasts, such as urban and rural, that impact health. Because of artificial borders and forced migration during Soviet times, it contains numerous ethnic minorities and two official languages—Russian and Kyrgyz. It is predominantly Muslim, but the North is more secular and economically developed, while the South is more conservative and impoverished. The open sexuality of young people, who grew up with Western media and ideas, clashes with that of the generation in power, for whom communist taboos against sex remain strong. The health care system is a decaying remnant of Soviet times, and reproductive health receives virtually no government support. Sex education is absent from schools, and UNFPA, in conjunction with local non-governmental organizations (NGO’s), provides most of the reproductive health education and programs in the country.

In this context, I worked on three projects: (1) coordinating the second round of pilot testing of two bilingual Russian/Kyrgyz reproductive health brochures for young people, one for males and one for females; (2) assisting with the development of a family planning leaflet; and (3) developing a process evaluation plan with tools for the Youth Peer Education Network (Y-PEER) Kyrgyzstan program.

The most interesting project for me was Y-PEER, a network of peer education programs for youth, stretching from Central Asia to Africa. Y-PEER Kyrgyzstan focuses on HIV prevention; the rate of HIV in the former Soviet Union has increased dramatically in recent years, especially due to the availability of cheap opiates from nearby Afghanistan. During my second week, I participated in a camp for peer educators and young refugees, where I lived in a yurt and interviewed the young people and their supervisors from partner NGOs. I then developed tools for evaluating Y-PEER trainings and monitoring activities of the NGOs in each of the seven oblasts, or provinces. The tools were adopted by several other Y-PEER’s at the XVI International AIDS Conference in August. I not only applied what I had been studying, but I left with an appreciation of the importance of individuals to initiate change in a climate where it will not come from policymakers.

Several other activities rounded out my experience. I developed materials for focus groups and wrote a culturally appropriate brochure on family planning, which was produced as I was leaving. I visited several levels of reproductive health care—first obstetric points in villages, polyclinics in towns, and the largest perinatal hospital in

Finally, I traveled to Lake Issyk-kul in the North and Osh and Jalalabad in the largely Uzbek South.

I would like to say, “Spasiba bolshoy,” to the Bixby Program, Drabkin family, and Population Fellows Program for their funding, without which this experience would not have been possible.

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