“The health of every single family in our community is extremely important to me. I have always been paying close attention to the neighbors surrounding me, I do care about every single one of them and that is actually an integral part of my mission,” says Nyshangul Ibragimova.

In her Rural Assembly of Citizens, Nyshangul, 54, is a specialist who works with women and is responsible for strengthening the spiritual and moral values in families. Also, she has graduated from the "UN Volunteer School" focusing on healthcare issues after successful completion of a series of regular trainings held by UN Volunteers in Karakalpakstan.

Desiccation of the Aral Sea , once the fourth-largest inland lake in the world until 1960, with an area of 68.9 thousand square kilometers and water volume 1083 cubic kilometers caused spreading of various diseases such as - anemia, renal and liver failure, gastrointestinal, cardiovascular diseases and respiratory diseases, etc. Since 2012, UN Volunteers have been providing assistance to the UN Joint Programme* for the Aral Sea region by giving training for local community volunteers on healthcare issues. This helps to increase the medical literacy of the population spreading the knowledge of different types of prevalent diseases caused by difficult environmental situation, and preventive measures. As a result of joint efforts, according to the Karakalpak branch of the Institute of Health and Medical Statistics under the Ministry of Health of the Republic of Karakalpakstan, the tuberculosis incidence rates for every 100,000 people have been reduced from 106 cases in 2014 to 80 cases in 2018.

Nyshangul opa visits residents and holds meetings with them regularly. She speaks about the importance of disease prevention. She distributes informational posters and infographics with description of disease symptoms that people should pay attention to. What’s more, she cares about the health status of each of her colleagues. Fortunately, hard work pays off, her efforts did help to prevent the serious ailment occur in one of the families in the district.

- I noticed that my colleague’s wife has lost weight abruptly, she coughed a lot and did not look healthy at all. It was quite hard for me to ask anything about her health status, therefore I decided to organize an information campaign. During the next household visit, I highlighted the causes and symptoms of respiratory diseases as well as the prevention methods. I communicated with all the participants and then I came up to her. However, unfortunately, I realized that the woman had been coughing for a long period of time, and the other symptoms were observed as well – chest pain, fever, loss of appetite and body weakness. Even though she took the practice of self-medication, the treatment did not help her to improve the situation. Realized how risky and how terrible the consequences could be if she kept ignoring the health problem of her body, the women agreed to consult the medical specialist in the end. - says Nyshangul Ibragimova.

After that, a full medical examination and laboratory examination have been conducted in the clinic and the report revealed that the woman who wished to remain anonymous had a pleurisy - a respiratory disease, often associated with the accumulation of fluid between the two layers of pleura, known as pleural effusion. This was followed by a long-term and phased treatment under strict doctor supervision. Luckily, the woman is fully recovered now, and she keeps on remembering the importance of preventive measures for diseases. Therefore, she is now living happily with her family and she is capable to continue her favorite sewing job again.

All in all, 261 healthcare community volunteers were trained in the Kegeyli district, more than 2,080 in the entire area of Karakalpakstan. This programme not only allowed 14,683 significant meetings between volunteers and residents, but also the successful awareness raising campaigns on promoting the importance of preventing cardiovascular, gastrointestinal, respiratory tract ailments as well as the protection of mother and child in 23,354 households with a coverage of 52,125 people.

In addition, the well-trained volunteers include psychologists, teachers, specialists from rural citizens' association, patronage nurses and housekeepers – all of them with the same mission, in the hopes of increasing the medical culture among the population, contributing to enhancing the healthcare environment and security in the region.

* The UN Joint Programme for the Aral Sea region has been operating since 2012. The first phase of the programme was focused on ensuring the livelihoods of the population affected by the Aral Sea crisis. As part of the second phase, since 2016, the programme has been strengthening the resilience of communities affected by the Aral Sea crisis through the establishment of the Multi-Partner Human Security Trust Fund for the Aral Sea region.