Stop TB Partnership

Success Story Karaganda


My main weapon is trust, says Dinara Balgimbekova

"They say that outreach is men’s work. As is well known, the vast majority of labor migrants are from the stronger sex. But they trust women more. I say this, as a psychologist with years of experience."

Dinara Balgimbekova is no stranger to outreach work. She has engaged in this activity with 6 non-governmental organizations’ projects. She has also worked in the Regional Center for Prevention and Control of AIDS and Narcology institutions. In Karaganda city, she is well known as a competent psychologist. From the first days of her work in the NGO "Umit", Dinara proved to be an experienced outreach worker This non-governmental organization is one of the 6 NGOs that implement cross-border activities contributing to control and treatment of TB/ MDR-TB and TB/HIV among labor migrants. The international organization "Project HOPE", which is the primary recipient of the Global Fund to Fight AIDS, tuberculosis and malaria’ funds, provides technical support to these activities.

"At the beginning of this project there were difficulties. There was no clinic to which labor migrants could be ‘assigned’. All services were charged for. Therefore, it took much effort to persuade people to get tested for TB. Over time however, clinics became available. A list of services for labor migrants was formed, covered by Project HOPE through the grant funds. However, to motivate migrants to leave their workplaces and come to a health facility remains a problem."

Respect - when you and your personality become public, and the people pass your name to each other as a confidence password - is the major sign of success of work with labor migrants. It is not easy to earn, which is only possible through good deeds, everyday work, and the ability to make decisions in crisis situations.

One of these crises occurred with Dinara a year ago. The family of Ilhom, a labor migrant from Uzbekistan, asked her for help. Dinara came to their dwelling and was shocked by the living conditions. A ramshackle hut, a cold stove, a felt mat on the floor instead of beds, ... A family of four children. Father is the only bread winner in the family - a loader in the market. The little children are constantly sick. The youngest child was born in Kazakhstan, but did not get a birth certificate. For this reason, the child could neither be examined nor treated. And the child was suspected of having tuberculosis. Seeing all this, Dinara realized there was no to time to lose. She had to see lots of authorities, speak with officials, persuade, and finally she managed to obtain a birth certificate for the child in at the public services center, and arrange an examination in the clinic. The outreach worker did everything to help the labor migrant’s family and to protect the child from a dangerous high-toll disease.

"Our outreach-workers often work evenings and weekends. They go to construction sites, to markets, to catering establishments... Karaganda city is scattered, it is not possible to get to each construction site by public transport. In the winter months, it is difficult to walk because of the deep snow. But our outreach workers - the people responsible and experienced - despite the vagaries of the weather and distance, look out for labor migrants, talk with them, tell them about tuberculosis, accompany them to the clinic for examination. To improve the efficiency of our work we have mapped the city into 7 areas - matching the number of outreach workers we have. In such a way, each is responsible for own specific area," says Gulmira Smailova, the director of the NGO "Umit".

Dinara Balgimbekova’s "catchment areas" are construction sites. As soon as she learns about a new site, she rushes off to see migrants, talk to them about life, home, health values. Such themes always help establish contact and mutual trust. Dinara admits that at first it was scary to walk around construction sites among bricklayers, finishers, electricians - all men. But no one has ever been rude, on the contrary, they always greet her warmly, with a smile, as adults, even fatherly. And they willingly agree to be tested for tuberculosis.

"These people are torn from their homeland, many from their family and children. It's hard for any man. They are always on the lookout. Afraid of new people, unfamiliar environments, surveys. It happens that they run away, do not want to be tested for tuberculosis. They are convinced that they would be sent off home, while they need to earn money for the family. All these fears can be dispelled only by trust and human understanding. After all, we are all humans. All want to live happily and be healthy."