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Environmental HEALTH ASSESSMENT AND INTERVENTION PROGRAMS

Kyrgyzstan

improving health outcomes by reducing heavy metal exposure

Batken Province, home to just over half a million people, sits at the crossroads of the fertile Ferghana Valley and the rugged mountains of southwestern Kyrgyzstan. For decades under the Soviet Union, the region was heavily mined for strategic minerals, including gold, mercury, antimony, and uranium.

When the USSR dissolved, Batken’s mineral economy collapsed, but its environmental legacy remained. Severe contamination from historic mining and smelting continues to threaten the health of communities. Climate change and the region’s location in one of the world’s most seismically active zones increase the risk of transboundary pollution disasters, including those caused by landslides, floods, and earthquakes.

Kyrgyzstan village with mountains in the background - environmental health

A Collaborative Environmental Health Project

Médecins Sans Frontières (MSF) has been working in Kyrgyzstan since 2006, with a focus on combating drug-resistant tuberculosis. In 2016, the Kyrgyz Ministry of Health (MOH) and MSF invited the TerraGraphics International Foundation (TIFO) to assess the risks of heavy metals in Batken. By 2018, the three partners launched an environmental health project targeting the Soviet-era mining towns of:

Aidarken – one of the world’s largest mercury operations

Chauvay – site of an abandoned mercury mine and smelter

Kadamjay City – home to antimony mining and smelting

TAKE ACTION

Key project activities

This project works with local leaders to reduce exposure to individuals living in contaminated communities. MSF developed programming in collaboration with the MOH related to non-communicable diseases and maternal health. Simultaneously, TIFO collaborated with all partners to perform:

Biological Monitoring (2021)

  • Focused on vulnerable groups, including children and women of childbearing age residing in high-risk areas identified in the risk assessment.
  • Identified elevated levels of antimony and arsenic in blood and urine.

Human Health Risk Assessment (HHRA, 2019-2021)

  • Quantified risks to people exposed to hazards such as contaminants in soil, water, air, and food.
  • Identified three major contaminants in the communities: arsenic, antimony, and mercury. The first two are byproducts of mercury extraction.

Environmental Sampling (2019)

  • Targeted public and residential areas in Aidarken, the villages surrounding Aidarken, and Chauvai. Active mining operations were not assessed.
  • Supported Kadamjay Rayon Sanitary Hygienic Laboratory’s (SHL) capacity to assess sites for contamination that exceeds health-risk criteria at low cost.
  • Prioritized and secured the support of the community, Kombinot, local governments, and the stakeholder committee, which was key to the successful implementation of one of the largest environmental sampling efforts ever undertaken in the region.

Seismic Risk Assessment (2018)

  • Estimated the potential loss of human life due to earthquake damage to buildings and mining wastes.
  • Predicted potential impacts to mine waste in the event of landslides, rock falls, lake outbursts, and mudflows during earthquakes or intense weather events.

Staff health and safety assessment and mitigation program (2016-2022)

  • Assessed potential exposure risks to MSF staff living in the region.
  • Developed exposure reduction recommendations and routine environmental and biological monitoring programs for staff.

INTERVENTION PROGRAMS

Following the assessments, TIFO and partners shared findings with local stakeholders and recommended action plans.

IMMEDIATE INTERVENTIONS

Consistent, thorough washing and peeling of fruits and vegetables.

Consistent dust abatement measures indoors (frequent cleaning).​

Discourage/prevent children from visiting industrial sites.

Fence off contaminated areas.​

To the extent possible, avoid growing crops in soil with high concentrations of heavy metals.

Designate “safe” outdoor play areas with barriers preventing access to contaminated soils.

Train local doctors and nurses in environmental health intervention priorities, with a focus on reducing exposure.​

Develop environmental awareness messages to reduce exposure to heavy metals among the general population, particularly children.​

LONG-TERM INTERVENTIONS

Spot remediation to provide safe play areas.

Re-route and/or treat mine and Kombinot water to prevent residential and agricultural use.

Remediate residential, public, and agricultural areas that have high contamination.

Remediate Aidarken sludge ponds, the Chauvai Kombinot area, and Eshme field tailings.

Program for residents to have produce tested for metals by Kadamjai Rayon Sanitary Hygienic Laboratory (SHL).

Continue to assess and analyze medical, environmental, and public health system needs.

    • Building Capacity Through Education

    In 2024, TIFO and the Massachusetts College of Pharmacy and Health Sciences (MCPHS) received a grant from the Public Diplomacy Department of the U.S. Embassy in Bishkek to launch the Environmental Health Education Program (EHEP) in Kadamjay District.

    Working with MOH, the International Higher School of Medicine (IHSM), and the State Sanitary and Epidemiological Surveillance (SES), EHEP developed a training framework for healthcare providers and environmental professionals—aligned with Kyrgyz national standards and informed by U.S. best practices.

    Gulzat leading environmental health training of medical professionals in Kyrgyzstan

    EHEP Goals:

    Equip healthcare workers to integrate exposure-reduction interventions into patient care.

    Strengthen partnerships between Kyrgyz and U.S. agencies, universities, and training programs.

    Build long-term local expertise in environmental health management.

    Kyrgyz resident quote - environmental health

    Toward a Healthier Future for Batken

    This ongoing partnership demonstrates how science, local knowledge, and cross-border collaboration can address even the most complex environmental health challenges. Through sustained assessment, targeted interventions, and capacity building, Batken’s communities can move toward a safer, healthier future—free from the toxic legacy of its industrial past.

    PARTNERS

    Kyrgyz Ministry of Health (MOH)
    Kadamjay Rayon Sanitary Hygienic Laboratory (SHL)
    Aidarken Hospital and surrounding clinics (under MOH)
    Kadamjay Hospital
    Local Stakeholder Committee
    International Centre of Earth Simulation (ICES)
    Kyrgyz Ministry of Emergency (MOE)
    International Higher School of Medicine (IHSM)
    State Sanitary and Epidemiological Surveillance (SES)
    Médecins Sans Frontières (MSF)
    U.S. Department of State
    Massachusetts College of Pharmacy and Health Sciences
    TIFO Publications
    Comparison of XRF and AAS Results for Environmental Health Assessment at Mercury Site in Kyrgyzstan
    Environmental Health Human Health Risk Assessment (HHRA) in Kyrgyz Republic
    Скачать: Оценка рисков для здоровья человека (ОРЗЧ) в сообществах в Кадамжайском районе Баткенской области, Кыргызская Республика Environmental Health Risk Assessment translated to Russian
    US Flag - Environmental Health grant US State Department

    This work was supported in part by a grant from the United States Department of State, grant number SKG10023GR0109..