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. 2004 Jul 31;329(7460):299.

Saving lives on the Silk Road

James Owen Drife 1
PMCID: PMC498091

Long haul flights are exciting but rarely scary nowadays. We British tend to go to countries that were once pink on the map. It is a new experience to fly to someone else's former empire, to places you had not heard of until recently.

Kyrgyzstan lies between Kazakhstan and China. Tajikistan separates it from Afghanistan—only just, but enough to reassure the wimp in me. The Kyrgyz capital, Bishkek, was not in my atlas but according to the web it did exist. Until the Soviet Union broke up it was called Frunze.

At Bishkek airport you cannot help noticing the United States Air Force planes. Then, as your taxi turns east along the Silk Road, you see an endless range of snow capped mountains. When the sun begins to set, they turn pink. Gee whiz, this is a beautiful country.

The central Asian republics have convoluted borders said to have been drawn by Stalin to prevent their peoples uniting. Now their leading doctors and midwives were being brought together by the World Health Organization (WHO) to discuss how to reduce maternal mortality.

Their rates are good compared with some nearby countries. In Afghanistan mothers are dying in huge numbers. In Iraq, sanctions multiplied the maternal mortality rate more than tenfold, even before last year's invasion. Central Asia's rates—at least officially—are only four or five times those in Western Europe. One way to reduce them, we hope, is UK-style confidential inquiries.

Each delegation sat at a long table with a little flag. Everyone except the WHO visitors spoke Russian. You had to remember to remove your earpiece when answering questions, otherwise you heard yourself in Cyrillic.

I was prepared for disappointment. International meetings often generate only hot air. Soon, however, we were making delayed-action jokes through our interpreters and by the end there was an unmistakable air of resolve. We were all professionals who had seen women bleed. We got quite emotional.

The farewell party beside a moonlit lake involved toasts, a bonfire, a sheep's head (delicious), Moldovan brandy, communal Kazakh dancing, and a not entirely successful Scottish reel. I felt surprisingly at home, but then I come from a long line of shepherds.


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