Health workers in Kyrgyzstan have been forced to work long hours, often without promised extra pay and sometimes even with reduced pay, and subjected to a "prisonlike" quarantine regime during the COVID-19 pandemic, Amnesty International said in a new report on September 25.

Unofficial sources said 40 health workers died at the height of the outbreak from mid-March to late July, while official data from the Ministry of Health put the toll at 29 deaths, the new report said.

According to a tally by Johns Hopkins University, Kyrgyzstan has 45,757 confirmed coronavirus cases, with 1,063 COVID-19 deaths.

"Kyrgyz doctors have worked selflessly, risking their lives every day looking after their patients, often in the absence of vital medical supplies,' said Heather McGill, Amnesty International's researcher on Central Asia.

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'It is appalling that in return they were denied their human rights, underpaid and forced to keep quiet about their problems for fear of retaliation,"

said McGill.

The report -- titled Kyrgyzstan: Beyond The Call Of Duty: The Rights Of Health Workers In Kyrgyzstan -- says that since May, doctors have been working daily 12-hour shifts for two weeks in a row followed by 14 days of quarantine.

According to one doctor, quarantine conditions resembled "being like in prison" with reports of health workers often living 10 in a room and unable to see their families, the report said.

"I am now working 24 hours a day. I can't leave because there are so many patients. I am working in a COVID department. I am the only doctor. I have an assistant who is a surgeon. I am the manager and I can't just leave at the end of my shift. I have to be there constantly. We manage to sleep three to four hours. I have been working like this for 30 days," one doctor told Amnesty International.

In the early phase of the outbreak, health workers were forced to work without adequate supplies of personal protection equipment (PPE). When they did receive such equipment, its quality was below standard and medical personnel lacked adequate training to use it, the report says.

Adding to their plight, Kyrgyz doctors and nurses, who are among the lowest paid professionals in the country, haven't been paid in a timely manner, while some have even had their salaries cut, the report revealed.

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"The main thing is that they pay us the salary they promised. I have to feed my family," one doctor told Amnesty, complaining that this promise was not met.

Because of low salaries, Kyrgyz medical personnel have migrated to other countries and to the private sector -- a trend that caused a chronic shortage of doctors in the state sector.

Amnesty says that, in addition to the great difficulties they encounter on a daily basis, Kyrgyz health workers also face repression. Doctors contacted by the rights group were often reluctant to speak out and those who accepted to be interviewed asked that their identities be kept anonymous for fear of reprisals from their superiors.

In the rare cases when health workers have publicly complained, they have suffered threats, dismissal, or humiliation from their employers.

"The government of Kyrgyzstan should take steps to build greater resilience in the health system to better cope with the pandemic, and focus on protecting the rights of health workers. It must also ensure that everyone in the country can exercise their right to freedom of expression, and adopt measures to protect whistle-blowers," said McGill.

The report urges Kyrgyzstan to meet its human rights obligations under the International Covenant on Economic, Social, and Cultural Rights and guarantee just and favorable conditions of work for all workers, including health workers.

Kyrgyzstan's Ministry of Health must ensure that all doctors are provided with PPE that complies with international standards and that they are properly trained in how to use it to avoid infection, the report concluded.

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