Aidai Temiraly Kyzy, a nurse at one of the biggest hospitals in the country, puts on the music and leads her patients in the Kara Jorgo, the national dance of the central Asian country.
Kyzy is not doing it for fun, but he is doing a range of body movements that leave everyone smiling. A treatment programme is offered to people with a lung condition called COPD.
She says that almost all patients complain of a cough before doing this, and that the improvement is noticeable on the second or third day. They can do more physically.
Kyzy says that he has seen patients with low moods transform into happy people.
Symptoms of COPD include breathlessness, a chronic cough, and phlegm. Smoking and air pollution cause it. It can lead to premature death if left unaddressed. It can be treated and managed if it is detected early.
It is one of the top three causes of death, and most of the deaths occur in low- and middle-income countries. According to the Global Initiative for Chronic Obstructive Lung Disease, there are 3 million deaths a year from COPD, but this number is expected to rise to 5.4 million by 2060.
The director of the National Centre of Cardiology and Internal Medicine in the capital city of Kyrgyzstan says that COPD is a very serious problem. According to research, up to 200,000 people out of a population of about 6 million have the disease.
The human toll of NCDs is rising. More than 40 million of the 56 million people who die every year are in the developing world. You can't catch NCDs, unlike a virus. They are caused by a combination of factors. Cancer, chronic respiratory illnesses, diabetes and cardiovascular disease are the main types. Around 80% are preventable, and all are on the rise, as old populations and lifestyles pushed by economic growth and urbanisation make being healthy a global phenomenon. The poor now have a grip on NCDs, which were once seen as illnesses of the wealthy. Being poor makes it less likely that you will be diagnosed accurately or treated for disease. The cost to families, economies and communities is staggeringly high when it comes to tackling common and chronic conditions. In low income countries, NCDs are seeing a fraction of the money needed being invested or donated. The death toll from Malaria, Tuberculosis and HIV/Aids have all gone up in recent years, yet the death toll from cancer has gone down. A common condition is a new Guardian series reporting on NCDs in the developing world, their prevalence, the solutions, the causes and consequences, and the stories of people living with these illnesses. Tracy McVeigh is an editor.Quick GuideShow
We have patients who don't understand why they have a cough. He says that they don't visit health services.
The number of sufferers is expected to increase. The country has more than 500,000 smokers and there is a lot of indoor pollution caused by people in mountainous and remote regions heating their homes with wood, dung or coal.
The man decided to act. COPD patients in many countries have to buy drugs to treat the disease. It can cost more than a monthly salary in the country. An EU-funded research project called Fresh Air was started by Sooronbaev and his team to experiment with a physical exercise programme for people with lung conditions.
I didn’t believe it would work. I thought only inhalers or injections could help. But it had a massive impact
The programme has incorporated patient feedback over the years. It is already in place in three hospitals and two GP surgeries in the country. It runs for six weeks and has a couple of two-hour sessions a week. A regime of physical exercise incorporating elements of volleyball, walking, cycling on exercise bikes, and dancing has been added to lectures, diet information and patient support groups. Patients can continue with what they are taught at home.
One woman cried when she saw the effect. She was depressed.
She smiled and her body language was more active after she took part in the programme. That's in my mind.
In the Naryn region, 190 miles from Bishkek, there is a village with a market for animals. He noticed his health deteriorated in 2015, but thought it was a smoker's cough. He was coughing up phlegm and becoming breathless by the end of the year. He was diagnosed with COPD after spending 10 days in the hospital.
He was invited to take part in the pulmonary rehabilitation programme by the hospital, which was still involved in a research project. I didn't think it would work, I thought only injections could help. I had nothing to lose.
It had a huge impact. I still cough and have flare-ups of COPD, but I'm more active. I can do more walking around the house. I was surprised to see that simple exercises could improve my respiratory health. My whole outlook changed.
From this year, pulmonary rehabilitation will be available throughout the country. Patients who have undergone the programme are being trained to teach others, and Sooronbaev and colleagues are due to speak at medical conferences to inform other healthcare professionals about their progress with the programme.
He says that COPD medicine and drugs are not a real medical service. This is why we have plans to extend and why we will share our experience with other countries.
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