Bayan-Olgii
Recently, I flew up to Bayan-Olgii, all the way in the furthest North-West corner of the country. Bayan-Olgii is mainly Kazakh (90%) and the rest of the 100,000 people there are from other minority populations. While the landscape is relatively similar to that of the rest of Mongolia (wide-open spaces) the feel of the place is very different. Although Kazakhs, like Mongolians, use the Cyrillic alphabet, their language is entirely different. Also, they are Muslim, as opposed to nominally Buddhist like the rest of Mongolia, which means that there are mosques in every town and I got to hear a few call to prayers.
A friend helped start a kindergarten out in Sogog, a small town two hours West of the provinical capital, Olgii, and so I went to see it while there. The kindergarten, which was built in time for school to start in September, is really pretty, and the toys and books in each classroom are so much nicer than anything else I've seen in Mongolia. The American woman who helped start it is trying to make the kindergarten self-sustaining, so she brought in designers who taught the women of the community how to make some of the more intricate Kazakh patterns, and she then hired the local women to make all the crafts needed for the classrooms. There's also the potential of starting a cafe or other venues to raise money. The kindergarten currently has 54 students, many of whom are bused in from several kilometers away.
Of those 54 students, five have cerebral palsy. CP, as it is often refered to, is a funny disease, in that it appears to have a lot of different causes, and there are varying degrees of damage and no one seems to know exactly what causes it when. Essentially, though, it's a neurological disease that affects motor skills, rendering some unable to speak or walk or use any of their limbs. The causes appear to include babies not receiving enough oxygen to their brains during the birthing process, fetal alcohol syndrome (FAS), and incest, or intermarriage among too close relations. For some children, it appears to occur at a few years, possible due to diseases such as meningitis or due to malnutrition.
That essentially 10 percent of children of this Kazakh community appear to have the disease, however, gives pause. In the developed world, approximately 2-2.5 childrenn per 1000 develop the disease, which is hugely different than one in ten, as it is in Sogog. One explanation, beyond how small the gene pool is, is the quality of the doctors in the area. I've heard horror stories of dentists there helping women give birth. Someone who doesn't know what they are doing has a much higher chance of cutting off a baby's oxygen supply by accident.
The kindergarten in Sogog has wheelchairs, but, in general, physical therapy and other ways to help children with CP are out of the price range for the people in Bayan-Olgii, who live mainly in a non-monetary community, subsisting off the land.
Someone, I want to say USAID, charitably started a school for CP children in Olgii, but it wasn't heated, which is terrible for people with CP in particular, as their muscles are already so cramped, and it didn't serve meals, which is considered necessary in Mongolian schools. So I believe it closed, despite the obvious need for such a school.
I'd love to go back and try to track how many people in the area have the disease and how much its prevalence has increased in recent years. Getting better doctors would likely decrease the number of cases, but as the gene pool becomes even smaller, more might be necessary.