He had high temperature and pain in his lungs. He is doubtful whether he will ever be able to work again. The region suffers from unemployment and even young and strong wander about idle. Many choose to get on board the direct train from Kara balta to Moscow. Many also return, not much richer than they were before - but definitely sicklier.
Tuberculosis is a disease of the poor, and the migration increases it.
Golovko suspects he was infected while serving the bus passengers, but in fact, that is only one possibility out of many. Following the economic crisis and the disruption of the Soviet Union, tuberculosis has been spreading at a disquieting speed in the newly independent Central Asian republics. In Kyrgyzstan, the detected TB-cases have doubled in five years. Kyrgyzstan is one of the more advanced countries in the region in tackling the epidemic. With DOTS, hospital treatment is limited to two or three months.