HEALTH: Uzbeks Pay for Past Environmental Sins

By IPS Correspondents Reprint | | Print |

Sergey Naumov

URGENCH, Uzbekistan, Sep 28 2005 (IPS) - Asked about the health system when this country was part of the Soviet Union, Gulbabor, a mother and accountant, mused: ”It was all free of charge in Soviet times and now we need to pay for everything. Money is tight”.

A Central Asian country still grappling with changes as a result of the economic transition from the Soviet system, Uzbekistan is often reported for the continuing environment, health, social and human disaster that is the Aral Sea region in the north-west.

Talk of the Millennium Development Goals (MDGs)-a set of commitments by governments to meet targets from curbing poverty and maternal and infant mortality to improving environmental sustainability – is alien to people like Gulbabor.

But her sentiments refer to the same concerns that governments, including hers, have pledged to address by 2015. ”Current incomes of many people barely exceed 30 US dollars a month. People prefer not to see a doctor to undergo treatment in a hospital,” she said.

Yet, the basic health needs of this country of 26.3 million people- not least given the impact of the Aral Sea disaster that has led to large numbers of people with typhus, respiratory illnesses, cancer and tuberculosis-are clear.

The highest rates of disease and mortality can be found in the southern and north-western regions of the country, some of it the legacy of heavy use of chemicals in agriculture when Uzbekistan was part of the Soviet Union and there was a massive drive to produce cotton, a revenue earner.

Infant and maternal mortality rates have declined over the past decade, according to statistics by the United Nations Population Fund (UNFPA) which puts infant mortality at 41 out of 1,000 live births.

According to the Uzbek National Statistics Commission, the under-one infant mortality rate in the country was 18.7 per 1,000 live births in 2000, while in 2004 that figure went down to 16.5 per 1,000 live births.

Ninety percent of pregnant women in Khorezm and Karakalpakstan, an autonomous region that makes up almost 40 percent of Uzbekistan, are anaemic and half are affected by thyroid and kidney illnesses.

More than 40 percent of the maternal mortality rate in Uzbekistan concerns first time mothers, according to Nariman H, a paediatrician from the north-western Khorezm region.

These figures are just some signs of the problems Uzbekistan faces today. In many ways, the situation around the Aral Sea region has become a laboratory of what can happen when human beings use technology to mess up nature and now have to live with consequences.

In this case, in the sixties the former Soviet Union ordered Uzbekistan, which was then one of its republics, to divert waters of two rivers away from the Aral Sea – the fourth largest lake in the world. This was to irrigate massive areas that had been turned into cotton fields.

To grow cotton, huge doses of chemical fertilisers, pesticides and defoliants were used on the land. These entered the groundwater and reached river basins where people used the water for drinking and cooking and got ill.

In the eighties, the average amount of chemical fertilisers pumped into each hectare of agricultural land in Uzbekistan had reached more than 300 kg, nearly three times the average amount in the whole Soviet Union.

The water-surface area of the Aral region shrank to almost half, water became salty and the volume reduced by three-fourths. Fisheries came to a halt and pastures that relied on the waters of the Aral shrank. Large swathes of land turned into desert, and some say this process continues. The Syr and Mu rivers were full of agricultural chemicals.

Today, dust salt from the dried and toxic seabed, with toxic pesticides and heavy metals, is brought by annual winds around Central Asia and Western Europe. It is a cross-border issue, starting with neighbouring Kazakhstan.

The health burden-–at a time when people have to bear the costs on their own-–also continues.

At one point, the tuberculosis sickness rate was six times above the World Health Organisation standards. New WHO figures say that TB patients in Central Asia are 10 times more likely to have multi drug-resistant TB than the rest of the world. The TB prevalence rate is 156 per 100,000 people.

People living in the Aral Sea area fear tuberculosis as well jaundice much more than HIV/AIDS.

Doctors also talk of deformities, which they trace to damage to genes from chemicals used in agriculture in the past.

”They often bring me babies without hands, legs and even without genitals, or having excessively big heads. How can I help them out?” asked Tohtabay Baltabaevk, who treats high-ranking government officials in one of the southern districts of Karakalpakstan.

In Karakalpakstan alone, there are some 17,000 children with various disabilities and deformities, doctors say.

The impact of the Aral Sea disaster is an issue that has brought in international funding and prompted leaders’ summits in the region over the years.

In 1992, Uzbek President Islam Karimov called for international cooperation to save the Aral Sea, but some say the focus on producing cotton remains. State purchases of raw cotton are very low but processed and finished cotton wool is sold by the state in the world market at high prices.

”The regular use of child labour on cotton plantations, every autumn, is the best picture representing state indifference toward its citizens,” Marat Zahidov, an Uzbek human rights activist, said in an interview.

But today, the pains and problems of the Aral area seem to move neither the international community nor local authorities as much as in the past. Much time has been wasted, rues Oral Ataniyazova, a doctor and leader of the non-government organisation ‘Perzent’ from Nukus, also in the north-western area of the country.

She explains that an Uzbek government regulation on genetic preservation in the Aral area was approved in April 2004 and that if the 12 million dollar fund is efficiently used for the purpose, this could be an example of a step forward.

Nargiza Jurabaeva, MDG coordinator for the United Nations Development Programme (UNDP), said that the organisation is preparing, this year, a report on the country’s performance on all seven MDG targets. ”We are now in the last stage,” she explained.

”The work on performance evaluation in every region with following reports will start next year. What we really need is a reliable statistical database for every region, and that’s what we are working on,” she said.

In the report ‘A Future within Reach’, Uzbekistan is listed among nations achieving ‘slow’ progress in meeting the MDG goals of reducing under-five mortality rate by two-thirds and reducing the maternal mortality ratio by three-quarters from 1990 to 2015. It is classified as ‘regressing’ in the goal of addressing tuberculosis prevalence and death.