Aral Sea crisis continues to erode health

Millions of people living near the Aral Sea face a bleak future, with health experts saying diseases like tuberculosis (TB) and cancer are having a terrible impact. The sea, located on the border of Kazakhstan and Uzbekistan, was once the fourth largest lake in the world. However, it continues to shrink despite regional commitments to halt the draining of the rivers that feed it. It is now a quarter of its original size. Over the last 40 years an estimated 45 million mt of salt-contaminated dust has been created due to the shrinking, resulting in massive health problems that affect millions of people, experts say. In 1994, the governments of Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan established the International Fund for Saving the Aral Sea (IFAS) to address the environmental impact. Usman Buranov, IFAS' technical director of the Global Environment Facility (GEF) projects, said that the health problems in the region were related to the low quality of drinking water. He said agriculture and cattle breeding around the sea were less productive, unemployment was climbing and certain diseases were more prevalent. The polluted air around the sea contained a toxic cocktail of salt, pesticides and chemicals that contaminated drinking water and led to liver and kidney illnesses, as well as a variety of respiratory diseases. Daphne Biliouri, an environment and development policy consultant based in Wales, did not see a bright future. “I believe that the health situation will only continue to deteriorate as there has been no substantial attempt to help the people of the region by improving the quality of the water and provide them with the essential medical assistance to improve the quality of health.” Biliouri added that efforts to improve the situation had been short-lived. “Current activities are localised and driven by the initiatives of people within the region - the problems of the Aral Sea have dropped down on the international community's list of priorities.” Meanwhile, the World Health Organization (WHO) said that there had been an increase in immune system disorders, birth abnormalities and cancer rates in the region. WHO said one problem specific to Uzbekistan was the high prevalence of bronchial asthma in Karakalpakstan, the autonomous region that borders the Aral Sea, while anaemia and TB were also endemic. In Muynak, a former port on the sea now 150 km from the water’s edge, the number of TB cases had increased nearly 70 percent in the past decade, according to Medecins Sans Frontieres (MSF), the health NGO that has been active in the region since 1997. Karakalpakstan’s 1.5 million residents had one of the highest incidences of multi-drug-resistant tuberculosis (MDR-TB) in the world, according to MSF. MDR-TB is resistant to two or more of the primary drugs used for the treatment of the disease. Thierry Coppens, MSF’s head of mission in Uzbekistan, said a survey they conducted in 2003 concluded that 30 percent of new cases of TB were drug resistant. In an effort to tackle the problem, MSF, in collaboration with with Uzbekistan’s Ministry of Health, started a drug-resistance project in Nukus (Karakalpakstan’s capital) at the end of 2004. However, the treatment is demanding. Patients must take up to a two-year course of medicines to kill the TB and there can be serious side effects.

As the Aral Sea shrank, many fishermen in the region lost their livelihoods

IFAS said other serious conditions in the area were linked to a lack of jobs. The fishing industry, which once had an annual yield of 40,000 mt, collapsed in the 1980s. IFAS has created the Social Assistance Fund (SAF), a support programme for those living around the Aral Sea, to try and mitigate the situation. Buranov said that the fund provided micro-loans to help establish new jobs and rehabilitate the area, but remained sceptical. “The pollution levels of the water supply continue to remain high and there are no attempts from the local authorities and the governments of the neighbouring states, as well from the international community to address this issue," he said. “I am afraid that there has been very limited effort over the years. Unfortunately the lack of a strategic significance of the region within the international political agenda will always keep the Aral Sea region at the bottom of the priority list,” he added.