Focus on the health impact of the Aral Sea crisis

The ecological disaster caused by the shrinking Aral Sea in Central Asia, continues to seriously affect the health of millions of people in Turkmenistan, Kazakhstan, and the northern Uzbek region of Karakalpakstan. The Aral Sea is now just a third of its original size following Soviet attempts to divert the rivers that fed it for irrigation purposes. "In the past 15 to 20 years, we have witnessed a worsening of the situation for people living around the Aral Sea," Dr Oral Ataniyazova, deputy of the Karakalpak parliament in the regional capital Nukus, told IRIN. Given the increased salt and pollutant content in the air and soil, as the sea shrinks, the rate of tuberculosis, anemia, cancer and birth defects have all increased, she explained. Epidemics and respiratory diseases continue to threaten people living in the area. A recent Karakalpakstan ministry of health surveys reveal a 80 to 90 percent rate of anemia among women and children, the highest rate anywhere, according to the World Health Organisation (WHO). Doctors maintain that the very high levels of anaemia are caused by poor nutrition and pollutants around the Aral Sea. Local drinking water is polluted by drainage water laden with salts and concentrated chemicals from the cotton fields, as well as a high content of metals such as strontium, zinc and manganese - all of which contribute to conditions such as anaemia. Of particular concern is the rise in tuberculosis. According to the Uzbek Ministry of Health, more than two thousand people a year die of the disease around the Aral Sea area, proving a major challenge for local health officials. Medecins Sans Frontieres (MSF) in cooperation with the health ministry, is working to improve treatment for victims of the disease. "Nowadays about one thousand people are taking part in short-term treatment within this framework around Karakalpakstan," head of the National Tuberculosis Prophylactic Centre, Daribay Doshetov told IRIN. Commenting on the urgency of the problem, Zamira Koptleuova told IRIN that along with her two daughters, she was now having treatment under the MSF programme. "If we didn't have their help, my family would lose a few more members," she said. "My husband, son and daughter-in-law all died of tuberculosis. We didn't have the money to provide them treatment," she said. Once the world's fourth largest lake, the Aral Sea began to shrink following an ill-fated scheme by Soviet planners to increase cotton production during the 1950s by diverting the waters of the Amu Darya Syr and Darya rivers that feed the Aral Sea. Within 20 years, a vast network of irrigation channels covering 7.6 million hectacres stretched across the deserts to irrigate the cotton fields, primarily in Uzbekistan and Turkmenistan. However, with less water making its way to the Aral, widespread salination began, leading to acute soil degradation. According to a report by the UN's Food and Agriculture Organisation (FAO), the result was what water experts call "disruption of the prevailing water balance" in the Aral basin. With many of the tributaries of the Amu Darya and Syr Darya over exploited, the rivers ceased to provide adequate water to the Aral. As the sea began to shrink, fishing communities were left miles away from the water that traditionally had provided a livelihood, some as far as 70 km. Today there are three separate sections of the sea: the Small or Northern Sea in Kazakhstan, the Central Sea, and the Western Sea, mostly located in Uzbekistan, the report said. The collapse the fishing industry in the early 1980's - an industry which once had an annual yield of 40,000 mt - was the first in a chain of ecological reactions, followed by a change in the climate. The draining of the Aral Sea has even had a neagtive impact on the regional weather system. Once noted for its mild temperatures, summers are now shorter, hotter, and rainless, while winters tend to be longer, colder and without much snow. According to a report by the UK-based NGO People and the Planet, the growing season for farmers has been reduced to an average of 170 days, fewer than the 200 frost-free days needed to grow cotton. The Karakum and Kyzylkum deserts now meet on the Aral's former seabed. The more than three million hectares of desert-like exposed sea bed lead to dust storms, spreading salt and pesticide residues over the entire region. By 1993, some 75 mt of dust and salt had been left on surrounding areas, the report said, adding that salts from the Aral Sea had been traced as far away as Belarus, over 1,000 km to the northwest. Deeply affected by the closing of the fishing industry, traditional communities have been slow to to adapt, leaving the economies once reliant on the sea in deep recession. Massive unemployment has led to extreme poverty. Most families have five to six children on average, and nutritional standards have fallen sharply. In addition to economic difficulties and climate changes, the region faces other deteriorating environmental conditions that contribute to poor health. "As the Aral Sea is shrinking and drying out, the flora and fauna have been dramatically altered," Shabat Khodzhev, director of the Virology Institute of the Uzbek Academy of Sciences, told IRIN. As a result, infections and diseases traditionally found in desert or semi-desert areas have now expanded to inhabited areas, he explained. "There are basically no healthy children around the Aral Sea," Zita Mazhitova, general secretary of the Pediatricians Association of Kazakhstan, told IRIN. "89 percent of them suffer from internal diseases, digestive problems, delayed sexual maturity, reduced weight and height," she maintained. Many people have left the region because of growing health concerns. "My husband and I were born and lived in Kungrad, a town which is now the epicentre of the ecological catastrophe," Bakhytgul Yesenova, a former resident told IRIN. "We raised our family and enjoyed a very good life. Recently we started to get sick, but when our grand-daughter was born with dropsy we moved far away to Kazakhstan. Still my husband has developed asthma and our second grand-daughter has anemia," she said. International and local organisations are now working with respective regional governments in the area to find long-term sustainable solutions to the crisis. But any remedy would be expensive and take years, experts warn. According to the FAO report, it has been estimated that at least 73 cubic km of water would have to be discharged into the Aral Sea each year for a period of at least 20 years in order to restore the 1960 level of 53 metres above sea level.