Aral Sea crisis threatens public health

The Aral Sea, located on the border of Kazakhstan and Uzbekistan, was once the fourth-largest lake in the world, but it has now shrunk to one-quarter its original size. The shrinkage, brought on largely by over-irrigation of rivers feeding the landlocked sea, and widespread pollution have led to grave health problems affecting millions of people and economic decline in the region.

Despite regional commitments to halt the drainage of the rivers that feed it, the Aral Sea continues to shrink. In addition, chemical waste from industrial projects and fertiliser runoff before and after the break up of the Soviet Union have poisoned soil and drinking water, posing a health hazard to those living in the area. Over the last 40 years, the shrinking shoreline has left behind an estimated 45 million metric tonnes of contaminated dust. The polluted air around the sea - a toxic cocktail of salt, pesticides and chemicals - has led to an increase in liver, kidney and respiratory diseases, experts said.

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 damage. Usman Buranov, a spokesman for IFAS, said health problems in the area were related to the poor quality of drinking water. Agriculture and cattle breeding around the sea had declined; unemployment was on the rise; and certain diseases had become more prevalent, he added.

Photo: David Swanson/IRIN

The local fishing industry has collapsed due to decreasing water levels

Daphne Biliouri, an environment and development policy consultant and expert on the region said that without international intervention, health in the region would continue to deteriorate. “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,” she said, adding that any local efforts to address 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 the list of priority from the international community,” she said.

The United Nations World Health Organisation (WHO) has reported an increase in immune-system disorders, birth abnormalities and cancer rates in the Aral Sea area. The agency cited one problem specific to Uzbekistan, which was the high prevalence of bronchial asthma in Karakalpakstan, the autonomous region bordering the sea. Anaemia and tuberculosis were also widespread.

In Muynak, a former port that now lies some 150km from the water’s edge, the number of tuberculosis cases had increased nearly 70 percent in the past decade, according to Médecins Sans Frontières (MSF), which has been active in the region since 1997. The agency reported that Karakalpakstan’s 1.5 million residents had one of the highest rates of multidrug-resistant tuberculosis (MDR-TB) in the world.

Photo: David Swanson/IRIN

"Pollution levels remain high…. And there is no attempt to from governments or the international community to address this issue"

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 an agency survey in 2003 found 30 percent of new tuberculosis cases to be drug resistant. MSF, in cooperation with Uzbekistan’s Ministry of Health, launched a drug-resistance project in Nukus, the capital of Karakalpakstan, 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.

IFAS said the region had also decline economically, leading to higher unemployment rates. The fishing industry, which once had an annual yield of 40,000 metric tonnes, collapsed in the 1980s. IFAS has set up the Social Assistance Fund (SAF), a support programme for those living around the Aral Sea, to try and mitigate the situation. Buranov said the fund provided micro loans to help create new jobs and rehabilitate the area.

Still, Biliouri 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,” she 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 on the bottom of the priority list.”