|Central Eurasian Water Crisis: Caspian, Aral, and Dead Seas (UNU, 1998, 203 pages)|
|Part II: The Aral Sea|
|5. the Aral Sea and socio-economic development|
Infant mortality (the number of infant deaths under one year of age per 1,000 births) is an important indicator of the degree of maturity of a society. Data on deaths, specifically infant mortality, were among the greatest secrets in the former Soviet Union. Figures were first disclosed in 1986 after Gorbachev began his glasnost campaign, allowing more openness in society. However, international criteria have not yet been adopted with respect to statistical methods, and the figures could be double or triple. It is evident that Central Asia is now confronted with highly adverse circumstances on a scale unparalleled elsewhere in the world.
It has been reported that in the Karakalpak republic of Uzbekistan 11 per cent of all babies born there die before they are one year old one of the highest infant mortality rates in Asia. It is also reported that two-thirds of people there suffer from hepatitis, typhoid or throat cancer, and that 83 per cent of children have serious illnesses. Among people of all ages, cases of infectious hepatitis, jaundice, and gastrointestinal disease have multiplied. Malnutrition, anaemia, rickets, and even leprosy have reappeared.
Kazakhstan is in the same situation. In the 1970s and 1980s it showed a 3-29-fold rise in total morbidity for various infectious and somatic diseases associated with the drastic worsening of the ecological situation in the Aral Sea region. Child and maternal mortality rates have significantly increased. Investigations at the Institute for Regional Nutritional Problems of the USSR Academy of Medical Sciences have shown that pesticides, mineral fertilizers, and various microorganisms and their toxic metabolites are major pollutants of food products in all Kazakhstan regions (Sharmanov, 1989). The important role played by nutritional status in showing the carcinogenic effect of nitro compounds must be established. A complex of measures aimed at improving state sanitary control over the environment and food products must also be elaborated. It must be noted that environmental degradation in Central Asia is directly connected not only with irrigation but also with dirty industries. Radioactive pollution in Leninabad (Uzbekistan) and Maili Sai (Kyrgyzstan), and heavy metal air pollution in Chimkent (Kazkahstan), among others, are all connected to the Aral Sea problem, but they must be solved separately.
The situation in Turkmenistan is much worse. In 1989, 125,054 infants were born and 6,846 died under the age of one (a mortality of 54.74/1,000). Stores in Takhta District, which is located along the right bank of the Amudarya, have not sold butter, meat, or chicken for the past 10 years. Some 85 per cent of families in the district do not have their own livestock and, therefore, it is very difficult to buy meat, milk, and dairy products even in the market. In some families, especially large ones, children are dying of starvation. In many rural areas of Turkmenistan, the autocratic state which was thought to have prevailed until the beginning of this century still exists. Among the chairmen of Turkmenian collective farms there are quite a few who behave like absolute rulers, masters of people's fates within their territory. No one has the right there to marry without their consent. Turkmenistan produces two and a half times as much raw cotton per capita as Tajikistan. Production of cotton, both per capita and as a proportion of the arable land, is the highest in Central Asia. This explains the acute shortage of foodstuffs, rising social tension, chronic hunger, and high infant mortality. Hereditary diseases - autosomal recessive (or latent) - may be another cause of high infant mortality. Intra-family marriages (most often between cousins) are common in Turkmenistan, sometimes accounting for 10 per cent or more of the total, and in some places accounting for 60 per cent. The economic reason for these blood ties is bride price ("kalym"). Those who demand and pay a bride price and those who keep a young woman confined in her father's house after the 40-day "honeymoon" until the husband's relatives pay the bride price in full (which can take years) are rarely punished.
Even highly educated leading medical doctors need to understand the role of infection in modern medicine. The direct cause of any disease ending in death is attributable to infection. No matter what kind of modern and high-tech medical equipment and medicines are introduced into Central Asia from Western countries, they will be either useless or dangerous to patients if public and medical concern about infection is not heightened. Mothers are quite often the carriers of infection and their babies die of intra-uterine septicaemia.
It has been very difficult to establish the real reasons why children are getting sick and dying in Central Asia. Doctors have most often diagnosed the problem as pneumonia, which is hard to disprove. People used to believe that their children died of pneumonia. In fact, these deaths were most often caused by infectious diseases, particularly intestinal infections that can be prevented. However, if the deaths can be blamed on pneumonia, then no one is responsible and no additional facilities or services have to be established. Only 40 per cent of the republic's population has a piped water supply. The rest use water from irrigation canals and ditches. This affects not just villages or small towns. Cities, even in Tashauz, have no sewerage systems. Where there is a water purification plant, the equipment is not properly maintained.