The Aral Sea and drought
The challenges faced are epitomized by the disaster of the Aral Sea, which had a devastating impact upon the surrounding areas. During the period from 1960 until 1992 the area of the sea was halved and its volume quartered, as the Amu-Darya and Syr-Darya rivers were channeled and dammed to provide irrigation for agriculture.
The areas most affected are Karakalpakstan (which contains the Aral Sea) and the neighbouring region of Khorezm, which together contain a population of over 2.5 million people at risk.
The Aral Sea
The people in these regions suffer from high levels of anaemia, together with rising levels of tuberculosis, whilst children suffer from liver, kidney and respiratory diseases, micronutrient deficiencies, cancer, immunological problems and birth defects.
The situation in Karakalpakstan and Khorezm has declined further as a result of two consecutive years of drought. The drought has so far affected a population of over 2.5 million people, resulting in 2 years of crop failure that has undermined the local economy which is dependent on agriculture.
Although the government has made progress, still only 54% of urban and 3% of rural populations have access to adequate sewage systems (source: UNDP Human Development Report), those without relying on very basic and unhygienic pit latrines. The use of this type of latrine, together with inadequate drainage and poor hygiene practices, lead to high levels of food and water contamination.
The government and UNICEF are working with the World Bank and Asian Development Bank. Interventions aim to improve safe water supply and environmental sanitation and to encourage the adoption of better hygiene practices in the most acutely affected rural districts. The need is urgent as 70% of community water sources are disfunctional, due to poor maintenance, and subsequently become contaminated.
One of the major problems is salinization and although Karakalpakstan, for example, has 63 out of 80 (source: UNICEF survey) desalination units functioning, the majority of these are working well below their capacity and need major repairs. Furthermore, the water testing laboratories have old and out-dated testing equipment and a shortage of chemical reagents for water testing is also a major concern.
Community water quality monitoring
Furthermore, hand-operated water pumps, suitable for areas with varying water table levels are being developed, with the potential to benefit 40,000 people during the pilot stage and many more in the future. Another 30 water sources, such as well manholes and hand pumps have been repaired.
Improved personal and domestic hygiene practices are also essential to improve the health status of children. Communities are encouraged to obtain drinking water from safe sources; keep water in clean, covered vessels; and when there are doubts on water quality, boiling is encouraged in order to kill bacteria. Furthermore, washing with soap when handling and cooking food or feeding children is encouraged, along with the protection of food by washing it before consumption; and keeping kitchens and kitchen utensils clean. Sanitation kits containing soap for washing and cleaning materials for toilets and garbage bins have been provided.
An effective child-friendly hygiene programme and new sanitation facilities in schools will stimulate children to develop and use essential hygienic habits.
Drought Emergency Programme
The assistance from the Government of Japan and UNICEF provided technical and policy support to strengthen the government’s capacity to plan, design and implement effective evidence-based technical and health system interventions, as well as to identify the necessary actions to be taken at the community level to improve maternal and child health.
These initiatives, which have continued after the end of the Japanese funding, have had a significant impact upon maternal and child heath: improving rates of exclusive breastfeeding of infants aged between 0 and 6 months; improving the knowledge of health workers, professionals and parents, the latter in recognizing danger symptoms and seeking medical services immediately, to prevent child death (According to Ministry of Health statistics, the results of interventions were a decrease of infant mortality within 24 hours by 47.6% and reduction of infant mortality at household level by 52%); and provision of iron supplementation to women and girls between the ages of 12-39 (resulting in an average increase of haemoglobin levels of 30% and a decrease of post-partum haemorrhage and other complications of pregnancy due to iron deficiency, according to Ministry of Health data).
Water and Sanitation facilities have been improved, through training and promotion of better hygiene practices among households; introduction of new water seal technology toilets in schools and homes; and the upgrading of water sources in schools.
Without access to clean water, and improved hygiene and sanitation facilities, the children of Uzbekistan face a bleak future, one in which they are increasingly exposed to illnesses and diseases that are preventable. With infant mortality at 5 times the rate of Western European countries, the future for many children is threatened.
UNICEF, our partners and our donors are providing a better future for the children of Uzbekistan and our programme of activities has already had a major impact: providing water and sanitation facilities to areas previously without; contributing to a reduction in water-borne and water-related diseases; and improving the nutritional status of the population in general and children in particular.