Acting on an environmental health disaster: the case of the Aral Sea.

Abstract

The Aral Sea area in Central Asia has been encountering one of the world's greatest environmental disasters for more than 15 years. During that time, despite many assessments and millions of dollars spent by large, multinational organizations, little has changed. The 5 million people living in this neglected and virtually unknown part of the world are suffering not only from an environmental catastrophe that has no easy solutions but also from a litany of health problems. The region is often dismissed as a chronic problem where nothing positive can be achieved. Within this complicated context, Medecins Sans Frontieres, winner of the Nobel Peace Prize in 1999, is actively trying to assess the impact of the environmental disaster on human health to help the people who live in the Aral Sea area cope with their environment. Medecins Sans Frontieres has combined a direct medical program to improve the health of the population while conducting operational research to gain a better understanding of the relationship between the environmental disaster and human health outcomes. In this paper we explore the health situation of the region and the broader policy context in which it is situated, and present some ideas that could potentially be applied to many other places in the world that are caught up in environmental and human health disasters.

Settlement abandonment in the context of global environmental change

“…The area of irrigated land in the region doubled between 1960 and 1990; over the same period water levels in the sea dropped steadily, and the lake's south basin margins retreated more than 100 km in places (Zonn, 1999). Sediments containing high levels of agrochemicals became exposed to the air and prone to aeolian erosion (Small et al, 2001). Irrigated land became highly saline and less productive, and rivers and groundwater accumulated high levels of agrochemicals and industrial pollutants (Crighton et al, 2003).…”

“…Political uncertainty following the collapse of the Soviet Union accelerated out-migration, with an estimated 100,000 leaving between the late 1980s and early 1990s (Crighton et al, 2003;MSF, 2003). By 2003, migration out of Karakalpakstan was estimated at 3-4000 per year, many being young, skilled ethnic Russians (MSF, 2003;Small et al, 2001).…”

Worldwide environmental threats to salt lakes

“…Bacterial contamination of drinking water has spreading and has led to high rates of typhoid, paratyphoid, viral hepatitis, and dysentery [11][12][13][14]. On the other hand, salinity and pollution of water have led to the extinction of many fi sh species, as it caused reduction of fi sh population from 43,430 tons in 1960 to 17,460 tons in 1970 and approximately 0 in 1980 [15]. Salinity caused damage to more than 6 million ha of the region [16].…”

Dust storms: Recent developments

“…Perhaps more importantly, dust emissions from dried lake basins (e.g. the Aral) introduce fine particles, salts and chemicals (including herbicides) into the atmosphere, with a suite of health impacts, including not only respiratory complaints, but also other serious illnesses (Small et al, 2001). Dust storms can lead to particulate levels that exceed internationally recommended levels (Brunekreef and Forsberg, 2005;Chu et al, 2008;Ozer et al, 2006) and transport allergens, including bacteria and fungi (Kellogg and Griffin, 2006).…”