As the Aral Sea retreats, dust and disease flourish

Catastrophe: In Uzbekistan, scientists try to determine whether the decimation up of a sea has touched off a tuberculosis epidemic.

February 14, 1999|By Kathy Lally | Kathy Lally,SUN FOREIGN STAFF

MUYNAK, Uzbekistan -- A trim work boat festooned with cheerful bunting stands next to the town hall, and a brightly painted mural depicts a thriving seaport, with strapping fishermen, a busy cannery and bright, blue water.

It's a ghostly sight. There's no water here. One of the world's great environmental catastrophes descended on Muynak 30 years ago, when the Aral Sea began drying up. Today, Muynak is a dusty wasteland. The sea is about 70 miles away from its original shoreline.

The fresh air that once brought tourists flocking to the beaches and sanitariums is now laden with germs. A plague of tuberculosis, which thrives among the poverty-stricken, has descended on Muynak and nearby towns in remote, Western Uzbekistan, sickening more people every day.

Carefree vacationers have been replaced by a handful of doctors and scientists who are trying to stem the epidemic and answer a vexing question: Has the destruction of the environment by leaders of the former Soviet Union somehow nurtured a disease that was once widely considered under control?

The available facts are terrifying. Doctors estimate the new cases of tuberculosis in Muynak amounted to 200 per 100,000 people last year, which means it's as dangerous to live in this part of Central Asia as to be locked up in a Russian prison, notorious for poor diet, miserable conditions and soaring tuberculosis rates.

"The people of Muynak are suffering silently," says Dr. Tunde Madaras, a tuberculosis specialist at the U.N. World Health Organization in Copenhagen, Denmark. "This small corner of the world has been forgotten."

Human arrogance, greed

And all this pain, she says, is the result of human arrogance and greed.

Muynak (pronounced Moon-ahk) is in a region of Uzbekistan named Karakalpakstan, populated by about 400,000 Karakalpak (it means Black Hat People) along with about 400,000 Uzbeks and 300,000 Kazakhs. The town used to be full of fruit trees and greenery, until Soviet planners began to divert water from the Aral's tributaries to irrigate the fields that produced cotton, Uzbekistan's main crop, which was sent to Moscow as tribute.

The irrigation, begun in the late 1950s, gradually shrank the Aral Sea. As it shrank, the slightly brackish water turned saltier. All but two of the sea's 20 species of fish disappeared. Crops declined. People in the region became poorer and poorer, their diets worse and worse. About 40 percent suffer from malnutrition. A quarter of the children have stunted growth. Nearly all women of child-bearing age are anemic. Tuberculosis thrives.

"The main reason is the ecological disaster," Madaras says. "The Aral Sea is a man-made disaster. This was a beautiful green area turned into desert by man."

Though scientists the world over are concerned about the Aral, undoing man's folly is difficult. Re-diverting the Aral's tributaries would dry up Uzbekistan's cotton crop, killing off what's left of the main source of revenue.

Delicate politics

And the politics are delicate. The main tributary, the Amu Darya, begins in Tajikistan and flows along the border with Afghanistan -- two countries torn by civil war. Those countries, along with Kazakhstan and Turkmenistan, would have to agree on any plan. An international commission has been trying to find ways to restore the sea, but so far has accomplished nothing. All the while, the former seabed continues to poison luckless towns like Muynak.

Uzbekistan always used large amounts of pesticides -- an estimated 50 pounds per acre compared with the 7 pounds considered average elsewhere. Eventually, the chemicals ran off into the sea, polluting it. And when the water receded, the toxins stayed behind on the exposed seabed, blown with salt through the dusty air.

Scientists have never demonstrated a link between chemical pollution and the human immune system, says Dr. Joost van der Meer, research coordinator here for Doctors Without Borders. His mission is to find out if there is one.

When the Aral Sea left town, it was as if the richest employer had skipped out in the middle of the night, leaving only bad debts behind. The main source of income in the region disappeared, along with the fruit trees.

The poverty brought poor health even as the former system of medical care was falling apart, and tuberculosis has spread quickly across the former Soviet Union. Uzbekistan has a TB incidence rate of 54.8 per 100,000 -- which WHO considers an epidemic level -- and Muynak's is nearly four times that. Russia's is 82.3. (The U.S. rate is about 8 per 100,000, the Baltimore rate 14 per 100,000.)

"It's been a paradise for infectious diseases," says Damir R. Babanazarov, Karakalpakstan's minister of health. "We can say that to a certain extent changes in the environment have created the background for tuberculosis."

Poor medical care

The collapse of the health system brought on by the demise of the Soviet Union probably aggravated the situation because of the disruption of treatment and social upheaval, van der Meer says.

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