Public health problems in the Aral Sea region

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After irrigation projects diverted water from the Aral Sea it began to dry up and left behind salts, other minerals, and toxins in the soil. These not only contaminated the soil but also were picked up by winds and storms, and traveled to other areas, including over crop lands. This has led to increased health problems like respiratory diseases and cancers, among others. The change in the size of the Aral has also affected the local climate and resulted in increased occurrence and worsening of storms.[1]

## Background

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There is no doubt that the shrinking of the Aral Sea has resulted in health problems for the local community. However, there is debate as to what extent of these problems can be sourced to this environmental situation. The full effects could take a generation to fully materialize and patterns of health problems to show up. Some of the main reasons why the Aral sea area suffered greatly were from "over irrigation and water mismanagement." Environmental impacts resulting from the changes in the Aral Sea region that could affect human health are "the salinization of the water table, pesticides in the environment and food chain, dust storms and air quality."[2]

In the Soviet period, water from the Amu Darya and Syr Darya rivers that had previously flowed into the Aral Sea was redirected into the cotton fields of Uzbekistan.[3] Grazings and gainful grounds of Amu Darya and Syr Darya employed more than 100 thousand individuals in the fields of poultry, harvest development and livestock.[4] In the Uzbek region years of monoculture agriculture of cotton fields left soils depleted of naturally occurring minerals and nutrients. This eventually led to an increased use of pesticides and fertilizers to try to counter these new soil deficiencies. However, these increased chemicals found their way into the soils, water, and finally the Aral Sea.[5] These types of agricultural activities have also "resulted in widespread soil erosion, chemical pollution, and poor water quality and quantity."[6]

Health infrastructure, including hospitals and medical centers, in the Aral Sea region are in need of fundamental medical tools, and other equipment for improving health services.[2] Medical staff does not have necessary conditions to successfully accomplish their job.[2]

## Effects on infant mortality rates

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As the sea dries up, the contaminants become exposed on the surface and enter the soil, while also being blown in the air. This has adversely affected the health of local residents. Around 35 million people live near the Aral Sea Basin, of whom 3.5 million live in the disaster area.[7] Increases in many diseases and conditions have been noted and linked to the shrinking of the Aral. Infants and chldren face the highest risk from exposure to contaminants and toxins, leading to an increasing infant mortality rate in the area. According to Newbold the infant mortality rate is defined as "the number of deaths of infants younger than one year of age per one thousand births."[8]

Infant mortality rates have been increasing in this region since the 1970s, while elsewhere in the world they have generally been going down.[9] Residents of the Aral sea region have suffered high "exposure to industrial pollutants such as polychlorinated biphenyl (PCB) compounds and heavy metals but also to pesticides."[10] This has led to increased infant mortality rates: as high as 70 per 1000 in Kazakhstan as of 1993.[10] Toxins can be absorbed by breathing them in from the air, drinking water, and from food. It has been found that these contaminants can be passed down through breast feeding and "in a number of areas the physicians recommend against breast feeding babies, as the nursing mother's milk is toxic."[5]

The table shows that infant mortality rates have also increased in other surrounding countries and areas. Although many other factors contribute to infant mortality rates, the environmental state in the area has a definite influence on increasing rates. When compared with developed countries these rates can illustrate differences in health care and access to health care between the areas.

## Infant mortality rates, 1985–2008

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Sources:[11]

Infant mortality rates in Aral Sea region, with other countries for comparison  | 1985–1990  | 1990–1995  | 1995–2000  | 2004  | 2008

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Afghanistan  | 170  | 160  | 152  | 165  | 163
Kazakhstan  | 36  | 35  | 35  | 52  | 29
Kyrgyzstan  | 45  | 40  | 40  | 42  | 50
Tajikistan  | 58  | 57  | 57  | 50  | 65
Turkmenistan  | 58  | 55  | 55  | 74  | 74
Uzbekistan  | 53  | 44  | 44  | 62  | 48
United Kingdom  |  |  |  | 5.3  | 4.9
Canada  |  |  |  | 5.2  | 5.4
USA  |  |  |  | 6.7  | 6.6

## List of adverse health effects

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In Turkmenistan alone, 50% of all reported illnesses in children are related to respiratory system difficulties.[12] The effects of this situation are far reaching and affect people in a wide range of ailments. Following is a list of health problems contributing to high infant mortality, death, and lower standard of living in the Aral Sea area:

* diarrheal diseases
* vaccine preventable diseases such as tuberculosis
* nutritional deficiencies
* upper respiratory tract infections[10]
* teratogenesis
* endocrine disruption
* neurodevelopmental effects
* behavioral effects[2]
* gastro-enteritis[5]
* typhoid fever
* hepatitis
* esophageal cancer
* various other cancers
* hypertension
* heart disease
* anemia
* kidney disease[2]
* eye disease

## Solutions

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A large concern of remediation of the area is the reduction of the blowing salt and minerals from the exposed sea bed. Some solutions include constructing dikes to control water flows and restricting the water amounts diverted for irrigation. However, the health effects have already been felt and will continue to be present for a long time even if the situation is turned around in the very near future.[1]

## References

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1. ^ a b Micklin, P. P. (1988). Desiccation of the Aral Sea: A Water Management Disaster in the Soviet Union. Science. 241(4870), 1172 & 1175.
2. ^ a b c d e Small, I., Van Der Meer, J., & Upshur, R. E. G. (2001). Acting on an Environmental Health Disaster: The Case of the Aral Sea. Environmental Health Perspectives. 109(6), 547 & 548.
3. ^ Gaybullaev, Behzod; Chen, Su-Chin; Gaybullaev, Dilmurod (2012-12-01). "Changes in water volume of the Aral Sea after 1960". Applied Water Science. 2 (4): 285–291\. Bibcode:2012ApWS....2..285G. doi:10.1007/s13201-012-0048-z. ISSN 2190-5495.
4. ^ "Проблемы Арала и водных ресурсов региона | Uzbekistan". www.un.int. Retrieved 2020-03-26.
5. ^ a b c Precoda, N. (1991). Requiem for the Aral Sea. Ambio. 20(3/4), 113.
6. ^ Franz, J. S. & FitzRoy, F. (2006). Child Mortality and Environment in Developing Countries. Population and Environment. 27(3), 264.
7. ^ Vinogradov, Sergei; Langford, Vance P.E. (2001). "Managing transboundary water resources in the Aral Sea Basin: in search of a solution". International Journal of Global Environmental Issues. 1 (3/4): 345. doi:10.1504/IJGENVI.2001.000984. ISSN 1466-6650.
8. ^ Newbold, K.B. (2007). Six Billion Plus: World Population in the Twenty-First Century. 2nd Edition. Lanham: Rowman & Littlefield. 2.
9. ^ Zhiming, B., Norio, I., Yoshiaki, K., Ariyoshi, K., Kunio, M., Tomokazu, O. & Otsuka Kenji. (2006). Inner Asia: Balancing the Environment with Socioeconomic Development. The State of the Environment in Asia 2005/2006. 167.
10. ^ a b c Kiessling, K. L. (1998). Conference on the Aral Sea: Women, Children, Health and Environment. Ambio. 27(7). 562.
11. ^ Population Reference Bureau. (2004). 2004 World Population Data Sheet. Retrieved from http://www.prb.org/pdf04/04WorldDataSheet_ENG.pdf Archived 2017-03-29 at the Wayback Machine. Population Reference Bureau. (2008). 2008 World Population Data Sheet. Retrieved from http://www.prb.org/pdf08/08WPDS_Eng.pdf Archived 2017-12-19 at the Wayback Machine., United Nations: Economic and Social Commission for Asia and the Pacific (n.d.). Infant mortality rates, 1985-1990, 1990-1995 and 1995-2000 and mortality under age 5 years, 1990-1995 and 1995-2000. Retrieved from "Archived copy" (PDF). Archived from the original (PDF) on 2004-12-25. Retrieved 2009-02-06.`{{cite web}}`: CS1 maint: archived copy as title (link)
12. ^ Wiggs, G.F.S., O'Hara, S. L., Wegerdt, J., Van Der Meer, J., Small, I., & Hubbard, R. (2003). The Dynamics and Characteristics of Aeolian Dust in Dryland Central Asia: Possible Impacts on Human Exposure and Respiratory Health in the Aral Sea Basin. The Geographical Journal. 169(2), 143.