International Activity Report 2001
Uzbekistan and Turkmenistan

"DOTS" for Two Million

International staff: 23 National staff: 110

The former Soviet Union, in an effort to become self-sufficient in cotton, diverted tributaries of the Aral Sea for massive irrigation of cotton fields in the Aral Sea area. The result has been environmental devastation: since 1960, the sea level has dropped 50%. Residents of Uzbekistan and Turkmenistan are paying the price, as winds whip tons of contaminated dust from the dry seabed into the air, leading to respiratory infections, diarrheal diseases, and some of the highest rates of tuberculosis in the former Soviet Union. MSF currently runs 12 programs in the two countries focusing on prevention and treatment of TB and other diseases, and conducts research into the effects of the environmental catastrophe on the health of people in the Aral Sea area. MSF began work in the region in 1997.

Combating Tuberculosis

Tuberculosis has reached epidemic levels in Uzbekistan and Turkmenistan. By early 2001, MSF's Directly Observed Treatment Short Course (DOTS) program for treating TB was in full swing. "DOTS for All" targets over two million people in the two countries. MSF administers drugs to TB patients, trains local medical staff, and works for some improvements in water and sanitation. There is hope that this program can be handed over to the Ministry of Health within the next few years.

Operational Research

A thin layer of sea salt now covers much of the ground surrounding the Aral Sea. Giant dust clouds spring from dry riverbeds, and salinity of ground water is cause for alarm. An MSF research program looking into the connection between these harsh conditions and the health problems of local residents is ongoing.

A health education project in the Ferghana Valley has been underway since 2000.