International Activity Report 2002
Uzbekistan and Turkmenistan

DOTS in 30 districts

International staff: 20 National staff: 110

Despite some international attention to the environmental disaster of the shrinking Aral Sea, the health of the people living in nearby areas of Uzbekistan and Turkmenistan remains neglected. MSF is focusing medical activities on the high incidence of tuberculosis (TB); and continues to research links between the degraded environment and human health.

MSF has implemented the DOTS (Directly Observed Treatment Short-course) strategy to fight TB in a total of 30 districts in the autonomous republic of Karakalpakstan and Khorezm in Uzbekistan, and Dashoguz in Turkmenistan. Over 13,000 patients have registered since 1997. Patient compliance is good and treatment success rates average 70-76%. High levels of multi-drug resistant TB (MDR-TB) are a main reason for treatment failure. MSF is preparing a pilot program to treat MDR-TB in the coming year. It is also rehabilitating a 600-bed TB facility in Nukus.

Another project in Karakalpakstan, handed over to the Ministry of Health in March 2002, trained more than 500 health workers in the prevention and management of respiratory infections and diarrheal diseases in children under five.

In the Ferghana Valley, MSF provides health education through traditional social structures called makhallas.

Ashgabat in Turkmenistan was an important staging point for MSF when it was forced to leave Afghanistan in late 2001, and is still used for logistical support.

MSF has been in Uzbekistan since 1997 and in Turkmenistan since 1999.