In less than 25 years, central Asia's Aral Sea, once the fourth largest inland body of water in the world, has dried up to 50% of its original surface area. The two rivers that feed the sea have largely been diverted since the 1950s to irrigate Soviet cotton fields.

The volume of water flowing into the sea has decreased by 75% and the water level has dropped 16 meters. The salinity of the water is now higher than that found in oceans, resulting in the disintegration of the fishing industry. Years of unchecked pesticide application during Soviet times left the sea bed highly polluted.

Some 38,000 square kilometers of what was once sea, is now highly saline and polluted wasteland, as the shoreline has receded as much as 100 kilometers in places. Every year wind storms pick up more than a hundred thousand tons of toxic laden salt off the dried sea bed and sweep it through the villages.

The upstream areas also suffer from serious environmental problems due to the mismanagement of water resources. The agricultural land and the rising ground water table have become highly salinized. Combined with the collapse of the Soviet system, the five million people in the area are now struggling for their economic survival.

A human tragedy

As a result of this ongoing environmental disaster, the Aral Sea area is also suffering a humanitarian and health crisis. Due to the economic decline the population in the area is increasingly vulnerable and the health system is unable to respond to the health crisis.

The situation of tuberculosis, often referred to as 'the disease of poverty', is the worst of Europe and the Former Soviet Union. The high incidence of several other diseases in the area are suspected to be related to the environmental problems. Levels of anaemia are the highest in the world and the incidence of other diseases is much higher in this region than elsewhere in Uzbekistan.

In the spring of 1997 Médecins sans Frontières (MSF) arrived in the Aral Sea area out of concern for the health of the population. To date, MSF remains the only international medical NGO based in the region.

Action to be taken

Countless officials, scientists and international organizations have visited the area, but little direct assistance has taken place to address the humanitarian and health problems. UNESCO and the March 2000 2nd World Water Forum in The Hague have chosen a long term perspective, aiming for solutions to the worldwide water problems by 2025. They did not, however, address the acute health crisis.
MSF is concerned about the health effects of the environmental and economic degradation around the dying Aral Sea. If action is not taken now, the organization fears further premature deaths and even ecological refugees.