Tajikistan Travel Report Dr. U. Enderlein
TRAVEL REPORT
From: / Dr. Ute S. Enderlein, Public Health Officer, WHO/EURO, EHA MoscowDate: / 27 August 2000
Our Ref:
Country: / Tajikistan / Town(s): / Dushanbe / From:
To: / 21August 2000
28 August 2000
(a)Purpose of travel:To draft the WHO input on water and sanitation for the UN Inter-Agency Flash Appeal for drought-related needs in Tajikistan, in close cooperation with MOH/SES Tajikistan and UNICEF.
(b)Main place(s), institution(s), people visited or title, date(s) and organizer of meeting:
- 1 -Tajikistan Travel Report Dr. U. Enderlein
Monday, 21.8.
Arrival in Dushanbe
Briefing with Dr Nazira P. Artykova, WHO Liaison Officer
Tuesday, 22.8
Mission to the south of Kathlon oblast together with Dr B. Shoismatulojew, Director, Repub. Sanitary Epidemiological Station(SES),
SES Kolchosabad region, meeting with chief doctor SES, Dr Kalandarov,
SES Kumsangirski region, meeting with chief doctor SES, Dr Chotamov,
visit of the drought affected regions of Dusti and Pianj
NGO Ecologia, Kolchosabad, meeting with director, Dr Ikram Davronov,
NGO Merlin, responsible for the Kathlon region,
UNICEF, Mr T. Thomasen, Representative for Central Asian Republics,
UNICEF, Mr B. Doyle, consultant,
Kurgan-Tjube, meeting with deputy governor of Khatlan oblast, Ms T. Almardonova,
Head of water/sanitation in Khatlon oblast, Mr Borodov
Night spent in Dushanbe
Wednesday, 23.8
Mission to the east of Khatlon oblast, together with Dr B. Shoismatulojew
SES Nurek region, meeting with chief doctor SES, Dr Murodov,
SES Dangara region, meeting with chief doctor SES, Dr Chamidov
visit of the drought affected areas in the regions
Night spent in Dushanbe
Thursday, 24.8
Prof Lyubomir Ivanov, Head of WHO office
Dr Nazira P. Artykova, WHO Liaison Officer
Ms Mansurkhodjaeva, Administrative Assistance
Ms Witt, WHO Pharmaceutical Advisor
Dr P. Shodmonov, National Expert of Sanitary-Epidemiological Service
Dr B. Shoismatulojew, Director, Repub. SES
UNICEF Dushanbe, Mr B. Thomasen, Mr B. Doyle, Mr B.Jekic, country repres., Mr S. Kurbanev, Program assistant
Friday, 25.8.
Dr B. Shoismatulojew
Dr P. Shodmonov, National Expert of Sanitary-Epidemiological Service
Debriefing Liaison Officer, Dr. Nazira P. Artykova
Saturday, 26.8.
Mr N. Abdusabaev, Adviser to the Minister of Health, TJK
(c)Main achievements:
1.To have discussed and reached agreement with the Ministry of Health/Sanitary-Epidemiological Station on the activities on water and sanitation WHO will propose in the current UN-Agency Appeal related to the impacts of the drought.
2. To have discussed and reached agreement with UNICEF representatives for Central Asia and Tajikistan on the WHO water /sanitation interventions, in order to avoid overlapping or gaps of activities.
(d) Recommendations
1. WHO activities on water/sanitation for the current appeal will strengthen the analysis, control and monitor capacities of Sanitary-Epidemiological Stations, as the responsible center for drinking water quality by improving/repair of existing laboratory equipment and distribution of 8 portable drinking water testing kits to the drought-affected regions.
2. The WHO training courses for medical and laboratory staff of SES and for laboratory and management staff of regional water works are needed to improve the quality and quantity of analyses on drinking water testing, to rise awareness for and improve the protection of drinking water sources, like wells, springs and other water intake areas and contribute to better management of available water resources.
3. WHO drug and laboratory media supply for water-related diseases, as well as disinfectants are very needed by the SES and hospitals. These items are listed under the sector health and nutrition.
(e) Notes
In agreement with SES (Dr B. Shoismatulojew) and under consideration of financial constrains, WHO should invest in the repair of the existing laboratory equipment for water quality analysis in the laboratories of the SES in the oblasts of Khatlon, Dushanbe and Leninabad. Furthermore the purchase of consumables for these equipment would assure a continue work flow on drinking water analysis. The purchase of further 8 field drinking water testing kits “Oxfam” and one set of extra consumables by WHO, together with the delivery of 3 Oxfam sets by UNICEF would strengthen the capacity of the regional SES in drinking water testing in the affected regions.
The training courses are foreseen for the oblasts of Khatlon, Dushanbe and Leninabad.
Training on water quality analyses is most needed by SES, separately for microbiological and chemical components for laboratory and medical staff. It was proposed that this courses should take place twice in all three oblasts to train a large number of staff (about 180 people).
Training in drinking water quality, source protection, and management, as well as training about safe wastewater disposal should be held for medical and laboratory staff of SES and for laboratory and management staff of water works. These courses could be combined with training on the proper use of the “Oxfam” field water testing kits, which could be carried out by a national expert (Dr P. Shodmonov).
UNICEF is carrying out training courses on resource management, water monitoring, hygiene, proper installation of pumps, wells, latrines etc. and launching public education campaign’s on hygiene.
During the mission UNICEF representatives were undertaking a one week need assessment through the drought affected areas in the Khatlon and Leninabad oblasts and informed about the current situation in the fields of food and water supply, sanitation, health and hygiene and their current and future activities in the region. Furthermore, I was invited to participate on a meeting with Ms Almardonova, Deputy Head of the Khatlon oblast.
The following overview is summarizing the current situation.
The drought in parts of Tajikistan has to be seen as part of the general drought in Central Asia and contribute once more to the ecological and economical disaster of the Aral sea basin.
In whole Tajikistan about 15% of the population is seriously affected by the current drought. It is reported that water levels of rivers and lakes have decreased by 50-60% in comparison with the past years.
The Kathlan oblast is the most suffering region because of mostly rain feeded agriculture, large automatic irrigation canal system and hot climate. The Leninabad oblast in the north of Tajikistan is also affected by the drought. Through the decline of the water table, the effects of water pollution, including salinisation, high hardness of water and pollution with agrochemicals, has diminished the availability of drinking water resources. Because of lack of time, I was not able to visit the Leninabad oblast, the information are taken from the “Rapid Assessment Mission on Drought in TJK, 27-29 07 in Kathlon oblast and 31 July-3 August 2000 in Leninabad oblast” (attachment 1).
The SES of the Kathlon oblast I have visited, reported about an huge increase in the last seven month of malaria, diarrhea, typhoid fever and other water-related infectious diseases. An example are the data of SES Nurek, were the cases of malaria increased for 3,5 times and for diarrhea for 2 times until now (August) in comparison to 1999. Tables with the number of cases with infectious diseases for 7 month (1999 and 2000) for the Khatlon oblast and Nurek region are attached for information (Attachment 2). All SES expressed their concern about the increase of brucelloses and anthrax cases because of the drought. Even hospitals and other health care centers do not have always safe drinking water available.
The general situation in the water sector (Kathlon oblast, south Tajikistan)
The water supply system in the Kathlon oblast is divided into water piped systems (30%), irrigation canals and ditches (56%), and wells (10%). The rest comes from rivers, rain water or is brought by water tanks (Attachment 3). It has to be stated, that not all communities are equally severe affected by the drought. The communities suffering most are that which are situated at the fringe of the mountains and using springs, shallow wells, or are supplied by piped water. Because of limited snow and rainfall this year, most of the springs and wells are dried out and force the population to go to the valleys for water and put further stress on the already scarce water resources in the lower parts of the mountains, to sell the cattle in order to buy water for them self’s, or finally to leave their villages and find refuge with relatives in other regions. The population which is supplied with piped water suffers because of frequent water cuts (in Kurgan-Tjube only 3h per day water is distributed, if any water is supplied). In an increasing number of villages the water pipe system breaks down completely, because of no maintenance over many years.
In the whole oblast more than 80% of the population has no access to clean water, and therefor the population is using water from unprotected and uncontrolled sources, like directly from open irrigation canals or shallow wells. Villages which were usually served by water tanks do not have the financial means anymore because of harvest failure and losses of transport capacity during the civil war. Furthermore, there are only limited possibilities to cook the water before use, because of lack of wood, fuel or other combustibles in many villages. The sewage system is in an even worst situation than the drinking water system, some villages use septic tanks, others have nothing. Because of the drought and the resulting economical damage, the oblast is not able to make any investment in the water sector. Minimum requirements for drinking water supply are 70 pumps and about 700 km of drinking water pipes which need repair or exchange.
International and national aid on water/ sanitation
UNICEF
Delivery of 15 t of chlorine/chlorine lime for disinfection
Installation of water pumps, different training in water resource management, hygine and installations
UNHCR/WFP
Cleaning of irrigation channels
UNOPS
Provision of water pumps, training in water quantity
World Bank
Project on water resource planning and management (masterplan)
NGO “Ecologia”
National implementing NGO for UNICEF, installation of 200 small hand pumps for schools
NGO “MERLIN”
Provision and installation of some water pipes, some repairs on pipes, delivery of water disinfectants.
Attachments per fax:
1.Rapid assessment mission on drought in TJK…
2. Comparative table of cases of infectious diseases for 7 month in Khatlon oblast
3. Number of population using water from different sources
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