MSF and two UK universities launch respiratory research project in Aral Sea

Press release, June 5, 2000, International Environment Day - MSF, together with the British Universities of Nottingham and Sheffield and local scientists, launches a unique and important research project to determine the relationship between air quality, particularly dust content, and the high incidence of respiratory diseases in children in the Aral Sea area in Uzbekistan.

Owing to the decline in volume of the Aral Sea, about 38,000 square kilometres of the seabed has been exposed, with an increase in dust
storm activity. In 1999, a pilot study conducted by the British researchers in the Aral Sea Area, demonstrated that the dust exposure rates are amongst the highest in the world and that the dust is contaminated with pesticide. It is widely believed that the dust has a high salt content, contains heavy metals and is highly toxic.

Routinely collected data from Uzbekistan suggests an increased incidence of obstructive lung diseases in the region, with a higher prevalence in Karakalpakstan, the area bordering the Aral Sea. Respiratory infections in children in the Aral Sea area account for 50% of child mortality.

As no data exists about the relationship between air quality, particularly dust content, and respiratory diseases in children in the area, Médecins Sans Frontières (MSF) has taken on this study as part of its Operational Research program. The Operational Research programme aims to develop a greater understanding and awareness of the relationship between health effects and the environmental crisis of the Aral Sea through research and advocacy.

Crucial information about respirable dust, including its composition and contaminants, and an improved understanding of the contribution of
dust exposure to asthmatic symptoms in children in Karakalpakstan are the expected outcomes of the dust study. These results, the first of which should be available by the end of the year, could be vital to improve child health in the Aral Sea area.

Data about dust will be collected in 20 sites across Karakalpakstan during one year, using simple dust traps. Physical and chemical analysis of the dust will include grain size parameters, salt content, heavy metals and organophosphate content. Information on meteorological conditions and relevant air pollutants will be collected.

In a cross-sectional survey, 1000 10-year old children will be randomly selected from these areas. The main carer for the child will answer a questionnaire on respiratory symptoms in the child, other relevant determinants of respiratory disease, and socio-economic information. Following the interview, the interviewer will perform spirometry with a validated method suitable for children.

In less than 25 years, the Aral Sea, once the fourth largest inland sea in the world, has dried up to 50% of its original surface area. Since the 1950s, the two rivers that feed the sea have largely been diverted to irrigate Soviet cotton fields. The volume of influent water has decreased by 75% and the water level has dropped 16 metres. Salinity has now surpassed oceanic leves and years of unchecked use of pesticide during the Soviet era has seriously polluted the sea bed.

This ongoing enivironmental disaster has plunged the area around the Aral Sea into a humanitarian and health crisis. Economic decline has made the population increasingly vulnerable and the health system is unable to respond to the mounting needs. In the spring of 1997, MSF arrived in the Aral Sea area out of concern for the health of the population. To date, MSF is still the only international medical NGO based in the region.

MSF, the recent winner of the Nobel Peace Prize, is an independent non-profit medical relief organization working in over 80 countries all over the world. MSF's extensive operational research programme in the Aral Sea area aims to determine how the environmental disaster of the Aral Sea is affecting the health of the population. With the continuing results of this programme, MSF is actively advocating for international community and donor attention to the issues of the Aral Sea.

Besides the various operational research projects, MSF is also involved in implementing TB control in the Aral Sea area, the prevention and treatment of diarrhea diseases and acute respiratory infections in children, training of national staff, health education and water and sanitation improvements in hospitals.