A place called Azerbaijan
8 June 1999
Azerbaijan MSF activities are throughout azerbaijan with programmes being conducted in Baku, Sumgayt, Imishli, Saatli, Fazuli. Our presence represents a real mix of nationalities with Dutch, Azeri, French, Russian, Pakistani, Italian, German, Swiss staff in the country. Statistics
Population approx 7.7 million (July 1997)
83% of the population Azeri
Other ethnic groups in Azerbaijan include Russians, Armenians and
Main religion - Muslim (87% of population)
Main language spoken - Azeri (82% of population)
Number of IDPs living in Azerbaijan - 845,000
Less than 5% of IDPs have been able to return to their place of origin
Unemployment estimated at 37%
World Bank estimates over 60% of population live below the poverty
Infant mortality rate of 22.6 deaths per 1000 live births
Maternal mortality rate of 44.6 per 1000 live births
Recently the Azeri Government passed a new law requiring people to pay
for their medical care. While some people say that this is just
legalising a process which has long taken place anyway (ie people used
to have buy their health care unofficially), numbers of hospital
admissions have drastically reduced. One MSF doctor who works in
Sumgayt's Hospital Number One, said that since this new law came into effect, admissions have fallen by 50%.
There are on-going tensions and disagreements between Azerbaijan and Armenia over the
territorial rights to Nagorno Kharabagh - an enclave of land currently
controlled by Armenia but surrounded by Azeri land. Conflict started
in 1988, cease-fire since 1994. There are still a large number of troops
situated on both sides of any border territory, occasional border
skirmishes, and no agreement between the two countries, despite
attempts at mediation by the OSCE. A 1994 cease-fire is still in
As a result of the Nagorno Kharabagh conflict, 845,000 IDPs live in
Azerbaijan. Many of these people are Azeris who had a comfortable
standard of living in Nagorno Kharabagh before the conflict, and now
live under extremely difficult conditions - in rail-way carriages,
refugee camps of mud and wooden huts, in what were once student
dormatories - 5-7 people per room. In these dormatories there can be
140 on one floor with just one male and female toilet and one kitchen.
As a result, the prevalence of disease in such places is higher than for
the average population.
These people live a life in limbo where they hope, but do not know when
they will be able to return to Nagorno Kharabagh. Most have been
living in Azerbaijan for about six years. There are reports of people who
keep their bags packed for the day they can go home. Many of these
people are jobless - you see men gathered in big groups on the streets
just passing time talking to each other. State allowances are
inadequate and these IDPs have the lowest status of any group in the
There is no national drug policy. As a result, there is not much
control of the supply of drugs and the quality. Border controls are
inadequate so now many drugs of varying qualities are being brought
into Azerbaijan and sold.
Also, all kinds of medications can be
purchased without prescription. This poses a problem for diseases such
as TB where people could buy drugs and treat themselves,
or be taking poor quality drugs, increasing the likelihood that they
will develop multi-drug resistant (MDR) TB.
MDR TB is extremely
difficult and expensive to treat, and the cure rate is much lower than
for drug-sensitive TB.
40 mins drive north-east of Baku on the coast
According to the CIA's World Factbook website, Sumgayt is "the most
ecologically devastated area of the world".
Workers in Sumgayt suffer from cancers, heart and bone defects,
deficiency in immune systems there is a high incidence of birth
In 1933 the Soviet Government decided to situate the infrustructure
for Azerbaijan's oil industry in Sumgayt. Over the next 50 years, the
population of Sumgayt grew from 6,000 to 350,000.
In the 1950's, other industries started to develop in Sumgayt. From
this time onwards, until the collapse of the Soviet Union, toxic chemicals including DDT and
caustic soda, phosphate fertiliser and even chemical weapons were produced in Sumgayt.
According to the UNDP, at the height of production an estimated
70,000-120,000 tonees of toxic waste was released into the atmosphere
Following the collapse of the Soviet Union, many of these factories
lost their raw material supply, marketplace, and lacked the funds to
modernise to bring their production up to Western standards to compete
on the open market. As a result, the factories in Sumgayt today only
run at 10% of their capacity.