Uzbekistan: Rural Infant Mortality Doubles

Uzbekistan's infant mortality rate has more than doubled in some rural areas in the last five years.

Ziyoda Juraeva, director of the only maternity hospital in the southern Kashkadarya oblast, told IWPR that 15 per cent of babies are either stillborn or die in a matter of days - twice the figure recorded in 1997.

And local health data for the region shows that nearly half of the 120 children born there every day suffer from a disability or illness of some description.

Uzbekistan's official infant mortality figure, as recorded by the CIA World Factbook, is around seven per cent. That figure - a worryingly high by international standards - can be even higher in rural areas.

The republic's doctors blame these appalling statistics on the poor health of mothers nationwide, along with the low standard of equipment and sanitation in maternity wards.

Oishar Rakhimova, an obstetrician and gynaecologist at the Kaskhadarya maternity hospital, located in the oblast's capital Karshi, told IWPR that many expectant mothers have heart conditions or suffer from anaemia, while the majority are malnourished and suffer from vitamin deficiencies.

Uzbek women traditionally have large families, and a recent government-backed sexual health and contraceptive programme has failed to reach rural areas due to lack of funds. This has led to many mothers becoming pregnant again before they've had a chance to recover from their last birth.

The 1991 collapse of the Soviet Union, with its all-encompassing social welfare systems, hit the local population - who mainly live in rural regions - very hard.

The tiny wages received for growing cotton and other crops are now barely enough to buy bread, let alone pay for the spiralling cost of healthcare in the wake of slashed medical subsidies.

Many people in remote areas live on a diet consisting almost solely of bread and tea, and can go for months without eating meat or fresh vegetables.

Rakhimova also points out that indifference and carelessness by staff members is also taking its toll. "Every third child that is born is injured by the doctors themselves," she claimed, adding that the condition of medical supplies and sanitation in the hospital is "deplorable".

Patient Matluba Safarova, a mother of two from Karshi, agrees, "The wards here are not disinfected, and we have to bring our own bedding or we risk infection at worst or a dose of lice at best. And you can forget about medical supplies - we have to buy those ourselves."

Karima Nusurova, from the village of Khonobad, has given birth to two children in the hospital.

"My second delivery was successful, but afterwards my child caught an infection in the maternity hospital. His stomach hurts constantly, and he cries all the time. The doctors diagnosed him with a bowel disorder," she said.

There is also a problem with underpaid and disillusioned health workers demanding bribes or presents from patients for any special treatment or attention required.

Juraeva says that such issues have been raised with the oblast authorities several times by the largely female maternity hospital employees, to no avail.

"The Uzbek male mentality [a traditional and conservative one] means it is not the custom for the khokimiyats (local administration) to listen to women leaders," explained Juraeva.

The government appears to believe that the construction of new hospitals and clinics around the country constitutes an improvement in the health service. However, many of these buildings have since been shut down for repairs.

Indeed, a gynaecological and paediatric centre was recently opened in the Kashkadarya oblast - only to close again the very next day.

Juraeva believes that the local authorities are generally unconcerned about public health. "Our hospital requires around 20 million soms - around 20,000 US dollars - worth of repairs, but the local authorities are unable to provide this money, as the entire budget has been used to build colleges.

"I went to the local charity Soglom avlod uchun (For a healthy generation), but they are also powerless to help."

At a recent meeting of the Kashkadarya oblast khokimiyat, every business in the region was ordered to help raise 300 million soms to support the local football club.

President Islam Karimov recently declared, "Our children should be more intelligent, healthier and happier than we are".

It would appear that children's lives and health are worth little compared with civil servants' passion for football.

Kamol Kholmuradov is an independent journalist in Karshi.