Central and South Asia are currently suffering from severe drought. Significant losses of livestock and crops, rapid deterioration of health and sanitary conditions and some population displacements have already been reported. Unfortunately the deteriorating situation has received little international attention. Immediate donor response will be critical to assist the people most seriously affected.
As part of the efforts to respond to the crisis in a co-ordinated manner, the Inter-Agency Standing Committee (IASC) has formed a Drought Task Force, which is based in Geneva and co-ordinated by the Office for Co-ordination of Humanitarian Affairs (OCHA). Uzbekistan was added upon the request of the Government. Within this Task Force (with WHO participation, there was emerging consensus that situation likely to decline, with life-threatening food and water shortages in some of the most severely affected countries and that most affected countries considered to be Afghanistan, Iran, Pakistan and Tajikistan, albeit in varying degree; in excess of 60-80 million people might be affected. The disaster has also spread over Mongolia, northern and western China, Iraq, Armenia, Syria and Jordan
General Health impacts of Drought
- Food insecurity.
- Lack of access to water (drinking water, irrigation, sanitation).
- Poor health status of the population due to the ongoing instability, insecurity, and severe economic recession.
- Political crisis, Economic downward trend.
- Continued/population movement.
- Reduced food intake leading to protein-energy malnutrition micro-nutrient deficiency, especially iron and iodine which are already existing deficiencies
- Communicable diseases:
- Water borne diseases such as diarrhoea diseases (including cholera) and typhoid fever which are epidemic in the area
- TB - a major existing problem, increased risk for young children, very old, and immuno-suppressed
- Malaria - endemic in the area since 1990 and epidemic since 1996.
- Vaccine- preventable diseases
The country is affected by a drought which is the worst for 30 years, with the situation compounded by the effects of civil war. UNOCHA field team is extremely active with the establishment of a local, inter-agency drought task force, closely monitoring the situation; an appeal (strategy paper) launched on 6 June for US$ 67 million of drought-related projects (US$ 48 million food component, now re-adjusted to US$ 55 million). Pledges/contributions received to date stand at 57%. CAP mid-term review reveals US$ 125 million overall shortage, (US$ 29 million shortage for drought-related projects). Good response noted for food and life-saving measures, less so for sustainable livelihood to reduce vulnerability. A holistic approach adopted by the system to the multi-faceted humanitarian emergency in Afghanistan. Drought hand-in-hand with overall appeal.
The recent 'Edict on Women' has effectively banned employment of Afghan women in all except health sectors. Resident Co-ordinators efforts to reverse this decision of the Taleban authorities to no avail thus far. A meeting is to take place in Islamabad between the Ambassadors of Canada, Germany and Switzerland with the Afghan Ambassador, to convey their concern about the serious consequences of this decision. Resident Co-ordinator still hopeful for a positive solution. However, despite these constraints, life-saving assistance in Afghanistan will continue to be provided.
On 9-11 May 2000, Dr. Shah Wali Popal, National Health Co-ordinator of WHO in Kandahar, conducted an assessment of the health situation in five drought-affected districts of Zabul and Kandahar provinces.
In June 2000, WHO appeals for $113,000 for strengthening of assessment regional co-ordination, training, water quality testing.
No OCHA mission is planned in the near future. The gender issue is shadowing the UN action in the country.
The feared cholera outbreak started lately: more than 1200 cases were reported from Sar-I-Pol in the conflict affected south and from the north west Afghanistan. WHO launched an appeal for cholera outbreak control and for disease surveillance. It is feared that cholera will hit the IDPs in the Panchir and the city of Kabul, where it was focussed in the last two years (26,000 cases in 1999 and 34,000 in 1998, mainly in Kabul.
Tajikistan is a typical forgotten emergency; the country?s CAP chronically under-funded. WFP/FAO food assessment mission alerts to a looming famine. The country is experiencing its driest year for 75 years. Only 6% of the counties land arable but 50% of the population depend on agriculture. Estimates indicate that some 3 million people (half the population) will need assistance. Crisis compounded by post-conflict phase, and could generate population movements. The 2000 harvest 46% lower than in 1999, resulting in a need for 300,000 MT of wheat, in addition to regular imports. Logistics a major problem: this is a land-locked country and most of the incoming supplies are traditionally transported from Riga by rail. Furthermore, all shipments for northern Afghanistan have to transit through Tajikistan. Tajikistan?s CAP 2000 is US$ 23 million under-funded; out of US 11 million available towards this year?s requirements, only US$ 2.5 million have actually been received, the rest is carry-over. OCHA and Country Team are planning to organise a donor mission to Tajikistan, probably in October.
Diarrhoea incidence has increased 1.6 times in all regions.
The incidence of anthrax and brucellosis is much higher than in other Central Asia countries averages.
Owing to intense malaria control interventions, the reported incidence of malaria has dropped from 29 794 to 13 493, by more than 50% during 1997 ? 1999.A sharp rise in the number of malaria cases was reported in the country in 2000.
Rodents-vectors of a number of communicable diseases (such as, e.g., tularaemia) have migrated into higher populated areas, increasing the risk of exposure.
WHO was part of the UN assessment Team which drafted the humanitarian needs assessment report to be launched soon. In addition, a water and sanitation expert has finalised her assessment and provided the results into the UN Donor alert now in processing. A senior epidemiologist is visiting Tajikistan as of 15 September to assess the health situation and elaborate WHO Plan of Action. Several WHO kits were delivered to support the National and Local MOH in Khatlon and Leninabad provinces. Some funds were also put at the disposal of the MOH for local purchase of essential drugs. The objectives of WHO actions in response to the drought are:
- strengthening the capacity of health care system to prevent and control outbreaks of water borne and other communicable diseases, caused by the drought.
- reinforcing control of micronutrient deficiencies, food-borne diseases, nutrition education for women and children.
- reinforcing control of malaria.
- WHO will continue coordinating health-related humanitarian assistance in the country. This will include fortnightly meetings in Dushanbe and joint field visits; information sharing among all the actors; maintaining an electronic information service; issuing a monthly newsletter in Russian and English. The proposed actions will be coordinated with the UN Agencies, national and local health authorities and international NGOs represented in health sector. WHO technical support will be provided inter alia by monitoring the proper use of donated medical supplies and equipment; continuously assessing and monitoring changing needs and the effectiveness of emergency health programmes.
- WHO will strengthen the control of communicable diseases by expanding the disease surveillance system, and improving the diagnostic capacity of laboratory services. Basic equipment and supplies will be provided for diagnosis of malaria, diarrhoeal diseases, anthrax, brucellosis and other communicable diseases.
- Given the scope, complexity and depth of the malaria problem in Tajikistan, WHO in co-ordination with other partners will implement an emergency malaria control programme providing necessary drugs and vector control measures. UNICEF will implement a broad social.
- WHO will promote proper feeding practices including breastfeeding. A growth monitoring system will be expanded to all children and growth charts with instructions on complementary feeding will be available.
Since November 1999, 23 Districts of Balochistan Province (88% of the province) and 3 Districts of Sindh Province (14% of the province) have been affected by the drought. The worst affected areas are: Chagi, Kalat, Killa Saifullah and Aranji in the Khuzdar District of Balochistan.
In Balochistan province, it is estimated that 1.5 million people and 10.65 million livestock have been affected. Sixteen persons and 2.18 million livestock have perished. In Sindh province, it is estimated that 700,000 people and 5 million livestock have been affected. More than 120 persons and 30,000 livestock have lost their lives. A recent FAO/WFP crop and food supply assessment estimates 2000-2001 cereal output in Balochistan at 1.2 million tons, 20% below average. The drought has also devastated livestock production, on which some 70% of the people depend for their livelihood. Livestock prices have declined tenfold, meaning that many of the people do not have the income to buy food even when it is available.
The UN country team is working in close co-operation with the Government in monitoring the situation. On behalf of the Government, the Ministry of Food, Agriculture and Livestock requested WFP on 11 March to assess the drought situation and assist the Government?s efforts in food aid, health and water in the Arnaji tehsil of Khuzdar district of Balochistan. Following this request, three assessment missions (one of them supported by DFID) were fielded in the affected areas. FAO and WFP conducted a Crop and Food Assessment Mission in Balochistan (Pakistan) and Afghanistan. WFP is launching a 40-day operation, running from 1 July through 9 August for 748,000 beneficiaries, to provide 18,400 tons of food aid, at a total cost of USD 7.4 million. The UN system in Pakistan is currently working with government authorities to establish a Drought Management Committee in Quetta, the capital of Balochistan, with staff from UN agencies (WFP, UNICEF and WHO) as well as NGOs, to ensure co-ordination of programmes and that the situation is closely monitored.
No appeal for international assistance has been made for immediate assistance. However, international assistance is welcome. GOP provided $39 million.
UN country team assessment. UNDMT 21-27 March 2000 (WFP/FAO and UNICEF).
Drought Management Committee was established in Quetta (with WHO participation). A WHO staff was fielded to Quetta to continue assessment and provide co-ordination. WR-Pakistan provided $10,000 to the Provincial MOH to locally purchase essential drugs.
Since July 1999, 18 of 28 provinces of Iran, mostly in southern, eastern and central Iran, have been affected by the drought. The worst affected areas are: Sistan-Baluchestan, Yazd, Fars, Kohkiluyeh Boyer-Ahmad, Bushehr, Hormuzgan, Kerman, and Khuzestan. It appears that all but the northern provinces on the Caspian coast are facing some form of water shortage.
The Government estimated that 60 % of the rural population in the 18 affected provinces and 12 million people in urban and rural areas are experiencing a shortage of potable water. Twenty percent of the livestock population, 65% of which is nomadic, have either died or have been slaughtered due to a lack of water. Crops in 8.4 million hectares of orchards and irrigated and non-irrigated farms have been lost and 9.6 million hectares of forests and woodlands are currently endangered. The Government has estimated the material losses at USD 1.7 billion. However, according to UNDP and FAO, the real cost of damage in terms of public health and disease, as well as material and social costs, foregone opportunities, etc., will likely be much higher than the estimated amount.
The UN, particularly the Iran-based UN Task Force on Drought, is working closely with the Government in monitoring the situation and addressing the short-term needs and in developing long-term solutions. In May 2000, UNDP and FAO country offices fielded joint missions to observe the drought situation in the provinces of Khuzestan, Sistan, Khorasan, and Ilam. Currently, UNDP is financing a project for the Ministry of Interior to field a needs assessment mission by a team of consultants from FAO, UNESCO, WHO and OCHA to formulate comprehensive measures to address the short-term needs and the long-term action plan. An official request for this needs assessment mission is expected shortly from the Ministry of Foreign Affairs. The inter-agency team is planned for 21 July. In addition, some relief items will be provided to the hardest hit provinces within this UN programme.
WFP provides food assistance to 80,000 of the most vulnerable Iraqi and Afghan refugees in 28 camps, as well as up to an additional 40,000 of the most vulnerable refugees living outside the camps. UNDP and FAO are also supporting projects that will combat desertification and drought. Sub-regional cooperation to address the cross-border issue with Afghanistan is being addressed.
No appeal for international assistance has been made. However, Iran has indicated that international assistance is welcome. GOI provided $290 million.
Available data indicate that to date there is no particular epidemic as a result of the drought. However, the severe disruptions of safe drinking water supply systems in rural areas has increased the risk of population exposure to enteric, diarrhoeal and water born diseases, (i.e. Hormozgan, South Fars and Yazd). There has been some indication of reporting of skin and eye infections due to the lack of adequate water and consequent deterioration of sanitary condition.
If drought continues, diarrhoeal diseases, parasitic diseases and zoonotic diseases may increase. In the meantime since there is a view that meningitis and measles may increase at the time of drought, particularly when temperature is elevated the surveillance of these diseases need more care.
An inter-agency mission (with WHO) visited in the drought affected area. A donor briefing is delivered on 24 August in Geneva. The Representative of Iran declared that his Government is on appealing for assistance but accept cash money.
This year, Karakalpakstan received only 10% of the water it normally gets from the Amudarya River. The basis of the economy of this Republic is agriculture. All cultivated land must be irrigated. This year only 50,000 hectares out of 110,000 were cultivated with rice. 90% of this crop has failed. All efforts are now being made to try and save the remaining 10% of the crop so that it can be used as seed for next season's planting.
In the hardest hit areas there is no water to sow the second crop, winter wheat. Consequently, the populations living in these regions have no income or food. Most farmers traditionally maintained sufficient stock of provisions to carry them to the next harvest. This as a rule takes place end August/September. It is therefore predicted that the real impact of the drought will start to be felt after October. A total of half million people live in these constituencies as shown in the table below.
An assessment mission conducted on 24-25 July by UNICEF. The most serious health concerns are the outbreak of cholera, increased cases of diarrhea, and hepatitis A. There appears to be a need for psycho -social support, given Government requesting international assistance. UN assessment mission being envisaged.
WHO provided New Emergency Health Kits to Uzbekistan and some funds for local purchase of drugs. An assessment mission by a senior public health expert is planned for the second half of September (also including Tajikistan).
CONCLUSIONS AND TALKING POINTS
Assessment was carried out in all countries affected by CAD with variable engagement and results. The common findings were:
1. The lack of drinking water is the most grave and visible consequence of the drought.
The response of the local health and water authorities varied from commitment to complete coverage of the affected communities with drinking water (Iran) to time limited assistance in this field (Afghanistan and Uzbekistan).
The rise of water born diseases varied also from doubling of the incidence (Tajikistan) to non-change of the pattern (Iran).
Water quality control varied also along across the region.
2. Malnutrition and lack of micronutrients is also variable. No malnutrition was noticed in Iran compared to Afghanistan and other countries.
3. Vaccine preventable diseases: none has been observed so far.