Tajikistan's tragic tale

14-year-old Mohira (l) is caring for her sister Honzoda

By Rory Mulholland in Dushanbe, Tajikistan

The former Soviet republic of Tajikistan has gone from being part of a superpower to one of the poorest countries on earth in less than a decade.

Malnourished children weigh a fraction of what they should

The suffering of a one-year-old girl is a symbol of the country's rapid decline.

Honzoda Bozorova has just been admitted to the feeding centre for malnourished children in Kabadian hospital in the southeast of the country, where she weighed in at 4kg (nine pounds)

Healthy girls of her age weigh around 11kg (24 pounds).

She was born with a hernia that now protrudes several centimetres from her back. Surgery will be required to remove it. But before she's strong enough for an operation she'll need weeks of proper nourishment.

Drought

Fortunately there are few cases of malnutrition as severe as Honzoda's but they are likely to increase.

She can be seen as a product of the war, drought and economic collapse that Tajikistan has faced in recent years.

This mountainous country of six-million people is one of the least developed in the world and the poorest in Central Asia, with some 80% of the population living below the poverty line.

Last year the drought was the worst in 74 years, and this year it looks like it's going to be even more severe. It has worsened the people's already poor nutritional status, and drought-related diseases are putting many children's survival at risk.

The drought is compounded by a deteriorating socio-economic climate and few employment opportunities, posing a serious threat to the living conditions of hundreds of thousands of families.

Disease

Khatlon oblast, or province, where Honzoda lives, is one of the worst hit areas.

Disease-prevention campaigns can only do so much

Diarrhoea, typhoid and malaria are on the increase here. The main cause is the consumption of unsafe water from irrigation ditches as well as poor sanitation and hygiene.

"Since independence 10 years ago the Central Asian republics have all faced rapid economic decline and drought," says Sabir Kurbanov, a worker with Unicef, the United Nations children's agency, in the Tajik capital Dushanbe.

"But here in Tajikistan we also had a civil war."

War

That war, which pitted the Moscow-backed government against the Islamist-led opposition, cost up to 50,000 lives and displaced more than half-a-million people.

By the time it ended in 1997 it had inflicted severe damage on an already crumbling health infrastructure.

In many areas of the south the entire population took refuge in neighbouring Afghanistan at the height of the conflict in the mid-1990s.

When they returned not only were most of their homes, but also their hospitals, health centres and schools looted of anything of value.

Reconstruction

The United Nations and other international aid organisations and non-governmental organisations have been helping rebuild, but the challenge is enormous.

No country for the old - nearly half of Tajikistan's population is under 14-years of age

The Tajik Government's budget is so limited that it can barely afford to pay health workers' salaries, let alone allocate funds to refurbish run-down hospitals.

A paediatrician in the hospital in the southern town of Shaartuz says the institution hasn't received any drugs from the state in over four years. It is entirely dependent on whatever aid organisations decide to donate.

Another example of just how cash-strapped the state is to be found in the northern region of Sugd. There the annual health budget is the equivalent of US$200,000 for a population of around two million people.

In such a setting, Honzoda can be considered lucky. At least there is a local feeding centre for her to go to. For thousands of malnourished children across Tajikistan there is not.