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Uzbekistan: Women Face Health Care Challenges

Prague, 10 August 1998 (RFE/RL -- In her speech to women in Samarkand, Uzbekistan last November, U.S. First Lady Hillary Clinton said that if a woman is healthy, a family is healthy. And if a family is healthy, a nation is healthy.

Uzbekistan's government says Clinton's words ring true for it too. Yet despite government slogans like "For A Healthy Young Generation" and "The Year of family," the health status of Uzbekistan's women is still a matter of deep concern.

A recent health survey conducted by the government's Research Institute of Obstetrics and Gynecology, estimates Uzbekistan's infant mortality rate at 49 infant deaths per 1,000 births. The survey estimates mortality among children aged one to four at 59 deaths per 1,000 children, and mortality rate for mothers at 59 deaths per 10,000 women.

The survey reveals that 60 percent of women and 61 percent of children in Uzbekistan suffer from anemia as a result of iron deficiency. Doctors say anemia causes many serious illnesses among women and children, including increased chances of complications during childbirth. Although the abortion rate among women in Uzbekistan is relatively low, the survey says doctors still consider it a dangerous method of contraception.

In 1995, the government of Uzbekistan launched a national campaign to promote alternative methods of female contraception. The United States Agency for International Development's (USAID) representative to Uzbekistan David Mandel says his agency is helping the Uzbek government reform the country's deteriorating health care system through several projects.

One project involves using local media, government and health institutions to market contraceptives as a form of family planning. Uzbek women recognize the campaign through its "red apple" trademark.

Mandel says the focus of the project is not to limit the population of the country, but to make it healthier.

"The Ministry of Healthcare understands that women who have too many children too frequently become sick, and their children become sick. They represent a burden on the state. That is why the policy of the government of Uzbekistan is to promote family planning" Mandel said.

USAID, in cooperation with the ministry and John Hopkins University also trains Uzbek doctors in modern methods of contraception.

Dilorom Abdullaeva, a doctor of gynecology and coordinator of UNESCO's Population Program in Uzbekistan says the ministry's women and children's healthcare programs starting in 1991 and 1993, respectively, have had major payoffs. From 1991-1997, the mortality rate among women decreased three times, and among children, four times. Abortions have also decreased.

Abdullaeva says about 5.5 million women in Uzbekistan are within childbearing age. Of that population, doctors recommend that 15 percent of those women not have children because they suffer from diseases. Sixty percent of women who can have children must seek some sort of medical treatment before pregnancy.

Abdullaeva says that Uzbekistan keeps better statistics on women's health than the former Soviet Union and other developing countries. But she admits that compared with developed countries such as Japan and the US, Uzbekistan still has a long way to go.

In the remote western republic of Karakalpakstan, the Aral Sea's gradual evaporation has endangered women and children's health. Despite limited finances and medical supplies, the Women's Center in the capital of Nukus uses what resources it has to help women protect their health. The center's director, Oral Ataniyazova, says more people are suffering from diseases as water levels in the Aral Sea decrease.

Most infections, she says, come from drinking water. To combat the spread of disease, specialists from the center often travel to remote areas to educate rural people on how to protect themselves from illness. But Ataniyazova says a money shortage and insufficient attention to the problems of the region make the center's work challenging.

Elsewhere, Tashkent's Women's Wellness Center serves more than 600 women each week. Director Dilmurod Yusupov says the medical facility was opened in conjunction with the University of Illinois medical school and aid from the U.S. government under the direction of First Lady Hillary Clinton. In 1992, Uzbek doctors visited the University of Illinois to learn more about modern medical treatment. The doctors now serve clients at the wellness center.