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In Azerbaijan, a lot of
environmental problems have
accumulated in all the spheres of industry and life.
The state of water supply and sewerage system is
generally quite unsatisfactory. The environment in Sumgayit is particularly
grave because intensive expansion of chemical enterprises has been done
without corresponding levels of environmental protection.
Transition to market economy must exert a positive
influence, as a whole, on the efficiency of exploitation of resources, as
well as on the state of environment. But in the very period of transition
the environmental situation is becoming even more aggravated.
Among the factors polluting the environment in the republic must be
mentioned the worn out equipment and obsolete technology, discarded oil
industry equipment scattered throughout the Apsheron Peninsula, continuing
to pollute the environment and deforming the landscape. Very critical is
the problem of recultivation of land polluted with oil.
That's why protection of environment and questions
of environment have become forming the state policy. Based on the principles
adopted by the world community, in a short period of time a number of fundamental
documents, namely, "Environmental Conception of the Azerbaijan
Republic" and the "law On Protection of Nature and Use of Natural
Resources" have been drafted and ratified in the republic. Unfortunately, solutions to
environmental problems
are being carried out under the present circumstances of an economic crisis
and acute budget shortages. It is evident that the necessary financing to
resolve environmental problems is not available.
Among the
national parks of Azerbaijan the most unique is Gizilaghaj, recognized by
the Ramsarian Convention. Azerbaijan is planning to expand protected
natural zones. However, as a result of the aggression 20% of the republic's
territory is being subjected to predatory plundering and turned to
"dead zones", forests are being felled, rare, unique
springs polluted, the policy of "scorched earth" pursued.
As the
international experts witness air in Azerbaijan is not environmentally
critical. The cities of Baku and Sumgayit make exceptions, where the level
of pollution of air in industrial zones is higher than in dwelling ones.
Obsolete methods and technology are being used in water supply and sewerage
system, water treatment is in effective.
The largest
rivers in the republic Kur and Araz are extremely polluted by industrial
and domestic wastes from neibghbouring Georgia and Armenia.
Application of intensive methods of land cultivation, with excessive
use of fertilizers and pesticides during the Soviet period has resulted in
serious pollution of soil and subsoil waters. There has been a tendency
towards swamping and erosion of soil in large areas of the land, according
to experts 1,4 million hectares of soil have been affected.
The entire
Baku Bay and 36% of coastal waters are characterised by a complex
pollution. More than half of the rivers (65,3% ) of 100 km. length are
heavily polluted. All the lakes of republic's lowlands are affected by
thermal, biological and chemical changes. Lakes of the Absheron Peninsula
and Kur-Araz lowland with a total area of 190 sq. km. are in critical
state.
At present
the level of the Caspian lake increases by 144 - 168 mm. per year, or by 12
to 14 mm. per month. The entire seacoast of Azerbaijan, 830 km. is flooded
along her whole length. The depth of the maximal flooding is 25 to 35 km.,
and for subflooding is 35 to 45 km. All the towns, settlements and
economic-facilities situated in this region need engineering protection, or
relocation from their current sites.
There are 755
health centres, 1,624 ambulatories and polyclinics, including 757 medical
ambulatories and 2,288 maternity centres. Azerbaijan has lost 5.920
hospital beds in the occupied territories, among the refugees there are
1.416 doctors and 5.874. There are 39.2 physicians and 9.52 auxiliary
medical workers per 10,000 population. Medical University annually trains
1,300 doctors. Secondary medical schools (technicums) train 8,000 medical
workers with secondary education for all health fields. There are eleven
medical-research institutes dealing with various medical problems, but their
material and technical conditions are far from satisfactory.
The
number of hospital beds total 76,900 or 104.4 per 10,000 - well above
European Community levels. But this quantitative indicators, which were the
main criteria for planing and financing, do not reflect accurately the
state of affairs in public health. Ninety per cent of hospital beds in
rural areas are in buildings unfit to be called hospitals. There is an
acute shortage of medical equipment and medicine. What equipment there is
often worn out or absolute.
Health
receives 4.5 per cent of the state budget. In circumstances of economic
crisis and inflation, this allocations don't meet even minimal
requirements.
There are
inadequate resources to maintain current facilities or to improve them. Thus
they cannot provide care in adequate volume or quality.
On the other
hand, the impoverishment of the population and the presence of some one
million refugees and displaced persons are hindering the transition of
health care financing to less reliance on state budget allocations.
Recently, the incidence of diseases associated with social factors has
risen greatly: tuberculosis, infecious-parasitic diseases, etc. Annually
about a million cases of acute chronic diseases are diagnosed. Cases
connected with drug addiction, alcoholism, and toxic substances have
increased since the late 1980's. Poor quality water has led to outbreaks of
acute intestinal diseases. Inadequate sanitary conditions have led to high
percentage of invalidism among people with diseases. This indicator in
Azerbaijan is very high, fluctuating between 60% and 80%. In connection
with the ongoing Karabakh conflict, the number of patients admitted bullet
wounds and traumatic injuries is very high, not to mention the enormous
human loses. The republic lacks facilities to render adequate medical
assistance in such cases. Health care management still follows in part the
rigid Soviet model and is in need of gradual decentralisation. The Health
Ministry is the leading body in this field. District and municipal
government maintain their own medical services.
The search
for new financing means will have to include three ways to render health
care - free state care, insurance, and patient payments. Economic and
social criteria will determine the mix among this options. Extensive
redesign of the health care network, as well as retraining of personnel,
are also needed. For all this Azerbaijan requires the consultative
assistance of international institutions.
Programs are being elaborated on several health care fronts - immunisation,
anti-TB campaigns, drug addiction treatment, family planning, measures
against infectious diseases, etc. UNICEF and the World Health Organization
are active in Azerbaijan.
The
pharmaceutical industry consists mainly of one large, but ill-equipped
enterprise, which sorely needs modernization. Medicine is distributed from
the central store, which has is own laboratories to control quality.
The state is obligated to provide the population
with imported medicine, unfortunately, lack of foreign currency does not
allow to purchase all the required medicine abroad and provide a certain
category of patients free of charge.
Key medicine
and equipment shortages include: insulin, anaesthetics, blood substitutes,
blood-transfusion equipment, disposal syringes, injections, vaccines,
serums, anti-TB and cardio-vascular medicines, and cancer preparations.
Today the
only way to supply Azerbaijan with medicine is to import vital
pharmaceuticals on a timely and reliable basis. But local industry and its
distribution also needs complete reorganization.
As a whole,
specialists consider health care in Azerbaijan to be in critical state. The
transition from centralized economy to a market one will definitely
facilitate decentralization of the health care system as well.
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