In Azerbaijan, a lot of ecological
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 ecological 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 ecology 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, "Ecological 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 ecological 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
ecological 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 ecologically 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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