TB Project

Due to the natural disaster of the Aral Sea, the region faces immense environmental challenges such as land degradation, desertification and suffers increased vulnerability to natural and man-made disasters. These challenges have impacted negatively on the livelihoods of the people and their communities as one of the low-income regions in Uzbekistan.
Tuberculosis (TB) is an infectious disease associated with poverty and low incomes. In Karakalpakstan the disease has reached epidemic proportions and is exacerbating the poverty situation in the area. Case notification in 2006 in Karakalpakstan (120.9 per 100,000 population) was 72% higher than the average for Uzbekistan. Unusually, the number of cases among women is higher than men, with 123.8 per 100,000 compared to 118.7 for men. In Uzbekistan as a whole, the number of cases is 63.7 per 100,000 for women and 88.9 for men.
Karakalpakstan continues to suffer the consequences of the Aral Sea Disaster: once rich fishery sector has collapsed due to a drastic diminishing of the sea and pollution that has subsequently led to extinction of fish. Likewise the agricultural sector is in decline due to land degradation and desertification. The population’s health is declining, in tandem with its economic decline, and the risks of contracting TB are increasing. Documentary evidence indicates a strong linkage between tuberculosis and low living standards at societal, community and patient levels. Reducing TB prevalence is therefore important not only to ease the pain of individuals, but also to improve the socio-economic situation and livelihoods more generally.
Local authorities and community representatives have recognised both the need for TB to be tackled, and the value of engaging civil society directly in their development efforts.  The commitment of the local authorities and willingness of the communities to address these challenges have also been confirmed. However, civil society is still developing, and volunteer-involving organisations in Uzbekistan have limited capacity to effectively support development.
Working in collaboration with the UNDP ‘Area Based Development Programme’, WHO, national and local authorities, local civil society and the indigenous volunteer group, the Mahalla Foundation, this project will build up and draw upon the support of 3,000 local volunteers in five selected districts of the Karakalpakstan region to tackle high incidences of poverty and Tuberculosis through an integrated holistic approach.
The situation in Karakalpakstan supports the growing evidence of a link between poverty and TB.  The region, still recovering from the effect of the Aral Sea disaster and has higher than average prevalence of both poverty and TB.  The project aims to draw upon and develop volunteer and civic engagement of local communities, to facilitate improved communication between the people and local authorities, to enhance the sense of responsibility that local people can and should play in the efforts to improve their health and wealth. The project aims not only to reduce the incidence of infection, but to encourage a higher proportion of victims to seek medical assistance, and to ensure that treatment regimes are followed.  Not only is it expected that this project will impact on the prevalence of TB and poverty, but also that it will highlight the role of volunteerism and civic engagement as a development resource.