Poverty in the Developing World - The Central Asian Republics
Kazakhstan
The United Nations Development Program (UNDP) reports in Human Development Report: Kazakhstan 2004 (2004, http://hdr.undp.org/docs/reports/national/KAZ_Kazakhstan/Kazakhstan_2004_en.pdf) that Kazakhstan saw a dramatic decline in its human development indicators immediately after independence from the Soviet Union in 1991, dropping in rank from fifty-fourth to ninety-third on the UN's Human Development Index (HDI) of 177 countries. Between 1996 and 2002, though, Kazakhstan rose on the HDI to seventy-eighth place, due largely to its steady economic growth that averaged 10.4% annually from 2000 to 2004, and as of 2005 it ranked eightieth. However, as with other developing regions, a growing economy has not necessarily translated to a decrease in poverty or an increase in the standard of living for ordinary people, especially for those living in rural areas.
The World Bank's Dimensions of Poverty in Kazakhstan, vol. 2: Profile of Living Standards in Kazakhstan in 2002 (November 9, 2004) reports that the total poverty rate in 2002 was 15% (about one in six people), down from 18% in 2001. Sixty-four percent of the poor lived in rural regions and 15% in large cities. As in Russia, poverty in Kazakhstan tends to be shallow, meaning that the greatest number of the poor are concentrated near the poverty line. The UNDP's Millennium Development Goals in Kazakhstan, 2005 reports a large gap between urban and rural households in the availability of in-house utilities. While 81% of urban households had piped water in 2004, only 8.3% of rural households did, with just 0.8% of rural houses having a hot water supply, versus 56.1% of urban houses. Although nearly 100% of both rural and urban households had electricity, just 1.9% of rural homes had central heating, contrasted with 68.6% of urban homes. Sanitation was also lacking in rural households: only 4.3% had improved sewage systems, while 73.7% of urban households did. This situation in particular seems to be worsening over time. In 1999, 73.9% of urban and 10.4% of rural houses had access to a sewage system. Given that the public expenditure on health has been decreasing since 1995, this is a partial explanation for these worsening conditions. (See Figure 5.6.)
According to the UN's report MDG1: Eliminate Extreme Poverty and Hunger (2005, http://www.undp.kz/library_of_publications/files/1568-75446.pdf), Kazakhstan has already achieved the first MDG of halving extreme poverty by 2015, reducing its total poverty incidence from 39% of the population in 1998 to 16.1% in 2004. In rural regions, however, the poverty rate averaged 24.8%, almost three times the rate of 9.2% in urban regions. This huge gap indicates uneven development and growth throughout the country. The average annual per capita GDP was $7,363 as of 2005.
EDUCATION AND LITERACY
Kazakhstan has already exceeded the MDG of universal primary school education: 84% of children are enrolled in primary school, and the adult literacy rate is 99.5%, according to the UNDP report The Great Generation of Kazakhstan: Insight into the Future (2005, http://www.undp.kz/library_of_publications/files/5811-13639.pdf). However, the country has a high inequality ratio because of the great differences between rural and urban areas, especially in secondary education.
FIGURE 5.6 Public expenditure on health, by country in Central Asia, 1995 and 2002
HEALTH AND MORTALITY
Life expectancy in Kazakhstan is fairly low: fifty-six years for men and sixty-seven years for women in 2004, according to the World Health Organization (2006, http://www.who.int/countries/kaz/en/). Healthy life expectancy at birth in 2002 was 52.6 years for men and 59.3 years for women. Under-five child mortality in 2002 was eighty-three per 1,000 live births for males and sixty-two for females. Different agencies within the country report different numbers for maternal mortality, and there are to date no official statistics. The Kazakhstan Ministry of Health reports that there were 75.8 deaths per 100,000 live births in 1990, while the Agency for Statistics reports fifty-five. Both groups report a decrease between 1990 and 2004, to 36.9 deaths per 100,000, although the number is still considered unreasonably high, particularly in light of the fact that nearly 100% of births in Kazakhstan are attended by health professionals. This indicates an issue with the quality of obstetric care.
One of the biggest health challenges confronting Kazakhstan since the dissolution of the Soviet Union is drug use. Because of its location on the drug trafficking route between the major drug producers of Southwest Asia to major drug-consuming regions such as Russia and Eastern Europe, Kazakhstan has become a major link on the route. According to the Silk Road Studies Program and the Central Asia-Caucasus Institute's "Country Factsheet, Eurasian Narcotics: Kazakhstan 2003" (2004), Kazakhstan's customs union with Russia, Belarus, and the Ukraine permits the passage of closed containers without inspection across borders, making it especially attractive to smugglers. Kazakhstan, however, does not just provide a passage through which illicit drugs can easily pass. The country is also becoming a bigger producer of heroin and cannabis for use within its own borders. As in all countries with a high rate of intravenous drug use, HIV infection is on the rise in Kazakhstan. The Silk Road Studies fact sheet reports that as many as 3% of the country's citizens are believed to be intravenous drug users, and about 23,000 people are believed to be HIV-positive, with 84% of those infected being intravenous drug users. Suicide is a major cause of death among the HIV-positive population of Kazakhstan.
Kyrgyzstan
Kyrgyzstan is a small, almost entirely mountainous, landlocked country of about five million people. Historically, the people of the region were nomadic, but when it was incorporated into the Soviet Union in 1924, Kyrgyzstan was converted to an agricultural-manufacturing lifestyle and economy. By the time the Central Asian republics were granted independence in 1991, Kyrgyzstan's manufacturing sector relied almost entirely on the Soviet Union's military-industrial complex. With its collapse, Kyrgyzstan's manufacturing sector also fell apart, which left its economy in ruins.
POVERTY AND HEALTH INDICATORS
By 1999 the rural poverty rate was 60%, according to Kyrgyzstan's National Poverty Reduction Strategy, 2003–2005 (April 2004, http://poverty2.forumone.com/files/Kyrgyz_PRSP.pdf), and the urban rate was 42.4%. In 2001 the numbers had declined to 51% for rural dwellers but had risen to 47.6% for those in urban areas. As in much of the rest of the world, poverty in Kyrgyzstan is heavily concentrated in rural regions. While 65.3% of the total Kyrgyzstani population lives in rural areas, 70% of the poor are rural dwellers. The overall rate of extreme poverty in 2001 was 13.5%. For those in rural regions the extreme poverty rate dropped between 2000 and 2001, from 20.5% to 15.6%, as did the urban regions rate, from 12.7 to 9.6%.
According to the UN Human Development Program's "Country Sheet: Kyrgyzstan" (2006, http://hdr.undp.org/statistics/data/countries.cfm?c=KGZ), Kyrgyzstan's literacy rate and primary school enrollment are high: 98.7% of adults were literate in 2002, and 82% of children were enrolled in primary, secondary, and tertiary schools. According to the World Health Organization (2006, http://www.who.int/countries/kgz/en/), in 2004 life expectancy was fifty-nine years for men and sixty-seven for women. The healthy life expectancy at birth was 52.2 years for men and 58.4 years for women in 2002. In 2004 the under-five child mortality was seventy-two per 1,000 live births for boys and sixty-three per 1,000 for girls. The average per capita GDP in 2005 was $1,751. In 2003 Kyrgyzstan ranked 109 out of 177 countries on the UN's Human Development Index.
Like Kazakhstan, Kyrgyzstan has a growing presence in the international drug trade and, consequently, an increasing number of intravenous drug users and HIV cases. In fact, according to the British nongovernmental organization One World UK (2006, http://uk.oneworld. net/guides/kyrgyzstan/development), unofficial sources estimate that there may be as many as 6,000 cases of HIV, most unreported, in the country. Additionally, Kyrgyzstan has high rates of deaths from circulatory and respiratory diseases, and incidences of tuberculosis, syphilis, and malaria have increased since the 1990s.
Tajikistan
After independence in 1991, Tajikistan fell into a civil war that lasted from 1992 to 1994. The conflict seriously deteriorated conditions throughout the country, which has not entirely recovered as of 2006. The World Bank reports in Republic of Tajikistan Poverty Assessment Update (January 6, 2005, http://www.untj.org/files/reports/Tajikistan%20Poverty%20Assessment%20Update.pdf) that Tajikistan is the poorest of the former Soviet republics, indeed, one of the poorest countries in the world, with 64% of its population living on less than $2.15 a day in 2003. This is down substantially from 81% in 1999. The rate of extreme poverty (less than $1.08 a day) in 2003 was 18%, down from 36% in 1999. In 2002 the average gross national income per capita was less than $200, despite economic growth averaging 8% since 2000. Tajikistan does not have a national poverty line, so all calculations are based on the international lines (adjusted to $1.08 and $2.15 per day based on 2000 purchasing power parity).
The UNDP's Investing in Sustainable Development: Millennium Development Goals Needs Assessment (May 2005, http://www.undp.tj/home/MDG_NA_Full_Eng.pdf) for Tajikistan reports that steady economic growth and increased income and consumption have not really improved living standards for most Tajiks, even though extreme poverty has decreased by as much as fifty-five percentage points in some provincial regions since 1999.
HUNGER AND FOOD INSECURITY
Food insecurity and malnutrition are key poverty-related problems for Tajiks: the UNDP Millennium Development Goals report states that 83% of the population suffered from nutrition-related poverty in 2003. Families reported cutting down on food consumption and relying on food given as gifts to get by. Unbalanced diets that cause a number of nutritional deficiencies are the norm in Tajikistan, especially an over-dependence on bread as a primary source of nutrition. Children are the demographic group most affected by nutritional deficiencies. Of children aged six-months to fifty-nine months old, 36% are chronically malnourished, and 5% have acute malnutrition. Poor maternal nutrition results in 15% of Tajik babies being born malnourished.
The most common nutritional problems, other than simply a lack of food, in Tajikistan are deficiencies of iodine, folic acid, vitamin A, and iron. Iodine and folic acid deficiencies cause mental retardation and enlarged thyroids; in 2003, 89% of Tajik children had low levels of iodine, and 58% were deficient in folic acid. About 10% to 15% of Tajiks of all ages were believed to have enlarged thyroids. Vitamin A deficiency can cause blindness and increases susceptibility to infectious diseases. In Tajikistan approximately 52% of children aged six-months to fifty-nine months were Vitamin A deficient in 2003. Iron deficiency—the most common nutritional deficiency in the world, affecting 66% to 80% of the world's population—is experienced most often by children and pregnant women. In fact, anemia (very low levels of iron in the blood) is a factor in up to 20% of all maternal deaths. In Tajikistan 37% of preschool children, 40% of women, and 48% of pregnant women were believed to be anemic in 2003.
Overall malnutrition and food insecurity increased in Tajikistan between 2003 and 2004, according to a March 2005 press release from the UNDP's donors agency. Twenty-seven percent of rural Tajik households were either chronically food insecure or at risk of food insecurity. Hunger, food insecurity, and malnutrition were not limited to Tajikistan's poorest households. Even steadily employed householders reported a lack of adequate food. Low income was not, however, the only reason for such widespread food insecurity. The UNDP press release cites a Tajik survey that found a 17% drop in the country's cereal production from 2003 to 2004.
EDUCATION AND LITERACY
All the former Soviet republics have generally high rates of primary school enrollment and literacy because of the former Soviet Union's compulsory education system. In Tajikistan the pre-Soviet literacy rate was 4% for men and 0.1% for women. Even after the Soviets introduced their program of state-run schools into the country, the subject of education was not always welcomed by the native population; Islamic leaders vocally opposed public education, and antieducation violence resulted in school burnings and the murders of teachers. By the 1980s Tajik education was well below that of other Soviet republics, with only 55% of adults having completed secondary schooling. Nevertheless, in "Country Sheet: Tajikistan" (2006, http://hdr.undp.org/statistics/data/countries.cfm?c=TJK) the UNDP reports that the literacy rate in Tajikistan was 99.5% in 2003, and the primary school enrollment was 94% in 2002–03. Even though factors such as poverty and hunger make it increasingly difficult for children to attend school, an estimated 88% of enrolled children attend school.
HEALTH AND MORTALITY
According to the World Health Organization (2006, http://www.who.int/countries/tjk/en/), life expectancy in Tajikistan was sixty-three years in 2004, sixty-two years for males and sixty-four years for females. Healthy life expectancy at birth was 53.1 years for males and 56.4 years for females in 2002. Under-five child mortality was 120 deaths per 1,000 live births for males and 115 per 1,000 live births for females in 2004. Data on infant mortality vary by source. Existing birth and death records are not considered reliable in Tajikistan. However, in January 2005 IRINnews.org reported that infant mortality rates appear to be going up in the northern provinces of the country. The article cites estimates for 2003 from both the United Nations Children's Fund (UNICEF) and the U.S. Agency for International Development (USAID). According to UNICEF, the infant mortality rate was ninety-two deaths per 1,000 live births, but USAID's rate was 112.1 deaths per 1,000. Tajikistan's health ministry chief believed the numbers could actually be three or four times higher.
As in the other Central Asian republics, HIV/AIDS cases are on the rise in Tajikistan because of the country's geographical location on the trafficking route and because of an increase in intravenous drug use and prostitution. In fact, if the number of HIV cases continues to increase at its 2005 rate, experts say the number could double every thirteen months ("Tajikistan: Donors Call on Country to Strengthen Battle against HIV/AIDS," February 23, 2006, http://www.aegis.com/news/IRIN/2006/IR060259.html). Besides its role in the drug trade, Tajikistan has many citizens who temporarily migrate abroad—mostly to Russia—for work. Increasingly, these migrant workers become infected abroad and bring the disease back to Tajikistan, where they spread HIV.
Turkmenistan
Turkmenistan is considered the most closed society in the former Soviet bloc. In July 2004 the last international radio outlet to broadcast in the country—Russia's Mayak radio station—was cut off by Turkmenistan's authoritarian government, leaving the Turkmen people with no access to outside information. According to an article from the Power and Interest News Report (PINR; "The Erosion of Political Institutions in Turkmenistan," December 30, 2004, http://www.pinr.com/report.php?ac\=view_report&reportid=250&language_id=1), as of 2006 Turkmenistan and North Korea were the only countries in the world to retain their Stalinist regimes, meaning that they were ruled by dictators who control every aspect of their societies. The PINR lists many problems with the Turkmen government:
documented human rights violations, forced resettlement of ethnic minorities, rigid press censorship, high unemployment, a drug epidemic among the youth, widespread corruption, a declining educational system …, vast symbolic building projects (including an ice palace in the desert), isolation of the country from the rest of the world, collapsing public health (including reported cases of plague), and a political system in which no opposition to the government is tolerated.
Although exact figures are difficult to obtain because Turkmenistan does not have an established poverty line and what calculations the government does keep are not widely available, poverty is believed to be high and human development indicators low despite the potential for national wealth because of the country's huge oil and natural gas reserves. Turkmen president Saparmurat Niyazov has ruled Turkmenistan since independence in 1991, but in 1999 he declared himself "president for life" and adopted the title "Turkmenbashi," which means "father of all Turkmen."
According to Bernd Rechel and Martin McKee's report Human Rights and Health in Turkmenistan (April 2005, http://www.lshtm.ac.uk/ecohost/projects/turkmenistan%20files/Turkmen%20report.pdf), Turkmenistan has evolved to become the most oppressive of all the former Soviet republics. The Turkmen government controls all media and communications and refuses to report health data to the World Health Organization or development information to the United Nations. In March 2003 the Turkmen government imposed a ban on the issuance of exit visas to its citizens, preventing them from leaving the country. Threats of trade sanctions from the United States caused the Turkmen regime to abandon the exit visa ban in January 2004, although the government maintains a blacklist of people not allowed to travel.
Because of this atmosphere, the United Nations has been unable to research and publish a human development report on Turkmenistan since the 1990s. As of early 2006 the country was on uneasy terms with the World Bank because it refused to report its international debt, so all statistics related to poverty are speculative and based on data that are in most cases ten years old. Rechel and McKee, however, deduce from the information available in the World Bank's 1998 Living Standards Measurement Survey that urban unemployment in Turkmenistan was approximately 50% in 2003, and rural unemployment about 70%. In 1998 an estimated 44% of Turkmen lived below the international poverty line of $2 per day. Rechel and McKee note that "there is anecdotal evidence that the economic situation has deteriorated considerably since then."
Like all other statistics about the country, information on the health and education status of the Turkmen people is of dubious accuracy; the last time the country reported health data to the World Health Organization was in 1998. In February 2006 EURASIANET.org reported in "Turkmenistan Vulnerable to Public Health Catastrophe" (http://www.eurasianet.org/departments/recaps/articles/eav020606.shtml) that health care in Turkmenistan since independence has been deliberately targeted by President Niyazov, who has officially denied the existence of contagious diseases such as AIDS in the country, leaving citizens with no real options for medical aid. When they are able to see a doctor, extortion is not uncommon because the medical system is essentially a black market: for example, a parent taking her child in for a doctor visit might be forced to undergo testing herself so that the doctor makes more money. In 2004 Niyazov dismissed 15,000 health care professionals and replaced them with untrained military conscripts (people who have been drafted into the military involuntarily) to cut down on government spending. In 2005 he announced that all hospitals outside the capital city of Ashgabat would be closed indefinitely. In 2002 the World Health Organization (2006, http://www.who.int/countries/tkm/en/) estimated that the mortality rate was 51.6 years for men and 57.2 years for women. The child mortality rate for those under five years old had risen from ninety-seven per 1,000 live births in 1990 to 103 per 1,000 in 2004, as reported by UNICEF; an estimated 11,000 Turkmen children under five years old died in 2004 (http://www.unicef.org/infobycountry/Turkmenistan_statistics.html).
In late 2005 the Turkmen government began cutting benefits to about 100,000 of the country's 400,000 people, mostly the elderly, who receive government pensions. Other government benefits have been cut by 20%, according to IRINnews.org ("Turkmenistan: Pension Cuts Begin to Bite," February 6, 2006, http://www.irinnews.org/report.asp?ReportID=51553&SelectRegion=Asia&Select Country=TURKMENISTAN). This move was expected to push thousands of older people into almost instant poverty. IRINnews.org notes that unemployment in Turkmenistan is believed to be as high as 80%.
Uzbekistan
Uzbekistan is the most populous of the Central Asian republics, with 25.8 million people—36.7% in urban areas and 63.3% in rural, according to the UNDP's "Country Sheet: Uzbekistan" (2006, http://hdr.undp.org/statistics/data/countries.cfm?c=UZB). Poverty in Uzbekistan is not generally as dire as in some of the other Central Asian republics. The country is the fourth-largest producer of cotton in the world and the seventh-largest producer of gold; in addition, it has large reserves of gas and oil. However, rising unemployment, a government crackdown on civil liberties, and economic policies that many observers consider disastrous have put Uzbekistan on the brink of total disarray.
According to "Country Sheet: Uzbekistan," in 2003 Uzbekistan ranked 111 out of 177 countries on the Human Development Index, ahead of Kyrgyzstan's 109 and Tajikistan's 122, but behind Kazakhstan's 80 and Turkmenistan's 97. As in all the other Central Asian republics, life expectancy decreased in Uzbekistan between 1990 and 2003, from 69.17 to 66.68 years. The UNDP's Central Asia Human Development Report: Bringing Down Barriers—Regional Cooperation for Human Development and Human Security (2005, http://hdr.undp.org/docs/reports/regional/CIS_Europe_CIS/Central_Asia_2005_en.pdf) states that in 2003, 47% of Uzbekistan's population lived below the international poverty line of $2.15 per day, compared to a high of 74% in Tajikistan and a low of 21% in Kazakhstan. Yet, Uzbekistan's annual economic growth lagged behind that of all the other Central Asian republics, at around 7.5%.
As in all the Central Asian republics, HIV and AIDS pose a risk not just to the physical health but also to the economy of Uzbekistan. In "A Silent Killer Threatens Central Asia" (December 28, 2004, http://www.eurasianet.org/departments/civilsociety/articles/pp122804.shtml), Antoine Blua states that the projected long-term loss in economic growth in Uzbekistan because of HIV and AIDS infection could total 21% by 2015. However, unlike the rest of Central Asia, the cause of the burgeoning epidemic in Uzbekistan is not so much intravenous drug use as a huge increase in prostitution since independence in 1991. According to Gulnoza Saidazimova in the article "HIV Infections Build in Uzbekistan as Prostitution Rises" (December 29, 2004, http://www.eurasianet.org/departments/civilsociety/articles/pp122904.shtml), Uzbekistan's large population, high unemployment—especially among women—and role as a major transit stop for truck drivers throughout the republics has caused an increasing number of women to turn to prostitution to earn a living. With an average monthly income in the country at just $15, condoms to prevent HIV and antiretroviral drugs to treat it are too expensive for prostitutes to afford.
Of further concern to the international community is the potential for widespread unrest in the region if Uzbekistan should become even more unstable. A government crackdown on civil liberties began after armed protesters stormed a prison in the city of Andijon in May 2005 to free twenty-three men accused of membership in an extreme Islamic group. Government troops were sent to stop the insurgency, but eyewitness accounts say they fired indiscriminately into crowds of people, killing as many as 1,000 Uzbek citizens; since then, the International Crisis Group has called leadership in Uzbekistan one of the most repressive regimes in the world. With political refugees from Uzbekistan fleeing to other Central Asian republics, especially the already-fragile Kyrgyzstan, the entire region could, according to some observers, fall into total disarray. The United States and the European Union both condemned the May 2005 government massacre and have since cut off nearly all ties to Uzbekistan. After the events of May 2005, Uzbek leaders halted the activities of at least 60% of nongovernmental organizations in the country. With aid groups forced to close facilities and leave the country, the Uzbek people have become even more vulnerable to the effects of poverty.
According to the International Crisis Group's Policy Briefing "Uzbekistan: In for the Long Haul" (February 16, 2006, http://www.crisisgroup.org/home/index.cfm?id=3952&l=1), the ruling party's economic policies have been disastrous for the Uzbek people. Although the country is the world's second biggest exporter of cotton (which is used mostly to produce blue jeans for the U.S. and European markets), the rural farmers—mostly women and children—who grow and cultivate it are essentially slave labor, with all the revenues going to the small but powerful upper class. Unrest has continued since the Andijon uprising despite the government's increase in the minimum wage to $9 a month. A growing number of Uzbeks are leaving the country for Russia and Kazakhstan to work as illegal, and therefore unprotected, temporary laborers.
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