Tajikistan is one of five Central Asian countries that were formerly part of the Soviet Union. Tajikistan is one of the poorest of these countries, with less than 7% of its land available for cultivation. Tajikistan became an independent nation in 1991 as the result of the dissolution of the former Soviet Union. The shift in its status from being a member of a totalitarian republic to an independent nation brought with it certain challenges. Basic public services (e.g., health care, water supply, and sewer systems), previously guaranteed for even the poorest nations in the Soviet Union, were no longer supported through the Soviet cost-sharing system. Financial hardships and inadequate tariffs in Tajikistan severely limited provision of services and maintenance of equipment. Faulty design and installation of equipment while Tajikistan was still part of the Soviet Union added to these problems. To make matters worse, shortly after becoming an independent nation, Tajikistan experienced a civil war that continued until a cease-fire occurred in 1996. During the civil war, an estimated 50,000 lives were lost, and 1.2 million persons were internally displaced.3 In addition, a substantial number of trained technical and professional workers left the country. By 1997, the country’s economy and much of its infrastructure had collapsed. Consequently, the health of the people of Tajikistan suffered. Diseases rarely seen before the dissolution of the Soviet Union reappeared in increasing numbers. Residents of Tajikistan received primary health care at designated polyclinics based on their place of residence. The polyclinics provided ambulatory care and certain acute care services but lacked surgical and post-operative care facilities. Limited hospital beds at nationally run hospitals were available for patients needing in-patient services. Cases of notifiable disease were reported each week from the polyclinics and hospitals to the Sanitary Epidemiologic Service (SES), the public health unit that monitored infectious diseases. In February 1997, an increase in typhoid fever cases was reported in Dushanbe, the capital of Tajikistan (population approximately 600,000). Although typhoid fever was endemic in this area, more than 2,000 cases had been reported during January 29−February 11 (i.e., a 2-week period), compared with approximately 75 cases each week during the previous month. During the same 2- week period in 1996, only 23 cases had been reported. All typhoid fever patients were hospitalized at one of six full-service hospitals in the city, as required by a central government edict. SES staff studied the situation to determine the likelihood of an outbreak. Question 1: What health problems are common in countries with displaced populations, economic hardships, and deteriorating infrastructure?
Tajikistan is one of five Central Asian countries that were formerly part of the Soviet Union. Tajikistan is one of the poorest of these countries, with less than 7% of its land available for cultivation. Tajikistan became an independent nation in 1991 as the result of the dissolution of the former Soviet Union. The shift in its status from being a member of a totalitarian republic to an independent nation brought with it certain challenges. Basic public services (e.g., health care, water supply, and sewer systems), previously guaranteed for even the poorest nations in the Soviet Union, were no longer supported through the Soviet cost-sharing system. Financial hardships and inadequate tariffs in Tajikistan severely limited provision of services and maintenance of equipment. Faulty design and installation of equipment while Tajikistan was still part of the Soviet Union added to these problems. To make matters worse, shortly after becoming an independent nation, Tajikistan experienced a civil war that continued until a cease-fire occurred in 1996. During the civil war, an estimated 50,000 lives were lost, and 1.2 million persons were internally displaced.3 In addition, a substantial number of trained technical and professional workers left the country. By 1997, the country’s economy and much of its infrastructure had collapsed. Consequently, the health of the people of Tajikistan suffered. Diseases rarely seen before the dissolution of the Soviet Union reappeared in increasing numbers. Residents of Tajikistan received primary health care at designated polyclinics based on their place of residence. The polyclinics provided ambulatory care and certain acute care services but lacked surgical and post-operative care facilities. Limited hospital beds at nationally run hospitals were available for patients needing in-patient services. Cases of notifiable disease were reported each week from the polyclinics and hospitals to the Sanitary Epidemiologic Service (SES), the public health unit that monitored infectious diseases. In February 1997, an increase in typhoid fever cases was reported in Dushanbe, the capital of Tajikistan (population approximately 600,000). Although typhoid fever was endemic in this area, more than 2,000 cases had been reported during January 29−February 11 (i.e., a 2-week period), compared with approximately 75 cases each week during the previous month. During the same 2- week period in 1996, only 23 cases had been reported. All typhoid fever patients were hospitalized at one of six full-service hospitals in the city, as required by a central government edict. SES staff studied the situation to determine the likelihood of an outbreak.
Question 1: What health problems are common in countries with displaced populations, economic hardships, and deteriorating infrastructure? ( Answer in 500 words)
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