Community environmental health risks

Karakalpakstan, Uzbekistan

assessing health risks related to drinking water contamination

The Aral Sea Crisis

Once the world’s fourth-largest inland water body, the Aral Sea is regarded as one of the world’s most significant ecological disasters. In the 1960s, the Soviet government began diverting the two rivers that feed the sea, the Amu Darya and the Syr Darya. Water was diverted from rivers to irrigate the surrounding desert for agriculture, primarily cotton cultivation. As a result, the water level in the Aral Sea began to decrease drastically from the 1960s onward. It is now 10% of its original size. As a result, the ecological crisis has created severe economic, social, and health impacts for millions of people.

Since 2022, TerraGraphics International Foundation (TIFO) has partnered with Médecins Sans Frontières (MSF) and the Ministry of Health of Karakalpakstan (MOHK) to address environmental health concerns linked to the Aral Sea crisis. In spring 2023, TIFO led a significant environmental sampling effort to investigate contamination and its potential impact on public health.

Key Findings:

Rising drinking water salinity in Karakalpakstan is exacerbating health risks. It is potentially altering the interactions of other pollutants in the environment.
Persistent pesticides still pose real health hazards.
Improved laboratory capacity, regular monitoring, and collaborative interventions are urgently needed.

★Elevated salinity is linked to cardiovascular, gastrointestinal, and kidney disorders.

★Pesticides like lindane, DDT, aldrin, and heptachlor pose neurotoxic, reproductive, liver, kidney, and carcinogenic risks—especially for children and pregnant individuals.

Cocktail Effect

The combination of salinity, chemical contaminants, and drinking water chlorination may be reacting with each other to create new, harmful compounds.

Project goals

Safe drinking water
Reduce pesticides & salinity in drinking water to help decrease non-communicable disease among the population. Especially in women and children.

Support moving forward in a new environmental context
Support the Karakalpak people in adapting to a landscape without the Aral Sea. Focus on mitigating the related environmental impacts.

Establish research collaboration
Support scientists and other actors who continue to work on this issue.

In 2024, TIFO worked with MOHK to digitize and combine historic environmental monitoring data in the rayons (similar to a county in the U.S.) prioritized by MOHK. We also gathered first-person accounts related to the environment and the Aral Sea. MOHK chose to focus efforts on drinking water contamination and pursuing interventions in that area, especially for people in rural areas.

To support long-term analysis and identify trends in water contamination, TIFO scientists are analyzing five years of historic monitoring data. Combined with findings from the 2023 sampling effort, this analysis will guide advocacy for interventions, particularly in the area of water quality, a key concern for the Ministry of Health and a significant public health risk in Karakalpakstan.

Preliminary environmental
Assessment Report

Partners

Additional Resources

A drying sea half a world away carries a message for those worried about the Great Salt Lake

Will Utahns need to adapt to a smaller, dustier salt lake? Or can the watershed unite to reverse its decline? Salt Lake Tribune

World of Change: Shrinking Aral Sea

A Soviet-era irrigation project turned fertile dreams into ecological disaster, shrinking one of the world’s largest lakes and transforming the Aral Sea basin into a cautionary tale Earth Observatory

Aral Sea Catastrophe

A Case Study of International Pollution Issues International Pollution Issues

Organochlorine Pesticides and Salinity in Karakalpakstan, Uzbekistan: Environmental Health Risks Associated with the Aral Sea Crisis

This TIFO co-authored study highlights severe environmental health risks in Karakalpakstan, including pesticide contamination, water salinity, and degraded water quality. International Journal of Environmental Research and Public Health

Responding to an environmental health disaster in Central Asia

The Aral Sea’s collapse left toxic land, scarce water, and severe health impacts. MSF describes the ongoing human cost of this environmental disaster and what we can do about it. Médecins Sans Frontières

Joint brief: The Lancet Countdown on Health and Climate Change & Médecins Sans Frontières

Climate change is worsening health crises in low-resource settings where MSF works (including Karakalpakstan). This brief outlines MSF’s response—mitigation, adaptation, and advocacy—and highlights how climate impacts complicate care and deepen humanitarian needs. Médecins Sans Frontières