UNICEF TAJIKISTAN
20 FEBRUARY 2008
FUNDING PROPOSAL
Maternal and Child Survival in Extreme Winter Conditions in
Tajikistan
Addressing Immediate Needs of Newborn Babies and Children
Maternal and Child Survival in Extreme Winter Conditions in Tajikistan
Addressing Immediate Needs of Newborn Babies and Children

USD 190,000 is urgently needed to respond to the needs of the most vulnerable children and
their families in Tajikistan as the country experiences the harshest winter in several decades.
The sub-zero temperatures, dire shortage of water, gas and electricity is affecting the health,
livelihood and well-being of the population. The current situation has severe consequences for
children and specifically maternal and child survival.

The rapid health assessment data showing a sharp increase in the number of severe burns
and frost bite cases in the last two months.

In Tajikistan 120.000 of 180.000 annual births are in rural areas. Premature babies
account for almost 8 percent of newborns and they are now at risk of hypothermia.

Ministry of Health statistics indicate that maternal deaths in January 2008 have more then
doubled in comparison with the same period of last year.

Of particular concern are schools and hospitals, which provide opportunities for the spread of
disease in conditions of poor sanitation, a problem generally arising from a lack of adequate
clean water. Around 60 per cent of Maternal and Child Health (MCH) hospitals have no
access to safe water.
Further, many urban residents use electricity for boiling water, a limited option when
lengthy black outs occur, and there are few water purification alternatives. With at least
two bottled water companies in Dushanbe closed due to a lack of electricity, even buying
commercially purified water can be a challenge, particularly for a large family.

The funds will be used to deliver essential life saving supplies including but not limited to;
incubators, baby warmers, manual resuscitators, hospital new born cots, generators and
midwife delivery kits.
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Background:
Tajikistan is experiencing the harshest winter in three decades
with temperatures averaging -15 degree Celsius and dropping
to as low as -22 degrees in the evenings. There is a dire
shortage of water, gas and electricity. Most of the antiquated
water lines have either broken if not clogged or frozen. Along
with heating, availability of water has also become a serious
crisis in most institutions such as hospitals, maternity centers,
schools and child care institutions.
Compounding the severe cold weather is an energy crisis that
has reached emergency proportions. The country imports electricity from Turkmenistan and Uzbekistan, but
it has been reduced due to power shortages in these two countries. In many villages, people receive one or
two hours of electricity a day. The energy crisis in the rural areas has fueled a wave of internal migration.
People have moved to live with relatives and friends who have stockpile of coal or those with relatively
better power supply situation in the urban areas.
The government has imposed stringent rationing of electricity and requested closure of restaurants, saunas,
non-essential factories and shops and has also diverted energy from aluminum industries to the general
population but still with no measurable improvement. Operation of street lights in the city has already been
suspended.
The risk of avalanches has increased as a result of extreme weather conditions, Data from observation
stations showed that snowfall in the mountains of Anzob and Shahristan has exceeded the normal values
that could result in avalanches in the central and northern regions and might likely block roads and
settlements. Over a dozen people in Tajikistan have already perished under the snow avalanches since the
beginning of this winter season.
Of immediate concern is the water level (7 meters) in the Nurek Reservoir which, as a result of frozen inlet
streams, is not being replenished at levels commensurate with off-take (average 60 cm per day). Hydroelectric experts from the World Bank in Dushanbe warned a possibility of a complete power cut in the next
10 -15 days. According to the regional weather outlook, cold temperatures and extreme weather might
likely continue in February.
Initial accounts from the field show the following:
 Cases of newborn deaths in Dushanbe maternity hospitals were reported in January 2008 due to
shortage of electricity and extreme cold weather.

Almost half of Maternal and Child Health hospitals in the country reported an increase of morbidity
among children due to severe weather conditions including power, gas and water shortages. Some
districts reported death cases.

Children of all the 3800 schools and 400 kindergartens learn in extremely severe learning
conditions, as most schools have almost no or very limited heating facility.

Thousands of children, mostly from poor families and orphans, placed in institutions in Dushanbe,
Sughd and Khatlon oblasts suffer double vulnerability. They are all affected by the electricity cuts
and water shortages. The majority of institutions are provided two to seven hours electricity which is
not sufficient to warm, cook and accommodate children in classrooms and bedrooms.
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The water, sanitation and hygiene issues arising from the cold weather and electrical crisis lead to
significant problems in urban areas, where water systems serve large numbers of persons. Contaminated
water can rapidly spread preventable disease. Disrupted supplies (for which there are few immediate
alternatives) create shortages in water for consumption, sanitation and hygiene. Damaged water supplies
are already tagged as a possible source of typhoid in Kulyab.
Of particular concern are schools and
hospitals, which provide opportunities for the
spread of disease in conditions of poor
sanitation, a problem generally arising from a
lack of adequate clean water. Around 60 per
cent of Maternal and Child Health (MCH)
hospitals have no access to safe water.
Further, many urban residents use electricity
for boiling water, a limited option when
lengthy black outs occur, and there are few
water purification alternatives. With at least
two bottled water companies in Dushanbe
closed due to a lack of electricity, even
buying commercially purified water can be a
challenge, particularly for a large family
Join UNICEF to save the lives of Tajik Children
Tatyana, 35, mother of four children, gave birth to her twins, just
two days ago, at a maternity hospital in Dushanbe. Tatyana is
trying to smile at us, but her face is a picture of anxiety as she
needs to leave the hospital soon and go home…
“Even though I am an experienced mother I do not know how to
keep my newborn twins warm in these harsh winter conditions. I
live in the city center but we were not prepared for this cold. I do
not have a stove, I have an electrical heater but we have
electricity only for couple of hour’s everyday.”
Hasan and Hussein (twins) holding onto life,
1 day old, Maternity Hospital # 2 of
Dushanbe, February 13-02-2008
Children of Tajikistan are not only suffering from the most severe
winter in the last three decades and energy shortage but also a
lack of life-saving emergency materials.
The total population of the country is around 7M and ¾ M are children, some 50% of the population is
living under the poverty line. (living on less than $ 2 a day).
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Impact on Children
Some new born deaths in maternity hospitals have been reported due
to power cuts and cold. The number of acute respiratory infections
and other childhood illnesses have increased. Only 19% of the
hospitals and health clinics have access to electricity. Currently only
twenty percent of the population has access to piped water. Access
to safe drinking water is very limited, the vast majority of the
population using sources that are not safe or secure. Snow prevents
access to the people lives in remote areas.
“Repaired” incubator, Maternity
Nutrition situation is alarming and a very difficult epidemiological
hospital # 2, Dushanbe
situation is developing.
There is high risk for infectious disease outbreak. Hospitals are in urgent need of emergency equipment like
incubators, baby warmers, baby cribs and blankets especially for the newborns.
UNICEF’s Response
In Dushanbe, the capital of Tajikistan, UNICEF helps children for the
best start in life. Some examples of the supplies already distributed
include: Life-saving health kits, jerry cans, baby blankets, hygiene sets,
high protein biscuits, and generators for child and maternity hospitals
and residential child care institutions.
The needs of the children and women are huge and urgent Your help is vital in ensuring that we can continue to deliver essential emergency supplies listed below to
Tajik children affected by this compound crisis.
Item
Incubator
Baby Warmers
Resuscitator hand operation
Hospital type new born cot
Midwife delivery kit (enough for
50 home deliveries)
Total
Unit price
$ 5,300
$ 800
$
90
$ 300
$ 400
Immediate Need
20
40
100
100
30
Midterm Need
40
80
100
300
50
$ 189,000
$ 383,000
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