Belarus Getting Sicker

UNCLAS SECTION 01 OF 04 MINSK 000152 SIPDIS SENSITIVE SIPDIS E.O. 12958: N/A TAGS: SOCI ECON TBIO ENRG MNUC SENV BO SUBJECT: Belarus Getting Sicker Ref: 05 Minsk 837 ¶1. (SBU) Summary: Despite Lukashenko's "Third Way Economic Miracle," the Belarusian population is now sicker, dies earlier and has fewer children than during the late Soviet period. Doctors at the CitiHope NGO recently passed to Econoff a report they drafted chronicling the systematic worsening of the health of the Belarusian people. General morbidity has risen for almost all diseases. Some of this increase is directly attributable to the Chernobyl nuclear accident, but the majority is due to declining socio-economic factors. Maternal and children's health are especially hard hit, even though the GOB has succeeded in lower the infant mortality rate. As a result, the Belarusian population is aging. Currently 25% of the population are pensioners. When this number rises in the next few years, the GOB will be hard pressed to make pension payments. End summary. Chernobyl's Affects Still Being Felt -------------- ¶2. (U) According to this report, the Chernobyl accident contaminated 23% of Belarus with cesium-137 levels above 1 Ci/km2, with the highest levels around the regional capital of Gomel. At the time, 2.2 million people lived in that area; now 1.5 million live in these contaminated zones. The contaminated area includes 22% of Belarus' agricultural land and 21% of its forests. The report found that the population, as well as life expectancy, has been steadily falling in this area. ¶3. (SBU) Although the report agrees that the true number of casualties from Chernobyl is subject to dispute, there is consensus that at least 1,800 children in the most affected areas have contracted thyroid cancer because of the accident. CitiHope cites a 2002 UNICEF report that estimated another 8,000 people, who were children at the time of the accident, will contract thyroid cancer in coming years. However, WHO projected 50,000 new cases, and a German radiation medicine specialist, who has run a thyroid center in Belarus since 1991, estimates Chernobyl will result in 100,000 cases of thyroid cancer among all age groups. ¶4. (U) The report also blames Chernobyl for doubling the incidence of breast cancer in the Gomel region, and predicts there will also be increases in urogenital, lung and stomach cancers. General Morbidity on the Rise -------------- ¶5. (SBU) CitiHope believes that Chernobyl, as well as economic instability and falling living standards throughout the 1990s, resulted in an increase in general morbidity. CitiHope pointed out that tuberculosis (TB) is a good indicator of the general socio- economic situation. TB rose from 24.8 cases per 100,000 in 1990 to 50 cases in 1998. It fell again by 2002 to 40.7, but rose in 2003 to 42.9 cases. Not just diseases rose sharply, but also the incidence of accidents, poisonings and other external forms of morbidity. ¶6. (U) From 1990 to 2003 (the latest statistics available),the number of all newly diagnosed diseases rose 1.4 times, from 55,330 to 78,108 per 100,000 residents. The charts in the report show the incidence of several diseases peaking in the late 1990s and falling by 2003. However, most categories of illness indicated increasing prevalence over the entire period, and show no sign of decreasing. Cancer and heart disease in particular continue to rise, with cases of heart disease doubling from 1138.2 cases per 100,000 people in 1990 to 2283.4 per 100,000 in 2003. ¶7. (U) The report provided the following data: Cases per 100,000 residents 1990 1995 2003 Pulmonary disorders 31651.0 40340.0 39074.9 Injuries, poisonings and other 6259.9 7006.5 8045.2 external causes Infectious and Parasitic 3022.1 4675.5 3603.9 diseases Of which: Pulmonary Tuberculosis 24.8 39.2 42.9 Syphilis 2.7 150.6 48.7 HIV 0.1 0.1 7.2 Diseases of the skin and 2404.1 4033.2 4268.5 hypodermic cellular tissue Diseases of the musculoskeletal 1848.4 3088.5 4092.4 system and connective tissue Urogenital disorders 1301.8 2475.4 3078.1 Cardiovascular disease 1138.2 1397.1 2283.4 MINSK 00000152 002 OF 004 Psychiatric and behavioral 577.1 1084.6 1364.0 disorders Tumors 476.9 598.7 862.4 Of which are cancerous 264.3 298.6 352.5 Of which in the thyroid 2.8 6.1 11.0 Diseases of the blood, 139.9 193.0 246.9 hematogenic organs and the immune system Congenital malformations and 56.2 75.4 116.7 chromosomal disorders Substance Abuse -------------- ¶8. (U) The report found that alcohol-related morbidity more than doubled from 1995 to 2003, to 285 per 100,000 residents (28,100 total cases). Among women it increased 2.4 times and 4.1 times among teenagers. The number of registered drug abusers rose five times from 1990 to 2003, to 9 per 100,000 (15 per 100,000 for men, 3 per 100,000 for women). In December, the Ministry of Health announced that Belarus has 253,000 registered alcoholics and drug addicts. HIV/AIDS -------------- ¶9. (U) As of January 2004, Belarus had 5,485 registered cases of HIV, with 84 of them having AIDS. As of that date 381 Belarusian had died of AIDS. There were 31 children under 14 with HIV; 23 of them were born to HIV infected mothers. There were 779 children between 15 and 19 with HIV, as well as 1,610 women. The main cause of the spread of HIV is believed to be intravenous drug use. Maternal Health Especially Hard Hit -------------- ¶10. (SBU) CitiHope particularly pointed to negative trends in maternal and children's health, exacerbating the country's population decline. Since 1994, the number of children (under 16) in Belarus has fallen by 600,000 (out of a total population of just under 10 million). In that period the share of children in the total population fell from 22.5% to 16.5%. ¶11. (U) The report states that in 2003, 77.5% of women undergoing their first prenatal exam were diagnosed with a disease. On average, 2.2 medical conditions were found per pregnant woman. This high ratio led to a sharp drop in normal childbirths, to only 28.7% of all births. Anemia was the most common condition, growing from 20.8 cases per 100,000 pregnant women in 1994 to 28.3 cases in ¶2003. In the same period, the number of expectant mothers: with urogenital diseases grew from 10% to 27.2%, resulting in complications in 15.6% of all births; with thyroid conditions grew from 13.3% to 18.6%; with toxemia grew from 7.4% to 10.3%. The number of pregnant women with cardiovascular problems fell from 9.6% to 7.9%, but the number of pregnancies at risk of miscarriage grew from 27.5% in 1997 to 30.2% in 2003. In one area of success, maternal mortality fell from 26 per 100,000 live births in 1994 to 17 per 100,000 in 2003. ¶12. (U) Belarusian women are three to five times more likely than men to become infected with a sexually transmitted disease, although in recent years the incidence of STDs has dropped. The prevalence of syphilis grew 40 times from 1991 to 1996, from 5.2 cases per 100,000, to 210.9 cases. It then fell by 2003 to 48.7 cases. Acute gonorrhea rose from 70.3 cases per 100,000 in 1991 to 130.1 cases in 1994, only to fall again to 60.3 per 100,000 in ¶2003. Some Success Stories in Children's Health -------------- ¶13. (U) The GOB has had some successes, particularly regarding children's health. New equipment and training for medical staff resulted in a drop in infant mortality from 13.2 per 1,000 live births in 1994 to 7.7 in 2003. The main improvement was in reducing infant deaths due to digestive, infectious and parasitic conditions in the first month of life. The GOB was also successful in providing immunizations, with coverage of 98% of all children. From 1994 to 2003 this resulted in a sharp drop in child parasitic and infectious morbidity, from 120,183 per 100,000 children to 7,806. No polio cases were found in Belarus in 2002 or 2003. But Children's General Health Worsening -------------- MINSK 00000152 003 OF 004 ¶14. (U) Despite these successes, children's health overall has worsened. The number of infants born ill or who developed an illness shortly after birth grew from 142.1 per 1,000 live births in 1994 to 214.5 per 1,000 in 2003. Cases of iron deficiency have increased by 50%, leading to 2,024.9 cases of blood or hematogenic disease per 100,000 children in 2003. The incidence of other diseases mostly increased in this period: Cases per 100,000 children 1994 2003 Diseases of the digestive system 10609 11668 Respiratory disease 81164 109684 Mental and behavior disorders 2907.2 4301.3 Chronic pharyngitis, nasal 2200.9 2529.3 pharyngitis, chronic adenoid, and tonsil infection Urogenital diseases 2013.3 2975.5 Musculoskeletal diseases 1288 2796.7 Diseases of the nervous system 1051.9 2282.4 Bronchial asthma 445.7 847.5 Tumors 224.8 464.8 Allergic rhinitis 67.9 179.7 "Sugar" diabetes 39.7 60.9 ¶15. (U) The report concludes, "Child morbidity has grown for all types of disease. The health status of children of all ages is clearly deteriorating. Rising numbers of children are being diagnosed with congenital and hereditary disorders, chronic respiratory diseases, mental conditions, allergies and diseases of the digestive and urogenital systems. A growing proportion of childhood diseases are chronic and recurrent. Newly diagnosed chronic diseases of the internal organs are also becoming more common." The report calls upon the state to become more active in improving the health of the population, to avert a social and demographic crisis. The Demographic Crisis Approaches -------------- ¶16. (U) In many ways, Belarus already faces a demographic crisis. The Belarusian population fell by 49,900 in 2005 (0.5%),to 9,750,200 according to the Ministry of Statistics. This is down from a peak population of 10.24 million in 1993. The GOB expects the population to fall another 2.2%, to 9.567 million, by 2010. A UN report estimated the Belarusian population would fall to 7 million by 2050. ¶17. (U) In the first eleven months of the year there were 82,800 births (up 1,200 from a year before) and 129,000 deaths (up 1,900). The GOB announced that in the past five years the birth rate has fallen by 9.1%, while the death rate has increased 14.3%. Life expectancy for men has fallen to 62.8 years, while it remains at 74.3 years for women. A demographic conference in December concluded that the population is shrinking due to a low birth rate (from socio-economic reasons),increasing incidence of disease, rising alcohol consumption, the high divorce rate, emigration of the educated, and poor diet and exercise. ¶18. (U) Meanwhile the Belarusian population is aging. The GOB announced in August that there are 2.5 million pensioners, roughly 25% of the population. The retiree-to-worker ratio grew from 46 to 60 retirees per 100 workers in the past 15 years. By 2010 the GOB estimates the number of workers will drop from the current 4.303 million to between 4.14 and 4.23 million. This aging of the population will put increasing strain on the country's pension system. One independent economist speculated that the current pension system will collapse in 2007 if it is not reformed. At the other end of the spectrum, the number of schoolchildren has fallen by 18% since 2000. As a result of this trend, in 2005 the GOB closed 48 primary and 42 secondary schools. GOB Efforts to Counter Demographic Drop -------------- ¶19. (U) In an effort to correct this imbalance, in September the Council of Ministers approved a five-year plan on demographic security. This plan aims to achieve a life expectancy of 70 years, raise the birth rate to 9-10 births per 1,000 people (it recently leveled off at 9.1 births),reduce the mortality rate to 12-13 deaths per 1,000 people, and to reduce infant mortality to 6 per 1,000 live births. The GOB also hopes to lower the abortion rate from the current 30 abortions per 1,000 women of reproductive age. ¶20. (U) On February 8, President Lukashenko announced his own views on demography. He stressed that every Belarusian family should MINSK 00000152 004 OF 004 have at least three children. "The most global problem that the country is now facing is that only 10 million people live on our relatively large territory. We may not speak about security if there's no one to protect this land... I am confident that the Belarusian land can feed 30 million people. We currently have one or two children per family on the average. Three is a rare occasion already. We should ensure that each family in Belarus has at least three children. Then we'll have a certain population growth. Can our families and women give birth and have three and more children? Of course, they can," To encourage more births, Lukashenko suggested selling apartments for half price to families with three children, and opening special baby food stores. Comment -------------- ¶21. (U) The general rise in most types of morbidity and the falling population demonstrate that all is not well in Lukashenko's economic paradise. Economic and social service reforms are needed to raise standards of living and health care and correct the negative trends. However, Lukashenko appears to be moving in the opposite direction, clinging to the Soviet-type health care and social welfare system, which has failed to protect the nation's health, and even closing or taking over private medical clinics (reftel). PHLIPOT