Health Risks
OVERVIEW
Water-borne diseases, diarrheal diseases, and malaria are the three main concerns for the project area. The resettlement plan will bring together people, many vulnerable to disease, creating denser living conditions. The higher concentration could bring novel infections, decreased sanitation levels, and greater incidences of disease.
Water-borne diseases, diarrheal diseases, and malaria are the three main concerns for the project area. The resettlement plan will bring together people, many vulnerable to disease, creating denser living conditions. The higher concentration could bring novel infections, decreased sanitation levels, and greater incidences of disease.
MALARIA
Malaria rates have been slowly declining in the region, due to increased attention paid to mosquito breeding grounds and a national, free vaccination program with accompanying free treatment. Since implementation of the program, levels have decreased from epidemic rates. However, in some areas the malaria rates, while still low, have begun to fluctuate and slowly rise. It is unclear if this is due to the civil unrest in the area (causing many people to leave their villages and enter new populations), or other environmental factors. DAMMING Damming will affect the shore of the Tigris river. It is noted that due to the precipitation characteristics of the area, the water levels will recede, both in the reservoir and along the shore, several times throughout the year. This will expose alluvial mineral deposits and gravel. As construction on the project will have immense needs, these deposits may be used in construction. Removing the alluvial mineral deposits or gravel along the shore may create areas where puddles can form during low water level states. As well, removing the gravel could allow these puddles to combine, thus allowing more water to accumulate, and allowing each deposit to persist for longer periods of time. Both of these factors create optimal breeding areas for several harmful insects, including mosquitoes, which are the vector for the much-dreaded malaria, which this region was only recently getting under control. |
INTESTINAL & DIARRHEAL DISEASES
Intestinal diseases are by far the biggest concern for the project area, with diarrhea being a chief issue, as noted in the 2005 RAP overview. Burcella and tuberculosis infections are high, and Hepatitis A & B are common as well. Infections of typhoid, dysentery, and paratyphoid are frequent in this area. These infections are generally associated with inadequate water supply (including drinking water), sanitation (waste water treatment) and personal hygiene.
In 2000, 60% of the population in rural areas did not have a toilet and 22% did not have pipe water. There are also few health services in the area to offer advice or treatment for any of these chronic infections. There is no hospital in the reservoir area and only 16 of the 199 affected settlements have a permanent health unit. Many other settlements rely only on mobile health units.
VULNERABLE POPULATIONS
It is noted quite clearly in the report that the health of elderly populations is known to be very adversely affected by resettlement. Turkey has experience with resettling peoples, and it is likely this information is from close-at-hand experience. The significant changes to living conditions and livelihood resettlers will face are likely to have both physical and mental health effects. Of course, the elderly and the other vulnerable populations (those who suffer illnesses and other disabilities) will be most strongly impacted by any difficult change.
Intestinal diseases are by far the biggest concern for the project area, with diarrhea being a chief issue, as noted in the 2005 RAP overview. Burcella and tuberculosis infections are high, and Hepatitis A & B are common as well. Infections of typhoid, dysentery, and paratyphoid are frequent in this area. These infections are generally associated with inadequate water supply (including drinking water), sanitation (waste water treatment) and personal hygiene.
In 2000, 60% of the population in rural areas did not have a toilet and 22% did not have pipe water. There are also few health services in the area to offer advice or treatment for any of these chronic infections. There is no hospital in the reservoir area and only 16 of the 199 affected settlements have a permanent health unit. Many other settlements rely only on mobile health units.
VULNERABLE POPULATIONS
It is noted quite clearly in the report that the health of elderly populations is known to be very adversely affected by resettlement. Turkey has experience with resettling peoples, and it is likely this information is from close-at-hand experience. The significant changes to living conditions and livelihood resettlers will face are likely to have both physical and mental health effects. Of course, the elderly and the other vulnerable populations (those who suffer illnesses and other disabilities) will be most strongly impacted by any difficult change.
Mitigation Proposed by EIA
The EIA report mentions a few key points to mitigate health-specific issues that occur during the project.
The resettlement program includes construction of new health services, which is essential as many previous villages lacked basic services other than electricity and access to an elementary school. Also promised to relocatees is better home infrastructure (including a new home altogether), and indoor plumbing and water services. Giving the villagers access to proper sanitation equipment and water supplies should help decrease diseases currently problematic in the area. However, water quality from the new reservoir would be less adequate for human consumption under high yearly draw-downs. This is because of a reduced dilution factor of untreated waste water being released upstream, higher concentrations of minerals resulting from upstream irrigation, as well as presence of decaying vegetation. The monitoring that is mentioned in the report will focus on only the resettled people, and possibly those peripherally affected (such as traders, or service workers). It is not mentioned specifically what will be monitored, however, it does not that "specific psychological and social guidance" should be provided. Also noted is that region and local NGOs should be associated with appraising the results of the monitoring, and determining what action should be taken. There is no mention of which specific NGOs will be involved, and what action should be taken if a problem is detected. Malaria cases are also proposed to be monitored, but only within 1KM around the reservoir area. The effects of the damming, however, are likely to be greater than this, as the Tigris river, as it intersects Turkey, passed a large region. The monitoring is mentioned to be carried out regularly, though a specific time frame is not mentioned. |
Coordinates of Ilisu Dam Area: 37.5312° N, 41.8497° E. Retrieved from Google maps.
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The report mentions "other health indicators" to be monitored, analyzed, and reported to "responsible entities" if they are found to be caused directly by the project. A time frame, geographical region or population is not mentioned concerning these health indicators.
Critique of Proposed Mitigation Plans
Concerning malaria control, there is no mention of what should be done regarding the alluvial deposits or rising and falling water levels that would lead to more mosquito breeding grounds. Presumably, Turkey should continue with it's vaccination program, but will this be enough as new pools of water exacerbate the insect populations? Moreover the monitoring of malaria within a 1KM buffer zone seems insufficient.
It should be noted that in Turkey, pharmaceuticals (except those necessary for malaria vaccination and treatment) must be paid at full cost. The wider population of the affected areas survive on a very low income. Survey results mention that most people do consult health services when they are available in the region, but the greater majority cannot afford the actual treatment. This leaves many treatable illnesses endemic in the area, allowing for spread to a greater population and a chronic problem. Resettling the population and building new health services seems unlikely to be of much benefit in this regard.
Furthermore, many issues were raised but no mitigation strategies were proposed. This includes no mention of construction noise in this lengthy project (which has already run much longer than it was intended to), and no mention of the possible air-quality declines in and around the dam site or new villages. There is no reference to potential health problems in the newly created and much denser living areas, or what will be done if a problem is found to arise. There is specific mention that the resettlement and project will harm the older and more vulnerable population members but no mitigation measures are proposed.
Finally no geological area, no timeline and few responsible parties are defined in the mitigation measures. Moreover it is unclear if the few responsible agencies listed have actually agreed to cooperate.
It should be noted that in Turkey, pharmaceuticals (except those necessary for malaria vaccination and treatment) must be paid at full cost. The wider population of the affected areas survive on a very low income. Survey results mention that most people do consult health services when they are available in the region, but the greater majority cannot afford the actual treatment. This leaves many treatable illnesses endemic in the area, allowing for spread to a greater population and a chronic problem. Resettling the population and building new health services seems unlikely to be of much benefit in this regard.
Furthermore, many issues were raised but no mitigation strategies were proposed. This includes no mention of construction noise in this lengthy project (which has already run much longer than it was intended to), and no mention of the possible air-quality declines in and around the dam site or new villages. There is no reference to potential health problems in the newly created and much denser living areas, or what will be done if a problem is found to arise. There is specific mention that the resettlement and project will harm the older and more vulnerable population members but no mitigation measures are proposed.
Finally no geological area, no timeline and few responsible parties are defined in the mitigation measures. Moreover it is unclear if the few responsible agencies listed have actually agreed to cooperate.