TB Monitor International-In Chechen camps, TB stalks refugees
Conditions are 'catastrophic'
TB is soaring in the breakaway republic of Chechnya, with incidence rates estimated at 200 per 100,000 people, according to the Russian Ministry of Public Health.
Among the estimated 180,000 refugees who have fled fighting to neighboring Ingushetia, a tiny republic in the Russian Federation, conditions are "catastrophic." According to several recent press accounts from the war-torn region, Russians are refusing food and medicine to refugees crowded into tent camps as a means of forcing them to leave.
The most recent figures for Ingushetia show the number of new cases detected rose from 65 per 100,000 to 80 per 100,000 between 1997 and 1998, according to the World Health Organization.
Without "an improvement in living conditions for displaced persons, including lessening of overcrowding," conditions in refugee camps in Ingushetia will continue to deteriorate, says Xavier M. Leus, MD, who is head of Emergency and Humanitarian Action at WHO.
Relief agencies are struggling to cope with the situation. After assessing capacity, WHO says it will provide laboratory equipment to Ingushetia and basic training to lab technicians where necessary. WHO and other relief agencies also are working with the Russian Ministry of Public Health to implement a disease surveillance system in Ingushetia.
The Moscow-based All-Russian Center for Disaster Medicine, working in partnership with WHO, has sent two TB experts and three mobile units for TB examination to the affected area, and a temporary dispensary for TB drugs has been established in Chechnya.
In the Sputnik refugee camp, about 5,000 refugees huddle in square, ill-heated, Russian-army-style tents. Many more people take shelter in the cars and buses that brought them to the camp. Rations in the camp amount to less than 10 ounces of bread per person per day.
Camp officials say they are offering free train fares to refugees wishing to resettle "anywhere in the Russian federation" or transport to the empty plains of northern Chechnya, which have been occupied recently by Russian troops, according to a report from The Christian Science Monitor. So far, there have been no takers.
Only about a tenth of all refugees have been stably housed, with the rest crowded into one of six tent camps along the border or in two half-mile-long passengers trains that have been sidelined.
Ingushetia, a tiny impoverished republic whose inhabitants share the same language and culture as those of bordering Chechnya, is one of the poorest regions in the Russian Federation.
Many Ingush citizens, sympathetic to the plight of the Chechens, have taken refugees into their homes and are sheltering them at their own expense. But Ingush officials say the territory of 300,000 people is too poor to withstand the strain of supporting big refugee populations for long.
"This is becoming a huge social danger and an intolerable strain on our economy," says Maj. Tugan Chaponov, police commandant in charge of the Sputnik camp.
The United Nations does not plan to establish a permanent presence in Ingushetia because of the danger to personnel, says Nick Coussidis, who is a United Nations high commissioner for refugees and the leader of the first U.N. team to visit the region since the war began.
Several Red Cross workers and United Nations officials have been killed or kidnapped recently in the region.
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