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Uzbekistan - SOCIETY
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The population of Uzbekistan, estimated in 1994 at about 23 million, is the largest of the Central Asian republics, comprising more than 40 percent of their total population. Growing at a rapid rate, the population is split by ethnic and regional differences. The Russian component of the population shrank steadily in the years after independence.
Relative to the former Soviet Union as a whole, Uzbekistan is still largely rural: roughly 60 percent of Uzbekistan's population lives in rural areas. The capital city is Tashkent, whose 1990 population was estimated at about 2.1 million people. Other major cities are Samarqand (population 366,000), Namangan (308,000), Andijon (293,000), Bukhoro (224,000), Farghona (200,000), and Quqon (182,000).
The population of Uzbekistan is exceedingly young. In the early 1990s, about half the population was under nineteen years of age. Experts expected this demographic trend to continue for some time because Uzbekistan's population growth rate has been quite high for the past century: on the eve of the collapse of the Soviet Union, only Tajikistan had a higher growth rate among the Soviet republics. Between 1897 and 1991, the population of the region that is now Uzbekistan more than quintupled, while the population of the entire territory of the former Soviet Union had not quite doubled. In 1991 the natural rate of population increase (the birth rate minus the death rate) in Uzbekistan was 28.3 per 1,000--more than four times that of the Soviet Union as a whole, and an increase from ten years earlier (see table 2, Appendix).
These characteristics are especially pronounced in the Autonomous Republic of Karakalpakstan (the Uzbek form for which is Qoroqalpoghiston Respublikasi), Uzbekistan's westernmost region. In 1936, as part of Stalin's nationality policy, the Karakalpaks (a Turkic Muslim group whose name literally means "black hat") were given their own territory in western Uzbekistan, which was declared an autonomous Soviet socialist republic to define its ethnic differences while maintaining it within the republic of Uzbekistan. In 1992 Karakalpakstan received republic status within independent Uzbekistan. Since that time, the central government in Tashkent has maintained pressure and tight economic ties that have kept the republic from exerting full independence.
Today, the population of Karakalpakstan is about 1.3 million people who live on a territory of roughly 168,000 square kilometers. Located in the fertile lower reaches of the Amu Darya where the river empties into the Aral Sea, Karakalpakstan has a long history of irrigation agriculture. Currently, however, the shrinking of the Aral Sea has made Karakalpakstan one of the poorest and most environmentally devastated parts of Uzbekistan, if not the entire former Soviet Union.
Because the population of that region is much younger than the national average (according to the 1989 census, nearly three-quarters of the population was younger than twenty-nine years), the rate of population growth is quite high. In 1991 the rate of natural growth in Karakalpakstan was reportedly more than thirty births per 1,000 and slightly higher in the republic's rural areas. Karakalpakstan is also more rural than Uzbekistan as a whole, with some of its administrative regions (rayony ; sing., rayon ) having only villages and no urban centers--an unusual situation in a former Soviet republic.
The growth of Uzbekistan's population was in some part due to in-migration from other parts of the former Soviet Union. Several waves of Russian and Slavic in-migrants arrived at various times in response to the industrialization of Uzbekistan in the early part of the Soviet period, following the evacuations of European Russia during World War II, and in the late 1960s to help reconstruct Tashkent after the 1966 earthquake. At various other times, non-Uzbeks arrived simply to take advantage of opportunities they perceived in Central Asia. Recently, however, Uzbekistan has begun to witness a net emigration of its European population. This is especially true of Russians, who have faced increased discrimination and uncertainty since 1991 and seek a more secure environment in Russia. Because most of Uzbekistan's population growth has been attributable to high rates of natural increase, the emigration of Europeans is expected to have little impact on the overall size and demographic structure of Uzbekistan's population. Demographers project that the population, currently growing at about 2.5 percent per year, will increase by 500,000 to 600,000 annually between the mid-1990s and the year 2010. Thus, by the year 2005 at least 30 million people will live in Uzbekistan.
High growth rates are expected to give rise to increasingly sharp population pressures that will exceed those experienced by most other former Soviet republics. Indeed, five of the eight most densely populated provinces of the former Soviet Union--Andijon, Farghona, Tashkent, Namangan, and Khorazm--are located in Uzbekistan, and populations continue to grow rapidly in all five. In 1993 the average population density of Uzbekistan was about 48.5 inhabitants per square kilometer, compared with a ratio of fewer than six inhabitants per square kilometer in neighboring Kazakstan. The distribution of arable land in 1989 was estimated at only 0.15 hectares per person. In the early 1990s, Uzbekistan's population growth had an increasingly negative impact on the environment, on the economy, and on the potential for increased ethnic tension.
<>Ethnic Composition
Population pressures have exacerbated ethnic tensions. In 1995 about 71 percent of Uzbekistan's population was Uzbek. The chief minority groups were Russians (slightly more than 8 percent), Tajiks (officially almost 5 percent, but believed to be much higher), Kazaks (about 4 percent), Tatars (about 2.5 percent), and Karakalpaks (slightly more than 2 percent). In the mid-1990s, Uzbekistan was becoming increasingly homogeneous, as the outflow of Russians and other minorities continues to increase and as Uzbeks return from other parts of the former Soviet Union. According to unofficial data, between 1985 and 1991 the number of nonindigenous individuals in Uzbekistan declined from 2.4 to 1.6 million.
The increase in the indigenous population and the emigration of Europeans have increased the self-confidence and often the self-assertiveness of indigenous Uzbeks, as well as the sense of vulnerability among the Russians in Uzbekistan. The Russian population, as former "colonizers," was reluctant to learn the local language or to adapt to local control in the post-Soviet era. In early 1992, public opinion surveys suggested that most Russians in Uzbekistan felt more insecure and fearful than they had before Uzbek independence.
The irony of this ethnic situation is that many of these Central Asian ethnic groups in Uzbekistan were artificially created and delineated by Soviet fiat in the first place. Before the Bolshevik Revolution, there was little sense of an Uzbek nationhood as such; instead, life was organized around the tribe or clan (see Entering the Twentieth Century, this ch.). Until the twentieth century, the population of what is today Uzbekistan was ruled by the various khans who had conquered the region in the sixteenth century.
But Soviet rule, and the creation of the Uzbek Soviet Socialist Republic in October 1924, ultimately created and solidified a new kind of Uzbek identity. At the same time, the Soviet policy of cutting across existing ethnic and linguistic lines in the region to create Uzbekistan and the other new republics also sowed tension and strife among the Central Asian groups that inhabited the region. In particular, the territory of Uzbekistan was drawn to include the two main Tajik cultural centers, Bukhoro and Samarqand, as well as parts of the Fergana Valley to which other ethnic groups could lay claim. This readjustment of ethnic politics caused animosity and territorial claims among Uzbeks, Tajiks, Kyrgyz, and others through much of the Soviet era, but conflicts grew especially sharp after the collapse of central Soviet rule.
The stresses of the Soviet period were present among Uzbekistan's ethnic groups in economic, political, and social spheres. An outbreak of violence in the Fergana Valley between Uzbeks and Meskhetian Turks in June 1989 claimed about 100 lives. That conflict was followed by similar outbreaks of violence in other parts of the Fergana Valley and elsewhere. The civil conflict in neighboring Tajikistan, which also involves ethnic hostilities, has been perceived in Uzbekistan (and presented by the Uzbekistani government) as an external threat that could provoke further ethnic conflict within Uzbekistan. Thousands of Uzbeks living in Tajikistan have fled the civil war there and migrated back to Uzbekistan, for example, just as tens of thousands of Russians and other Slavs have left Uzbekistan for northern Kazakstan or Russia. Crimean Tatars, deported to Uzbekistan at the end of World War II, are migrating out of Uzbekistan to return to the Crimea.
Two ethnic schisms may play an important role in the future of Uzbekistan. The first is the potential interaction of the remaining Russians with the Uzbek majority. Historically, this relationship has been based on fear, colonial dominance, and a vast difference in values and norms between the two populations. The second schism is among the Central Asians themselves. The results of a 1993 public opinion survey suggest that even at a personal level, the various Central Asian and Muslim communities often display as much wariness and animosity toward each other as they do toward the Russians in their midst. When asked, for example, whom they would not like to have as a son- or daughter-in-law, the proportion of Uzbek respondents naming Kyrgyz and Kazaks as undesirable was about the same as the proportion that named Russians. (About 10 percent of the Uzbeks said they would like to have a Russian son- or daughter-in-law.) And the same patterns were evident when respondents were asked about preferred nationalities among their neighbors and colleagues at work. Reports described an official Uzbekistani government policy of discrimination against the Tajik minority.
More about the <>Population of Uzbekistan.
Other social factors also define the identities and loyalties of individuals in Uzbekistan and influence their behavior. Often regional and clan identities play an important role that supersedes specifically ethnic identification. In the struggle for political control or access to economic resources, for example, regional alliances often prevail over ethnic identities. A United States expert has identified five regions--the Tashkent region, the Fergana Valley, Samarqand and Bukhoro, the northwest territories, and the southern region--that have played the role of a power base for individuals who rose to the position of first secretary of the Communist Party of Uzbekistan. Often clan-based, these regional allegiances remain important in both the politics and the social structure of post-Soviet Uzbekistan.
As with ethnic patterns and boundaries of post-Soviet Uzbekistan, the dominant native language, Uzbek, is in many ways a creation of the Soviet state. Indeed, until the beginning of the Soviet period, the languages spoken among the native population presented a colorful and diverse mosaic. Under Soviet rule, officially at least, this mosaic was replaced by Uzbek, which almost overnight became the official language of the Turkic population of the republic. But Russian, which at the same time was declared the "international language" of Uzbekistan, was favored above even Uzbek in official usage. Many Russian words made their way into Uzbek because Russian was the language of higher education, government, and economic activity throughout the Soviet era. In the 1980s, Uzbeks began a strong effort to eliminate the recent Russian borrowings from the language. The Latin alphabet was introduced to begin a gradual process of replacing the Cyrillic alphabet. But in the mid-1990s Russian still was widely used in official and economic circles.
<>Linguistic Background
<>Influences in the Soviet Period
<>Language in the 1990s
<>Literature
Uzbek is a Turkic language of the Qarluq family, closely related to Uyghur and Kazak. Although numerous local dialects and variations of the language are in use, the Tashkent dialect is the basis of the official written language. The dialects spoken in the northern and western parts of Uzbekistan have strong Turkmen elements because historically many Turkmen lived in close proximity to the Uzbeks in those regions. The dialects in the Fergana Valley near Kyrgyzstan show some Kyrgyz influence. Especially in the written dialect, Uzbek also has a strong Persian vocabulary element that stems from the historical influence of Iranian culture throughout the region (see Early History, this ch.).
Uzbek has a relatively short history as a language distinct from other Turkic dialects. Until the establishment of the Soviet republic's boundaries in the 1920s, Uzbek was not considered a language belonging to a distinct nationality. It was simply a Turkic dialect spoken by a certain segment of the Turkic population of Central Asia, a segment that also included the ruling tribal dynasties of the various states. The regional dialects spoken in Uzbekistan today reflect the fact that the Turkic population of Southern Central Asia has always been a mixture of various Turkic tribal groups (see Ethnic Groups, ch. 1; Social Structure, ch. 2; Population, ch. 5). When the present-day borders among the republics were established in 1929, all native peoples living in Uzbekistan (including Tajiks) were registered as Uzbeks regardless of their previous ethnic identity.
Until 1924 the written Turkic language of the region had been Chaghatai, a language that had a long and brilliant history as a vehicle of literature and culture after its development in the Timurid state of Herat in the late fifteenth century. Chaghatai also was the common written language of the entire region of Central Asia from the Persian border to Eastern Turkestan, which was located in today's China. The language was written in the Arabic script and had strong Persian elements in its grammar and vocabulary. Experts identify the Herat writer Ali Shir Nava'i as having played the foremost role in making Chaghatai a dominant literary language.
In modern Uzbekistan, Chaghatai is called Old Uzbek; its origin in Herat, which was an enemy state of the Uzbeks, is ignored or unknown. Use of the language was continued by the Uzbek khanates that conquered the Timurid states. Some early Uzbek rulers, such as Mukhammad Shaybani Khan, used Chaghatai to produce excellent poetry and prose. The seventeenth-century Khivan ruler Abulgazi Bahadur Khan wrote important historical works in Chaghatai. However, all of those writers also produced considerable literature in Persian. Chaghatai continued in use well into the twentieth century as the literary language of Central Asia. Early twentieth-century writers such as Fitrat wrote in Chaghatai.
In the late nineteenth century and early twentieth century, Chaghatai was influenced by the efforts of reformers of the Jadidist movement, who wanted to Turkify and unite all of the written languages used in the Turkic world into one written language (see The Russian Conquest, this ch.). These efforts were begun by the Crimean Tatar Ismail Gaspirali (Gasprinskiy in Russian), who advocated this cause in his newspaper Terjuman (Translator). Gaspirali called on all the Turkic peoples (including the Ottoman Turks, the Crimean and Kazan Tatars, and the Central Asians) to rid their languages of Arabic, Persian, and other foreign elements and to standardize their orthography and lexicon. Because of this effort, by the early 1920s the Turkic languages of Central Asia had lost some of the Persian influence.
Unfortunately for the reformers and their efforts to reform the language, following the national delimitation the Soviet government began a deliberate policy of separating the Turkic languages from each other. Each nationality was given a separate literary language. Often new languages had to be invented where no such languages had existed before. This was the case for Uzbek, which was declared to be a continuation of Chaghatai and a descendant of all of the ancient Turkic languages spoken in the region. In the initial stage of reform, in 1928-30, the Arabic alphabet was abandoned in favor of the Latin alphabet. Then in 1940, Cyrillic was made the official alphabet with the rationale that sharing the Arabic alphabet with Turkey might lead to common literature and hence a resumption of the Turkish threat to Russian control in the region.
Because of this artificial reform process, the ancient literature of the region became inaccessible to all but specialists. Instead, the use of Russian and Russian borrowings into Uzbek was strongly encouraged, and the study of Russian became compulsory in all schools. The emphasis on the study of Russian varied at various times in the Soviet period. At the height of Stalinism (1930s and 1940s), and in the Brezhnev period (1964-82), the study of Russian was strongly encouraged. Increasingly, Russian became the language of higher education and advancement in society, especially after Stalin orchestrated the Great Purge of 1937-38, which uprooted much indigenous culture in the non-Slavic Soviet republics. The language of the military was Russian as well. Those Uzbeks who did not study in higher education establishments and had no desire to work for the state did not make a great effort to study Russian. As a result, such people found their social mobility stifled, and males who served in the armed forces suffered discrimination and persecution because they could not communicate with their superiors. This communication problem was one of the reasons for disproportionate numbers of Uzbeks and other Central Asians in the noncombat construction battalions of the Soviet army.
The official linguistic policy of the Karimov government has been that Uzbek is the language of the state, and Russian is the second language. Residents of Uzbekistan are required to study Uzbek to be eligible for citizenship. Following similar decisions in Azerbaijan and Turkmenistan, in September 1993 Uzbekistan announced plans to switch its alphabet from Cyrillic, which by that time had been in use for more than fifty years, to a script based on a modified Latin alphabet similar to that used in Turkey. According to plans, the transition will be complete by the year 2000. The primary reason for the short deadline is the urgent need to communicate with the outside world using a more universally understood alphabet. The move also has the political significance of signaling Uzbekistan's desire to break away from its past reliance on Russia and to limit the influence of Muslim states such as Saudi Arabia and Iran, which use the Arabic alphabet. A major project is under way to eradicate Russian words from the language and replace these words with "pure" Turkic words that have been borrowed from what is believed to be the ancient Turkic language of Inner Asia. At the same time, Uzbekistan's linguistic policies also are moving toward the West. In the early 1990s, the study of English has become increasingly common, and many policy makers express the hope that English will replace Russian as the language of international communication in Uzbekistan.
Uzbekistan's literature suffered great damage during the Stalinist purges of the 1930s; during that period, nearly every talented writer in the republic was purged and executed as an enemy of the people. Prior to the purges, Uzbekistan had a generation of writers who produced a rich and diverse literature, with some using Western genres to deal with important issues of the time. With the death of that generation, Uzbek literature entered a period of decline in which the surviving writers were forced to mouth the party line and write according to the formulas of socialist realism. Uzbek writers were able to break out of this straitjacket only in the early 1980s. In the period of perestroika and glasnost , a group of Uzbek writers led the way in establishing the Birlik movement, which countered some of the disastrous policies of the Soviet government in Uzbekistan. Beginning in the 1980s, the works of these writers criticized the central government and other establishment groups for the ills of society.
A critical issue for these writers was the preservation and purification of the Uzbek language. To reach that goal, they minimized the use of Russian lexicon in their works, and they advocated the declaration of Uzbek as the state language of Uzbekistan. These efforts were rewarded in 1992, when the new national constitution declared the Uzbek language to be the state language of the newly independent state. At the same time, however, some of these writers found themselves at odds with the Karimov regime because of their open criticism of post-Soviet policies.
Islam is by far the dominant religious faith in Uzbekistan. In the early 1990s, many of the Russians remaining in the republic (about 8 percent of the population) were Orthodox Christians. An estimated 93,000 Jews also were present. Despite its predominance, Islam is far from monolithic, however. Many versions of the faith have been practiced in Uzbekistan. The conflict of Islamic tradition with various agendas of reform or secularization throughout the twentieth century has left the outside world with a confused notion of Islamic practices in Central Asia. In Uzbekistan the end of Soviet power did not bring an upsurge of a fundamentalist version of Islam, as many had predicted, but rather a gradual reacquaintance with the precepts of the faith.
<>Islam in the Soviet Era
<>Islamic Fundamentalism
<>Mainstream Islam in the 1990s
Soviet authorities did not prohibit the practice of Islam as much as they sought to coopt and utilize religion to placate a population that often was unaware of the tenets of its faith. After its introduction in the seventh century, Islam in many ways formed the basis of life in Uzbekistan. The Soviet government encouraged continuation of the role played by Islam in secular society. During the Soviet era, Uzbekistan had sixty-five registered mosques and as many as 3,000 active mullahs and other Muslim clerics. For almost forty years, the Muslim Board of Central Asia, the official, Soviet-approved governing agency of the Muslim faith in the region, was based in Tashkent. The grand mufti who headed the board met with hundreds of foreign delegations each year in his official capacity, and the board published a journal on Islamic issues, Muslims of the Soviet East .
However, the Muslims working or participating in any of these organizations were carefully screened for political reliability. Furthermore, as the Uzbekistani government ostensibly was promoting Islam with the one hand, it was working hard to eradicate it with the other. The government sponsored official antireligious campaigns and severe crackdowns on any hint of an Islamic movement or network outside of the control of the state.
Moscow's efforts to eradicate and coopt Islam not only sharpened differences between Muslims and others. They also greatly distorted the understanding of Islam among Uzbekistan's population and created competing Islamic ideologies among the Central Asians themselves.
In light of the role that Islam has played throughout Uzbekistan's history, many observers expected that Islamic fundamentalism would gain a strong hold after independence brought the end of the Soviet Union's official atheism. The expectation was that an Islamic country long denied freedom of religious practice would undergo a very rapid increase in the expression of its dominant faith. President Karimov has justified authoritarian controls over the populations of his and other Central Asian countries by the threat of upheavals and instability caused by growing Islamic political movements, and other Central Asian leaders also have cited this danger.
In the early 1990s, however, Uzbekistan did not witness a surge of Islamic fundamentalism as much as a search to recapture a history and culture with which few Uzbeks were familiar. To be sure, Uzbekistan is witnessing a vast increase in religious teaching and interest in Islam. Since 1991, hundreds of mosques and religious schools have been built or restored and reopened. And some of the Islamic groups and parties that have emerged might give leaders pause.
For the most part, however, in the first years of independence Uzbekistan is seeing a resurgence of a more secular Islam, and even that movement is in its very early stages. According to a public opinion survey conducted in 1994, interest in Islam is growing rapidly, but personal understanding of Islam by Uzbeks remains limited or distorted. For example, about half of ethnic Uzbek respondents professed belief in Islam when asked to identify their religious faith. Among that number, however, knowledge or practice of the main precepts of Islam was weak. Despite a reported spread of Islam among Uzbekistan's younger population, the survey suggested that Islamic belief is still weakest among the younger generations. Few respondents showed interest in a form of Islam that would participate actively in political issues. Thus, the first years of post-Soviet religious freedom seem to have fostered a form of Islam related to the Uzbek population more in traditional and cultural terms than in religious ones, weakening Karimov's claims that a growing widespread fundamentalism poses a threat to Uzbekistan's survival. Available information suggests that Islam itself would probably not be the root cause of a conflict as much as it would be a vehicle for expressing other grievances that are far more immediate causes of dissension and despair. Experts do not minimize the importance of Islam, however. The practice of the Islamic faith is growing in Uzbekistan, and the politicization of Islam could become a real threat in the future.
In developing a national education system to replace the centralized education prescriptions of Moscow, Uzbekistan has encountered severe budgeting shortfalls. The education law of 1992 began the process of theoretical reform, but the physical base has deteriorated, and curriculum revision has been slow.
Education is supervised by two national agencies, the Ministry of People's Education (for primary, secondary, and vocational education) and the Ministry of Higher Education (for postsecondary education). In 1993 Uzbekistan had 9,834 preschool centers, most of which were run by state enterprises for the children of their employees. An estimated 35 percent of children ages one to six attend such schools, but few rural areas have access to preschools. In the early 1990s, enterprises began closing schools or transferring them to direct administration of the Ministry of People's Education. A modest government construction program adds about 50,000 new places annually--a rate that falls far short of demand. Although experts rate most of Uzbekistan's preschools as being in poor condition, the government regards them as contributing vitally to the nutrition and education of children, especially when both parents work, a situation that became increasingly frequent in the 1990s.
In 1993 enrollment in regular and vocational schools, which covered grades one through eleven (ages six through sixteen), was 4.9 million of the estimated 5.7 million children in that age-group. Because of funding shortages, in 1993 the period of compulsory education was shortened from eleven to nine years. The infrastructure problem of schools is most serious at the primary and secondary levels; the government categorizes 50 percent of school buildings as unsuitable, and repair budgets are inadequate. Construction of new schools has been delayed because the boards of capital construction of the two education ministries do not have direct control over contractor pricing or construction practices at local levels. School nutritional levels often are below state standards; an estimated 50 percent of students do not receive a hot meal. In 1992 about 5,300 of Uzbekistan's 8,500 schools had double shifts; because most of these schools were rural, this situation affected only 25 percent of students, however.
In 1993 an estimated 220,000 students were in vocational training programs, with about 100,000 students graduating annually from 440 schools. Working in close cooperation with local employers, the schools choose from 260 trades to offer instruction conforming with industrial needs. In the post-Soviet era, vocational curricula were modified to accommodate an upsurge in light industry. Experts agree that, as the national economy diversifies and expands, the vocational program must expand its coverage of key industries and streamline its organization, which suffered disorientation in its transition from the rigid Soviet system.
In 1992 some 321,700 students were enrolled in institutions of higher learning; of those, about 43 percent were in evening or correspondence courses. The enrollment represented about 19 percent of the seventeen to twenty age-group, a decrease from the more than 23 percent reported in 1990. In 1992 enrollment declined because an entrance examination was used for the first time, Russian emigration continued, and the economy's demand for college graduates fell. Experts predicted that the government would restrict admittance levels until its policies succeed in expanding the economy. Fifty-three institutions of higher learning, many with productive research programs, were active in 1993. Higher education is hindered, however, by a shortage of laboratories, libraries, computers and data banks, and publishing facilities to disseminate research findings.
The state higher education system includes three universities, located at Nukus, Samarqand, and Tashkent. Tashkent State University, which has 19,300 students and 1,480 teachers, is the largest university in Central Asia; it has sixteen full departments, including three devoted to philology and one to Asian studies. Some twenty research institutes offer courses in specialized areas of medicine, veterinary science, and industry and technology. Another thirty institutes of higher learning offer postsecondary studies in medicine, agriculture, teaching, engineering, industrial technology, music, theater, economics, law, pharmacy, and political science; seventeen of the latter category are located in Tashkent.
<>Curriculum
<>Instruction
In the early 1990s, the greatest controversy in curriculum policy was which language should be used for teaching in state schools. In 1992 Uzbek and the other Central Asian languages were made the official languages of instruction, meaning that Uzbek schools might use any of five Central Asian languages or Russian as their primary language. Uzbek and Russian language courses are taught in all schools. After independence, a new emphasis was placed on courses in Uzbek history and culture and on increasing the short supply of textbooks in Uzbek in many fields. For a time, the Karimov regime closed Samarqand University, which taught in Tajik, as part of a broader crackdown on the country's Tajik minority.
The expansion of curricula, including the addition of courses in French, Arabic, and English, has placed new stress on a limited supply of teachers and materials. In the mid-1990s, a major curriculum reform was underway to support the post-Soviet economic and social transformation. Among the changes identified by Western experts are a more commercial approach to the mathematics curriculum, more emphasis in economics courses on the relationship of capital to labor, more emphasis in social science courses on individual responsibility for the environment, and the addition of entirely new subjects such as business management. Because such changes involve new materials and a new pedagogical approach by staff, the reform period is estimated at ten to fifteen years.
In the early 1990s, the thirty-six technical schools and six teacher colleges produced about 20,000 new teachers annually for the primary and secondary levels, and another 20,000 for higher education. In 1993 the ratio of staff to students was 1 to 12 in preschool institutions, 1 to 11.5 in primary and secondary schools, 1 to 12 in vocational schools, and 1 to 6.8 in institutions of higher education. The range of these ratios indicates that Uzbekistan prepares too many teachers for the needs of the existing student population, but experts do not consider the existing staff adequately trained to deal with upcoming curriculum changes and with the need to teach in Uzbek.
Experts have noted that the teacher training program must be reduced to concentrate government funds on a few high-quality research and training centers. Such a shift would free resources for material support, salaries, and administrative and supervisory personnel, all in short supply in the mid-1990s. Currently, teachers for preschool and grades one through four are trained at technical schools; those for grades five through eleven must train at the university level. The technical school program is five years beginning after grade nine, and the university program is four years beginning after grade eleven. Both programs combine pedagogical and general courses.
In the early 1990s, the government made significant improvements in teacher salaries and benefits. Many top teachers were lost to other sectors, however, because salaries still were not competitive with those elsewhere in the economy. In higher education, salaries were competitive with those in other occupations in Uzbekistan but not with those on the international teaching market.
As Uzbekistan struggled to revise its Soviet-era health care system, the physical condition of its population was exacerbated by severe environmental conditions that were inherited from the Soviet period and were not addressed effectively in the first years of independence. Key health indicators showed a correlation between the high level of air and water pollution and health problems (see table 5, Appendix).
In the mid-1990s, Uzbekistan continued a health care system in which all hospitals and clinics were state owned and all medical personnel were government employees. Although health care ostensibly was free of change, this rarely was the case in practice. In the early 1990s, some private medical practices have supplemented state facilities to a small extent. In 1993 Uzbekistan undertook a program of privatization that began with the introduction of health insurance and continued with the gradual privatization of health care facilities, which is optimistically projected at about three years. Under the new program, the government would require private health facility owners to maintain the same standards as state facilities and to offer minimum free health care for the indigent. In the first few years of the program, however, only pharmacies and small clinics were privatized. Plans for 1995 called for privatizing twenty-four dental clinics and twelve prenatal clinics. In 1995 no plan provided for government divestiture of medium-sized health care facilities.
The government disburses its funds through the national Ministry of Health, through the health agencies of local and province governments, and through specialized facilities serving ministries and state enterprises. Treatment in the last two categories is generally better than in general state facilities because staff salaries and work conditions are better. As in the Soviet system, special facilities exist for top political, cultural, and scientific dignitaries. In 1994 some US$79 million, or 11.1 percent of the annual budget, was allocated for health care. Of that amount, about 60 percent went to state hospitals, 30 percent to outpatient clinics, and less than 6 percent to medical research.
Despite marked growth throughout the Soviet era, the public health care system in Uzbekistan is not equipped to deal with the special problems of a population long exposed to high levels of pollutants or with other health problems. Although the numbers of hospitals and doctors grew dramatically under Soviet rule--from almost no doctors in 1917 to 35.5 doctors per 10,000 population and to 1,388 hospitals and clinics per 10,000 population in 1991--the increasing incidence of serious disease raises questions about the effectiveness of care by these doctors and their facilities.
In 1993 a total of 16.8 million patients were treated, of whom 4.8 million were treated in hospitals and about 275,000 in outpatient clinics--meaning that the vast majority of patients received treatment only at home. Experts predicted that this trend would continue until the level of care in government facilities improved substantially.
Among the serious problems plaguing health care delivery are the extremely short supply of vaccines and medicines in hospitals; the generally poor quality of medical training; and corruption in the medical profession, which exacerbates the negative impact of changes in the system for the average patient and diverts treatment to favored private patients. According to a 1995 private study, the state system provided less than 20 percent of needed medicine and less than 40 percent of needed medical care, and budget constraints limited salaries for medical professionals. In 1990 the percentage of children receiving vaccines for diphtheria, pertussis, measles, and polio averaged between 80 and 90 percent. That statistic fell sharply in the first years of independence; for example, in 1993 fewer than half the needed doses of measles vaccine were administered.
The Ministry of Health has recognized that Uzbekistan has a serious narcotics addiction problem; illicit drug use reportedly stabilized between 1994 and 1996. The seven substance abuse rehabilitation clinics treat both alcoholism and narcotics abuse. The Ministry of Health has identified the following as its priorities, should expansion of services become possible: improvement of maternal and infant health care, prevention of the spread of infectious disease, and improvement of environmental conditions leading to health problems. In 1995 Uzbekistan was receiving aid from the United States Agency for International Development (AID), the United Nations Children's Fund (UNICEF), and the World Health Organization (WHO) for improving infant and maternal health care and for storage and distribution of vaccines.
<>Health Conditions
According to experts, the most immediate impact of the environmental situation in Uzbekistan is on the health condition of the population (see Environmental Problems, this ch.). Although it is difficult to establish a direct cause and effect between environmental problems and their apparent consequences, the cumulative impact of these environmental problems in Uzbekistan appears to have been devastating. Frequently cited in Uzbekistan's press are increasing occurrences of typhoid, paratyphoid, and hepatitis from contaminated drinking water; rising rates of intestinal disease and cancers; and increased frequency of anemia, dystrophy, cholera, dysentery, and a host of other illnesses. One Russian specialist includes among the ailments "lag in physical development," especially among children. According to this observer, sixty-nine of every 100 adults in the Aral Sea region are deemed to be "incurably ill." In 1990 life expectancy for males in all of Uzbekistan was sixty-four years, and for females, seventy years. The average life span in some villages near the Aral Sea in Karakalpakstan, however, is estimated at thirty-eight years.
In the early 1990s, only an estimated 30 percent of women in Uzbekistan practiced contraception of any kind. The most frequently used method was the intrauterine device, distribution of which began in a government program introduced in 1991. In 1991 the average fertility rate was 4.1 children per woman, but about 200,000 of the women in the childbearing age range have ten or more children.
Infant mortality increased by as much as 49 percent between 1970 and 1986 to an average of 46.2 deaths per 1,000 live births. In 1990 the average rate of mortality before age one for the entire country was sixty-five deaths per 1,000 live births. In the mid-1990s, official data estimated the level of infant mortality in parts of Karakalpakstan at 110 per 1,000 live births; unofficial estimates put the level at twice that figure. In 1992 the national maternal mortality rate was 65.3 per 100,000 live births, with considerably higher rates in some regions.
According to the WHO, Uzbekistan reported one case of acquired immune deficiency syndrome (AIDS) in 1992, one in 1993, and none in 1994. No treatment centers or AIDS research projects are known to exist in Uzbekistan.
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