Epidemics rage across Russian hinterlands

CHOLERA, diphtheria and anthrax are breaking out across the vast expanse of Russia and other republics of the former Soviet Union. At least 18 people have died of cholera this summer in the southern Russian republic of Dagestan, and four have died of diphtheria in Izhevsk, capital of the Udmurt republic, 570 miles (910 km) east of Moscow.

The epidemics appear to be the worst in the former Soviet Union for many years. However, comparisons with epidemics in the Soviet period are hard to make because of uncertainty over the reliability of Soviet statistics.

Cases of cholera have been reported in places as far apart as Georgia, Tajikistan and the Siberian city of Omsk. In Russia alone, outbreaks have been recorded in 104 locations, according to the Ministry for Civil Defence, Emergencies and Natural Disasters. There are eight cases of cholera in the Moscow region, but officials say the patients are all refugees from Rwanda.

Authorities in the Sverdlovsk region of the Urals recently reported a serious outbreak of diphtheria. In Izhevsk, where 37 people have contracted diphtheria, there are plans to vaccinate 80 per cent of adults and 90 per cent of children by the end of October. Western doctors are advising foreigners intending to live in the former Soviet Union to be vaccinated against diphtheria.

Meanwhile, anthrax has appeared in Armenia, the Crimean peninsula, the Russian republic of Tuva, near the Mongolian border, and the city of Voronezh, south of Moscow. The seven patients in Voronezh are soldiers and members of their families. The authorities say they caught the disease from meat, bought from private traders.

Health authorities say they have the problems under control but in the case of Dagestan's cholera epidemic, the situation is clearly considered dangerous. The Russian government sent Interior Ministry troops to the region last week to prevent the spread of the disease, and medical students have been released early from university to help out.

Yevgeny Belyayev, the Russian health official in charge of handling the crisis, predicted last week that the cholera epidemic would be eliminated by mid- October. According to government statistics, 686 people were ill with cholera last week and 669 were carrying the disease.

Radio Russia reported on 22 August that emergency measures were being taken to suppress cholera in the oil-producing town of Nizhnevartovsk in the Tyumen region of western Siberia. How the disease penetrated Siberia is unknown. But the radio said that managers of oil and gas enterprises had been ordered to check all workers coming from southern regions of Russia.

The precise causes of Dagestan's cholera epidemic are unclear but they appear to be linked to a gradual breakdown of law and order since the Soviet Union's disintegration and the subsequent deterioration of water and health services. The authorities in Dagestan alleged that Muslim pilgrims had brought cholera back from Mecca and Medina but the Saudi government denied this.

Mr Belyayev said that 65 per cent of new cholera cases in Dagestan were caused by unsanitary practices at funeral rites. 'We cannot ban these rites. But we are putting pressure on people to wash their hands in disinfectant and to prepare less food. We are also compiling lists of those who take part,' he said.

One thousand people a day are being tested for cholera in Dagestan and those wanting to leave the republic must produce medical clearance certificates. However, such is the anarchy on Dagestan's borders with Azerbaijan and the Chechen republic, which is trying to secede from Russia, that it has proved impossible to stop people getting out.