Nicolas Guigas, what are the priority focuses for Swiss cooperation in Tajikistan?
Health, access to drinking water, development of the private sector and promotion of the rule of law are the four priority areas formulated in the Swiss Cooperation Strategy Central Asia 2012–2015. In addition, water management and the prevention of conflict and natural disasters linked to water management are also main priorities for the SDC in three of the Central Asian countries (Kyrgyzstan, Uzbekistan and Tajikistan). Furthermore, Switzerland supports artistic and cultural production in Tajikistan and the whole of Central Asia.
On the subject of health, what major advances have been made over the last 15 years?
During the Soviet Union, the Tajik Soviet Socialist Republic was the poorest republic in the USSR and received substantial aid from Moscow, in particular for the healthcare system, which was heavily subsidised. This enabled Tajikistan to provide an acceptable level of healthcare to its population at an affordable price. However, this healthcare system, which was based on a network of specialist hospitals, was rather costly.
At the fall of the Soviet Union, Tajikistan's economy, like those of the other Soviet republics, collapsed and the payments from Moscow were suddenly cut off. During the ensuing civil war, many of the country's infrastructures were destroyed or damaged and many qualified workers fled the country to escape the fighting and hardship. At the end of the war, the country and its healthcare system were falling into ruin.In 1997, Tajikistan's GDP per inhabitant was just a quarter of what it had been in 1988. Health indicators were catastrophic.
It was not possible to recreate a functioning healthcare network like that of the Soviet era with the few human and financial resources that remained. With the support of development partners, in particular the SDC, the government of Tajikistan has developed a decentralised healthcare system and networks of family doctors. This system has many advantages: it is low-cost, focuses on prevention and the early detection of health problems, and reaches poor and isolated rural communities.
At the same time, hundreds of health facilities have been rebuilt or renovated and furnished with basic medical equipment. More than 400 doctors and 700 nurses have been trained to practise this type of local medical care. The SDC also supported the Tajik State Medical University in the development of a curriculum that meets international standards.
Whereas 15 years ago, the vast majority of the population had no access to any healthcare at all aside from the services provided by international emergency relief, today over a quarter of the population benefits from these new structures. There is still a long way to go, however.In particular, the government of Tajikistan urgently needs to increase the budget earmarked for healthcare expenditure. To do this, however, requires the creation of more wealth and a broader tax base, in particular through development of the private sector.
So that is why Switzerland is also focusing on the development of the private sector in Tajikistan. In which areas could the country best position itself?
Tajikistan is a mountainous country (93% of its territory is mountainous and Mount Somoni – formerly known as Communism Peak – is nearly 7,500 m high). The people are friendly and welcoming and the country boasts magnificent wild landscapes and a culture that goes back thousands of years. It therefore has huge potential as a tourist destination.
Unfortunately, Tajikistan is a country unknown outside of the former USSR. I remember in 2008, when I took the plane in Geneva to be posted in Dushanbe, the check-in assistant asked where Tajikistan was because she'd never heard of the country. In the ten years she had worked at the airport, she couldn't remember having seen a passenger going there. When I told her that Tajikistan was a republic of the former Soviet Union north of Afghanistan, she replied: "Oh, but it must be really dangerous going there!"Actually it isn't. If you behave in a sensible, safe manner, Tajikistan is a very safe country with low criminality.
Thanks to its long, hot summers, Tajikistan produces fruit and vegetables of outstanding quality, such as Fergana Valley apricots and mountains of melons of all shapes and sizes. There is a great deal of potential for exporting this produce as fresh fruit, dried fruit and fruit juice, in particular to the other former Soviet republics, where the climate is not as good for fruit-growing.
Tajikistan is a big cotton producer and thanks to low labour costs has developed a textile industry specialising in certain niche markets. With the creation of the Eurasian Customs Union, currently made up of Belarus, the Russian Federation and Kazakhstan, and probably soon to include Kyrgyzstan and Tajikistan, the country could serve as a production base for the world textile industry and would thus benefit from preferential tariffs to sell its products to the Customs Union.
Turning to the issue of water, what fundamental changes does access to drinking water mean for people's daily lives?
Under the Soviet Union, the urban population had constant access to drinking water for next to nothing since the distribution costs were heavily subsidised. For example, people in Dushanbe drank water straight from the tap like most Swiss people do nowadays! After the fall of the Soviet Union and the civil war, these distribution systems were no longer maintained and fell into disrepair. In Khujand, the country's second-largest city, only 75% of households were connected to the water supply network in 2005 and these only had water of poor quality for 8–12 hours per day, which had to be boiled before drinking. Of course nobody was prepared to pay for such a service when they had been able to get water any time for practically nothing in the past.
The SDC, in partnership with the European Bank for Reconstruction and Development (EBRD), provided funding and technical support for the renovation of the system to Vodacanal, the municipal water company in Khujand. Today, the whole population of the city, some 165,000 people, have access to drinking water 24 hours a day. Metres indicating exact water consumption have been installed in every household. These have increased people's awareness of the problems linked to wastage and allowed water consumption to be reduced from 680–465 litres per person between 2005 and 2013. The consumers now pay their water bills – thanks to the metre system, a household that doesn't pay its bills can have its water supply cut off. This provides revenue to allow Vodacanal to continue renovating its water distribution network and improving its services. Encouraged by its success in Khujand, the SDC decided to launch a similar programme in 11 other cities in Tajikistan.
The SDC also supports the creation of drinking water networks serving rural areas where the population have to make do with the water from irrigation canals, which is often polluted, or pay a high price for more or less drinkable water delivered by water trucks. Nearly 60,000 people in many villages and peri-urban developments have benefited from these programmes, which have had an impressive effect on health: the prevalence of diseases such as hepatitis A has fallen by 95% and the number of cases of chronic diarrhoea is down 65% in these pilot areas.
The SDC endeavours to ensure conflict-sensitive project management. How exactly does it do this?
Development programmes are often carried out in countries with unstable economic, social and political conditions, which are liable to degenerate into open conflicts. Our aim is to promote peaceful and harmonious development and to avoid stirring up tensions and violence at all costs. To help us to achieve this, several tools have been developed that allow us to monitor and analyse conflict situations and react in an appropriate manner.
To give you a concrete example: in the centre of Tajikistan, in the mountains, lies the very poor Rasht Valley, which was one of the strongholds of the opposition in the civil war and the site of fierce battles with government troops. Even since the end of the war, skirmishes are still breaking out between the army and the rebels (the latest took place in September 2010). Until very recently this valley was ignored by the government and development agencies for domestic policy and security reasons. Aware that poverty and exclusion exacerbate the tensions and are a potential source of conflict, the SDC has decided to launch a programme there to improve drinking water distribution and create a network of family doctors. The aim of this pioneering move is not just to encourage the development of this region and diffuse the tensions: we also intend to show other development agencies that it is possible to work successfully in the Rasht Valley.