Azerbaijan: Death Stalks Newborns

The Sumgait children’s cemetery - known as the “baby cemetery” to locals - is a desolate and forlorn spot. Located on the outskirts of Azerbaijan’s third largest city, 30 kilometres from the capital Baku, it is strewn with rubbish and no grass grows there. No fence surrounds the site, which measures around 600 square metres, and homeless dogs and other animals wander freely, digging up the ground.

The children were once buried separately from the larger “adult” graveyard, but with the growing number of infant mortalities, the line between the two is slowly vanishing. The graves themselves are much smaller and simpler than those of the adults. The newborns are usually marked with a small stone. Those who lived longer, from the ages of five to ten, have more elaborate headstones and sometimes follow the custom of the former Soviet Union by displaying a photo of the deceased.

According to the World Bank, Azerbaijan leads the Caucasus in its infant mortality rate. Of every 1,000 infants born, 90 will not live to see their fifth birthday. The figure is twice as high as in Georgia and three times that of Armenia.

According to Dr Adil Geibulla, a paediatrician, Azerbaijan’s continuing economic difficulties have increased the number of viral infections among newborns. “If the mother is too poor to eat properly, to have medical check-ups at the right time, and to take medication if required, then of course such problems are hard to avoid,” he said.

Pregnancy treatment, he adds, is prohibitively expensive. “A blood test today costs between 35 and 70 US dollars, depending on the type of clinic,” said Dr Geibulla. “Ultrasound and other tests cost even more.”

“On average, it costs an Azerbaijani anything up to 500 dollars to have a child. And if there is a complication and the pregnant woman needs a caesarean, then the cost is double.”

Arzu Mamedova lost her first-born three days after he was born. “The doctors said it was because of toxoplasmosis,” said the 27-year-old.

“My husband doesn’t have a job, we barely manage to make ends meet. It costs more than 50 dollars just to have a blood test, not to mention the treatment itself. And to buy medicine and pay for a doctor you have to have 200 dollars at the very least. We don’t have that kind of money.”

According to respected economist Allahyar Muradov, Azerbaijan’s average wage in 2004 was 483,000 manats - around 96 dollars - per month. The poverty line, however, is 556,000 manats, or 111 dollars.

But Azerbaijan’s chief paediatrician Nasib Guliev disputes the data in the World Bank report. “As far as the official statistics go, I can certify that the number of infant deaths in Azerbaijan has fallen recently,” he told IWPR. “As for the reasons for these deaths, they are the same as anywhere else in the world.”

Hadi Rajabli, chairman of parliament’s social policy committee, told IWPR that while infant mortality rates have fallen recently, the World Bank’s figures still deserve serious attention.

Rajabli argues that the mortality rate is not caused by difficult economic conditions alone. It’s high in those regions where families traditionally have many children, he said, and a badly informed public makes it difficult to carry out vaccination programmes.

Doctors at government clinics refused to comment on the level of infant mortality. Likewise, officials at the health ministry’s press service turned down numerous requests for interviews.

According to Azerbaijan’s state statistics committee, 131,609 children were born in Azerbaijan in 2004, of whom 1, 287 died before they reached one year old - that is, roughly one per cent. The main causes of death were respiratory disease in the case of 612 children, followed by perinatal illness in that of 292. Last year 614 stillbirths were recorded by officials.

The state statistics committee also acknowledges that, of children up to one year old, two per cent have not had vaccinations for TB, diphtheria, and whooping cough; four per cent have not received a vaccination for measles; three per cent for polio; and three per cent for viral hepatitis.

In the case of Sumgait, the town’s heavy industrial past is also a big factor. Sumgait was built in the Forties as a centre for the petrochemical industry and is recognised as one of the most polluted places on earth. Pollutants such as DDT and mercury line the soil around the town’s many deserted factories.

The children’s cemetery dates back to Soviet times and to this deadly legacy.

Although many of the chemical factories in Sumgait are now closed, specialists say they continue to affect the health of children. Approximately a third of the town’s population are refugees and people who have been forced to move there. Living conditions in the town are far worse than those in neighbouring Baku.

Lamia Hajieva, 24, lives in a refugee village in Imishi in central Azerbaijan. She also lost her newborn twins because of disease. The boys were born fifteen days prematurely and died two hours later. She sees a lack of cooperation on the part of her family as one of the reasons her children died.

“My husband and my mother-in-law were against my going to Baku for treatment,” she said. “In the refugee village the conditions simply aren’t right. My mother-in-law didn’t understand. She kept saying that she and her generation had managed to have lots of children and bring them up without any medicine, so why couldn’t I?”

It is possible that the real statistics are actually worse than is accepted. It should be noted that the official numbers only reflect the data for state or private clinics, and do not include births and infant deaths that take place at home without doctors present.

Husnia Ahmedova, who decided to have her baby at home, said, “It is very expensive to go into hospital, and if you don’t pay the medical workers, they don’t even come near the child or the mother. So I decided to have my baby at home as it was three times cheaper - we just called the doctor to our house and paid 70 dollars.

“True, it was a nightmare to get the child registered afterwards, and we had to pay more money on top for that.”

Because of her family’s financial straits, another woman, Khalida Halilova, also decided to give birth at home. “I couldn’t afford to go into hospital. And I lost my first child, without even having held him in my arms… He died of birth trauma,” Khalida told IWPR tearfully.

Shahla Abusattar is a correspondent for the Information and Resource Oil Industry Monitoring Centre of Azerbaijan.