I live in the Autonomous Republic of Karakalpakstan.
You probably will not have heard of Karakalpakstan. It is considered ‘the world’s most obscure ’Stan’. It took me about two months of living here to even come to terms with pronouncing its name.
I am here volunteering as a doctor. I signed up to a medical charity and began to prepare myself mentally for deployment to a sleeping sickness outbreak in the DRC; a refugee camp in South Sudan; an HIV programme in Zimbabwe. But I have somehow found myself here, with a small handful of colleagues, in a former Soviet tin-pot state, embracing the humanitarian crisis that is Central Asia’s drug-resistant tuberculosis epidemic: a frightening rollercoaster of a plague, spiralling silently out of control.
Karakalpakstan lies east of the Caspian Sea, at the tip of the great Silk Road, sandwiched between Kazakhstan, to whom the Karakalpak residents feel ethnically closest, and Uzbekistan, which lords it over them. But the Uzbeks, with their own distinct populace and language, have a distant regard for the plight of the Karakalpaks.
The Karakalpaks are warm and welcoming. They are proud of their heritage. They enjoy a laugh … even more, a drink. They work hard and want the best for their families. I have worked across the globe and have had just one epiphany, which I suspect I may have actually bastardised from something Lenny Henry once said: we humans are all basically the same, we just happen to live under different governments.
Karakalpakstan’s 160,000 square kilometres of ecological disaster is no conventional tourist destination. Its former pièce de résistance, the Aral Sea, was once the world’s fourth largest inland body of water and teemed with fish. Now it wavers on the brink of extinction, reduced to barely 10 per cent of its original size, while its only nourishing river, the Amu Darya, is plundered for irrigation. The resultant drought, purge of fauna and agricultural collapse has left a population in mute despair. Those who have the means to escape do so, those who cannot, face an onslaught of prospering communicable diseases. Tuberculosis is King. Karakalpakstan’s temperatures can no longer be moderated by its dwindling, land-locked sea: to label its climate extreme would be an under-statement. In the winter we are plunged to minus 30 degrees Celsius. As the ink freezes in my biro, I take a pencil to my unheated clinic, only to abandon that too as I lose sufficient sensation in my fingers to produce anything in my patients’ notes other than strange shapes resembling assorted pagan symbols. In summer the temperature soars to 50 degrees Celsius and by lunch I have sweated half my body weight into my respiratory protection mask alone. I did, however, very much enjoy the three balmy days in April that were spring.
Three of my most intrepid friends from my university days ask to visit. I reply to the email by quoting A.A. Gill from The Sunday Times Magazine in 2000: ‘[Karakalpakstan is] the worst place in the world’. They all book flights.
One month later, and at 2am, I am woken by a flurry of text messages. My three pals are separately, simultaneously being denied attempts to board planes from Istanbul, Saint Petersburg and London; their letters of invitation having been received with scepticism at their respective airports. A full description of the ensuing events is surplus to requirement, but I can conclude from our collective experiences that night that if you persistently make enough phone calls to enough embassies in enough countries (five in this case) anything is possible. Twenty-four hours later all three friends are miraculously and safely ensconced in Nukus, my adopted home city.
We find a local Russian man, Dennis, with a four-wheel drive willing to take us, and two of my Karakalpak colleagues, on the 250 kilometre drive through barren steppe to the shores of what remains of the Aral Sea. My two colleagues have lived in Karakalpakstan all of their lives but have never had the resources to fritter on such a trip. It will be the first time either of them have ever seen a body of water bigger than a river. For my English companions and me this is a novelty, an oddity and an adventure to pass the time. For our accompanying Karakalpaks this is a poignant pilgrimage: an opportunity to pay their last respects to the sea before it breathes its last. I try to imagine greeting and bidding farewell to a moribund River Thames all in one day.
Our route takes us through the city of Muynak, formerly a bustling and prosperous fishing port. The Aral used to lap at its edges but has now receded dozens of kilometres away. The streets are empty, and skinny dogs chase our vehicle. To our right, the sea basin rolls out to the horizon but there’s not one drop of water to be seen. We venture out of the car and feel the warm sand between our toes. Shells surround our flip-flops. They might have looked more appropriate on Mars. We are on the seabed: a morbid armada of rusting ship hulks – once a fishing fleet – stand before us. Camels roam among them. Poster boards depict aerial photographs of the Aral from the 1960s to the present. The most recent one displays a small, green whisp of water: tearstains.
‘Aren’t you angry about this? Why don’t you do something about it?’ I ask our Karakalpak hosts.
‘Too late,’ they reply in resigned unison.
We take it in turns to adopt Jack-and-Rose-Titanic-poses at the prow of a former ship for our memento snaps and then continue on our way.
We drive for a further three hours across monotonous desert. All of a sudden a brilliant, turquoise bruise appears on the horizon. It conjures the impression of an embarrassed former celebrity, now recluse. I am reminded of the Marquise de Merteuil wiping off her make-up in the final scenes of Dangerous Liaisons. I feel like we are the only people on Earth witnessing this phenomenon: at this moment we are. We climb boulders and survey the deathbed.
Over the past six months, the health of the Karakalpak people has become my all-consuming obsession – I sleep, eat and breathe in drug-resistant tuberculosis. Now seeing this sad blue smudge is a smack around the head and sends my perspective reeling. This is so much bigger.
‘Bollocks to TB,’ I say aloud. The sight makes us want to cry.
Dennis plays techno as we drive the final stretch to the shoreline. On our arrival, he flips the CD to Boney M.’s greatest hits. To ‘Rivers of Babylon’ we strip to our swimsuits, link hands and step out onto the thick rind of salt that coats the ground leading into the sea. The crust gives way suddenly underfoot and we are squealing, up to our knees in green mud. And then we are afloat. The Aral, once a freshwater sea, has been evaporated to such an extent that we are buoyed up by its new, scorching salinity. It takes all our energy to thrust our limbs under the water’s surface.
I suspect we are in the water alone. Not one fish visibly bathes with us. As well as toxic levels of salt, the water is polluted with chemical waste from former industry. As team medic I remind everyone not to taste the poisoned chalice. I daydream about looking down at some future newborn, post-delivery, and being greeted by three blinking eyes.
Our driver, Dennis, shouts over to us in Russian pointing at tire marks about five metres from the water’s edge.
‘He says this is where the water came to last year, those are his tracks,’ one of the Karakalpaks translates. Dennis then points to a raised bank about 200 metres behind him and says something more.
‘That’s where it reached when he first drove here.’
My Karakalpak colleague paddles round to face me.
‘One day you will tell your children that you swam in a sea that no longer exists’.