The district's death rate for respiratory illness is extremely high. The crisis is not a secret. In fact it has become almost a cottage industry. Over the past ten years, Western donors, including the World Bank and the UN, have spent hundreds of millions of dollars to ease the problem. But in Karakalpakstan, little has changed.
Critics blame a combination of incompetence, inertia and corruption.
Part of the problem is the Uzbek government itself, which gives lip service to solving the crisis, but is more concerned with watering the cotton fields, which provide most of the country's hard currency. In addition, the Syr Darya and the Amu Darya run through all five Central Asian countries, each of which has its own pressing water needs.