Original Research

Lack of medical resources and public health vulnerability in Mongolia's winter disasters


Shinji Otani1 MD, PhD, Associate Professor *

Abir Majbauddin2 DDS, PhD, Project Researcher

Youichi Kurozawa3 MD, PhD, Professor

Masato Shinoda4 PhD, Professor


1 International Platform for Dryland Research and Education, and Arid Land Research Center, Tottori University, Tottori 680-0001, Japan

2 International Platform for Dryland Research and Education, Tottori University, Tottori 680-0001, Japan

3 Division of Health Administration and Promotion, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan

4 Graduate School of Environmental Studies, Nagoya University, Nagoya 464-8601, Japan

ACCEPTED: 6 June 2018

early abstract:

Introduction: Many countries face the need to address medical resource shortages following various disasters. The dzud is a winter disaster that occurs in Mongolia following drought in dryland areas, and it leads to high livestock mortality. Affected provinces suffer increased mortality rates for children aged under 5 years. Using various factors, including medical resources, the present study aimed to evaluate the health risks for children during the dzud.

Methods: Data from all of Mongolia’s 21 provinces and the capital of Ulaanbaatar was analyzed. The change in child mortality (CCM) was defined as the difference in the under-5 mortality rate for 2009–10. To determine the correlations, the CCM was compared with the urbanization rate (proportion of urban population), number of physicians and nurses (per 1,000 residents), average temperature, total precipitation (October 2009 to February 2010), and declining rate in livestock numbers for 2009–10 (%livestock loss) in each province.

Results: The correlation coefficients between the CCM and each factor were as follows: number of physicians (r = −0.506; p = 0.016), urbanization rate (r = −0.467; p = 0.029), and %livestock loss (r = 0.469; p = 0.028). In the multiple regression analysis, the number of physicians was significantly negatively related to the CCM (standardizing coefficient −0.492, p = 0.020).

Conclusion: These results suggest that increased medical resources and infrastructure development have positive effects on child health – even in the setting of the dzud causing considerable damage to livestock.