International action needed on health in Turkmenistan

Health experts called on the international community to put pressure on the Turkmenistan government to improve health and stop human rights abuses.

A new report from Bernd Rechel and Prof. Martin McKee of the London School of Hygiene & Tropical Medicine said the health care system in the former Soviet Republic was poor, even by the "grossly inadequate" standards of Central Asian nations which used to be part of the Soviet Union.

Mr Rechel added that the situation in Turkmenistan had been made even worse by the country's autocratic president-for-life Saparmurat Niyazov, whose corrupt regime had virtually destroyed the health care system.

He added: "The international community and world bodies must act to pressure the Turkmenistan government to properly fund a basis health care system and end the human rights violations that have exacerbated public health problems."

The country has one of the world's largest reserves of natural gas and enormous potential wealth.

But LSHTM researcher Mr Rechel added that Niyazov had abolished free health care, fired 15,000 health care workers in a single day - replacing them with a small number of untrained and unpaid army conscripts - and ordered that all hospitals outside the capital of Ashgabat should be closed.

The Turmenistan government has also banned the diagnosis of infectious diseases - leaving the country open to epidemics of diseases like TB and HIV/AIDS which are already devastating neighbouring nations.

Prof. McKee said that Niyazov had also shut virtually all the country's higher education facilities - making it impossible for Turkmenistanis to train in medicine or as other health care professionals.

While life expectancy in Turkmenistan is now estimated to be lower than any other country in Europe and Central Asia, Niyazov's own health is looked after by a team of doctors specially flown in from Germany.

Mr Rechel said that drug-trafficking and drug abuse had rocketed, but the Turkmenistan government had failed to tackle the problem.

He added: "Many observers believe this is due to the government's complicity in the drugs trade."

Prof. McKee added that Niyazov also regularly makes pronouncements on health which have "absurd" results.

Niyazov has created a "Health Road" in Ashgabat which he forces government ministers and ordinary citizens to walk along in a bid to improve public health.

And a public comment that gold teeth were unhygienic led to spot checks on teeth at the entrances to universities.

Mr Rechel added that total government control of the media had created "an information vacuum" which stifled protest and made change even more difficult.

He said: "The health cutbacks in Turkmenistan cannot be justified on budgetary grounds - Turkmenistan has high levels of potential wealth.

"But economic collapse brought on by mismanagement and corruption in government circles and the lack of ways to redress grievances has led to heightened social stress.

"And that has made major public health concerns like suicide, prostitution and substance abuse, especially injecting drug use, much worse."

http://www.lshtm.ac.uk/