Healthcare system virtually destroyed, says UK-based group

A recent report on healthcare and human rights in Turkmenistan, published by the London School of Hygiene and Tropical Medicine, highlights a deteriorating situation in the former Soviet republic. The report urges the international community to put pressure on Ashgabat to institute immediate reforms. "The current situation in Turkmenistan's healthcare system is very serious and in recent years, the healthcare system has been systematically dismantled. Since independence, state funding for healthcare has significantly decreased," Bernd Rechel, one of the authors of the report, told IRIN from London on Thursday. "User fees have been introduced for an increasing range of medical services, rendering health care services financially inaccessible to the majority of the population. Many people are dying prematurely, because they cannot afford health care," Rechel added. The ‘Human Rights and Health in Turkmensitan’ report, by Rechel and his co-author Professor Martin McKee released on Friday, was undertaken in late 2004 and early 2005 by the European Centre on Health of Societies in Transition (ECOHOST) with funding from the New York-based Open Society Institute (OSI). The report said the healthcare system in Turkmenistan was poor, even by the "grossly inadequate" standards of Central Asian nations, with the situation in the energy-rich state being made worse by the country's autocratic president-for-life Saparmurat Niyazov, whose regime had virtually destroyed the health care system. It provides an in-depth analysis of the impact of the dictatorship in Turkmenistan on the health of the nation and outlines what should be done at national and international level to prevent further deterioration of the situation. “There are a number of human rights violations with obvious health implications, such as the habitual imprisonment, torture and beatings of perceived opponents of the regime, the suppression or deportation of religious and ethnic minorities, the incarceration of part of the population in unsanitary and overcrowded penal colonies or the demolition of private homes to make way for grandiose presidential projects,” the report said. "The neglect of the health sector culminated in the dismissal of 15,000 healthcare workers in 2004 and their partial replacement by untrained military conscripts. In February 2005, president Niyazov ordered the closure of all hospitals outside the capital, Ashgabat, undermining access to health services even further," Rechel maintained, adding that it would particularly affect those in greatest need of health services: the poor, children, the elderly and those with chronic diseases. According to Rechel, the dismantling of the healthcare system will inevitably result in a further deterioration of the health of the people living in the country. Life expectancy is already lower than in any other country in Eastern Europe or Central Asia and Turkmen people die on average 16 years earlier than their counterparts in Western Europe. "The government is also closing its eyes to a rising incidence of HIV and tuberculosis [TB]. It has issued an official ban on the reporting of infectious diseases. This policy of secrecy and denial is a recipe for disaster," Rechel warned. "Future outbreaks of plague, as well as a rising incidence of HIV and TB are very likely to happen." Moreover, Prof. McKee said that Niyazov had also shut virtually all the country's higher education facilities, making it impossible to be trained in medicine or other healthcare professions. Although, Niyazov's regime pretended that there were not enough resources for the health sector, it was virtually impossible to verify that claim as there were no transparent governmental budgets, Rechel noted. "The country resides over vast reserves of oil and gas. Instead of using this potential wealth for the benefit of the population, however, the president is amassing great personal fortunes and uses some of them to pursue grandiose vanity projects, while poverty has become very common," he claimed. Both experts called on the international community to put pressure on the government to improve health and stop human rights abuses. "The international community has to recognise the scale of the current health crisis, urge the Turkmen government to respect the human right to health and carefully condition external assistance to the country. It will also be necessary to increase the pressure on the regime to improve its human rights record," Rechel said.