Doctors, Hospitals, Clinics all very much with borders

by Asher Kohn on 1/10/2010

Medecins Sans Frontieres left Turkmenistan about a month ago, that much is old news. But EurasiaNet has a new story out on how far Turkmen Health Care has, while not precisely fallen, certainly skirted international standards:

Doctors quietly admit that access to the newer facilities is only possible with the payment of substantial bribes, despite the fact that the services are officially free.

Far more troubling to international observers is the government’s lack of interest in reversing the damage done by Niyazov’s malign neglect. During the last years of Niyazov’s rule, instruction for medical professionals was reduced from five years to just two, with one subsequent year of unsupervised training. In addition, many hospitals outside the capital were closed, and some were forced to use army conscripts to do the work of nurses. The drastic changes left Turkmen citizens increasingly vulnerable to epidemics.

As many new facilities have opened up and purported top-of-the-line care is offered, the reality of the situation has escaped the hyperreality of Ashgabat. Everything is new, cheap, and effective in the capital. Hardly anything exists outside of it.

I’m reminded of the old quote, “We have created France. Now we must create Frenchmen.” Turkmenbashi created Turkmenistan, but his Turkmenistan never expanded out of Ashgabat. The story’s mention of press limitations and endemic prostitution are just as much of Turkmenistan as the shiny mosques, we all know that. He just never got around to creating his kind of Turkmen.

But we’re likely not the audience. Turkmenistan needs investors, not analysts.. Berdymukhamedov knows that to turn the gas wealth into real wealth, he needs the mosques, the universities, and yes, the marble-clad clinics and hospitals. It’s the silk road redux that energy folks fly in expecting to see. Those will get the breathless articles. By branding Ashgabat as a new Samarkand, Berdymukhamedov is attempting to broaden his reach.

It’s an ugly bid at times, and a bit passe in many of our minds, but it may be effective. It is about the glory of the state and branding through architecture, not actual contemporaneous results. I’m interested to see what Ashgabat looks like in 5 years, post-boom and post-giant lake. Let’s see what the branding bid looks like then.

And just another note I found while browsing EurasiaNet: Continuing the Uzbek-Tajik feud, it looks now like Tajikistan isn’t getting literal trainloads worth of food it should be from its Uzbek border. What are the odds at cooler heads prevailing over this new import/export dispute?


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– author of 33 posts on 17_PersonNotFound.

Asher is currently in law school at Washington University in Saint Louis. He is studying natural resource law in Central Asia and its intersection with different theories of jurisprudence. Besides Registan.net, Asher has written for The Los Angeles Times, Run of Play, İstanbul Altı, and Istanbul Eats. He has worked with the Natural Resource Law Center and the International Crisis Group, where he studied legal and political traction over a variety of issues.

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