HEALTH AND HEALTH CARE IN TURKMENISTAN

HEALTH IN TURKMENISTAN

The infant mortality rare in Turkmenistan is highest and life expectancy is lowest in Central Asia. Life expectancy at birth: total population: 69.78 years; male: 66.77 years; female: 72.93 years (2015 est.), country comparison to the world: 156. "Life expectancy" is an abstract and complicated concept a complex formula that attempts to predict the lifespan of children born today by subjecting a hypothetical child born today to the current risk of dying in each bracket he or she mature through until, in effect, the accumulated risk of death is 100 percent.

Death rate: 6.13 deaths/1,000 population (2015 est.): total population: 0.98 male(s)/female (2015 est.). Infant mortality rate: total: 36.82 deaths/1,000 live births; male: 44.13 deaths/1,000 live births; female: 29.14 deaths/1,000 live births (2015 est.), country comparison to the world: 60. Obesity - adult prevalence rate: 18.8 percent (2014), country comparison to the world: 125. [Source: CIA World Factbook]

The most common causes of death are cardiovascular disease, cancer, and respiratory disease. Major health factors are poor diet, polluted drinking water, and the industrial and agricultural pollutants that are especially concentrated in the northeastern areas near the Amu Darya River and the Aral Sea. The reported occurrence of human immunodeficiency virus (HIV) has been less than 0.1 percent. However, sharp increases in drug trafficking through Turkmenistan are likely to increase that figure substantially. [Source: Library of Congress, February 2007]

Murray Feshbach and Alfred Friendly, Jr. describe environmental and health conditions in Ecocide in the USSR.

Health Care in Turkmenistan

Health expenditures: 2 percent of GDP (2013), country comparison to the world: 190 Hospital bed density: 4 beds/1,000 population (2012). [Source: CIA World Factbook]

In the post-Soviet era, reduced funding has put the health system in poor condition. In 2002 Turkmenistan had 50 hospital beds per 10,000 population, less than half the number in 1996. Overall policy has targeted specialized inpatient facilities to the detriment of basic, outpatient care. Physicians are poorly trained, modern medical techniques are rarely used, and medications are in short supply. Private health care is rare, as the state maintains a near monopoly. Free public health care was abolished in 2004. [Source: Library of Congress, February 2007]

People in Turkmenistan still rely heavily on amulets and folk medicine practices to ward off and treat sickness. In the Soviet era, Turkmenistan arguable had the worst health care system in all the Soviet republics. The infant mortality rate at one time was between 60 and 100 per 1,000 children.

According to Doctors Without Borders: “The people of Turkmenistan are being failed by their health care system, by their government, and by the international community. The system that is supposed to ensure their health is instead designed to conceal problems. This is not a case of individual practitioners failing to do their jobs but one that is far more systematic... Unlike most of the countries in which MSF works, Turkmenistan’s health crisis is not characterized by large-scale outbreaks of infectious disease, malnutrition or violence, nor by a complete absence of health care provision. Instead it is through systematic denial and manipulation; a system of smoke and mirrors reinforced by fear.” [Source: Doctors Without Borders/Médecins Sans Frontières (MSF), doctorswithoutborders.org <>]

“1) Access to health care for the population of Turkmenistan is restricted by fear of the social and political consequences of illness for both health care practitioners and patients and by stigma. 2) International standards and protocols exist mainly on paper, and are not routinely or consistently implemented in the country’s health care system. 3) Despite the appearance of greater openness since the accession to power of former Health Minister Gurbanguly Berdimuhamedov, real change has not taken place. Instead, greater engagement with the international community is serving only to mask the continuation of old practices, including the manipulation of health data.”

In the 1990s, as under the Soviet system, health care was universally available to all citizens without charge. The health care system that Turkmenistan inherited from the Soviet regime was fraught with deficiencies, however. On the whole, physicians were poorly trained, modern medical technologies were almost unheard of, and many basic medicines were in short supply. Although health care was available to most urban residents, the system was financially bankrupt, and treatment is often primitive. Only recently have some medical professionals been allowed to offer private medical care, and the state maintains a near monopoly of health care. [Source: Library of Congress, March 1996 *]

Health Care Under Niyazov

In the late 1990s, many rural facilities were closed, making care available principally in urban areas. President Saparmurat Niyazov’s 2005 proposal to close all hospitals outside Ashgabat intensified this trend. In 2004 Niyazov dismissed 15,000 medical professionals, exacerbating the shortage of personnel. In some cases, professionals have been replaced by military conscripts. [Source: Library of Congress, February 2007]

There was a large increase in child mortality under Niyazov. According to the BBC: During his rule, “the health system declined dramatically. Free health care was abolished, all hospitals outside the capital were closed, and thousands of health care personnel were sacked - 15,000 of them in just one day. [Source: BBC, March 3, 2008]

Niyazov dismissed 15,000 licensed health care workers in 2004 “to save money” and replaced them with military conscripts with little training. Niyazov closed down all regional hospitals in the country, calling them unnecessary luxuries. Anyone who needed medical treatment, he said, could just come to the capital, Ashgabat. Doctors and health care workers with foreign degrees were sacked because their training was “incompatible with the Turkmen education system.”

Paul Theroux wrote in The New Yorker: “It was questionable whether” Niyazov wanted “his people to be healthy. He...instructed the country’s doctors to pledge their allegiance to him and to “Ruhnama,” rather than taking the Hippocratic oath. Life expectancy had fallen to sixty-three, more than fifteen years below the European average, and, even though Turkmenbashi had banned the diagnosis of several communicable diseases, there had been unofficial reports of the plague in recent years.” [Source: Paul Theroux, The New Yorker, May 28, 2007 ~]

Lucy Ash of the BBC wrote: In the summer of 2006, “the London School of Hygiene and Tropical Medicine said the country was on the verge of a humanitarian catastrophe. It published a report on Turkmenistan's healthcare, which it described as poor even by the "grossly inadequate" standards of post-Soviet countries. It said the culture of secrecy under Niyazov's dictatorship extended to banning the reporting of infectious diseases such as anthrax, HIV/Aids and the bubonic plague. [Source: Lucy Ash, BBC, December 21, 2006]

Health Care Under Berdymukhammedov

Farangis Najibullah of Radio Free Europe wrote: In a dramatic U-turn,” Niyazov's successor, Berdymukhammedov — who came to power in late 2006 and is himself a dentist by profession and was the former Turkmenistan Health Minister— has been investing tens of millions of dollars to improve and modernize the reclusive nation's beleaguered health-care sector. The revamp included an annual Month of Health and Sports, which is currently under way in Turkmenistan and has thousands of people throughout the country taking long walks in parks and participating in compulsory physical fitness classes at their workplaces. [Source: Farangis Najibullah, Radio Free Europe, April 06, 2014 ><]

“Besides such ambitious health initiatives, numerous hospitals, clinics, and wellness and sports palaces have also been built in Ashgabat, all equipped with modern medical technology. According to media reports, Turkmenistan invested $56 million to build an ophthalmology complex in Ashgabat as well as another $47 million in a traumatology center in the same city -- to name just a few high-profile projects. Turkmen government websites are awash with photographs of impressive, multistory medical facilities that Berdymukhammedov's government has built in the Turkmen capital using the energy-rich country's natural-gas revenues. ><

“The reality, many Turkmen complain, is far less impressive. Only the facade of the country's medical sector has changed, they say. While Berdymukhammedov has, indeed, reopened rural hospitals shuttered by Niyazov, little appears to have altered in the quality of the medical services provided there, according to doctors and patients interviewed by Radio Free Europe. "Medical services in the Turkmen provinces still remain at the level of the 1970s," says a Turkmen doctor who identified herself as Maral Nedirova. Nedirova worked as a general practitioner in Turkmenistan's health sector for more than 20 years before leaving the country earlier this year. Her most recent stint was at Niyazov Hospital in Ashgabat. "While Ashgabat hospitals are engulfed in stifling corruption, village hospitals face a severe shortage of the most basic medical equipment, such as sterile medical materials," Nedirova says.” ><

In addition to performing his duties as president, Berdymukhammedov found time to perform surgery on television and write books on horses and medicine which are best sellers in Turkmenistan. In 2013, Bruce Pannier of Radio Free Europe wrote: “A new book authored by Turkmen President Gurbanguly Berdymukhammedov has been unveiled in Ashgabat. The state-run news website Turkmenistan.ru reported on September 3 that the opening ceremony of the fifth volume of "Herbal Remedies of Turkmenistan" took place at the Health Ministry conference hall. The book reportedly provides a list of 150 so-called medicinal herbs that grow in Turkmenistan and explains how the plants can be used to help treat a range of illnesses. The book is illustrated with glossy photos of the plants. Berdymukhammedov, a former health minister, has authored several books on herbal medicine, the history of Turkmenistan's healthcare system, and Turkmen horses. [Source: Bruce Pannier, Radio Free Europe, September 3, 2013]

Health Care in Turkmenistan in the 1990s

In the 1990s, the Soviet system of free care for all citizens remained in place, but in early 1990s supply shortages and poor medical staff made care inadequate in many areas. Health and welfare institutions were administered by the ministries of health, culture, education, and social welfare. Various coordination committees also operate under the aegis of presidential advisers. Between 1989 and 1992, health care as a share of the state budget declined from 11.2 to 6.9 percent, leaving inadequate local budgets to bear the brunt of expenditures. The comparison of health care statistics before and after 1991 is somewhat misleading, however, because the statistics do not account for changes in health budgeting at the end of the communist era. [Source: Library of Congress, March 1996 *]

In 1989 the republic had about 13,000 doctors and 298 hospitals, totaling more than 40,000 beds (111 per 10,000 persons). Some industrial enterprises had separate clinics for their workers. The number of doctors reached 13,800 or (36.2 per 10,000 persons) in 1991; at that time, medical personnel numbered 40,600, or 106.9 per 10,000. Until the early 1990s, all health personnel were government employees. *

Despite the nominally universal availability of free health care, in the rural areas medical care often is deplorable by Western standards. In both rural and urban areas, undertrained physicians and staff, underequipped facilities, shortages of medicines and supplies, and chronic sanitation problems contribute to the system's inadequacy. For example, one study found that because 70 percent of the obstetricians and gynecologists in Dashhowuz Province lacked adequate surgical training, half of their patients died. A factor in the high mortality rate is the provision of piped-in water to only 15 percent of maternity clinics in the republic. *

Because of the disruption of trade at the end of the Soviet period, pharmaceuticals must be obtained with hard currency, making them even more scarce than before. Of particular concern are shortages of oral rehydration salts for children, syringes and needles, and vaccines, which previously had been imported from Russia and Finland. According to experts, current conditions of conventional medical care may prompt many Turkmen to turn once again to "traditional" medicine. Healers employing herbs and prayer are common, and in some rural areas this type of treatment may be the only medical attention that is available. *

Health Conditions in Turkmenistan

Bruce Pannier of Radio Free Europe wrote: Lack of adequate medical facilities, misdiagnosis, and incompetence seem to be among the biggest health problems in Turkmenistan today.” Turkmenistan President Gurbanguly Berdymukhammedov “came to power in late 2006 pledging to reverse many of the bad decisions of his predecessor, one of those decisions being the dismantling of the healthcare system.But a promising start was short-lived and Berdymukhammedov, who was the country's health minister when former President Saparmurat Niyazov died, now seems to be paying almost no attention to the situation and authorities have actually taken measures to prevent people from seeking quality medical treatment outside the country. [Source: Bruce Pannier, Radio Free Europe, January 30, 2014 <<<]

“One Radio Azatlyk correspondent in the Birata district in eastern Turkmenistan's Lebap Province (Welayat) has reported that the closest, well-equipped medical facility takes several hours to reach. But even when Turkmenistan's citizens arrive at the medical facilities that do exist there seems to be no guarantee that their medical problems will be over. Quite the contrary, actually. <<<

According to the British Red Cross: In rural Turkmenistan communities face huge health challenges, ranging from clean water shortages and drug abuse to a lack of first aid skills or knowledge about diseases and maternal health. Many people live in remote areas affected by infectious diseases. A lack of clean drinking water means people are more likely to fall ill, increasing the chance of water borne disease epidemics. Injuries such as burns, poisonings and insect bites can also be a huge risk when little or no basic first aid information is available.

Many people living in rural areas do not know how to prevent common infectious diseases, and sexually transmitted infections such as syphilis and gonorrhoea, which are often left untreated. Many young people also lack information about the harmful effects of drugs. [Source: British Red Cross]

According to health statistics from the 1990s, life expectancy in Turkmenistan (62.9 for males, 69.7 for females) was the lowest in the CIS. The relatively high rate of natural population growth (2.0 percent per year), was based on a birth rate of 29.9 per 1,000 persons and a death rate of 7.3 per 1,000 persons. In 1992 cardiovascular disease was the most common cause of death, followed by cancer, respiratory disease, and accidents. Poor diet, polluted drinking water, and industrial wastes and pesticides cause or exacerbate many medical problems, which are especially acute in the northeastern areas of the country near the Amu Darya and Aral Sea. [Source: Library of Congress, March 1996 *]

In the 1990s, Women in their child-bearing years and children appeared to be in the poorest health and the most susceptible to disease and sickness. Of CIS countries, in 1991 Turkmenistan ranked first in infant mortality rate, with forty-seven deaths per 1,000 live births, and very high on maternal death rate, with fifty-five deaths per 100,000 births. Some specialists attribute high infant mortality to factors of diet and health care while others relate it to poor hygienic practices and lack of family planning. *

Turkmenistan Hospitals with Outhouses For Toilets

A tuberculosis hospital in Tagtabazar in Turkmenistan's southeastern Mary Province serves as an example of the poor state of Turkmenistan’s health care system. Farangis Najibullah of Radio Free Europe wrote: While the walls of its dilapidated building have recently been brightened with a new coat of paint, the hospital still lacks running water, a modern heating system, and modern toilets. Patients are forced to use an outhouse and sleep in Soviet-era iron beds, while the furniture in the hospital's canteen consists of an old fridge, a bench, and a shabby table covered with a plastic tablecloth. [Source: Farangis Najibullah, Radio Free Europe, April 06, 2014><]

According to Nedirova, the situation is similar in rural hospitals across the country. "They use outhouses instead of flush toilets," she says. "Many hospital buildings across the country haven't been renovated for years. There is a bad smell everywhere. The hygiene standards are very poor and rooms are cold. Patients routinely bring their own food. Patients pay for everything, but it's not clear where all the money goes. There are no central heating systems in rural hospitals and patients have to provide their own stoves during the winter." ><

Nedirova says those hospitals in Ashgabat that do have the latest high-tech equipment often don't have staff who have been properly trained to operate them. Bahar, a medical student in the eastern city of Turkmenabat, in interning at the district hospital. She describes conditions there as "appalling." "The hospital building is very old and all medical equipment and furniture is very old," she told Radio Free Europe's Turkmen Service. "Hospital rooms are small and cramped. There is a constant shortage of medicine." ><

“Despite their shortcomings, village hospitals are the only places where many impoverished Turkmen citizens can see a doctor. Those who are ill and have the money travel to Ashgabat, but the cost of treatment in the capital's modern hospitals is beyond the reach of even middle-income Turkmen.” ><

Incompetence in Turkmenistan Hospitals

Bruce Pannier of Radio Free Europe wrote: “One woman, calling herself Umyda, told Radio Azatlyk that doctors in Turkmenistan diagnosed her as having tuberculosis and recommended she avoid contact with her small child to prevent passing on the disease. The woman heeded the advice but managed to leave the country late last year for an examination in Turkey. Doctors there told her she did not have TB and was, in fact, completely healthy.[Source: Bruce Pannier, Radio Free Europe, January 30, 2014 <<<]

“Another woman told Radio Azatlyk that doctors had said her now two-year-old child was handicapped at birth and would never walk properly. That woman made it to a medical facility in Moscow and her child is now walking without difficulty. A third woman, calling herself Lale, told Radio Free Europe that her mother suffered from heart problems for some six years, being constantly in and out of the hospital. The doctors finally told the woman there was nothing more they could do for her and that she was going to die. The family went to Turkey where the mother had surgery and is now fine. Despite the anxiety all of these people experienced at being led by Turkmen doctors to believe their situation was dire, one could say they all had a happy ending. <<<

“Not so for another woman, calling herself Aina, who told Radio Azatlyk that doctors in her area of Turkmenistan treated her for several years for what they said was a small tumor or cyst in her breast. Sometimes they gave her injections sometimes they used acupuncture. She later went to Turkey where doctors told her she had cancer. Then there is the tale of a young man from eastern Turkmenistan who was diagnosed with a bone disease in his legs that caused his legs to swell up at times. According to his family, medications the doctors gave the man did not lead to any improvement in his condition so they took him to a hospital in the capital, Ashgabat. Doctors took X-rays of the man's legs and gave them to the family to take back and show doctors at their local hospital. Unfortunately, those local doctors could not read X-rays.”<<<

Bribery in Turkmenistan Hospitals

Farangis Najibullah of Radio Free Europe wrote: On paper, Turkmenistan's state-funded health insurance partly covers hospital treatment and medications in state medical facilities. In reality, however, patients tell Radio Free Europe that they end up paying for almost everything -- from hospital beds and food to medicines and surgeries. "Bribery is a rule in Turkmen hospitals," says Nedirova, who did not want to reveal where she is currently living. "Patients have to pay cash to everyone -- from junior medical staff to the surgeons. This is in addition to what they formally pay to a hospital before being admitted there." "In those marble-clad new medical centers in Ashgabat, doctors create completely unnecessary queues to make patients pay bribes for faster service," she adds. "For instance, to get an MRI [magnetic resonance imaging], patients have to wait two to three months if they don't pay." [Source: Farangis Najibullah, Radio Free Europe, April 06, 2014 ><]

“According to media reports, hospitals officially charge around $8,500 for a typical cancer surgery, some of which is covered by state health insurance. But Nedirova says the real figure is usually much higher after factoring in the bribes paid to doctors and nurses. For serious illnesses, patients have been known to sell their homes and cars or borrow money from relatives to raise the necessary funds. ><

“Arzu, a 55-year-old housewife from western Balkan Province, requires hospital treatment every six months for a chronic kidney ailment. Arzu says her grown children are forced to foot her ever-increasing medical bills and the almost compulsory bribes. She says she is considering giving up her treatment altogether because her family is no longer able to afford it. ><

Having to Seek Medical Care Outside Turkmenistan

Some Turkmen that can afford it travel to Turkey, Iran, or Russia to seek medical treatment. Bruce Pannier of Radio Free Europe wrote: It seems the only answer for those who are desperate about their health or that of their relatives is to get the patient to medical facilities outside Turkmenistan. For the vast majority of people in Turkmenistan the financial burden of going for medical treatment abroad is crushing. But not even that matters. Few are allowed to leave even if they can get the money. [Source: Bruce Pannier, Radio Free Europe, January 30, 2014 <<<]

Farangis Najibullah of Radio Free Europe wrote: “ In recent years, however, Turkmen authorities have introduced complex, time-consuming paperwork for those seeking medical treatment abroad, in an apparent effort to discourage such travel. Twenty-seven-year-old Ayna is suffering from breast cancer and claims that her condition dramatically worsened during the time she was awaiting proper treatment. "I wasn't allowed to go to Iran for cancer surgery. Then I went to Turkey, pretending I was going on vacation," she says, adding, "The authorities think the world would find out about the real state of our country's health care if Turkmen kept traveling abroad for medical treatment."” [Source: Farangis Najibullah, Radio Free Europe, April 06, 2014 ><]

A 2012 report from the Norwegian Helsinki Committee noted that "Due to the poor level of medical care in Turkmenistan, many who suffer serious illnesses are forced to leave... [and go] abroad to seek professional medical treatment." "However, since leaving Turkmenistan in search of foreign medical specialists can be considered an indirect form of criticism of the state of the country's national medical facilities, many are stopped at border crossings and airports when the purpose of their journey becomes clear," the report added. <<<

Pannier wrote: “Most reports about Turkmenistan in the Western media, and often in the media of other former Soviet countries, note that it is one of the most repressive countries in world. But inevitably the figure of the president of Turkmenistan enters these reports and a topic that should be serious takes on a comical aspect. President Berdymukhammedov and Niyazov before him have been eccentric leaders, to say the least, and outlandish might be a more appropriate word. However, the tales of the incompetence in Turkmenistan's healthcare system are a reminder, to me anyway, that it is not always a laughing matter. As some Turkmen friends said to me in the late 1990s, "it isn't funny for the people who live there."” <<<

Diseases in Turkmenistan

In his March 2004 proclamation on health care, Niyazov declared that all infectious diseases— cholera, AIDS, the plague—were illegal and talking about them was forbidden. Turkmenistan’s Anti-Epidemic Energency Commission stated that “the epidemiological situation in the territory of Turkmenistan is safe. There are no cases of dangerous diseases.”

According to Doctors Without Borders: “It is undeniable that communicable diseases such as HIV/ AIDS, tuberculosis (TB) and sexually transmitted infections are more prevalent than reported figures would suggest. It is equally clear that public health risks are not being effectively addressed and that prevention mechanisms are not in place. Misinformation about how to avoid contracting and spreading disease is rampant. However, rather than encouraging workers in the health care system to actively counteract this through it and encouraging people to seek help, serious health care issues are being driven underground. As a consequence, it is all but impossible to gauge the real state of the health of people in Turkmenistan today. [Source: Doctors Without Borders/Médecins Sans Frontières (MSF), doctorswithoutborders.org <>]

“Failure to acknowledge or address communicable diseases such as TB, HIV and sexually transmitted infections is most likely compounding upon and expanding existing problems. TB, particularly in its multi-drug-resistant form, is perhaps the country’s most serious public health threat, and poses a high risk of creating a serious crisis in Turkmenistan. <>

According to the United Nations: “Information on most social and health problems such as HIV/AIDS, drug abuse, and drug related crime are not officially disclosed and are difficult to estimate. Officially, the first case of HIV in Turkmenistan was reported in 1994 and a second case was reported in 1999. Currently, Turkmenistan reports only 2 cases of HIV (0.04 incidence per 100,000 people) and no cases of AIDS. According to the 1998 UNODC estimates, prevalence of opiate use in Turkmenistan is 0.3 percent of the adult population, the significantly lower than any other state in Central Asia. Many international organizations estimate both the drug abuse and HIV/AIDS problems to be of higher magnitude than these estimates and it is very likely that HIV/AIDS has increased with increasing levels of drug use. [Source: “Illicit Drug Trends in Central Asia”, United Nations Office on Drugs and Crime Regional Office for Central Asia, April 2008 |~|]

Plague in Turkmenistan

There have been periodic reports of the plague in Central Asia. The germ that causes the plague is common among rodents found throughout Central Asia. The strain they carry is among the most virulent and lethal pathongens known. Among the animals most associated with the disease are marmots and gerbils. One of the main carriers is a rat-size rodent with kangaroo-like legs called the great gerbil. In the early 2000s there was an population explosion of these animals that coincided with bumper crops of grains that they eat. The Black Death of 1347-1351 originated in Central Asia and made its way to Europe on ships leaving from the Crimea.

In 1950 thee was a large outbreak of the plague in Turkmenistan that killed several hundred people. The outbreak originated with a nomadic hunter who camped in a place inhabited by gerbils. He was bitten by fleas that carry the disease. When he returned to his camp the disease that spread to his lungs and he infected many of the people he came in contact. Some people fled from the camp and spread the disease to other camps. Only after military-imposed quarantines and the burning of corpses, animals and nomads tents and possessions was the disease brought under control.

At least 10 people died in an outbreak of the plague in the summer of 2004. Many think the death toll was much higher. There were reports of the disease in Ashgabat, Merv and Turkmenbashi and it was unclear how many cases were bubonic plague or the more lethal and dangerous pneumonic plague. Measures taken by the government included requiring heath care workers to sign a pledge saying they will not use the word “plague” and instituting border controls to “prevent disease from entering Turkmenistan from neighboring states.”

Tests in Uzbekistan confirmed the presence of the plague on rodents and fleas living along the Turkmenistan border, As as precautionary measure in that country cattle breeders, old workers and geologist and thousands of camels were quarantined. Uzbekistan also imposed border controls to prevent anyone with the disease from crossing the border from Turkmenistan. Antiepedemic teams were stationed in the area.

In the Soviet era the Soviet government had emergency plans in place to isolate and combat the disease when the outbreaks occurred. News of these outbreaks rarely reached the outside world — with the exception of Turkmenistan outbreak — and were quickly controlled and contained. The Soviet system to deal with disease emergencies are either no longer in place or are at least no longer sound as they once were. There are worries that a serious outbreak could occur. The situation is particularly worrisome in Turkmenistan, which is hostile to outsiders and international nongovernmental organizations.

Handicapped People in Turkmenistan

According to the U.S. Department of State: “The law prohibits discrimination against persons with physical, sensory, intellectual, and mental disabilities in employment, education, access to health care, and the provision of state services in other areas. Despite the law persons with disabilities encountered discrimination and denial of work, education, and access to health care and other state services because of strong cultural biases. [Source: “Country Reports on Human Rights Practices for 2014: Turkmenistan,” Bureau of Democracy, Human Rights and Labor, U.S. Department of State \*\]

The government provided subsidies and pensions for persons with disabilities, but the assistance was inadequate to meet basic needs. The government considered persons with disabilities who received subsidies as being employed and therefore ineligible to compete for jobs in the government, the country’s largest employer.\*\

Some students with disabilities were unable to obtain education because there were no qualified teachers, and facilities were not accessible for persons with disabilities. Although the law requires universities to provide specialized entrance exams to applicants with disabilities, students with disabilities experienced difficulties in gaining admission to universities. The government placed children with disabilities, including those with mental disabilities, in boarding schools where they were to receive education and, if able to work, employment. In practice, however, the schools provided neither. Special schools for those with sensory disabilities existed in the larger cities. Boarding schools with rehabilitation centers for persons with disabilities existed in each province and in Ashgabat. In September and October, the government opened six combined education and rehabilitation centers, one in each of the five provinces and one in the capital. Each center was designed to serve 420 students with disabilities. \*\

Although the law requires new construction projects to include facilities that allow access by persons with disabilities, compliance was inconsistent and older buildings remained inaccessible. A lack of consistent accessibility standards resulted in some new buildings with inappropriately designed access ramps. The Ministry of Social Welfare is responsible for protecting the rights of persons with disabilities. The ministry provided venues and organizational support for activities conducted by NGOs that assist persons with disabilities. The law provides for the right to vote for all, including for persons with disabilities. \*\

Image Sources:

Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, Lonely Planet Guides, Library of Congress, U.S. government, Compton’s Encyclopedia, The Guardian, National Geographic, Smithsonian magazine, The New Yorker, Time, Newsweek, Reuters, AP, AFP, Wall Street Journal, The Atlantic Monthly, The Economist, Foreign Policy, Wikipedia, BBC, CNN, and various books, websites and other publications.

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© 2008 Jeffrey Hays

Last updated April 2016

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