Just south of the Ashgabat city gates, a security checkpoint marks the entrance to a tightly controlled, 10-mile-wide no man’s land before Turkmenistan’s border with Iran. The guards turn back many Turkmen headed to the Islamic Republic, including those traveling for religious pilgrimage, aspiring students, and anyone else the authorities feel like blocking.
According to several Turkmen in Ashgabat, a new group is being stopped lately: medical tourists.
Moscow remains a destination for many Turkmen seeking higher-quality medical care, but the cost and complications of flying to Russia have begun to exceed the trouble of making a short trip south. Turkmen traveling to Iran can arrange fixers – often ethnic Turkmen from Iran – to provide translation, transportation, and accommodation during their stay, usually in Meshed, Iran’s second city, a half day’s drive from Ashgabat.
Patients reportedly appreciate the quality and service culture afforded by Iranian private clinics. Turkmenistan has one private medical facility, the Turkish-run Ashgabat Central Hospital, which is not well regarded by Turkmen or expats in the city.
One woman seeking fertility treatment turned to a private clinic in Iran after Turkmen doctors at the best maternity ward in Ashgabat prescribed her a list of drugs, vitamins, and folk cures three pages long. Many doctors in Turkmenistan, like their counterparts across the region, embrace folk practices and outdated Soviet-era theory over evidence-based medical treatments.
The ban on exits for medical tourists has been in place since summer, say Ashgabat residents. Some continue to make the trip, claiming to be on “business,” though sources in Ashgabat report that authorities limit even these trips to once in three months.
Why? It seems likely that someone in the Turkmen government could not abide the notion that scores of citizens would prefer Meshed over the motherland, which is run by a doctor (of a sort).
And run it he has. Gurbanguly Berdymukhamedov was promoted from Turkmenistan’s top dentist to its health minister in 1997, deputy prime minister for health and education in 2001, and president in 2007. He has been, directly or indirectly, responsible for Turkmenistan’s health system for the last 15 years. So ailing Turkmens turning to Iran for medical treatment would be seen as a direct indictment of Berdymukhamedov, their Arkadag – “Protector” – who has repeatedly promised improvements to the medical system during his reign.
If there is another explanation, it would probably fall under authorities’ other perennial priorities -- control and cash.
Turkmenistan’s leadership tends to welcome cooperation with Iran, though with as little direct human contact as possible. Thus, religious and educational exchange between the countries is informally restricted.
Finally, widespread corruption and informal payment schemes at state-run hospitals filter up, enriching officials. Each Turkmen heading to Iran for complicated, recurring medical treatment is one less paying customer for the country’s ostensibly free health care system.