Just about everyone in Azerbaijan has heard scary tales about the country’s healthcare system.
One recent case involved Tarlan Mammadova, an 87-year-old sufferer from diabetes, who had to have her left leg amputated because of the disease, only to have the doctor take the wrong leg during the operation earlier this summer. Mammadova died from complications from the botched procedure on July 31. Then there is four-year-old Arzu Gurbanli, who went in to a clinic for a tonsillectomy, only to die the day after from complications.
Such horror stories are helping to prompt lots of Azerbaijanis to travel abroad when they need to undergo all sorts of surgery. Precise numbers are hard to come by, but healthcare professionals cannot help but notice the trend.
“The tendency to go abroad for the treatment has increased since Azerbaijan’s independence from the Soviet Union,” said Adil Geybulla, a surgeon and professor at Azerbaijani Medical University. “The main reason is mistrust of the national health system.”
Where Azerbaijani citizens go for surgery depends on how much they can spend. An individual who can spend up to 5,000 Azerbaijani manats (over $3,000) tends to head for Iran, Azerbaijan’s southern neighbor. Someone who can afford upwards of 10,000 AZN (roughly $6,000) might go to Turkey. As for the superrich, they head to the United States or European Union.
Azerbaijan’s image is a sensitive topic for President Ilham Aliyev’s administration, which has spent heavily on such events as the recently held Baku Grand Prix with the aim of raising the country’s international profile. Thus, the healthcare system’s poor reputation rankles authorities.
Nasib Guliev, a top official at the Ministry of Health, vigorously defended the quality of state-funded healthcare in Azerbaijan, asserting that 600 government-operated medical institutions have been constructed or renovated over the past decade. Guliev blamed media outlets and social media for exaggerating problems and distorting public attitudes.
“What countries don’t have these kinds of problems?” Guliev said, referring to widely publicized botched operations.
The healthcare system has made marked improvements since the collapse of the Soviet Union, Guliev argued. “Compared with 1990s, the budget [for healthcare] has increased 11 times. The government allocates money, free food, free medicine. … Children are vaccinated totally for free,” he noted.
While citizens technically have access to low-cost healthcare, many Azerbaijanis report that corruption is rife in the healthcare system, in part because state salaries for medical personnel are relatively low. A nurse, for example, earns roughly $150 per month. Accordingly, would-be patients often must offer what some might describe as a supplementary payment, and others less charitably call a bribe, in order to obtain basic medical services.
While government allocations may have risen significantly over the past two-plus decades, spending has dipped by roughly 4 percent over the last year, due primarily to a budget crunch brought on by the decline of global energy prices. Azerbaijan is heavily dependent on energy exports. The rapid depreciation of the country’s currency also has hit the healthcare system hard, as many medicines and equipment must be imported.
According to Geybulla, the surgeon and professor, the rate of Azerbaijani state spending as a percentage of overall GDP lags behind that of other formerly Soviet states. He said the FSU average was 5.9 percent of GDP; for Azerbaijan, state expenditures on healthcare amounted to 4.5 percent of the country’s GDP.
At an opening ceremony for a new clinic in 2015, President Aliyev said he wanted Azerbaijan to become a destination for medical tourists. “We should create a system that draws foreigners to Azerbaijan for medical treatment,” he said.
Medical tourism is already a popular concept in Azerbaijan, but it works the other way. Responding to growing demand, several Turkish-based companies have launched operations in Azerbaijan specializing in helping Azerbaijani citizens find the right treatment, at the right price, in Turkey.
“Azeris will do everything for their health. They [are willing to] sell their house, cars, or cattle in order to come to Turkey and spend it on their treatment,” Azerbaijani doctor Orkhan Ibrahimov said. Ibrahimov received his training at a medical school in Turkey and now works at a family healthcare center in Istanbul.
According to Hamdi Kocer, an oncologist who treated women with breast cancer in Azerbaijan from 2011-2014, the number of patients coming to Turkey from Azerbaijan for treatment is increasing every year.
“Satisfied [Azerbaijani] patients refer more people,” he said, adding that many make great financial sacrifices to obtain desired medical care. “I feel sorry for most because they don’t have enough money and choose to come [to Turkey] by bus, and that takes 35-40 hours.”
Durna Safarova is a freelance journalist who covers Azerbaijan.