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RUCNMEM/EU MEMBER STATES COLLECTIVE
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RHEFDIA/DIA WASHDC
RHEHNSC/NSC WASHDC
RUEKJCS/SECDEF WASHDC
RUEKJCS/JOINT STAFF WASHDC
RUCPDOC/DEPT OF COMMERCE WASHDC
RUEATRS/DEPT OF TREASURY WASHDC

UNCLAS SECTION 01 OF 02 ASHGABAT 000055 
 
SENSITIVE 
SIPDIS 
 
STATE FOR SCA/CEN 
 
E.O. 12958: N/A 
TAGS: TBIO AMED PGOV SOCI TX
SUBJECT: TURKMENISTAN: MEDICAL CARE WELL BELOW WESTERN STANDARDS 
 
REFS:  A) 09 ASHGABAT 1269; B) 09 ASHGABAT 211 
 
ASHGABAT 00000055  001.2 OF 002 
 
 
¶1. (U) Sensitive but Unclassified. Not for Public Internet. 
 
¶2. (SBU) SUMMARY:  The system of medical care in Turkmenistan is 
unreliable, with the majority of hospitals being old, unsanitary, 
and lacking in basic diagnostic equipment and medical supplies. 
However, there are some well-educated doctors and a few new 
hospitals that come closer to Western standards.  It will take time 
for Turkmenistan, with the help of international assistance, to 
rebuild a cadre of experienced doctors with training in using modern 
equipment, facilities, and WHO standards.  END SUMMARY. 
 
¶3. (SBU) Turkmenistan does have some knowledgeable, well-trained 
doctors that work in both the private hospitals and the government 
hospitals.  Some of them have had training in the United States, or 
elsewhere outside of Turkmenistan, that has clearly improved their 
abilities.  One doctor at the Central Hospital, a Turkish-run 
private hospital in Ashgabat, takes very thorough patient histories, 
which is rare in Turkmen medical practice.  Although Turkmen doctors 
do not follow Western practices for assessing a patient's condition, 
they appear to usually correctly diagnose their patients. 
 
¶4. (SBU) Turkmen doctors are hampered by their working environment 
and their limited training.  The coordination of care between 
doctors is nonexistent.  As the family member of an Embassy employee 
was getting ready to have surgery, she underwent a number of 
pre-operation tests.  The day she checked into the hospital, she was 
told she needed to have all of those tests done again at the 
hospital, because they could not use the results from her previous 
tests. 
 
¶5. (SBU) New hospitals in Turkmenistan reportedly have modern 
diagnostic equipment, but it is unclear how many doctors are trained 
to use it (Ref A).  Experienced specialists that worked in old 
oncology and neurology departments have experience, but need 
retraining on analyzing the resqlts produced by the new equipment. 
In addition, the quantity of diagnostic equipment is lower than in 
the West.  A patient's room in a Western hospital has more equipment 
for monitoring blood pressure, pulse, and breathing than an 
emergency room in Turkmenistan.  Most Turkmen hospitals also lack a 
stock of even basic medicines.  One Embassy employee had stitches 
without anesthesia, because the hospital did not have any.  Another 
Embassy employee was told to bring with her all of the medicines, 
bandages, needles, and even plasma needed for a surgery. 
 
¶6. (SBU) Lack of cleanliness is a significant shortcoming of Turkmen 
hospitals, particularly the older ones.  An Embassy employee noticed 
that in one hospital that handled the donation and distribution of 
blood, there was dried blood splattered on the table and in the 
registration book.  Embassy employees have also noticed that even at 
a new hospital there was no soap, nor toilet paper in the public 
bathrooms, although they appeared clean.  Most doctors and nurses, 
even at Central Hospital, do not wear gloves. 
 
¶7. (SBU) Locals' level of trust in their government health care 
system is very low.  They have told us that if they had the money 
and ability, they would go to Moscow, or somewhere else outside the 
country, for medical care.  Those who must stay here manage as best 
they can by getting recommendations for good doctors and paying the 
necessary "fees" to get medicine and treatment they need (Ref B).  A 
hospital gave one local a list of plasma "donors" that she could 
call to get plasma for her husband's operation.  Each of these 
so-called donors asked her for 200-500 manat ($70-175) for the 
plasma. 
 
¶8. (SBU) COMMENT:  Turkmenistan's overall level of medicine does not 
approach Western standards, but there are individual doctors and 
hospitals that come close.  The biggest problem is that the system 
does not support those who are good.  Good specialists without 
Turkmen language skills are generally deprived of the ability to 
work at modern facilities, as are older, more experienced doctors. 
 
ASHGABAT 00000055  002.2 OF 002 
 
 
Medical education in Turkmenistan is conducted solely in Turkmen 
language, limiting doctors' ability to access medical journals from 
outside the country.  Furthermore, doctors are underpaid, working 
with undereducated staff, and lacking a proper stock of medicines. 
Turkmenistan is receiving U.S. Government and other foreign 
assistance to implement WHO standards in its hospitals and medical 
schools, but it will take time to build up the system.  And it is 
anyone's guess if they will continue to maintain it, even after 
training.  Turkmenistan will only have a more modern health care 
system when the new training has been institutionalized and when 
most doctors in the country have the experience to perform 
evidence-based medicine, as opposed to rote prescription.  END 
COMMENT. 
 
CURRAN