"X" marks the spot: do not enter. Photograph courtesy of Wikipedia (CC-usage).

Last week Médecins Sans Frontières (MSF) became the latest international humanitarian NGO to leave Turkmenistan after 10 years of working here.  Frank Dörner, General Director at MSF in a press release from 17 December, said:

Medical needs in Turkmenistan are still high and there is a good reason for us to work here. However, our project proposals have been repeatedly rejected which does not leave us with a lot of choice but to close down.  We had hoped to be able to assist the Turkmen population which is exposed to high rates of multi-drug resistant tuberculosis, but still has no access to care and effective treatment.

Their departure only adds to the absurdity of Turkmen healthcare.

Although Turkmenistan has one of the largest reserves of gas and oil in the world, much of its population is impoverished.  The severe shortcomings and the drastic cutbacks in the healthcare system during the rule of the country’s former president have created a health crisis in the country.

Niyazov allowed the country’s public health infrastructure to financially and administratively crumble.  His coup de grace was inn 2004, when he dismissed an estimated 10,000 medical workers.

Christoph Hippchen, MSF’s Country Manager in Turkmenistan. said the following to me about the organization’s decision to leave the country:

We started treating TB in 1999 and since last year we have tried to negotiate a new program, this time looking at drug resistant tuberculosis. We have been trying to negotiate a new program and the [Turkmen] government emphasized that it would want to continue our cooperation. But when we came down to negotiating how to do, we did not get anywhere.

It was very difficult to get meetings, difficult to come to any conclusion, we lost a lot of time. We felt that we couldn’t justify a program at this stage. We are still ready to negotiate but we cannot keep our office without the program.

In addition, Hippchen says that a program to treat drug-resistant TBC patients is highly technical and very complex:

According to the national strategy the first patients would be treated in 2013 but people are dying today.

It’s puzzling and morally troubling that the Turkmen government is willing to say, “No thanks, we don’t need you,” to an international humanitarian organization like the MSF, which receives non-governmental private funding from all over the world, a service that comes at no cost but to the benefit of its population when the government simply can’t meet alone the requirements.  In my next post on this topic, I’ll explore this further.