Lack of adequate medical facilities, misdiagnosis, and incompetence seem to be among the biggest health problems in Turkmenistan today.
The country's 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.
RFE/RL's Turkmen Service, Radio Azatlyk, has been looking into the woes of Turkmenistan's healthcare system and what the service found out is shocking.
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.
Tales Of Incompetence
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.
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 RFE/RL 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.
No Laughing Matter
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.
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.
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.
It is nearly impossible to talk about Turkmenistan's presidents and keep a straight face and I am one of many who have written tongue-in-cheek articles
about the antics of "Turkmenbashi" and "Arkadag."
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."
-- Bruce Pannier with contributions from Muhammad Tahir of RFE/RL's Turkmen Service