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Turkmenistan: Budget Cuts Will Hurt Health Sector, Schools

Turkmenistan's president has recommended cuts in the country's health care and education systems as a means to help balance the state budget. But RFE/RL correspondent Bruce Pannier says the proposed cuts could leave these already stretched systems in a state of near ruin.

Prague, 6 October 2000 (RFE/RL) -- Turkmen President Saparmurat Niyazov proposed the cuts at a cabinet meeting two weeks ago (Sept 22). He later spelled them out publicly:

"There are too many people in the medical sector -- 88,000. We do not need that many, some are superfluous. I suggest a cut of approximately 10,000 people from the medical sector. You should cut the 10,000 before the end of this year, and 5,000 people from the education sector."

A recent profile of Turkmenistan by Britain's Economist Intelligence Unit (EIU) notes that its current 4.5-million population has risen by more than a quarter since 1989. Today, four people enter the work force for every one who leaves. According to the EIU, too, "[educational] facilities are in poor shape and are coming under further strains as the number of students increases in line with the growing population. The quality of school and university education is low even by the standards of the former Soviet Union."

On Turkmen health care, the EIU said flatly that the country's system was "in crisis." The most recent Statistical Yearbook of the UN's Economic Commission for Europe says "Turkmenistan has an infant mortality rate which is 10 times higher than that of some [European] Nordic countries."

Now, with at least 15,000 more health care and education workers due to join the unemployed before the year is out, their families will lose at least part or possibly all of their means of support. Nor do the cuts decreed by Niyazov promise to make the current situation in health care and education any better.

The president has already closed rural hospitals, saying there is no need for them. Villagers must travel to regional centers to receive medical care. That can easily involve a long journey and not many villagers have cars or even a telephone.

The process of receiving medical treatment is a trip in itself. An ailing person must register on what is described as a "sick list." Within six days, a decision is made by local medical authorities on whether to send the would-be patient for medical care. The cost of the care is deducted from the patient's salary.

But if the sick have not been able to work recently because of their illness, they have no salary from which to deduct the medical fee. In such cases, it is not uncommon for medical care to be withheld entirely.

The country's educational system will now likewise face new challenges. Close to 60 percent of Turkmenistan's people are younger than 33 years of age. This year, the country's university system admitted 3,500 new students, less than 1 percent of the population. Very few Turkmen students are able to attend universities abroad because the cost is beyond their families' financial means. In addition, the government discourages study abroad for fear of the students being attracted either to western-style democracy or Islamic radicalism.

But Niyazov insists the cuts will improve health care and education:

"It should be clear that with a smaller number of employees in each sector (health care and education), one should be able to do [more] work and receive more money. There should be more competition and more work."

The "smaller number of employees" is apparently only the beginning. Bigger cuts to the same sectors are promised for next year.

(The Turkmen Service contributed to this report.)