Increasingly high prices for medicine and hospital treatment have forced many Turkmen to seek alternative options or, in some cases, even avoid lifesaving surgeries.
The health care situation in Turkmenistan has worsened in recent weeks as epidemics of flu spread in rural areas, RFE/RL's Turkmen Service reports, citing local residents and medics.
In the Sayat district of Lebap Province, approximately one-third of students aren't attending school after falling sick with flu, RFE/RL's local correspondent reported on December 12.
Not everyone, however, is visiting doctors or buying medicine because they can't afford the high prices of conventional treatment, said the correspondent.
"Doctors often prescribe Aflubin and Antigripp, which cost $21 and $1.50 respectively," the correspondent reported.
The average salary in Turkmenistan is about $228 a month.
"Families who can't afford to buy medicine are turning to self-treatment and traditional methods, such as fumigating their home with dry herbs such as peganum harmala, believing it treats their diseases," the Lebap correspondent reported.
"There were cases in which such methods worsened people's conditions," local doctors told RFE/RL.
Fearing retribution in the authoritarian country, which has a long record of brutally clamping down on any criticism of the state or sign of protest, the RFE/RL correspondents and their interviewees don't disclose their identities.
In Ashgabat, some families are sending their ill children to school because parents can't pay for a doctor's note required for a school absence, which costs about $16, RFE/RL correspondents in the Turkmen capital reported.
In Turkmenistan, children suffering from an illness are allowed to stay home up to three days without a sick-leave note.
"Many parents, especially those from impoverished households and families with many children, send their children to school on the fourth day of the illness even if they are not fully recovered," the correspondent reported.
The subsidized health insurance covers just part of any hospital treatment and medication in state medical facilities.
With rampant unemployment, many Turkmen don't have an insurance plan.
Unable to pay their medical costs, some people avoid needed surgeries.
"Before the surgery, doctors give a list of the medicines and medical devices the patients need to buy," an RFE/RL Ashgabat correspondent said. "They include [such basic things as] surgical gloves, sutures, elastic stockings, and a urinary catheter."
One Ashgabat resident had to spend nearly $260 on surgical thread alone, which she bought at a private pharmacy ahead of her surgery, the correspondent reported.
Prices for medicines skyrocketed in 2018 when residents saw the cost of some drugs double within a few months.
The country also faced a shortage of medicines that prompted some state-run pharmacies to offer customers natural alternatives, such as herbal infusions.
In 2018, Turkmenistan's Health Ministry officially recommended Turkmen to drink herbal teas "scientifically described in President Gurbanguly Berdymukhammedov's book Medicinal Plants Of Turkmenistan."
The ministry urged people to drink rosehip, mint, and chamomile tea -- all mentioned in the president's book -- to help "prevent acute respiratory diseases."
Authorities in the Central Asian country of some 6 million people never publicly comment on any possible problems people face in the strictly controlled, isolated nation, where many ordinary people live in poverty despite the country's immense energy resources.
Instead, state media often publish images of new hospital buildings, clinics, and diagnostic centers equipped with modern technologies. The government has reportedly spent millions of dollars to build state-of the art medical facilities in big cities.
Many Turkmen, however, say the impressive image of Turkmenistan's health care projected by state media is in stark contrast to reality.