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01.12.2007 | Research article | Ausgabe 1/2007 Open Access

BMC Medicine 1/2007

The effects of dictatorship on health: the case of Turkmenistan

BMC Medicine > Ausgabe 1/2007
Bernd Rechel, Martin McKee
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1741-7015-5-21) contains supplementary material, which is available to authorized users.

Competing interests

The author(s) declare that they have no competing interests.

Authors' contributions

BR participated in the design of the study, performed the data collection, and drafted the manuscript. MM conceived of the study, participated in its design and coordination, and helped to draft the manuscript. All authors read and approved the final manuscript.



There is a health crisis in Turkmenistan similar to, but more severe than, in other Central Asian countries. This paper asks whether the health crisis in Turkmenistan is attributable to the consequences of the dictatorship under president Niyazov, who died in 2006.


The basis for this paper was a series of semi-structured in-depth interviews with key informants complemented by an iterative search of internet sites, initially published as a report in April 2005, and subsequently updated with feedback on the report as well as a comprehensive search of secondary information sources and databases.


This paper describes in depth three areas in which the dictatorship in Turkmenistan had a negative impact on population health: the regime's policy of secrecy and denial, which sees the "solution" to health care problems in concealment rather than prevention; its complicity in the trafficking of drugs from Afghanistan; and the neglect of its health care system.


The paper concludes that dictatorship has contributed to the health crisis facing Turkmenistan. One of the first tests of the new regime will be whether it can address this crisis.
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