Turkmenistan, with a population of about 6 million, has, as of October 1, 2020, reported no SARS-CoV-2 infections, nor any COVID-19 related deaths. There are no daily updates and barely any testing. However, there are reports of more deaths from acute respiratory illnesses than normal, and the autocratic government, known for endemic corruption, puts these down to dust and air pollution.
Despite the government’s refusal to acknowledge that COVID-19 is present in the country, reports of cases circulate among friends, in social media, and by civil society organizations, and efforts are being made to track COVID deaths. The pandemic and related insecurity arising from fear of disease and lack of any information are affecting the Turkmen people’s physical and mental health. Despite known deaths in neighbouring countries, within its borders all the public hears is that “there are no confirmed cases of COVID-19 in the country.”
To Turkmens, this denial of their right to information, to health care, and to transparency is normal. The public has not seen any public health data from the government in the last 29 years since it became an independent country in 1991. The Ministry of Health and the State Committee on Statistics, TurkmenStat, do not provide any statistics that concern human development in Turkmenistan. It has not reported any HIV infections since independence. Public health data is missing in the government’s reports to the World Health Organization (WHO). Some UN country reports have acknowledged a significant difference between local and international data being reported.
The Soviet healthcare system that was inherited at independence is now struggling to cope with a chronic shortage of healthcare workers, medicines, other health supplies and poor management. Ranked 101 out of 195 in the 2019 Global Health Security Index, Turkmenistan is poorly prepared to cope with a pandemic. People’s rights to healthcare have been unfulfilled for so long, there is little confidence or trust in the population that the health system is able to help them.
Relying on civil society
In response to this pernicious and perilous, situation, alternative networks have emerged over the years to provide public health information. Since February 2020, Saglyk.org, a non-government organization founded in 2009, has been providing the public with science-based information on COVID-19, in the Turkmen language. The organization has also repeatedly sought to engage the Ministry of Health and WHO, and to provide science-based and ideology-free information, but Saglyk has received no replies to its requests.
The government acknowledged the risk of COVID-19 early in the pandemic, and in March was closing borders and quarantining those entering Turkmenistan. The country’s small population and relative geographical isolation may have actually curbed the spread of the virus, but without access to data and scientific information letting people know how to protect themselves, the government squandered its opportunity, and failed to uphold its obligations, to keep the people safe.
In April, a WHO expert mission announced it would visit Turkmenistan but it took three months, according to the organization, to clear logistical issues. The 10-day mission took place in July and at its conclusion released a statement noting there were no confirmed cases, but advising the country to act as if COVID-19 is present in the country. The WHO Head of Mission did not dispute the ministry’s report of increased pneumonia cases in the country. The WHO statement was disappointing for the population that had been hopeful it might nudge the government to embrace reality and fulfill human rights. Saglyk.org released a statement to the public on the government and WHO’s actions and expressing concern that the government and WHO were masking the public health emergency in Turkmenistan.
Saglyk has also found that doctors received no information about the pandemic, nor medical treatment or prevention protocols, until mid-August. Despite ongoing reports of pneumonia, the lack of testing for COVID-19 removes any possibility of confirming the presence of the disease. On August 7, 2020, the head of WHO Europe, Hans Kluge, tweeted that he was alarmed by the increase of pneumonia cases in the country and proposed that COVID-19 tests from Turkmen patients be conducted in WHO reference labs outside Turkmenistan. He also said that the President of Turkmenistan agreed to the plan. Yet, this news was not covered by the state media and on August 31, Saglyk wrote to WHO Turkmenistan asking for any update on the agreed upon testing. WHO responded that they are once again having logistical difficulties gaining access to the country. Many people who likely are COVID-19 positive choose to suffer at home and avoid contact with the healthcare system due to its state of disrepair and corrupt practices.
The failure in communication and management of the pandemic has brought the public’s trust to an all-time low. For the community, it is embarrassing that Turkmenistan has become a butt of jokes in international media. The Turkmen public watch governments of neighbouring countries providing COVID-19 data to their population but receive no similar data to help keep themselves safe from the virus.
The public and civil society are looking to WHO and other UN agencies to prevent deaths in Turkmenistan by not accepting or supporting Turkmen practices that defy reason, logic, science, and human rights, and continue to destroy trust.
Meanwhile it remains up to civil society in Turkmenistan to continue undertaking the state’s duties to inform and educate the public, and to hold the government and WHO to account for acting in ways that are resulting in preventable loss of human life in Turkmenistan.
Aynabat Yaylymova is the Founder and Executive Director of Saglyk.org
 Ministry of Health of Turkmenistan at http://www.saglykhm.gov.tm/app/home
 UNAIDS Turkmenistan page at https://www.unaids.org/en/regionscountries/countries/turkmenistan
 UNFPA Turkmenistan country factsheet at https://eeca.unfpa.org/sites/default/files/factsheets/en/Turkmenistan_factsheet.pdf
 The effects of dictatorship on health: the case of Turkmenistan by Bernd Reсhel and Martin McKee, Published online 2007 Jul 30, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1948003/
 Global Health Security Index at https://www.ghsindex.org/wp-content/uploads/2019/10/2019-Global-Health-Security-Index.pdf
 Saglyk.org’s section with COVID-19 information in the Turkmen language at https://www.saglyk.org/makalalar/keseller-barada-maglumatlar/infeksiyon/1620-natanys-wirus-koronawirus.html
 Saglyk’s letter to a reader with update on questions Saglyk is asking the Ministry and WHO at https://www.saglyk.org/makalalar/covid-19/1820-ovid-19-we-yurdumyz-kone-we-taze-soraglar.html
 “It came with the wind”, Human Rights Impact Assessment of the COVID-19 Response in Turkmenistan by IPHR and Turkmen Initiative for Human Rights at https://www.iphronline.org/wp-content/uploads/2020/07/Covid-19-Turkmenistan-report.pdf
 WHO’s expert missions to Turkmenistan press conference at https://www.euro.who.int/en/countries/turkmenistan/turkmenistan-response-to-covid-19-pandemic
 Saglyk’s reaction to WHO’s statement at https://saglyk.org/makalalar/covid-19/1796-statement-on-who.html
 The Daily Show’s segment on COVID-19 in Turkmenistan at https://www.facebook.com/thedailyshow/videos/318376685963584/