Iran is fast becoming a popular medical tourism destination for patients from neighboring Turkmenistan, who are unhappy with what they describe as a lack of qualified doctors in their home country.
Medical malpractice and misdiagnoses are widespread in hospitals across Turkmenistan, according to several Turkmen patients and their relatives who spoke to RFE/RL on condition of anonymity.
"Most doctors in Turkmenistan are incompetent," said an Ashgabat resident, who is accompanying his uncle to Iran, where he will have surgery on his knees.
"My uncle's friend, who had a similar medical condition, had surgery in Ashgabat but his condition worsened after the procedure," the resident said. "That man can no longer walk without crutches, which he didn't need before the surgery."
Another Turkmen citizen who is currently receiving medical treatment in Iran told RFE/RL that he doesn't trust Turkmen doctors.
"There are many new hospitals in Turkmenistan with modern equipment imported from Germany. But there are no specialists in Turkmenistan who know how to use this equipment," said the man, speaking by phone from the northeastern Iranian city of Mashhad.
Turkmenistan invested millions of dollars in the health-care sector to build state-of-the-art medical facilities with advanced equipment after the health-obsessed dentist turned politician Gurbanguly Berdymukhammedov came to power in late 2006.
Berdymukhammedov -- who ruled Turkmenistan until he handed the presidency to his son, Serdar, last year -- was known for ordering people to take part in compulsory mass walks, workouts, and bike rides to promote a healthy lifestyle.
Many Turkmen say the government has failed to educate enough health-care professionals with the knowledge and skills needed for high-quality, safe medical care.
Turkmen patients are particularly wary of doctors trained in medical schools in their home country. It is common knowledge in Turkmenistan that many students enter the country's medical schools only because they pay bribes.
Bribery often continues at the university and, after graduation, in finding employment. Those who pay the most or have powerful connections often get the highest grades and land the best jobs, regardless of their knowledge or skill level.
The man being treated in Mashhad said most of his fellow Turkmen patients in the same Iranian hospital had undergone surgery in Turkmenistan that did more harm than good.
"Iranian doctors sometimes perform surgery on such patients," the man said. "But in some cases, Iranian doctors refuse to treat them, saying it's already too late [to fix the damage that was done] or that additional surgery might put a patient's life at risk."
Some Turkmen patients said the Iranian doctors gave them a completely different diagnosis and subsequently different treatment than what they had received in Turkmenistan.
There are no official reports or statistics about misdiagnoses and medical malpractice in authoritarian Turkmenistan, where information is strictly controlled and criticism of the government is not tolerated.
Subsidized Health Care
Turkmen patients arrive in Iran on a tourist visa as the government in Ashgabat doesn't allow its citizens to seek medical treatment abroad.
"My niece and her husband booked an appointment at a fertility clinic abroad, because several years of treatment in Turkmenistan didn't work," an Ashgabat resident said. "But Turkmen authorities refused to issue them passports and didn't release their medical records, saying they will make Turkmenistan look bad by going to foreign hospitals."
The couple managed to go abroad on a tourist visa a year later and "decided not to inform their Turkmen doctor and authorities about it," the woman said.
Most Turkmen choose hospitals in Mashhad, which is located close to Turkmenistan's southern borders.
Turkmen patients said information about Mashhad hospitals was first spread by word of mouth after satisfied patients recommended them to others.
"There are certain hospitals in Mashhad that are well known among Turkmen clients," a Turkmen patient said. "For your first visit you do not need to make an appointment in advance. You come and see the specialist you need and set the dates for any surgery or future treatment you might need."
The Turkmen man accompanying his uncle to Iran said they are expected to make two trips, six months apart.
The total medical bill is estimated to reach about $12,000 with at least another $800 per person, per trip, set aside for hotel and plane tickets, he added.
Getting a passport is not easy in Turkmenistan, where authorities are wary of their citizens traveling abroad. Many patients said they had to bribe officials to get their passports.
"But obtaining an Iranian visa is relatively easy. It costs about $70," the man said.
Other foreign medical-tourism destinations for Turkmen include Russia, India, Turkey, and Uzbekistan.
But medical tourism is out of reach for the majority of Turkmen, many of whom live in poverty.
Many had to settle for treatment in their poorly equipped village hospitals, some of which don't have running water or a modern heating system, let alone adequate medical equipment.
Turkmenistan offers subsidized, affordable health care to its citizens with government-backed health insurance covering most treatments at state hospitals.
But in reality, corruption is reportedly rife in hospitals where patients often must pay fees to medics and for medication.
RFE/RL's Turkmen Service tried to contact health officials in Turkmenistan for comment but didn't' receive any response.
Meanwhile, Turkmen state media continued to report about new health-care facilities being launched in many parts of the country, including one in the newly built city of Arkadag.
Former President Berdymukhammedov, who still holds vast political clout in his role as the head of the powerful People's Council of Turkmenistan and as "leader of the nation," launched the construction of three massive health-care centers in Ashgabat in March.
