Turkmenistan: business empire of the head of a psychiatric clinic

Patients in a psychiatric clinic live in terrible conditions, systematically subjected to extortion by the medical staff. ACCA journalists managed to talk with patients and staff of one of the most closed institutions in Turkmenistan.

The psychiatric dispensary is located in Balkanabad, the chief physician of which is Araz Hydyrovich Hydyrov. The dispensary has two male departments and one female department, including one paid (VIP) ward and one general ward with 30-50 beds. The paid ward accommodates only the clients of the head physician Hydyrov. They have fans and air conditioners bought with the money of the patients’ relatives. The rest are in the common ward, where the beds are placed close to each other. The floors in the common wards are wooden and rotten. In summer, there is an unbearable smell due to the fact that patients defecate and urinate under themselves, all these masses seep through thin and torn mattresses and fall through the cracks under the floor. The institution doesn’t have white and new linen. All linen is brought from army barracks, hospitals and all this is used. Most of the patients wear worn-out army pants and shirts; they don’t give anything new at the dispensary.

Hygiene is bad. In summer, patients take a bath every other day and they are given one soap for all. In winter, patients bathe 1-2 times a month. In each department, there is a tank with water and one mug is tied to the tank for use by all patients. The water in the tank is not disinfected or boiled. In the summer, most patients suffer from diarrhea. Patients don’t have their own bedside tables and closets for storing personal belongings; they are prohibited from having personal utensils.

In the hospital, as in the whole city, there is no twenty-four-hour water supply. Patients go to the toilet under supervision 3 times a day, where there is a rusty bathtub or a barrel filled with water. All this water is intended for 40-50 patients. They are allowed to walk into the courtyard twice a day, in the morning and in the evening for 1-1.5 hours, the rest of the time the patients are kept in the wards, the iron doors are always locked.

The medical staff, with the knowledge of the head physician, uses physical force and beatings against the mentally ill people. Patients can be tied with wet rags to the bed for a day or more. In the dispensary, deaths from improper prescription of drugs are not rare, because there is not a single psychiatrist among the medical staff, all working doctors studied at institutes in other areas in the field of medicine. Among the doctors there is a pediatrician, a former family doctor, but no psychiatrist.

Meals in the psychiatric clinic are very poor due to the fact that the employees of the hospital canteen sell food intended for feeding patients. Food is sold to the hospital staff, and it can also be booked until the next paycheck. Many of the nursing staff survive like that until the next paycheck.

ACCA’s interlocutors said that people often bring food to patients to the hospital as help, but only a small part of them reaches the patients. For example, if several boxes of cookies and sweets are brought, the patients are given one candy and one biscuit, and the rest is divided equally between the senior nursing staff and the head physician. The junior nursing staff also receive one candy and one biscuit. If a cauldron of pilaf or a pot of soup is brought, then the fattest and largest pieces of meat go to the senior medical staff. According to our interlocutors, in the last 2-3 years the situation with medicines has worsened, and the relatives of the patients have to pay for the medicines allocated by the state. All proceeds from the sale of medicines are taken by the head physician. Also, our interlocutors reported that the head physician Hydyrov has his own business in the hospital. It’s a paid treatment of persons suffering from alcohol dependence, although there are medical centers in Turkmenistan for the treatment of alcoholics. The head physician has an agreement with the local police on the delivery of drunk detainees to a psychiatric clinic. It’s easy to get there, but getting out of there is a problem for at least $ 500. All our interlocutors claim that Hydyrov and the senior medical staff live in grand style. They all have cars, luxury apartments and don’t deny themselves anything. Hydyrov also has a mistress, for whom he built a large house and lives in two families.

For a long time, residents of Balkan region have associated the psychiatric clinic not with medicine, but with another corrupt, punitive body. People have known what was happening and there were even complaints, but Hydyrov enjoys the support of the National Security Committee, the Prosecutor’s office and the police. Hydyrov also has good profits from disabled people and retirees. Many people send their unwanted relatives to a psychiatric clinic, and their pensions and disability payments are taken by the head physician. The employees help in misappropriating apartments and other property from lonely pensioners and disabled people. For example, a pensioner or a disabled person has a good three-room apartment. Relatives or security officials (depending on who needs this apartment) forcibly send a person to a psychiatric hospital, where his/her medical history is falsified and the person is sent further to the psychiatric hospital “Kyzylkaya” for life imprisonment, where he/she dies a few years later. If the apartment is taken away for a relative, then the relative of the apartment’s owner must pay Hydyrov 25% of the cost of this apartment (the minimum price for a three-room apartment is $ 40,000). According to our sources, a lot of housing is being taken away for officers of the National Security Committee, prosecutors and police staff. Conscripts also bring good profits to Hydyrov; it will cost $ 5,000 or more to avoid the army service. 3-4 conscripts are commissioned a year, and they are mainly children of high rank officials, security officials and wealthy people.

Every year, checking commissions from Ashgabat come to the psychiatric clinic, but as usual they leave without finding any violations and with expensive gifts from the head physician. Before the arrival of the commission from the capital, Hydyrov received a call from the Ministry of Public Health and warned about the visit of the inspectors.