27.04.10 22:57

What goals did \"Doctors without Borders" pursue in Turkmenistan?

The most important feature of the foreign policy of Turkmenistan is aspiration to develop full-scale cooperation with international organizations. The country is open and willing to interact with them in various fields - economics, social life, development of democratic institutions, environmental protection and many others. Specialized UN agencies such as UNDP, the Office of the High Commissioner for Refugees, UNICEF, World Health Organization, the Office on Drugs and Crime, the Population Fund, the Regional Centre for Preventive Diplomacy, Office of the International Organization for Migration, the European Bank for Reconstruction and Development, "House of Europe" and several other international structures are operating in Turkmenistan on the continuing basis.

One of the areas where cooperation is most efficient and successful is health. In particular, it has resulted in obtaining international certificates. In 2000, Turkmenistan received the certificate on the elimination of dracunculiasis, in 2002 - the certificate on cessation of circulation of wild poly-virus in Turkmenistan, indicating that polio was eradicated completely. Turkmenistan was the first among the CIS and Central Asian countries and fourth in the world to ensure the universal salt iodization in accordance with the accepted international standards, and was recognized as the country that solved one of the pressing problems facing humanity - iodine deficiency. In recognition of this fact Turkmenistan received a certificate in 2004. In order to prevent diseases associated with lack of iron in the human body Turkmenistan in close cooperation with foreign partners is implementing a number of major projects to enrich foods, particularly flour and salt. There have been achieved real successes in combating other common diseases, including malaria, measles and rubella.

There were recently commissioned the International Head and Neck Center, Cancer Center, a number of spa resorts such as Archman, Yyly Suv, Bayramali renal sanatorium. By the decree of the President of Turkmenistan, the Directorate of the Center for Infectious Diseases of the Ministry of Health and Medical Industry of Turkmenistan was established on the basis of specialized medical institutions. Diagnostic centers are operating in all the administrative centers of the provinces of Turkmenistan. The attainment of program objectives for the protection of motherhood and childhood is part of the health system. The opening of modern "Ene Myahri" health centers all over Turkmenistan, the successful implementation of the national program on breastfeeding and anemia control were highly appreciated by major international organizations. In particular, almost all obstetric facilities have been awarded the status of "Child-friendly hospital", which was officially confirmed by WHO experts.

An important part of public health policy is consistent implementation of a strategy to reduce morbidity. Turkmenistan is among the states that successfully carry out immunization activities, occupying a leading position in the region in terms of availability of vaccines and immunization of the population. In Turkmenistan, the vaccination is free of charge. Hib-vaccination, which is also one of the most important preventive measures, started from 1 January 2010.

Turkmenistan is pleased with the fact that the national health system achieved successes thanks, not least, to active international cooperation. That is why the country is happy to develop such cooperation, while creating the most favorable conditions for representatives of WHO and other international organizations. This cooperation is multifaceted and being carried out in a systematic way. The long-term streamlined professional dialogue is underway. This is an everyday, sometimes routine but very necessary work of Turkmen and international health professionals united by a common purpose, which is to help people.

Against this background the activities of "Doctors without Borders" in Turkmenistan and their report of April 12 look totally unacceptable.

From the standpoint of professional medicine, the report is absurd. Instead of a serious research, the authors vented a set of accusations and claims against Turkmenistan based on subjective, not supported by concrete data, speculation and rumors. From the ethical point of view, the report also raises questions. The truth is that this report appeared shortly after "Doctors without Borders" decided to wind up their activities in Turkmenistan. Why didn't they do it during their work in the country in the framework of professional discussions of emerging issues with their Turkmen counterparts, which is the normal line of business followed by international organizations? Moreover, the Turkmen side has done everything possible to establish a constructive partnership with "Doctors without Borders" on the basis of national legislation and status of this organization.

Turkmenistan began cooperation with "Doctors without Borders" more than 10 years ago. As is known, this organization positions "providing medical assistance to victims of natural or man-made disasters, epidemics of infectious diseases, as well as victims of conflict" as its primary objective. Although none of these cases has been recorded in Turkmenistan due to its openness to the international community, our country responded positively to the proposal of "Doctors without Borders" for cooperation, believing that the assistance of this organization - within its jurisdiction and powers - can be useful. It goes without saying that Turkmenistan fully believed in a responsible approach, professionalism and integrity of the partner, who would follow high principles in their work.

It appears, however, that expectations of the Turkmen side in this sense have not been confirmed to put it mildly. The educational level of foreign staff sent to the country was visibly poor. The vast majority of staff of "Doctors without Borders" in Turkmenistan was at best paramedical personnel. Naturally, experts of such qualification were not granted certificates, admission and permit to provide medical services for the population. Their task was to provide mainly methodological and technical assistance as it was initially expected. However, "Doctors without Borders" attempted to treat people in violation of instructions without relevant documents. It is hard to believe that "Doctors without Borders" were unaware of, to say the least, irresponsibility of their actions and possible implications. At the same time, whenever the Turkmen side offered joint programs and projects in accordance with the status and competence of "Doctors without Borders" it always received a negative response.

Amid all this, it is clear that publication of an incompetent, unprofessional and biased report is of political nature, which is far of the true concern for the health of citizens of Turkmenistan. It is hard to say who wrote this report, especially given the fact that making assessments and recommendations for official bodies of this or that country is beyond the scope of "Doctors without Borders". In the system of international cooperation in health care this is a prerogative of specialized UN agencies. Therefore, if the authors of lies and distortions, that the report is literally packed with, claim that they are professionals, then they are clearly not medical professionals. They may be, however, professional provocateur-journalists, one of whom "Doctors without Borders" once brought to Turkmenistan under the guise of their staff.

In the report one can also see the desire to cast aspersions on Turkmenistan for purely selfish reasons, in this case unsatisfied. The fact is that despite the strenuous attempts by "Doctors without Borders" to gain access to international financial assistance to implement programs and projects in the health sector, the Turkmen authorities preferred to deal with other organizations who proved their competence and efficiency and won relevant tenders. So, the "difficult decision" of "Doctors without Borders" to leave the country has, it seems, very simple explanation.

There is another point talking about the "professional" and moral look of some employees of this organization. The Turkmen authorities have evidence of unseemly behavior of certain staff of this organization during the period of work in Turkmenistan. The point is about things that are incompatible with accepted ethical standards of behavior. It is about things that flagrantly violate national legislation of Turkmenistan contrary not only to the customs and traditions of the Turkmen people, but also the elementary concepts of morality, shame and decency. These facts also add to the explanation of the nature and objectives of this organization in Turkmenistan.

In such circumstances the determination of Turkmenistan's authorities to use the available legal mechanisms for protection against provocative publication appears logical and reasonable. "Doctors without Borders" grossly slandered the country, tried to undermine Turkmenistan's dignity and reputation as a responsible member of the international community, and should be held accountable for this. Possible retaliatory actions of Turkmenistan in this situation would be absolutely justified.

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