Hospitals and clinics in the Turkmen city of Turkmenabat are facing a growing staffing crisis as doctors and nurses resign en masse in protest over extortionate cash demands, particularly those tied to the annual cotton harvest. Efforts by local authorities to ease the burden have so far proven ineffective.
According to sources cited by Chronicles of Turkmenistan, three family nurses recently resigned from Turkmenabat City Clinic No. 2, leaving just 11 nursing staff at the facility. Their responsibilities have since been redistributed among remaining colleagues, nearly doubling individual workloads, while salaries have only risen by 30%. The added pressure has led many remaining staff to consider resigning as well.
Similar developments are unfolding at other clinics across the city. One doctor and two nurses have left Polyclinic No. 5, while multiple specialists have exited Polyclinics No. 3 and No. 4.
The primary cause, according to local healthcare workers, is systematic extortion, most notably mandatory contributions for cotton harvesting. In September, Turkmenistan’s Ministry of Health reportedly issued a directive requiring medical personnel to participate in the cotton campaign. Employees in the Lebap region were assigned daily quotas to pick 45 kilograms of cotton.
At both the new multidisciplinary hospital and the infectious diseases hospital in Turkmenabat, medical staff have been dispatched to the fields immediately after completing night shifts. Those unwilling or unable to comply must pay for a substitute picker, at a rate of 50 manats (approximately $14.30) per day.
In practice, the burden of physical labor during this period often falls on staff nearing retirement age. One doctor at the infectious diseases hospital revealed that up to two-thirds of some employees’ monthly salaries are spent hiring replacement pickers during the cotton season.
“Not everyone can work in the fields after a full shift, but everyone is expected to pay. That’s why many simply quit,” he said.
In an attempt to stem the exodus, clinic administrators reduced the daily contribution for hiring workers from 50 to 30 manats (around $8.50) in mid-October. However, sources told Chronicles of Turkmenistan that the adjustment has done little to stop the resignations.
Chief physicians have been trying to rehire former employees and bring retirees back into service, but interest remains low. As workloads increase and staff numbers dwindle, the quality of medical care continues to deteriorate.
