IN SOVIET CENTRAL ASIA, DEATH STALKS THE CHILDREN
By David Remnick
Washington Post Foreign Service
THE VAST LANDSCAPE OF WANT: POVERTY IN THE U.S.S.R. 3/3 , in a series Tuesday, May 22, 1990; Page A01
ASHKHABAD, U.S.S.R. -- ASHKHABAD, U.S.S.R. -- In the mud-brick hovels on the outskirts of Ashkhabad, children are the first casualties of poverty. Every year, thousands of infants throughout Turkmenistan and the rest of Soviet Central Asia die within 12 months of birth. Countless others suffer more slowly, weakened by the heat and infected water, the pesticides from the cotton fields, a diet built on bread and tea and soup.
"I consider myself fairly lucky. I've given birth five times, and only one child died," said Elshe Abayeva, a woman of 31 who looks 50. Some of her children played on a hillock of mud and garbage as she cut grass with a blunt scythe. Farther up the road, Abayeva's neighbors, the Karadiyevs, are not so lucky. "Five children are alive and three died -- two at birth and one after a month," the father said. "In Turkmenia, it's like this all the time. Worse in the villages."
Inside the Abayevs' two-room hut, the bare bulbs are furred with dust, flies buzz around the children's faces. The children are filthy and their clothes are frayed. Only heavy stones keep the tin roof from blowing off the outhouse and the rusted chicken coop. Aba Abayev, Elshe's husband, earns 170 rubles a month as a video technician for state television -- less than 6 rubles a day to support a family of six. The Abayevs have been waiting since 1975 to be assigned a decent, legal apartment.
"When that child was born, it was a cold winter morning," Aba Abayev said. "No one has phones here, and there are no hospitals or doctors around. I ran two or three kilometers to the pay phone and called. It looked like the baby was dying -- or was dead already, maybe -- and it took the doctors more than an hour to get here. By then the child was dead. This is the way our lives go out here. I have no hope, to be honest. And for my children, I don't think things will change, unless they get worse somehow."
In Turkmenistan, the official infant mortality rate in 1989 was 54.2 infants per 1,000 births, the highest for any republic in the Soviet Union, 10 times higher than in most West European counties and more than 2 1/2 times that of Washington, the city with the highest U.S. rate. Turkmenistan is about on a level with Cameroon.
In especially poor regions, such as Tashauz in the north, the rate soars to a staggering 111 deaths in every 1,000 births, and some Soviet and Western experts say the Central Asian republics underreport their infant mortality rates by as much as 60 percent.
Foreign and Soviet tourists come to Turkmenia for a glimpse of the exotic, to escape the concrete-and-dun landscapes of Moscow for the outdoor bazaar in the Kara Kum desert where traders deal in kaleidoscopic carpets, antique silver bangles and wine-and-gold velvet dresses. But the quaintness of the region does little to deflect attention from the poverty here: village hospitals with no running water or disposable syringes, debilitating child labor, malnutrition, inbreeding and ecological catastrophe.
Children here fall sick from a host of causes. Working in the cotton fields, they often drink from irrigation sources poisoned with pesticides and toxic minerals. Even seeing a doctor can be dangerous. In the first year of their lives, Turkmenian children are given an average of 200 to 400 injections, compared to three to five for American children.
"The doctors are inept and throw everything they have in the medicine cabinet at these poor kids, and within a few years the effect of the vaccines and so on is down to zero. The chance of terrible infectious disease multiplies out of sight," said Murray Feshbach a specialist in Soviet health care at Georgetown University. "Given the shortage of disposable syringes, the chances for transmitting AIDS and hepatitis is almost too terrible to think about. God help those kids."
Everything that has gone wrong with the Soviet system over the decades -- the centralization of authority, the vacuum of responsibility and incentive, the triumph of ideology over sense -- is magnified in Central Asia. Here the system is often described as "feudal socialism," a Soviet-Asiatic hierarchy led by Communist Party bosses and collective-farm chairmen. Ironically, Moscow's moves toward decentralization have only given those staunchly conservative regional bosses more authority.
"We had always been brought up to believe that our system was the best, that our lives were the best, and now we find just the opposite," said Yuri Kirichenko, a pediatrician at the Institute of Health Care for Mothers and Children in Ashkhabad, the Turkmenian capital, and a Communist Party member for 25 years. "This is not Africa -- children are not starving to death in the same blatant way -- but there is no way to hide it anymore: We are poor and we are suffering."
Outside Kirichenko's door, dozens of Turkmenian women, many of them pregnant, pace the hall and wait hours for treatment for themselves and their children. Some of the pregnant women are in their late forties and have already had a dozen or more children.
Some of the region's cultural traditions do nothing to ease the infant-mortality crisis. Because of the tribal legacy here, there is a high rate of inbreeding -- marriages among close cousins and other relatives. Many Turkmenian men scorn birth control, and women frequently give birth twice in one year, believing that more children will bring greater wealth -- "more hands, more rubles" --- but the opposite is true.
The Islamic tradition of kalim, or bride purchase, means that many young couples spend nearly all their meager incomes paying off the loans necessary for a payment to the woman's family of as much as 40,000 rubles. As a result, the couple is particularly poor just when the woman is in her prime childbearing years, and the effect on the family diet and child health can be ruinous.
"Of course, we need to educate people on birth control and all the rest. But as a party member -- and it hurts me to say this -- the truth is that poverty here is tied to politics," said Kirichenko. "Ninety percent of the blame lies with the system, the bureaucracy, the command system, the centralization of control. There is no escaping that."
Photograph of a Child: Hollow Eyes, Brittle Body
Ak-Mukhamed Velsapar, a young writer and one of Turkmenia's handful of dissident voices, grew up near the town of Mary, east of Ashkhabad. He was one of eight children. He never knew, until long after he was a young man and had seen the relative wealth of Moscow, that he had been raised in poverty.
"And that is the mind-set of nearly all Turkmenians: 'We have bread, we have tea, we have a roof, we are alive -- therefore, we are not poor,' " he said. "These people have no basis for comparison. There are 73 newspapers in the republic, and not one of them has any degree of freedom."
A few years ago, Velsapar and his young family lived in a mud hut on the outskirts of Ashkhabad, not far from the Abayev family. The district is called Nakhal-stroi, a semi-legal slum where people build their own crude shelters because there are no apartments left in the city center. Now Velsapar lives in what passes for middle-class comfort -- a crumbling concrete apartment house that seems as unsteady as it is ugly. Ashkhabad is in an earthquake zone. In 1948, a massive quake killed 110,000 people -- about two-thirds of the city's population at the time. Joseph Stalin refused to accept any foreign aid, and beyond Ashkhabad, the disaster was only a rumor.
"That is yet another of our problems now," Velsapar said. "The earthquake wiped out practically the entire Turkmenian intelligentsia. We lost whatever roots of free thought we might have had."
Last year, along with a few hundred other writers, journalists and workers in Ashkhabad, Velsapar organized Agzybirlik, a democratic advocacy group with two key aims: to bring glasnost, or openness, to Turkmenistan and to encourage radical economic change to end what one member calls "the cycle of poverty and the colonization of our resources." Members of Agzybirlik have met with nationalist leaders in the Soviet Baltic republics for crash courses on developing a mass movement.
The Agzybirlik activists believe that the ruin of Central Asia has been the decades-old demand from economic planners of Moscow that the republics turn most of their farmland into cotton fields. The cotton monoculture, they say, directed by Moscow planners and Central Asian overlords, has sent the region every plague from the tragic infant death rate to the drying up of the Aral Sea in the cause of irrigation.
Agzybirlik has struggled, seemingly powerless to challenge the republic's powerful Communist boss, Saparmurad Niyazov, and the rest of what it calls the "local party mafia." Group members were branded "right-wingers" and "reactionaries" and were unable to register candidates for the recent Turkmenian elections. Velsapar says he is often interrogated by party officials. "They'll just blatantly say they have been listening to my phone conversations and then make some wild accusation," he said.
When will we have democracy in Turkmenia? one Agzybirlik member asked Niyazov recently. "I am democracy," the party boss replied.
Velsapar did succeed, however, in stirring up the party leadership here last month by publishing a short article and a tiny photograph in the weekly newspaper Moscow News. "It is hard to believe," the piece begins, "but the majority of Turkmenian children in our time are permanently undernourished."
For local authorities, Velsapar's article was a humiliation. Not so much because it exposed the problem of infant mortality -- there have been articles in local papers -- but because it appeared outside Turkmenistan in a paper read by the country's liberal intelligentsia.
"It was a libel on all of us!" said Geral Kurbanova, vice president of the republic's Children's Fund. "No one goes hungry here. The Turkmenian people love to eat! And poor? Oh, they have lots of money, cars -- two sometimes. They could buy proper food if they wanted, but instead they buy carpets and expensive dresses."
What intensified the furor was the accompanying photograph of an emaciated 2-year-old child named Guichgeldi Saitmuradov. The image is hellish, like something out of the worst Ethiopian famines -- hollow, desperate eyes, a bare skeleton for a body.
Several sources corroborated the boy's fate: After repeated trips to a hospital near his parents' collective farm in the Tashauz region, the boy died in 1988. Before Guichgeldi's death, however, Khummet Annayev, a physician and senior researcher at the Institute for the Health of Mothers and Children, made a research trip to the region. He reported dire shortages of meat, butter, chicken and other foodstuffs over a 10-year period, abuse of pesticides and defoliants, miserable medical facilities. And when he saw Guichgeldi in a medical clinic, he asked someone to take the photograph that would eventually be published in Moscow News.
"In our republic, anything can grow, so there should be no hunger at all," Annayev said. "I'd never seen anything like this since World War II."
Inevitably, the higher the official, the greater the denial. "We have a problem with infant mortality here, but there is no hunger in Turkmenia," said Kurbanova of the Children's Fund. "An aberration," said the republic's deputy health minister, Dmitri Tessler, who pronounced Velsapar an "adventurer" and Annayev "out of his depth." The republic's newspapers never reprinted Velsapar's article, but they did run countless denunciations triple its length.
But doctors who work every day with Turkmenian women and children see it another way. Kirichenko says he regrets the storm the article created, but he found it "generally accurate."
"I wouldn't say the case of the emaciated boy in Tashauz is typical, but I have seen such children in this country, not only here in Central Asia, but also in Krasnodar, in Russia, where my last job was," Kirichenko said. "Best not to call it starvation, maybe. But it is hunger and, most of all, protein deficiency."
The government has increased its attention to infant mortality here to some degree, providing some food products free for children under 2. Kirichenko even calls some of the efforts "heroic."
But at the same time, the Turkmenian leadership seems determined to control the debate on infant mortality and poverty. Several Agzybirlik leaders say they have been blacklisted, unable to publish their books. Last year, director Yuri Karagezov made a film about child malnutrition and the use of chemical agents in the cotton fields. It was called "Diagnosis," and one doctor here said the footage of childhood suffering "looked like Leningrad during the Nazi blockade. It made my hair stand on end. I couldn't sleep for nights."
The Turkmenian government banned "Diagnosis" and seized the only copy.
On the Collective Farm: White Gold and Slow Death
Broad-bellied and wearing a crisp suit and a panama hat, Muratberdi Sopiyev looks like an antebellum Mississippi plantation owner. He is one of the most powerful men in the republic, a member of the Congress of People's Deputies in Moscow and, for the last 30 years, chairman of the Soviet Turkmenistan collective farm.
"We have democracy here on the farm," Sopiyev said. "Every so often I'll tell the people they can nominate an alternative candidate, but they say, 'Oh, no! Never! No need!' and that's that. Ho, ho!"
As he waits for his private car to take him into the capital, Sopiyev stands like royalty in front of the farm headquarters. With its marble pillars and fountain, the place looks like a cross between a bureaucratic palace in the West and an emir's mansion in the East. By this country's standards, Soviet Turkmenistan is a model farm: There is a gleaming Palace of Culture, a varied harvest of vegetables, potatoes and fruit, mud-brick houses that seem better constructed than those on the outskirts of Ashkhabad and in other villages.
The one recent Moscow innovation that seems to be taking hold here and on other farms in Turkmenistan is family farming, under which families are allowed to lease a plot on the collective farm and then sell its produce.
But the nationwide family-leasing plan has also turned out to be hazardous to childrens' health, especially in Central Asia. While the government has taken limited measures to see that children are not pulled out of school and sent into the fields for harvests, the families themselves have used the new independence to exploit their own offspring. Once more the children are in the fields, breathing and drinking poisons.
Sopiyev is one of hundreds of Central Asian legislators who are rarely heard from in Moscow. They are the silent majority, a huge bloc that never challenges the leadership and rarely fails to jeer the radical reformists. One of the few times the Turkmenian delegation has been heard from came last month when the national president of the Children's Fund, Albert Likhanov, praised Velsapar's article in Moscow News. "Shame!" they shouted. "Libel!"
"We here in Turkmenia don't believe that chatter and protest have anything to do with democracy," the delegation chairman said.
Sopiyev said the rate of infant mortality on his farm is "not so bad" as in the rest of the republic -- "45 out of 1,000," but that is still more than double that of Washington. Like the rest of the Turkmenian leadership, Sopiyev sees the "triumph of communism" as the road out of poverty.
"We have to keep fulfilling, even over-fulfilling, the five-year plans," he said. "We don't need private property. Not in this country. That will only bring exploitation. No one wants it. We know that in capitalist countries they have very, very poor people. We don't have that. We provide free apartments, gas, education, medical care.
"We don't need a multi-party system, either. We don't need the chaos that would bring. We need the Communist Party, and we have to follow the party line. That is the way to wealth." With that, Sopiyev got into his car, and his driver took him to a ministry in Ashkhabad where the republic gets its instructions from Moscow.
From a desert road west of Ashkhabad, not far from the hills that mark the Iranian border, one can see endless cotton fields and mulberry trees and numerous, easy symbols of the republic's poverty -- a crumbling, concrete Communist Party emblem, peeling propaganda posters extolling the harvest of the "white gold" cotton crop.
In the town of Bakharden, the Mir Collective Farm bakes in the dust. A mother and her dirt-caked, vacant-eyed daughter stood by a gate; a ragged dog slept curled in the road. In contrast to the palatial farm headquarters at Soviet Turkmenistan, the main building here is a fly-infested outpost with a few ancient desks, a half-empty bookshelf and a portrait of Lenin framed in gold. "There's no secret, this is a poor farm," said Amanmuradov Chari, the deputy director of the farm's agricultural committee. "We have about a 3.5-million ruble debt that we're working off." Mir is just one of thousands of such farms forged together in the 1930s when Stalin wiped out private farming with his bloody campaign of collectivization.
At a small house nearby, a young woman named Aino Balliyeva served tea to her visitors. She is 20 years old and unmarried. She picks cotton in the fields and helps care for the house. She said she has heard that there are dangers in the work, that she is undoubtedly taking in pesticides and defoliants that will one day hurt her children.
"But what can I do about it?" she asked. "I want to have children, because that is life. And as for the rest, I just don't know what to do. None of us do."
Articles appear as they were originally printed in The Washington Post and may not include subsequent corrections.