By Shimels Hussien (Dr.)
Ethiopia’s healthcare system stands on the brink of collapse, mirroring the catastrophic public health crisis that unfolded in Turkmenistan under dictator Saparmurat Niyazov. Under Prime Minister Abiy Ahmed’s government, systemic neglect, authoritarian policies, and disregard for medical professionals are driving the nation toward a similar disaster. It is alarming that Ethiopia’s doctors—among the most valued professionals globally—are enduring conditions akin to modern-day slavery. Without urgent reforms, Ethiopia faces a tragic trajectory: a decimated healthcare system, mass emigration of skilled professionals, and a devastating decline in public health.
Under Niyazov’s rule, Turkmenistan’s healthcare system was systematically dismantled. His disdain for medical professionals was evident in his rhetoric and policies. He restricted medical training opportunities and dismissed the importance of healthcare expertise, dismissively stating, “Anybody can put a drop of polio vaccine in a child’s mouth,” and comparing medical procedures to military tasks: “Handling an AK-47 is tougher than handling medication syringes.” Despite having no medical training himself, Niyazov claimed he could cure illnesses better than doctors, undermining the profession and centralizing power in his own hands. This toxic environment led to a mass exodus of medical professionals. Many doctors emigrated to countries where their expertise was respected, while others abandoned medicine altogether. Those who remained were overwhelmed by poor working conditions, lack of resources, and oppressive policies. By 2004, Niyazov dismissed 15,000 healthcare workers and replaced them with untrained military conscripts, further eroding the system. By 2005, his proposal to close all hospitals outside the capital, Ashgabat, left rural populations without access to care.
The authoritarian regime also prohibited reporting epidemics, fearing that public acknowledgment of disease outbreaks would tarnish its image. This suppression of information allowed preventable diseases like tuberculosis to spread unchecked. Ordinary citizens bore the brunt of these policies, left to seek expensive private care or rely on ineffective traditional remedies. Meanwhile, life expectancy plummeted, and the healthcare system spiraled into chaos. It was only after Niyazov’s sudden death from a heart attack in 2006 that the country began to explore rebuilding its healthcare system. But the damage was profound—decades of neglect and the emigration of skilled professionals left a generational gap in expertise that persists to this day.
Ethiopia’s current healthcare struggles echo the mistakes of Turkmenistan. Over the past seven years, systemic neglect and authoritarian responses under Prime Minister Abiy Ahmed’s regime have placed the nation’s healthcare system on the brink of collapse. The Ethiopian Health Professionals Association (EHPA) has warned of worsening conditions, citing underfunding, low salaries, resource shortages, and government repression as critical issues. The health sector has suffered significant budget cuts, with only 3.5% of GDP allocated to healthcare—far below the global and African standards. Hospital and health center expansions were largely canceled, and medical facilities often lack basic equipment and medications. These dire conditions have created a loss of hope among Ethiopian medical doctors, with over 60% of Ethiopian medical students intending to leave the country post-graduation, according to the Ethiopian Medical Association. Health professionals’ salaries, on average just 100 USD for a medical doctor and 40 USD for a nurse per month, are woefully inadequate amidst soaring inflation. Many health professionals live in poverty, unable to afford necessities. Frustrated by these conditions, Ethiopian health workers launched protests and a partial strike on May 13, 2025, demanding fair wages, better working conditions, and systemic reforms.
The Ethiopian government’s response has mirrored Niyazov’s authoritarian playbook. Prime Minister Abiy Ahmed has dismissed the concerns of health professionals, famously stating in 2024, “The government will not solve poverty by distributing salaries.” Reports of detentions of dissenting doctors across the country reveal the repressive measures taken to silence opposition. Most alarmingly, the deployment of unqualified personnel for critical tasks—such as immunization drives—has raised concerns about patient safety, echoing Turkmenistan’s reliance on untrained conscripts. If Ethiopia’s healthcare crisis continues unchecked, the consequences will be catastrophic. The nation’s healthcare system, already strained with only 1.1 physicians per 10,000 people, faces collapse if health workers proceed with their threatened nationwide strike. Such a strike would halt almost all health services, force most valued professionals to emigrate, lead to a loss of work morale, leaving millions—particularly the poor and those in rural and conflict-ridden regions—without access to care. This scenario could exacerbate existing crises, including infectious diseases, maternal and child mortality, and malnutrition.
Ethiopia stands at a critical crossroads. To avert a healthcare catastrophe, the government must act swiftly to address the grievances of health professionals and rebuild trust in the system. Key reforms should include increasing the health sector budget to align with global recommendations, ensuring timely salary adjustments to reflect inflation, and investing in training and retaining medical professionals. Protecting health workers’ rights to protest without fear of detention is also essential. International donors and organizations have a role to play as well. They must pressure Ethiopia to uphold healthcare neutrality and support systemic reforms. Lessons from Turkmenistan’s isolation demonstrate how critical international engagement is in averting public health disasters.
The movement of Ethiopian health professionals is not just a plea for survival but a warning of the looming public health catastrophe if systemic reforms are not implemented. By heeding their demands and reversing course, Ethiopia can avoid Turkmenistan’s tragic path. Failure to act risks plunging the nation into a crisis where the healers are silenced, and the poor Ethiopians pay the ultimate price.
The author of the op-ed is a Writer, Ass. Prof of Public Health, Researcher and Consultant, based in Addis Ababa. He can be reached at: Email: shimelsh@gmail.com
