Earlier this month, GZT.ru speculated on the regularly hypothesised possibility of Turkmen President Saparmurat Niyazov’s imminent demise. The basis for the latest round of predictions was based on reports that 66-year old Niyazov had collapsed shortly after a ceremony on October 2 marking the fifteenth anniversary of the foundation of the Ministry of National Security, the successor organisation to the KGB.
However, citing the expert testimony of Russian cardiologist, GZT.ru also sought to qualify conjecture:

“If a patient loses consciousness, that does not in itself indicate anything in particular. This could be connected with something other than heart problems, some less serious condition. However, you will not find a single doctor that would be prepared to give Niyazov a clean bill of health, especially after the (heart) operation that he underwent.”

Government sources sought to downplay reports of Niyazov’s ill-health, suggesting that they have been put about by wishful-thinking opposition forces. Yet, as AP reported, just less than three weeks after these rumours first emerged, Niyazov himself has lent credence to them while explaining why he would not be observing the fast during the holy month of Ramadan:

“Many of my deputies are fasting, but I cannot. … I ask you not to condemn me. I’m taking some drugs for heart disease - in the morning, afternoon and evening. … As you can see, life has exempted me from observing my duty in this sacred month of Oraz.”

Over the course of this year, Niyazov has successfully undergone two health checks, which were reported to show him in the clear. The Turkmen president has benefited from the attention of German and Turkish specialist for the last few years. After being given a routine check-up in September 2003, Niyazov spoke approvingly of his German specialists and suggested that Turkmenistan should extend its cooperation with Germany in the area of medical research.
The team of doctors conducting the routine check-up at that time was headed by cardiology specialist Hans Meisner, who also performed a heart operation on the Turkmen leader in September 1997. Meisner remained on close call for several years after that and allegedly spent some time living in Ashgabat. According to the English edition of the Pravda website, Meisner was not present at Niyazov’s most recent medical check-up, suggesting that the president was not complaining of any noticeable heart disturbances.
Direct and sourced testimony of Turkmen president’s actual state of health remains, for obvious reasons, a virtually inexistent commodity, which makes Niyazov’s admission particularly significant. Much previous speculation was based on the accounts of former Niyazov loyalist, Boris Shikhmuradov. While acting as Turkmen foreign minister, Shikhmuradov accompanied Niyazov during his convalescence from the coronary-bypass operation carried out in Munich in 1997.
In an interview with Radio Free Europe, Shikhmuradov spoke about his erstwhile leader’s deteriorating health condition after the surgery:

“At the moment of his surgery, blood circulation didn’t exceed 26 percent of his heart function. After the bypass surgery, the process was restored, but doctors warned him that he should keep a strict diet and follow medical prescriptions. Of course, he followed none of them. Quite the opposite. He continued to drink - in particular, cognac, which is his regular drink. This has completely ruined the results of the surgery. Starting in 1998, German doctors have regularly been warning that his health condition was degrading.”

As well as indicating that Niyazov’s health has indeed been far from perfect in the past, these four-year old observations reflect the fact that it remains virtually impossible to second guess his well-being. Yet, the apparent candidness of Friday’s remarks leave open the possibility that Niyazov could step down voluntarily, something he has repeatedly committed to do by the end of this decade. In the search for parallels, the analogy of Azerbaijan and the stepping down of the profoundly ill Heydar Aliev in favour of his son comes repeatedly to mind. Likewise, former Russian President Boris Yeltsin only properly recovered from the debilitating medical conditions that marred his tenure after unexpectedly resigning his post. The Turkmen scenario raises a third possibility; the diseased sultan pulling the strings from behind the scenes. This is not a likelihood that the supremely paranoid Niyazov would ever be likely to envisage without his worsening health taking the upper hand, but it has to be considered when even he publicly admits to his physical shortcomings and inability to perform basic feats of religious observance.