25 May 2004
To look at the row of boutique shops that just opened round the corner from my house, selling Versace shirts, Armani suits and Manolo Blahnik shoes at crippling prices, you'd never guess that Azerbaijan has an infant mortality rate similar to some of the poorest countries in Africa.
In fact, more babies die in Azerbaijan every year than in any country in the former Soviet Union, bar Turkmenistan. For every 1,000 children born here, 74 will die before their first birthday as compared to just five in Britain, 18 in Russia and 79 in Senegal.
It's a shocking figure by anyone's standards, and more than double the rate of its former Soviet neighbors Georgia and Armenia, with 24 and 30 infant deaths per 1,000 births respectively.
And it doesn't seem to make sense. The wealth per capita here is far greater than in many former Soviet states thanks to the flood of foreign investors eager to get their hands on the country's oil.
True, it's not Kuwait, and the government is not rolling in money. But neither is it sub-Saharan Africa. They should have enough income from the export of their crude oil to be able to fund a decent public health service.
So why are the levels of infant mortality so high? One explanation is Azerbaijan's refugee population. Hundreds of thousands of people who fled the war with Armenia in the early 1990s now live in miserable camps, which are breeding grounds for diseases like malaria.
But there is another reason. According to a report by UNICEF, the United Nations children's fund, part of the reason for Azerbaijan's high infant mortality rate is "the declining quality and rising cost of public healthcare services."
The key phrase here is the "rising cost" of health services. You see, in Azerbaijan healthcare is supposed to be free. But, of course, it isn't. My Azeri friends tell me that if you go to the doctor, you have to slip him a few crisp notes before he will even let you into his consulting room.
What this means is that the poorest families can no longer afford to get proper treatment. Women give birth at home, or they save up to go to hospital, but cannot pay if there are complications.
Of course, Azerbaijan is famous for its high levels of corruption. In international surveys of graft it comes out near the top and ranks along other champions of corruption like Nigeria and Bangladesh.
No one expects bribery and corruption here to disappear -- it's simply a part of life. But when babies are dying in critically high numbers because their parents can't afford to pay for basic treatment, perhaps the government needs to sit up and take notice.