By Monica Whitlock
BBC correspondent in Ashgabat
Reports from Turkmenistan say President Niyazov has ordered the closure of all the hospitals in the country except those in the capital, Ashgabat.
President Niyazov is known for giving eccentric orders
The order, announced by a government spokesman, is part of the president's radical health care policies.
Thousands of medical workers have already been sacked under the plan.
Civil rights activists have accused the president of sacrificing public services in favour of vast projects that glorify his regime.
President Niyazov apparently took the decision to close the hospitals at a meeting with local officials on Monday.
"Why do we need such hospitals?" he said. "If people are ill, they can come to Ashgabat."
For the Turkmens, it means the end of a nationwide health service already on its knees.
There are few able doctors and little medicine in rural Turkmen hospitals, and last year President Niyazov sacked 15,000 medical workers, replacing them with army conscripts. However the local hospital was the only place for sick people to go - especially those without the funds to travel to Ashgabat for treatment.
The foreign community will be horrified by the decision.
President Niyazov is well known for his idiosyncratic orders, but it is extraordinary for a head of state to take such a step.
At the same time, the president has also ordered the closure of rural libraries, saying they are pointless because village Turkmens do not read.
Criticism of the president is not allowed in Turkmenistan, but civil rights activists abroad say he has destroyed social services while spending millions of dollars of public money on grand projects, such as gold statues of the leader and a vast marble and gold mosque, one of the biggest in Asia.