Before the twentieth century, central Asia was inhabited mainly by the nomadic
people of the steppes and deserts, and by settled people living in the oases and
river valleys. For thousands of years, the region was a crossroad for the intermingling
of populations, cultures and religions, with a long history of successive
invasions by powerful neighbours, including Persians, Greeks, Arabs, Turks
and Russians. Central Asia is perhaps best known in the West as the setting for
the ‘Silk Road’ over which trade was conducted between Europe and China
before the inception of the sea route to the east.
During the eighteenth century, the khanates of Bukhara, Kokand and Khiva
retreated into isolation in the face of pressure from Russia and Britain, who
waged a long, largely covert campaign, the ‘Great Game’ (Hopkirk 1990), to
control this region and thus the land route to India. By the late nineteenth
century, however, central Asia had been annexed by the Russian Empire. From
1918 on, Soviet rule brought fundamental social and economic changes. Largescale
movements of population, including the imposition of a ruling Russian
elite and the forced migration of minorities (coupled with rapid urbanization
and collectivization), transformed the region. The present-day borders were
drawn in 1924, when Joseph Stalin divided the region into several nominally
independent republics.
In Chapter 2, on the history and politics in central Asia, Akiner outlines the
massive social engineering undertaken by the Soviet regime, which changed
most aspects of life for people in the region. Although this involved political
and cultural oppression, it also produced substantial benefits, such as the
establishment of a comprehensive health care system. Throughout the Soviet
era, the region continued to be isolated from the outside world, with all contacts
tightly controlled – in part, because it was the location of many elements of
the military–industrial complex. One result of this isolation was to cut these
countries off from developments in medical research, education and clinical