Inside Armenia’s underground wellbeing retreat where asthma patients seek relief

Deep beneath Armenia’s capital, a Soviet-era salt mine turned wellbeing hospital has become the unlikely centre of a growing debate over alternative medicine and modern healthcare.

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Visitors descend 235 metres underground into the Republican Centre of Speleotherapy in Yerevan, where treatment consists not of medication but of breathing mineral-rich air inside huge salt caves believed to ease respiratory illness.

Speleotherapy - from the Greek word spḗlaion, meaning “cave” - is a form of alternative respiratory therapy based on spending extended periods in underground environments such as salt mines.

The clinic opened in 1987 and for decades operated as part of Armenia’s public healthcare system. But in 2019, the government cuts its funding, saying the treatment did not meet the evidence-based standards required under the country’s new universal healthcare reforms.

Since then, the centre has been fighting to stay open, even as patients continue travelling long distances in search of relief.

An unusual medical retreat beneath the earth

Armen Stepanyan, a 63-year-old mechanical engineer from the Siberian city of Kemerovo in Russia, has returned to the caves every year for more than a decade to treat severe asthma. "I've had asthma since I was 37. It got really bad at some point, and nothing would help. I went to a sanatorium for treatment, but that didn't help either, so eventually I came here."

He describes the therapy as life-changing: "I thought it was salvation. After that, I came to Yerevan every year, except for the coronavirus year. This is already the 13th time I've come to these caves for treatment."

Inside the tunnels, patients rest in rows of beds, exercise, or sit together in group therapy sessions while doctors monitor their breathing and lung function. The underground environment is shielded from allergens, pollution and temperature fluctuations.

Doctor Anush Voskanyan has worked at the clinic since it opened nearly four decades ago. "The Republican Centre of Speleotherapy is located at a depth of 235 metres, deep in the salt mines. Our hospital was founded about forty years ago, and I've been working here since its creation. We treat mainly patients with bronchial asthma, allergic diseases, especially respiratory allergies, and skin allergies."

She says the conditions underground are key to the treatment’s effects: "The air here is ionised, and the temperature is constant year-round, 19–20°C, and doesn't fluctuate constantly. This is due to the depth down the earth's crust. Radiation is reduced to zero here."

"There are no surface magnetic radio waves, noise, dust, or allergens, and thanks to all these factors, we obtain the healing effect," she adds.

An old medicine under scrutiny

Supporters argue that speleotherapy has long been part of healthcare traditions across eastern Europe and the former Soviet Union, where natural environments such as mineral springs and mountain sanatoriums were widely used to treat chronic illness.

However critics argue there is still not enough large-scale scientific research proving the treatment actually works, and Armenian health officials say that with limited healthcare budgets, priority has to go to treatments supported by stronger evidence.

The withdrawal of state support has sharply reduced patient numbers and placed the centre's future in doubt.

"Our centre is currently facing a crisis, as we no longer receive government funding. The centre is at risk and may be forced to close down completely. As a result, patients are unable to receive treatment due to the lack of government support. We hope that investors will come forward and that the centre will be revived,” Voskanyan says.

The government is now trying to privatise its share in the facility, raising hopes that private investors or medical tourism could potentially help keep the underground clinic open.

Check out the video above to see inside the underground retreat.