Beneath the outskirts of Yerevan, Armenia, an underground clinic situated 250 meters deep inside an active salt mine offers an unconventional treatment for respiratory diseases, primarily asthma. Since 1987, patients have journeyed into the Soviet-era Avan salt mine to undergo speleotherapy, a method based on the premise that the mine’s salt-saturated, allergen-free air can alleviate breathing difficulties.

Each day, patients descend in an industrial lift into the mine’s cavernous chambers, where they spend up to six hours undergoing treatment. Inside the mine, maintained at a constant 19 degrees Celsius, the environment is free from allergens, pollution, noise, and radiation. Patients rest on narrow beds, perform breathing exercises, or simply find quietude in the subterranean space. Anush Voskanyan, a doctor who has worked at the clinic since 1989, noted that the treatment environment was developed following observations that salt mine workers experienced lower rates of respiratory illnesses despite prolonged exposure underground. Subsequent research into the mine’s microclimate led to the establishment of specialized clinics throughout parts of the former Soviet Union.

The treatment typically involves a three-week course, with patients spending six hours a day underground. According to clinic staff, initial sessions help the body adjust to the environment before clinical benefits become more apparent. Voskanyan emphasized the unique qualities of the setting, attributing health improvements to the combination of salt-rich air and the mine’s microclimate.

For many years, the clinic served thousands of patients annually, with the Armenian government providing state funding to make treatment accessible, often free of charge through the national healthcare system. However, this support ended in 2019 when the government withdrew funding, citing a lack of conclusive scientific evidence supporting speleotherapy’s efficacy. This move was part of broader healthcare reforms, including preparations to introduce universal health insurance that required reassessment of treatments qualifying for public funding. Since then, patients have been required to pay approximately $26 per session, significantly reducing the clinic’s accessibility and patient numbers.

The withdrawal of funding has left the clinic’s future uncertain. Voskanyan expressed concern that the facility was “on the brink of closing down,” with patient numbers drastically diminished from dozens at a time to just a handful. Despite the challenges, she remains convinced of the treatment’s value, particularly for children with asthma and allergies, citing cases where symptoms have improved significantly following a course of therapy.

Speleotherapy remains controversial within the medical community. While practiced in eastern Europe and former Soviet states for decades, the treatment lacks extensive large-scale scientific validation, and many respiratory specialists regard it as a complementary therapy rather than a substitute for conventional medical treatment. Nonetheless, longstanding patient experiences continue to support its use. Alvart Alihanyan, a patient from Russia who has returned repeatedly over the past decade, affirmed that personal improvement motivates continued visits.

As debates over speleotherapy’s clinical merits persist, the salt mine continues to offer patients a rare respite from the outside world—a quiet, technology-free environment that provides not only potential respiratory relief but also a temporary escape from daily noise and distraction.