There's much else that's shrouded in uncertainty, not least the question of who will succeed him after nearly three decades in power. But what's a bit clearer is his own political legacy.
"In 27 years in power, Karimov has built a totalitarian state best known in the West for its brutality and isolation, for the torture of political prisoners and a yearly cotton harvest produced by forced labor," my colleague Andrew Roth reported.
Under Karimov's watch, the country's jails filled up with political prisoners, dissent was quashed and religious freedoms suppressed by an omnipresent post-Soviet police state. His appalling rights record — which included reports of suspected Islamists being boiled alive — didn't stop the administration of President George W. Bush from cozying up to Tashkent as it prosecuted its war in Afghanistan in the aftermath of the Sept. 11, 2001, attacks; it won access to a strategic air force base on Uzbek soil.
That arrangement ended in 2005 after it was too unseemly for Washington to be in league with a dictator as grim as Karimov. On May 13 of that year, his regime presided over what was probably the bloodiest state-sanctioned massacre since Tiananmen Square in 1989.
Protests surrounding the trial of 23 local businessmen accused of links to Islamist extremism in the city of Andijan had gained momentum. Andijan is nestled in the Ferghana Valley, the cultural heartland of Central Asia. The trial attracted large crowds of locals, many of whom were also irked by the country's grinding economic woes.
Amid disputed reports of Islamist gunmen among the throngs of protesters, state security forces opened fire. Hundreds — perhaps more than 1,000 people — were killed, including women and children.
Last year, Amnesty International published some eyewitness accounts of the massacre to mark its 10th anniversary:
- A man, identified as Batir, recounted what happened after soldiers in an armored personnel carrier rained fire on the crowd: "Three people standing next to me were immediately killed. One of them was hit with a bullet in the head — the entire upper part of his skull was blown off by the shot. The other one was hit by two bullets — one in the stomach and one in the neck. I could not tell how the third one was wounded — other people carried him away immediately."
- "When the shooting started, the first rows fell," said another survivor, identified as Rustam. "I stayed on the ground for two hours, fearing to move. The soldiers continued to shoot when anyone raised their head." He lay still until dark and then crawled his way to shelter.
- The Amnesty researcher, Anna Neistat, added: "Several people told me they had not been able to find their relatives’ bodies after the massacre; there were rumors of mass graves outside the town. One man said that his brother, a conscripted soldier, had been ordered to help clear the bodies. His brother claimed that they had loaded truck after truck, and that the trucks had left town because there was no space in the morgues."
Because of Uzbekistan's relative obscurity in the global imagination, as well as the regime's viselike grip on the flow of information, the slaughter in Andijan is not well remembered elsewhere. Uzbek dissidents who have managed to flee the country remain vulnerable to the long arm of Karimov's security apparatus, which is thought to have kidnapped and assassinated opponents of the regime abroad.
Some analysts suggest that the regime's repression of political opposition in the impoverished nation of 31 million people has stoked violent militancy in the region. But for many in Uzbekistan, it's risky even mentioning the horrors of the past.
"Some things should be kept forgotten," said an elderly man interviewed in Andijan by Al Jazeera last year. "The less you know, the longer you live."
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