Бесплатный фрагмент - The finale takeoff despite all odds…

INSTEAD OF A FOREWORD

This is a book about people who are carrying out reforms in the most elite branch of medicine — cardiac surgery.

Reviewer: Professor A. Muratov

Kaldarmek Abdramanov is a true patriot of the country and a great specialist in his chosen field. We would have become a very advanced and developed country in the world long ago if such leaders were nominated for power…

Bayan Jumagulova, international journalist

He can be called by our epoch as a reincarnation of Isa Akhunbaev for his great service to the Kyrgyz medicine…

Beken Nazaraliev, editor of the newspaper «Zhany Ordo»

We are all indebted to this outstanding specialist and manager in his field. And it is a shame that he was often so underestimated. When I was the speaker of the KR Parliament, having learned that he was unemployed, I directly told the Minister of Health, «If you cannot employ him, then you’d better leave your position…» Finally, he was appointed as a director of the state clinic, and things moved forward.

Zhantoro Satybaldiev, former Speaker of the KR Parliament

THE MILESTONES OF DEVELOPMENT

— On May 19, 1959, Academician I.K. Akhunbaev performed the first heart surgery in Central Asia and Kazakhstan.

— On January 5, 1975, the great scientist and teacher of cardiac surgeons in the country, I.K. Akhunbaev, passed away. His work was worthily continued by his students.

— In 1976, the Republican Center for Cardiac Surgery with 50 beds was organized in the Republican Clinical Hospital, which, within 5 years, was among the top ten such centers in the USSR.

— All this served as the basis for the recommendation of the USSR Academy of Medical Sciences and the USSR Ministry of Health in 1981 to organize a branch of the A.N. Bakulev Institute of Cardiac Surgery of the USSR Academy of Medical Sciences in Frunze. Unfortunately, this good idea was not supported by local «far-sighted» medical officials.

— In 1984, on the initiative of Academician M. Mirrakhimov, the Republican Center for Cardiac Surgery was transferred to the Scientific Research Institute of Cardiology in the status of a scientific and clinical department.

— In 1984—2004, within the walls of the A.N. Bakulev Scientific Center for Cardiovascular Surgery of the USSR Academy of Medical Sciences, thanks to the friendly relations established at the time by Academicians I. Akhunbaev and V. Burakovsky, a galaxy of highly qualified cardiovascular surgeons was trained for Kyrgyzstan: more than 15 doctors and 30 candidates of medicine.

— All this and the titanic efforts of Akhunbaev’s students, Professors S.D. Dzhoshibaev, A.N. Maralov, and a team of cardiac surgeons of the country made it possible in 2004 to organize a legally independent Scientific Research Institute for Cardiac Surgery and Organ Transplantation at the National Center for Cardiology and Therapy (Institute).

— 2007. Scientific and practical conference dedicated to the 50th anniversary of the A. N. Bakulev National Center for Cardiovascular Surgery.

— 2007. Jubilee scientific and practical conference dedicated to the 30th anniversary of the organization of the cardiac surgery department: «Cardiac surgery in Kyrgyzstan: yesterday, today, tomorrow…».

— 2007. Convening the first congress of cardiovascular surgeons of Central Asian countries, with the organization of the Association of Cardiovascular Surgeons of Central Asian countries.

— 2008. Publication of the first issue of the Central Asian Journal of Cardiovascular Surgery.

— 2008. 100th anniversary of the founder of cardiac surgery in Kyrgyzstan, Academician Akhunbaev.

— 2008. Assigning the name Akhunbaev to the Kyrgyz State Medical Academy.

— 2008. International Symposium «Fruits of Cooperation between Two Luminaries — Academician I.K. Akhunbaev and V.I. Burakovsky».

— 2008. Visit to the Research Institute of Cardiovascular Surgery and Transplantation by the First Lady of the Kyrgyz Republic, T.V. Bakiyeva, opening of the Department of Invasive Diagnostics and Treatment of Cardiovascular Diseases, with the installation of a new angiographic system.

— 2009. International Scientific and Practical Conference News Horizons in Coronary & Peripheral Stenting.

— 2009. Anniversary Scientific and Practical Conference dedicated to the 50th anniversary of the first heart surgery performed in Central Asia and the 5th anniversary of the organization of the Research Institute of Cardiac Surgery and Organ Transplantation.

— 2009. Organization of the Dissertation Council in the specialty «Cardiovascular Surgery».

— 2010—2011. Campaign to harass Kaldarbek Abdramanov in the media. Vecherniy Bishkek newspaper

— 2011. Dismissal from NIIKHSTO and appointment as director of YURNCSSH

— 2015. 5th anniversary of YURNCSSH, achieving high indicators.

— 2015. Appointment as chief cardiac surgeon of Kyrgyzstan.

THE FUTURE OF CARDIo SURGERY OF KYRGYZSTAN

Cardiac surgery in the country, like all Kyrgyz medicine, has every chance to return to the forefront not only in the region, but also in Asia and the world. As was the case at the peak of the work of the outstanding surgeon of the 20th century, Academician Isa Akhunbaev.

And the team of the Research Institute of Cardiology and Orthopedics is moving in the right direction, striving not only for perfection in their work, but also provoking changes in other branches of medicine.

— It is not only about fully satisfying the needs of the republic and the people for high-quality medical care at all stages of the development of cardiovascular diseases, although even this goal is more than worthy of devoting your entire life to it — it is about fighting those diseases from which about half of our compatriots die. That is, in fact, the question is about the fate of the people, the protection of their gene pool, and the future of the country. Everything else is secondary.

That is why we can and must achieve a significant improvement in the moral and psychological climate in the medical environment and society as a whole during these reforms, since the salvation of a particular patient also depends on this, sometimes to a decisive degree. We must change ourselves during these reforms, become more honest, more responsible, and professional.

A surgeon knows well about the fragility of human life and the filigree work that is sometimes required to save a person.

However, the state, society, and the whole world as a whole also look fragile and defenseless in their own way — if all this can be saved from total destruction and degradation, then only through the consolidation of all constructive individuals, forces, institutions, societies, and countries.

The main practical achievements of the Research Institute of Surgery and Cardiology during its independence

1. Surgical activity increased from 21 to 60%.

2. International scientific ties with leading clinics in the world and the CIS expanded and strengthened.

3. Advanced structural divisions are being created and deployed, such as the department of emergency surgery and intensive care for newborns and infants, the department of surgical arrhythmology, transplantology, etc.

4. A base for training specialists has been organized — a license has been obtained for training in clinical residency and postgraduate studies, and doctoral studies. More than 10 young specialists from Kyrgyzstan, Kazakhstan, and Turkey are studying.

5. The number of operations has increased almost threefold — from 250 in 2004 to 650 in 2009.

6. The number of patients consulted annually in the KDO has increased from 4 thousand in 2005 to 10 thousand in 2009.

7. An active search is underway for investors for the construction of a new building of the center, where it is planned to house not only the cardiac surgery service, but also the vascular surgery service of the country as a single service.

8. The center is being intensively equipped with modern equipment.

9. A system for training specialists has been developed, from a resident to a doctor of medical sciences. This system meets modern trends in certification of specialists, will be useful, and will find its application in many scientific centers of the country.

10. NIICHSTO continues to increase the volume of its scientific activity (Over 4 years, more than 10 dissertations have been defended for the degree of candidate and doctor of medical sciences).

11. The scientific achievements of our center’s employees have repeatedly been recognized with the highest awards. A. N. Maralov and S. D. Dzhoshibaev were awarded the Akhunbaev Prize.

12. X-ray endovascular cardiovascular surgery is developing rapidly.

13. The Department of Internal Medicine of the Higher Medical School of the International University of Kyrgyzstan functions on the basis of NIICHSTO.

14. The office of the Association of Societies of Cardiovascular Surgeons of Central Asian Countries was organized and functions on the basis of NIICHSTO.

15. The Central Asian Journal of Cardiovascular Surgery is published.

16. The minimum material and technical base for full-fledged work as a specialized head institution of the country has been practically created.

17. New departments have been organized, including the department of invasive diagnostics and treatment of heart and vascular diseases, where expensive modern equipment for the treatment and diagnosis of heart and vascular diseases has been installed.

18. The office of the Society of Cardiovascular Surgeons of the country is based in the center.

19. Scientific and practical conferences are systematically held. The first congress of cardiovascular surgeons of the Central Asian countries was held on September 14—15, 2007.

20. The Dissertation Council on Cardiovascular Surgery has been organized at the Research Institute of Cardiovascular Surgery — 14-00-44.

And others.

All this and more became possible thanks to the reforms carried out in a separate branch of medicine — cardiac surgery.

SUCH MEDICAL CENTERS SHOULD APPEAR IN BISHKEK AND OTHER OUR BIG TOWNS. WHY IS THAT SO IMPORTANT?

Gradually, the public of Kyrgyzstan is beginning to realize the urgent need to implement this project, which painter created and what you see in the photo on the cover of the book.

In order to build such a modern cardiac surgery center and equip it with all the necessary equipment, a total of 18 million US dollars is required. Approximately third part of money the Americans paid to Kyrgyzstan per year for the rent of «Gansi» in Manas airport or as much as cost of nearly half a ton gold mined in Kumtor.

Of course, it is a huge amount of money — 18 million dollar.

But this medical center will be able to save thousands of human lives per year from imminent, almost unavoidable death.

let’s take everything in order.

In recent years, positive changes have been observed in cardiac surgery. The number of heart surgeries has been consistently and steadily increasing, their complexity has been increasing, and mortality has been decreasing. Moreover, for the first time in the country, heart surgeries have begun to be performed on infants.

Nevertheless, the situation in the field of heart disease treatment remains difficult. This is the opinion of Professor Kaldarbek Abdramanov, Director of the Research Institute of Cardiac Surgery and Organs Transplantation (RICSOT).

— Kaldarbek Alisherovich, what is the real situation with heart disease in the country?

— As a professional, I can only state that it is very, very complex and not everything depends on our will.

With the existing infrastructure and capabilities, our institute can perform a maximum of up to a thousand operations per year. The real need is much higher.

— What do you mean?

— According to WHO data, 5—6 thousand people in Kyrgyzstan need surgery every year. Only through creating, building such center will be possible to solve this problem. And most importantly, we able to save our babies with congenital heart defects, rhythm disturbances, and coronary heart disease. Recently we have successfully performed several such operations, and our institute has the most highly qualified personnel.

Modern cardiac surgery is a huge field of medicine. And we are forced to work only in a relatively narrow range of congenital and acquired heart defects, mainly due to the weakness of the material and technical base. In order to significantly expand our capabilities to conduct more complex and unique operations, including heart and other organ transplants, we need this center.

And the helicopter depicted in this picture is not a whim or fantasy of the artist: modern transplant surgery should be distinguished by a high degree of mobility, whether we are talking about a complex patient who needs to be delivered to the center for an operation in a matter of minutes or about the delivery of a donor organ.

— How much can we expect a decrease in mortality in the country if Kyrgyzstan acquires such a modern cardiac surgery center?

— As I said above, in order to put an end to this problem on a scale of all of Kyrgyzstan, it is necessary to do 5—6 thousand heart operations per year.

That’s why this center so urgently need for our Kyrgyzstan!

Every year, approximately 2 thousand children with congenital heart defects are born in the country. If they are not operated on in time, half of them will not survive 5 years old, and the rest will most likely also die at an early age or become disabled.

But this is, so to speak, the visible part of the sad statistics. The heart is an organ that must be under the constant supervision of specialists armed with the most modern equipment. Every day in the world, thousands of people die from sudden death syndrome, and more than half of these tragedies are caused by heart rhythm disturbances and coronary heart disease. So in our republic, these areas are practically not developing, mainly due to the lack of an appropriate material and technical base.

— Thus, the construction of a modern medical center solves a whole range of problems facing domestic medicine?

— Yes, exactly. We simply do not have the moral right to delay the implementation of this project. We must immediately begin building this center at our institute. We have a suitable plot of land for this, adjacent to an existing building, where we can erect a multi-story building equipped with modern operating rooms, intensive care, and high-tech equipment.

By the way, there is another argument in favor of this project: all over the world, cardiac surgery is developing together with vascular surgery, and only with such a union can it be highly effective. In our country, after the tragic death of our teacher Akhunbaev, these once united structures were disunited due to the group interests of some of our past leaders. But now our colleagues from vascular surgery understand not only the need to unite with us, but also, like us, suffer from the lack of a modern center. So with the appearance of the center, this unification will become possible.

In general, we need to build a medical center. As the head of the republican leading center of cardiac surgery, and our young team will do everything to make this dream come true in the near future.

2009.