Since the World Health Organisation’s revolutionary 1978 Declaration of Alma-Ata, which emphasised the importance of primary healthcare and put health equity on the international agenda, Kazakhstan has continued its trailblazing path in healthcare. Coming full circle, Astana’s 2018 Global Conference on Primary Health Care that gathered 1,200 delegates from more than 120 countries Oct. 25-26 to recommit to the global cause by adopting the Declaration of Astana demonstrates how far the country has come in enabling citizens to exercise their fundamental right to health.
“Over the past few decades, Kazakhstan has passed the stage of epidemiological transition, with non-infectious chronic diseases such as diabetes and cardiovascular diseases beginning to prevail over acute illnesses,” Yerbol Spatayev, Project Management Group Public Health and Digitisation Specialist at the World Bank, told EdgeKz. “Patients suffer from these diseases throughout their lives, meaning there are high costs taken on by our healthcare system in their treatment. Kazakhstan’s healthcare system should, therefore, be restructured. Under the Declaration of Astana on Primary Health Care adopted last year, Kazakhstan is systematically working on strengthening disease prevention and primary healthcare.”
(Photo top left: global healthcare conference in Astana)
Notably, digitising the country’s healthcare system entails launching mobile applications, unifying information systems and implementing electronic health passports and paper-free medical documentation for greater medical service quality, efficiency, accessibility and safety.
“Telehealth is also under development, which is particularly important for our country of a large area and low population density,” said Spatayev on treating patients irrespective of their location. “All these changes will accumulate and have a multiplier effect, gradually transforming our healthcare system.”
While the country forges its path toward digital healthcare innovation, Kazakh doctors are making surgical procedure history at the National Research Cardiac Surgery Centre, which has contributed to Kazakhstan entering the top 30 leading countries in cardiac surgery complexity.
In December 2017, its surgeons implanted a fully artificial heart, produced by Airbus and medtech firm CARMAT, into 60-year-old Kunanbay Abrayev with terminal stage heart failure. The Kazakh doctors went on to perform the world’s first orthotopic heart transplant Aug. 1 on the artificial heart implant patient.
The first human use of a wireless coplanar energy transfer with a continuous-flow left ventricular assist device (LVAD) was also carried out last year at the centre. Eight years ago, LVAD implantation had never been carried out in Kazakhstan, and the procedure is now routine at the centre. These efforts were recently recorded in an academic article in the Journal of Heart and Lung Transplantation and not lost on the journal’s Editor-in-chief and Harvard Medical School Professor of Medicine Mandeep Mehra.
“While we can sustain life with [left ventricular assist] devices, which have become better, these devices were not fully internalised – not contained within the body and connected to a battery outside it, a big problem in the field,” he noted at a Feb. 6 press conference. “The scientists before you, [including Ivan Netuka, Jiri Maly, Massimo Massetti, Stephan Schueler and Yuriy Pya,] through their sheer hard work, have been able to move the field toward convenient LVAD implantation. This is a critical advent in our field and should not be taken lightly.”
Also, in the capital, surgeons of the Kazakh Medical Centre Hospital of the President’s Affairs Administration performed hybrid cardiac surgery Dec. 19 for the first time in the post-Soviet space and the eighth time in the world. This type of surgery combines surgical and catheter-based intervention in the heart, rendering surgery less invasive and minimising the risks associated with traditional open-heart surgery.
Nazarbayev University scholars and students have kept up with the country’s healthcare innovation pace with an invention for stroke patients’ speedier recovery, named among the world’s top 20 innovations by the United Nations International Children’s Emergency Fund (UNICEF). The project ReLive features equipment and software for reading and recognising brain signals, a microcontroller and an exoskeleton of the upper limbs. Brain signals are recorded by a mobile electroencephalograph and sent to a computer, allowing patients to mentally manage an exoskeleton. The project was presented at the Oct. 25-26 international exhibition Astana Digital Health, receiving an award for best digital solution and earning a coveted spot at the UNICEF international exhibition on Assistive Technology in Accelerating Learning and Participation of Children with Disabilities in Geneva.
Beyond Astana, innovative surgeries are undertaken in Ust-Kamenogorsk. There, the country’s first robot surgery and transplantology centre opened last year and offers minimally invasive operations that result in reduced blood loss, minimal post-surgery pain and a faster recovery. In March, Italian surgeon Stefano Gidaro performed the country’s first robotic surgery, assisted by Kazakh surgeons Nartay Turakhanov and Rinat Muzdybayev.
It is no surprise that medical tourism is gaining ground in the country, with foreign patients hailing from China, the Czech Republic, India, Italy, the United Kingdom and the United States.
“I looked through the internet for necessary treatments and decided on Almaty because local specialists have good experience in conducting similar surgeries,” said American tourist Farida Workman to The Astana Times in a February 2018 interview. “The cost is affordable as well. The same operations in the United States or Korea will cost twice as much.”
Indeed, in a brief look at digitisation initiatives, complex surgery achievements and student-led startups, Kazakhstan has displayed a forward-looking, patient-centred approach to healthcare. With a new government pursuing a more socially-oriented agenda, the healthcare ministry looks to lead the way in improving citizens’ living standards.