Medical Teams International provides needed EMS training in Uzbekistan
Uzbekistan EMS Training Program
Medical Teams International
Uzbekistan is a presidential Republic with one of the largest populations in Central Asia, over 27 million residents. A large portion of the population is poor. Following independence from the Soviet Union in 1991, the Uzbek government maintained a Soviet-style economy with subsidies and tight control on production and prices. Reform measures have been undertaken but none include improvements to the social and health care sectors. Overall, Uzbekistan has encountered numerous challenges since independence, including the disruption of foreign trade, declining output and inflation, loss of the labor force through emigration and the loss of budget subsidies.
Medical service in the country is large, but inefficient. The health index for Uzbekistan is low with high mortality rates. A recent UNICEF report rated it 104th according to international health standards. The average salary of medical professionals is very low, and is paid by the government. This has contributed to 30,000 medical professionals, including 7,000 physicians, leaving the country in the past several years.
A key area lacking in medical care is EMS services. One of the greatest concerns is that many of the pre-hospital doctors working on ambulances do not have adequate emergency training. This lack of training leads to the misdiagnosis of many problems that can be easily identified by trained emergency personnel.
According to data collected by Fergana branch of Rescue Emergency Corps, 12% of patient cases had been misdiagnosed by their medical providers, 12% of doctors delayed emergency care because of lack of knowledge or resources to provide the care needed, 14.5% of healthcare providers had given or provided insufficient care, and 5% of the emergency calls resulted in improper treatment even when the correct diagnosis was made. In almost half of all cases, ambulance medical care was not provided correctly and/or in a timely manner. These statistics underscore the critical need for advanced training in the Uzbekistan EMS system.
Medical staff work in the ICU at Tashkent Pediatric Medical Institute. Medical Teams International, a relief and development agency based in Oregon, has been working to meet health needs in this area of Central Asia since 1997. In 2002, Medical Teams International began implementing the very first comprehensive EMS training program in Tashkent, Uzbekistan’s capital city. In addition to establishing two centers that teach advanced cardiac and pediatric courses in Tashkent, Medical Teams International also launched 8 basic EMS training centers in the country.
To further aid the training program, Medical Teams International donated more than $15 million in mannequins, defibrillators, basic medicines for trauma responses, and general medicines for use in hospitals. The agency also ships many pallets of hospital medical supplies and small equipment to the country.
Since the program’s onset, 54 master trainers have been trained to conduct courses in emergency medicine. These master trainers have helped Medical Teams International continue emergency medicine education in Uzbekistan as well as set up EMS training in neighboring countries. This instructor pool in Asia has strengthened EMS programs in other regions. These trainers have also been involved in disaster response teams, providing medical relief in Indonesia following the tsunami. Besides providing a valuable local resource, the creation of master trainers will enable the program to become self sustaining, providing lifesaving emergency care for generations to come.
The program is making a tremendous impact in local communities and Uzbekistan’s medical services. To date, more than 8,000 medical first responders and1,636 basic emergency medical pre-hospital care workers have been certified. These trained responders are stepping in and filling the need for trained emergency personnel. As these numbers continue to grow, the quality of treatment and diagnosis in pre-hospital care will improve dramatically--increasing chances of survival and reducing the risk of injuries. Most importantly, it will strengthen Uzbekistan’s work force, fortify community health and enhance the quality of life for all Uzbek families.
Batmanov Artyom a resident physician provides an example of the need for EMS training:
I’m a resident physician at the Tashkent Pediatric Medical Institute. I currently work in the Department of Pediatric Anesthesiology and Intensive Care and I would like to share a story with you about our need for EMS training in Uzbekistan.
I was on duty one evening last summer when suddenly I heard a loud noise coming from outside. I jumped up to see what had happened and found two men at the entrance door. One of them held an unconscious child in his arms and the other wore a medical uniform. The man with the child yelled loudly, "Help, help, this is my son."
I ran over to check the child’s condition and found no central pulse. We took him to intensive care and immediately started CPR, intubated him and connected a cardiomonitor to show his condition. His pupils were widely dilated, but not sensitive to light. I continued with CPR for more than 20 minutes but despite my best efforts, his condition did not improve. Realizing there was nothing more I could do to save this boy, I stopped CPR and delivered the heartbreaking news to his father. He slumped down on the floor and began to cry. I sat beside him and he told me what had happened to his son.
The boy had a viral infection so his mother took him to the hospital for care. The doctor prescribed some medication and when they got home, she gave one of the tablets to her son. The boy started choking and suddenly passed out. The father didn't know what to do, so he grabbed his son and drove quickly to a nearby ambulance station. The ambulance doctor at the station, said, "Let's go the hospital, right away," but he did not provide CPR. It took nearly 30 minutes to drive to the hospital and the boy did not get any oxygen during that time.
If the ambulance doctor had known how to care for a choking patient, the child could have survived. This is the reason we need EMS training in our country, so that children like this one will have a better chance at life.
Donors and partners: Bristol Myers Squibb, Johnson & Johnson, Watson, Ministry of Health, Uzbekistan Ministry of Health, Disaster Ministry, road police and local fire teams.
Photo: Medical staff work in the ICU at Tashkent Pediatric Medical Institute. Photo courtesy of Uzbek MTI field staff.