If there is one thing I miss the most in my life here in Kyrgyzstan, it is my regular life/work in the hospital setting in the U.S. There were few aspects of work in the hospital that I did not enjoy. I loved working in all different settings and with good people in the hospitals in four different states. So of course coming to understand the medical practices here in Kyrgyzstan has been an area of great interest. For a couple of months I had the privilege of working with Nursing education, developing curriculum and getting to know the strengths and concerns of the nurses and medical system here.
I learned one thing from the very beginning: it is night and day different from anything I had ever seen in the West. The philosophy is different; methodology and overall infrastructure took a lot of getting used to. In order to write adequate curriculum I had to spend some quality time mining the depths of the differences. I saw basements filled with western medical donations and every room in one of the main capital city hospitals had syringe pumps that were totally unused: there is no tubing here for syringe pumps, just tubing that you use to spike a bag with, excuse me, bottle…. Never have I seen a bag here. Which, without the use of pumps, and without the ability to squeeze a bag it would be hard to give a large amount of fluids quickly. But, I digress: I wanted to talk about the process of getting to a hospital.
The soviet system that is still largely in place is all about specialization – to the extreme. This hospital in this part of town is the neurological hospital, but they don’t deal with muscular- skeletal problems, and this hospital is for burns, while across campus they deal with cardiac issues, etc. etc. This creates a fascinating problem of triage. If you have multiple things going on at once, where do you go? And if you don’t exactly fit the criteria of the hospital you drive up to, they won’t take you. So it is very common knowledge that you may circle the city in your car with a severe trauma patient and not ever find a hospital that feels you fit the check list for their institution. It does present a problem! Not only this, but there must be some pretty strong negative feelings towards hospitals, because most have gates across the drive to approach the hospital with guards, sometimes carrying automatic weapons. I have heard of families rising up to kill the doctor who did not save a loved one, so there is the possibility that extreme measures are needed to protect the physicians. Needless to say, no one likes going to the hospital here. But, that would be a universal truth, now wouldn’t it, who does like to go to the hospital…. I guess I did to work there (in the US), but I would have to remind myself frequently that most people weren’t having a good day when I saw them!