On January 12, it became known that following the inspections, the director of the National Center for Cardiology and Therapy Talantbek Sooronbaev and the director of the Research Institute of Heart Surgery and Organ Transplantation Samidin Shabyraliev were dismissed due to identified violations.
Kadyraliev noted that inspections were conducted not only in these two institutions but also in other hospitals across the country.
He emphasized that consumables, instruments, and new equipment are often stored in inappropriate conditions, alongside construction materials. In Kyrgyzstan, cardiovascular diseases remain one of the leading causes of morbidity and mortality, and cardiology patients require constant monitoring.
“In intensive care units, it is necessary to continuously monitor hemodynamic indicators such as blood pressure, heart rate, and saturation levels. This should be done around the clock, but unfortunately, protocols are not always followed. If there are 18 patients in the ICU, ultrasound machines must always be available, which is also not always the case. In critical situations, doctors must make decisions quickly — within 5-10 minutes — to save a patient's life,” he added.
The increase in mortality from cardiovascular diseases is influenced by various factors, primarily related to treatment.
“According to available data, 5 children were re-operated after the work of this team [Research Institute of Heart Surgery and Organ Transplantation]. This is just the information I am aware of,” he reported.
Regarding the storage of instruments, Kadyraliev noted that consumables should not be kept in inappropriate conditions. On May 8, President Sadyr Japarov instructed to install an ultrasound machine in the intensive care unit, but this order was not fulfilled, which is a serious violation. Even without inspections, there are international standards mandating the presence of equipment in intensive care units. Currently, changes are being made to treatment standards, including the introduction of minimally invasive methods that have not been applied to adult patients in the last 2-3 years,” he added.
Kadyraliev also noted that problems begin with the treatment process itself, including the optimization of budget expenditures, which is not always organized properly. A separate commission was dealing with this issue. Currently, by order of the Minister of Health, a new commission has been established to conduct additional inspections. “We have an accreditation commission that identified serious violations two years ago, but during this time, none of them have been addressed. An accreditation check of all organizations is currently underway,” the deputy minister reported.
He emphasized that the state is doing a lot to improve healthcare, including funding and acquiring new equipment.
“However, as we see, this equipment often just sits idle in offices. It should be used to assist patients in reducing mortality from cardiovascular diseases. Our main task is to ensure that the directors of medical institutions are held accountable for their work, including treatment and process organization, as staffing issues also exist,” Kadyraliev noted.
“As for science, in the last 10 years, no Doctor of Medical Sciences has defended a dissertation, and the number of publications is extremely low. This indicates a lack of implementation of new approaches and technologies. Over the past 15 years, trained personnel have hardly worked in the system,” he added.
Old treatment methods, used for over 30 years, continue to be applied without continuity. A school with modern approaches has not been created, and science, personnel training, and modern treatment methods must be considered as a whole to achieve results,” he concluded.
Kadyraliev also reported a case where one patient was in the hospital for the ninth day, although according to international standards, diagnosis and consultation should occur the next day. The patient repeatedly came from the regions, and available machines could have been used, so this situation was recognized as incorrect by the commission.
In response to a question about the reasons for the dismissal of the two directors, Kadyraliev noted that no one deprived them of the opportunity to continue working in medicine.
“Their task is to pass on their knowledge and experience to young specialists, to be advisors and share practices, which is a common global practice. We believe that pulmonology specialists [Talantbek Sooronbaev] should know their field, and regarding cardiac surgery [Samidin Shabyraliev], no one took the scalpel away from him — he can continue surgeries at the institute,” he said.
“However, a good surgeon must also be effective in organizing work. During the inspection of the building under renovation, numerous violations were identified, including improper storage of consumables and expensive incubators for premature infants. Even if there is no space, equipment must be neatly placed in a separate room so that it can be used after the renovation is completed or so that funds can be allocated for other needs. The responsible directors were not removed from medicine; they can work in institutions but no longer hold leadership positions, as the inspection revealed serious deficiencies,” Kadyraliev added.
He also mentioned equipment worth 28 million soms that was purchased but not used.
The deputy minister noted that equipment was often taken and returned, although it should work for the benefit of patients.
“As for medications, for example, for thrombolysis: this medication is necessary in the absence of an angiograph when a stent is placed through a catheter. There is such a machine in Bishkek, so thrombolysis can be used during skin interventions. When a patient with a heart attack arrives by ambulance, the thrombolysis medication should be administered immediately before the stent is placed. This is not our recommendation, but an international protocol (guidelines). Even if an angiograph is absent, thrombolysis should be applied in the regions,” he emphasized.
“Thus, this third-level hospital has not always used thrombolysis in the last one and a half to two years. Our team created a working commission and halted this process, as the medication has not been used in the last two months. After a heart attack, it is already pointless to administer thrombolysis,” Kadyraliev added.
Moreover, every two to three years, recommendations should be updated, and work should be carried out in accordance with them. In Kyrgyzstan, vascular diseases traditionally rank first in mortality. Can it be said that this is related to untimely primary assistance and surgeries? Yes, there is a correlation, and this leads to the formation of unclear queues.
This is one of the reasons. In fact, the problem is complex — encompassing all levels from primary to tertiary. We have not yet been able to fully reform the system to eliminate queues. In our opinion, the organization within institutions was incorrect,” he summarized.
According to available data, about 700 children undergo surgeries in other countries,” he added.
Kadyraliev stated that each team coming into the system sets goals and objectives to change the situation.
“Many reforms are currently being implemented, but we need to work effectively and in an organized manner. It is necessary to establish discipline, and doctors on the ground must take responsibility,” he said.
“Speaking of reform, we have a separate system and protocols. A lot has already been documented, and our task is to bring this into order. For example, the same cataract in the right and left eye is treated differently by different specialists — this needs to be corrected. The same goes for heart surgeries: one surgeon works according to one protocol, another according to another. Therefore, our top priority is to establish order,” Kadyraliev concluded.
Moreover, we do not exclude anyone from the system, but invite modern specialists who have experience both abroad and here. Professors who have held their positions for 30 years, some specialists have moved to private centers or abroad. We invite those who are successfully working abroad to contribute to the healthcare of the country and share their experience. We strive to implement new technologies and modern approaches,” he summarized.
