A medical system that dates back 50 years by Western standards in the easternmost country of the Stan states, Kyrgyzstan, has drawn Dr Nick Woolfield (Sargood 1968-1972) to a retirement plan of service.
Woolfield and his wife Fay, a general practitioner, have been in Kyrgyzstan for more than two years. For the first few months Woolfield and Fay spent their time learning the basics of Russian and after about five months assisted with outreach clinics in remote regions to gain insight into the medical system.
“A child I saw with hydrocephalus at 12-months needed a shunt to stop the head growing and to allow for more normal development,” Woolfield said.
The cost of a shunt is about $600 and although this is relatively cheap by Western standards it is “four months wages” for Kyrgyz people.
The clinics where Woolfield treats these patients are third-world. Most lack running water and all have outside long drops.
“The hospital has only recently had a septic system installed that has allowed for inside toilets and running water for washing hands and bathing with hot water.”
Working in these conditions and gaining an understanding of the country’s medical practise has prepared Woolfield for the project ahead of him.
UNICEF, the Ministry of Health of Kyrgyz Republic and the Science Technology and Language Institute (the NGO that Woolfield and Fay work for) have funded a national project that will be led by Woolfield, the only Western trained paediatrician in Kyrgyzstan.
“We are introducing Western practises for treating children living with a disability.”
This form of practise requires a team of allied health professionals – physiotherapists, occupational therapists, speech language therapists, orthotists, psychologists and social workers.
“We work as teams, with therapists and doctors, to see improved function in children with disabilities and to see them manage as many of their daily activities with as much independence as possible.”
With no trained allied health professionals in Kyrgyzstan Woolfield will upskill the country’s current medical staff, training nurses who show an interest in the basics of physiotherapy, occupational therapy and in the skills of splinting of the lower limbs.
“A team of therapists is due to visit from Australia in September for a month of intensive training in the basics of assessment, planning and implementation of therapies.”
A disability centre in Karakol has become home to the project and will eventually become the training ground for local practitioners. At present, the centre treats more than 100 children every two weeks from all over the country.
“Most of the children we see have cerebral palsy but about twenty percent have other disabilities.
My role is seeing them to assess and diagnose if there are any specific conditions that have been left undiagnosed and then work with them to assist in improving their child’s functional outcomes.”
On a broader scale he is developing guidelines for the management of children with cerebral palsy and in a resource poor country he will need to be creative and “think differently about what can and cannot be done.”
Developing treatment practises based on a Western system, which would usually utilise modern facilities and medicines, isn’t going to be easy. Woolfield also faces an uphill battle of changing the way locals think about people living with disabilities.
“They are seen as a liability. Mothers are often divorced by the child’s father because of the belief that they are responsible for the disability.”
Despite the hurdles, Woolfield’s determination isn’t fading.
“It is going to take a lot of work, people and time to get the guidelines passed and the project off the ground but this is a great opportunity to make a difference to the lives of Kyrgyz children.”
