Supporting Healthcare Initiatives in an Ecological Disaster Zone

For 21 years, Madina Yergaliyeva has led Initiative Support, an NGO that tackles socio-economic challenges and ensures Kazakhstani citizens, including those living in ecological disaster zones, have fair access to healthcare. Living in Qyzylorda, a town in southern Kazakhstan close to the Aral Sea, Madina knows firsthand about the direct impact that ecological issues have on local life. For years, the irreversible processes of environmental degradation due to the shrinkage of the Aral Sea have worsened living conditions and ecology in the region.

“People living in the Aral Sea region are prone to numerous diseases because of bad ecology. Although the government provides clinics with equipment, the quality of medical treatment is not improving. The region severely lacks qualified doctors, and ordinary people are often unaware of their basic rights to receive qualified healthcare,” Madina notes. “I wanted to connect people with the government and ensure people in Qyzylorda region and around the country get the care they need.”

Madina knew her team could not tackle complex systems like healthcare institutions without government involvement. Thus, the first crucial step for Initiative Support was to build a constructive dialogue with government bodies. In 2020, with an Innovative Solutions Grant from EF’s Social Innovation in Central Asia (SICA) program, Initiative Support conducted a social audit of Qyzylorda’s regional healthcare sector. Based on the results of the audit, the team developed 30 recommendations for improving the healthcare system. At first, Kazakhstan’s parliament accepted the recommendations for consideration. However, Madina later learned that parliament postponed the discussion to a date beyond the end of their SICA-backed project.

“We were discouraged at first, as we could not finish the project with the results we wanted. We knew the recommendations we provided are important for tackling some of the issues that the country’s healthcare system deals with, and we decided to keep pursuing our goal to implement them,” Madina says.

With a second SICA Innovative Solutions Grant, the team developed their recommendations into a roadmap with a clear budget, timeline, and list of bodies responsible for improving Kazakhstan’s healthcare system. The roadmap focused on improvements in five key areas: developing a program to attract specialists to the Qyzylorda region, raising quality control standards of medical laboratories around the country, improving Kazakhstan’s healthcare mobile app, offering clinical rehabilitation for women with postpartum complications, and strengthening controls to eradicate corruption. This time, parliament approved most of the recommendations. Currently, government bodies are implementing about 80 percent of these recommendations.

Thanks to the Innovative Solutions Grant, Initiative Support also conducted a large-scale information campaign via social networks on people’s rights to healthcare, covering more than 200,000 people in the Qyzylorda region. They also helped organize a series of workshops for 25 physiotherapists and rehabilitation specialists from Qyzylorda clinics with the German kinesitherapist Evelyn Ebinger, who spent 20 days teaching local specialists about updated rehabilitation methods of movement treatment.

“Although I had to travel 180 kilometers every day [to the workshops with Evelyn], I never missed a session,” says Sakip, a doctor from Karmakshy district. “As professionals, we should never stop learning, and I am very glad I had a unique opportunity to learn for free about global trends in medical treatment and rehabilitation of patients.”

Together with her team, Madina is keen to improve the healthcare situation in the bad ecology zones like Qyzylorda region, as well as throughout Kazakhstan. “I really hope Initiative Support will advance people’s awareness of their rights [to medical treatment] as well as improve health facilities around Kazakhstan,” Madina says.