USAID Project Supports Healthcare Initiatives in an Ecological Disaster Zone

For 21 years, Madina Yergaliyeva has led Initiative Support, an NGO that tackles socio-economic challenges. Since then Madina has been assisting in improving the situation in the healthcare system, increasing the access of citizens of Kazakhstan, including those living in the Aral Sea ecological disaster zone, to medical services. 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. “We wanted to help people write appeals to government agencies 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 a USAID-funded Social Innovation in Central Asia (SICA) program Innovative Solutions Grant, 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. These recommendations were sent to the Government and the Parliament of the Republic of Kazakhstan for consideration. However, the unforeseen delay of the review and the discussion of the recommendations in Parliament substantially hindered the process.

“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. 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 the 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 the 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 the quality of medical services around Kazakhstan,” Madina says.