Methodist and Baylor in Partnership with Kazakhstan

Semipalatinsk, Kazakhstan, is a place that most people would have trouble locating on a map. Its very name suggests a place at least half a world away.

Health care facilities will almost certainly improve in
Semipalatinsk, Kazakhstan, with the advice and assistance of
Methodist and Baylor.

Semipalatinsk, a city of about 350,000, is located in the northeast corner of Kazakhstan, one of the former republics of the Soviet Union. From the late 1940s through the 1980s, it was a test site for nuclear weapons: over 500 blasts (at least 100 above ground) were detonated in the area.

The region has extraordinarily high levels of cancer and birth defects, as well as increased diseases caused by damaged immune systems. It may well be the most "at-risk" location on earth.

Now, thanks to a partnership largely engineered by the General Board of Global Ministries of the United Methodist Church, physicians and health care professionals from The Methodist Hospital and Baylor College of Medicine in Houston will work with their counterparts in Semipalatinsk to establish an infrastructure and protocols necessary to treat the endemic health problems of the region.

"With the Methodist/Baylor connection, the people of Kazakhstan now have access to the resources of the Texas Medical Center," says Dr. Armin Weinberg, director of the Center for Cancer Control Research at Baylor. "This is one of the most generous acts, and everyone involved should be saluted, especially the Methodist Church. Halfway around the world - 12 time zones away - we are actively sharing our expertise with a patient population in desperate need of it, and we are learning so much ourselves," says Dr. Weinberg. "The most obvious benefit is our opportunity to learn more about the long-term effects of low-dose radiation. This will be tremendously helpful to NASA and to many communities around the globe."

In the two years since the formation of the partnership (the United States Agency for International Development (USAID) and the American International Health Alliance (AIHA) assisted in strategic funding), more than 50 Houston physicians, nurses and faculty have visited the six hospitals in eastern Kazakhstan and over 60 physicians and health care professionals from there have come to Meth-odist, Baylor, Texas Children's Hospital, the VA Medical Center and the Harris County Hospital District for training. Many educational materials that address the several areas of emphasis in the program have been translated into Russian. Those areas of emphasis include: establishment of a cancer registry, cancer screening, infection control, maternal and child health, clinical pathology and laboratory medicine, health care financing, disaster management and emergency medicine, continuing medical and nurse education, and public health education.

It was Methodist's excellence in health care and Baylor's knowledge of radiation effects that initially attracted the USAID and AIHA to the Houston institutions.

Several examples serve to illustrate the great need which the region faces.

A number of neoplasms are prevalent in the area, especially acute lymphocytic leukemia, a childhood cancer which - if not aggressively treated - has a high mortality rate. In the U.S., it is one of the most successfully treated cancers, and the Methodist/Baylor/Texas Children's partners are working with their Kazakhstan colleagues to refine diagnosis and treatment approaches.

Thyroid enlargement is endemic in the Semipalatinsk area, and until recently the masses have been surgically removed - at great expense and morbidity. Benign masses can now be identified by fine needle aspiration. Pathologists from Methodist and Baylor have conducted training in Semipalatinsk and pathologists from there have come here for four-week training programs.

Nonsocomial infections (those infections caused after a patient is admitted to a hospital) are unacceptably high in Semipalatinsk's facilities. Health care professionals continue to undergo training with Methodist's infection control staff.

"Certainly, it's a big undertaking," says Dr. Weinberg. "Forty years of radiation, ineffective government policies, poor health care practices... But there is a sense of real excitement and commitment which comes, I think, from the conscience inherent in this work. And the word 'future' is used so often. We're helping to treat cancers and malnutrition and pediatric diseases every day but planning for a network of maternal and child health centers, and continuing professional education, and a health care system that will be effective."

- ROGER WIDMEYER

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©2006 Texas Medical Center

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