Our interlocutors are Jakhongir Jurayev, reanimatologist at Al-Jabr al-Ahmad hospital in Kuwait, compatriots Nikhola Madaliyeva and Umidjon Madaliyev, who work as general practitioners in England.
“Raising the problem will prevent further death cases”
Umidjon Madaliyev, member of the Royal Association of General Practitioners, doctor:
- We were saddened to hear about this situation in our country. We express our deepest condolences to the parents who have lost their children. Losing a child is extremely difficult, but we can hardly imagine the situation of parents who gave this medicine to their child who was waiting for salvation. This is a tragedy for our people.
There are several factors that lead to this situation: first of all, I believe that the healthcare system in Uzbekistan is not working properly, too much addiction to drugs, unknowingly consuming any medicines, drugs entering Uzbekistan are not properly inspected.
Jakhongir Jurayev, reanimatologist at Al-Jabr Al-Ahmad hospital in Kuwait:
- I think it is wrong to blame doctors for this tragedy. It can be said that managers in the pharmaceutical industry are irresponsible. This problem was raised because of the children’s death. Fortunately, the problem was raised – it might not have been addressed. I would like to thank our doctors who raised the issue. Until today, such problems did not arise in the medicine of Uzbekistan. The rise of the problem is a sign that further deaths will be prevented.
But punishing or dissuading doctors who raise the issue, or dismissing them, shuts down potential future issues.
“We were surprised to see drug advertisements on Uzbek TV channels”
Nikhola Madaliyeva, member of the Royal Society of General Practitioners, doctor:
- When I worked in Uzbekistan 15 years ago, there was not such a hunger for drugs. The pharmacy business was not so prosperous either. I think that the thing that encourages this, causes its increase, is the uncontrolled, free entry of drugs into the Uzbek market. When doctors prescribe medicine, they prescribe not one, but several medicines, and in many cases, it is necessary to have drops. This in itself led to the mushrooming of pharmacies.
Another factor is drug advertisement
Recently, when we visited our country, we did not watch any TV program properly, because there are ads in every 5-10 minutes, most of them are drug ads. Seeing this, even my children were surprised to take so much medicine.
These things are driving this market. Especially when famous people appear in advertising, it gives more confidence.
- Another reason is that doctors are not financially motivated enough. There is a huge meaning behind this statement, a hungry doctor begins to use his profession for his own benefit, and after that, agreements with pharmaceuticals, sales of unnecessary drugs automatically increase. I believe that it is not the doctor who is to be blamed for this, but the organization that did not financially encourage him. We have been through this situation before, and nowadays, because of such incentives abroad, we don’t come across such questions at all and we don’t even think about it, our main thought is only about the patient and we make decisions based on his condition.
In the current situation in Uzbekistan, they study for so many years, spend so much money and time to become mature doctors, they also have the desire to fulfill their dreams, and this is an important factor for them to cooperate with pharmacists or enter the path of corruption. If this situation is not rectified, there will be no growth in this particular area. This is the first reason.
The second reason is that doctors use the treatment methods of the former Soviet Union. I tried to explain this issue several times, but the Uzbek doctors did not understand it. When we came abroad with these rules and knowledge, the treatment method here seemed like a mistake, but later we realized that it is the most correct way. It is worth noting that in the past, a lot of unnecessary drugs were prescribed. Even if these drugs do not benefit the patient, they have seen the public face. But in America, Great Britain and similar countries, a separate protocol is drawn up for each patient, and each drug is recommended to him after the protocol is approved. That is why 90% of our doctors’ opinions are close to each other. In Uzbekistan, it’s the opposite: all doctors have different opinions, they all prescribe drugs that are not close to each other. This is not easy to change. We need to fundamentally change the world view of doctors, starting with the education system. Medicines are sold in very small quantities in pharmacies here. Additional trace elements, vitamins can be found. But in the sale of drugs, there are huge challenges.
Doctors working in Great Britain say that there is an organization that warns about the side effects of drugs. Both the patient and the doctor will be aware of this, and if this drug has a bad effect on the patient, he has the right to inform the organization. It is mandatory to report, because drugs are often controlled here. That is why there is no free trade in pharmacies. There is no pharmaceutical pressure on doctors.
“Our nation has formed the concept that an uneducated doctor prescribes less medicine”
- In the case of drug poisoning, I consider guilty those who ignore the free trade of drugs and allow the sale of any drug in large quantities. This is the tip of an iceberg. Because it is possible that the drugs were not poisoned during the examination, but unnecessary drugs were allowed. I myself have witnessed it many times. Most of the medicines in Uzbekistan you give to the patient do not work, the reason may be wrong composition or wrong dose. For this reason, we have conducted many tests, which resulted in large differences. The consumption of very strong drugs in Uzbekistan raises doubts about their quality. We have 10-15 different broad services during anesthetization of a patient, and one can use the drug that suits the patient’s condition. But in Uzbekistan, you are obliged to use the medicine brought to you by specialists. This will in some way limit your practice as a doctor.
Some drugs used by the developed countries of the world have not yet entered Uzbekistan, because it has not yet been approved by the above experts and therefore these drugs cannot be used. This is illogical.
“Infant deaths should be a lesson”
- Our family members often send us the prescriptions given by the doctor, and indeed there are 3-4 types of the same medicine written there. A variant of the same drug under different names, and the composition is the same.
In this situation, the opinion of the patient also plays an important role, because if the doctor prescribes him less medicine, he thinks: “This doctor prescribed me less medicine because he doesn’t know anything”. In this situation, the doctor may be forced to prescribe more medicine than he has to. In our country, people go to the doctor to get prescribed 4 or 10 medicines and give them to their child, and the child suddenly gets better. There are no miracles in life, everything takes time. Certain infections take a certain amount of time to go away. It is necessary to be able to explain it to them.
The healthcare system in Uzbekistan is like a locomotive that has lost its way. It lost the set station. The address is on the other side, but the locomotive is going the other way. Even the manipulator who drives it does not know where the station is. If we consider the doctors inside as conductors, they are busy dropping off the residents wherever they come across.
In order to correct this situation, a lot of work needs to be done in Uzbekistan, and for this, action should be started now. Otherwise, it could be a more serious situation. And most importantly, the whole system needs to be changed from the very beginning.
The most important thing is that the death of these babies should not be forgotten. It would be a good thing if our nation learns the necessary lesson from this situation and does not repeat these mistakes again.