“We’ve got a ticking time bomb right under our belt”
How the MedSupport Community of scientists and doctors promotes a responsible approach to health among Kazakh citizens
“There is a big distance between me and the planned vaccines. I am far from fighting against fake news”, — this is how Akmaral Tursunova, a lawyer, would not have believed a year and a half ago that she would lead a volunteer initiative to promote medical literacy. Nor could Botagoz Kaukenova, a graduate of Nazarbayev University’s School of Medicine, have imagined anything like this as she was preparing for exams to pursue her studies in the spring of 2020. When, in a couple of months, she decides to lecture her followers on vaccination via Instagram and records her first Stories, soon she finds that public speaking is not an easy experience for a graduate physician. Today, both ladies successfully run the MedSupport Community Trust, an organization aimed at combating misconceptions in health care with accessible and reliable information.
Akmaral decided that she would help pro bono Kazakhstani doctors, long before the COVID-19 Pandemic. The young lawyer’s assistant was once very impressed by the cases of two doctors who found themselves in a hopeless situation. Unable to help them, Akmaral resolved to do so in the future, but a new strain of the coronavirus spread around the world and forced her to change her mind. She decided to start with “awareness” advocacy for domestic health workers, who were facing such a serious threat for the first time. Her idea was supported by Dana Akilbekova, a professor at Nazarbayev University. It was she who invited qualified physicians who desired to join in translating scientific articles and clinical protocols into Russian and Kazakh.
Within a week the number of volunteer translators reached 60; Akmaral could hardly believe what was happening: “I was living under the delusion that I didn’t have like-minded people, but it turns out that there are a lot more civically committed doctors and scientists than I thought. And I am so glad I was wrong. Today volunteers from Almaty and Nur-Sultan, Aktobe and Atyrau, Pavlodar and Ust-Kamenogorsk, Italy and France, Switzerland and Hungary are supporting the Trust.”
Botagoz explains, “We do not limit volunteer recruitment to doctors and scientists. MedSupport is especially proud of the fact that they have managed to awaken interest toward healthcare among schoolchildren. “They write: ‘Thanks to you, I want to go into science to become a scientist and a doctor.’ And that’s cool, I think. I hope more kids get into it,” - Botagoz says.
Schoolchildren, of course, were not initially among the target audience of the initiative group, yet its expansion at some point seemed inevitable. Akmaral remembers this “moment” quite vividly: “On Facebook, a woman who introduced herself as the chair of the pathanatomy and pathophysiology department of some university said that [to treat the coronavirus] one should inhale with vodka. I got into an argument with her, but she crushed me with her authority. Then I realized that people had to be saved from this kind of information.” That’s how MedSupport has evolved into a community public page with an audience of nearly 50,000, who address their questions to volunteers on a weekly basis. In the past three months, the foundation’s Instagram content has totaled more than 140,000 people.
At first all the questions were about COVID-19 prevention and treatment, then the priority was given to vaccination against coronavirus. “The questions are about the same thing, but when some trending news item goes into the public domain, there’s a new roundup,” - Botagoz says. “People instead of just blindly believing the information, they ask us first. It’s very gratifying, and it puts an obligation on us to constantly keep our finger on the pulse and understand what’s going on there,” - Akmaral continues.
The organization had to work particularly hard during the COVID-19 mass vaccination kickoff, when volunteers could handle more than 500 inquiries per hour. The MedSupport Team liaised with regional health departments to inform citizens promptly about availability and range of vaccines.
“It was a scary period for us and very exhausting,” - Botagoz notes.
The next steps were aimed at getting even more people to the vaccination sites: MedSupport launched a website with answers to all the frequently asked questions about COVID-19 vaccination, and also emphasized the importance of communication in the current situation.
“Once you start talking to people even a little bit, there’s a very good response [you get]. The refusals to vaccinate were not because people were just stubborn and didn’t want to be vaccinated, but because there was no information,” - the MedSupport executive said confidently.
Another topic soon came up on the agenda, where the lack of reliable information was suddenly exposed, which is routine childhood vaccinations. “As we worked, we found out that all the criticism flowing from antivaxxers about COVID vaccination was having an impact on childhood vaccination as well. The word ‘vaccination’ has come to be used in a very negative context,” - Botagoz notes.
In addition, the system stalled badly in H1 2020: Authorities closed health facilities to preventive visits for the sake of reducing coronavirus exposure. “Children didn’t get their vaccines when they were supposed to, because they were asked not to risk going to the clinic. Now the problem is that people don’t go back to get vaccinated,” - the interviewee explains.
“And we have a ticking time bomb under our belt as we fight the coronavirus,” - Akmaral states. The MedSupport Team has been trying to defuse it, operating with the United Nations Children’s Fund (UNICEF) support. In collaboration with the Trust’s team, 11 videos were produced about routine vaccinations with reliable information about contraindications, possible side effects, symptoms and infections that these vaccines protect against, how they are transmitted and their effects.
Five live broadcasts about childhood immunizations on the MedSupport account reached more than 55,000 Instagram users, and eight topical posts reached another 99,000 people. Meanwhile, the most popular broadcast was about catch-up vaccination, and the most read post was about measles.
Botagoz, not yet a member of the MedSupport Team, first explained the dangers of not vaccinating to her subscribers with just the example of measles. “Even if a child has recovered from measles, the disease can have a lifelong impact. A person can get sick all over again with illnesses they’ve had before. All because the immune system is very compromised,” - she explains. Today, people continue to catch measles, and doctors are increasingly recording cases of a very rare complication of the infection - Subacute Sclerosing Panencephalitis.
Since May 2020 UNICEF has been implementing a program to prevent measles outbreak and strengthen the immunization system in Kazakhstan with the financial support of the United States Agency for International Development (USAID). The official information website EGU.KZ on routine childhood vaccination, launched in September 2020, serves to strengthen the Immunization System. MedSupport partnered with UNICEF in developing the online resource.
Today, MedSupport members recall the hardships of the project in different ways. Akmaral tells of how each text published on the website had to become “crystal clear” during the editing process, and Botagoz talks about the enormous amount of information that had to be studied. It could take days to weeks to debunk major myths about vaccination alone, she explains.
The EGU.KZ portal also provides a detailed description of each vaccine used in Kazakhstan, its contraindications and side effects. “Pediatricians use our website as a cheat sheet. The doctor explains and follows up by saying, ‘If you still have questions, read this site and then come see me.’ I know that many doctors use it this way,” - Akmaral shares. Botagoz is especially proud of the handy vaccination calendar on the online resource.
With its help, Kazakh parents who are not too far behind on their planned immunization schedule can catch up on their own, or simply not forget about vaccinations when the time comes (the calendar on the website can be integrated into the calendar on any device). Furthermore, EGU.KZ has a map for each city with all the private and public medical facilities where you can get vaccinated for a fee or as part of the GFMS (Guaranteed Free Medical Care).
EGU.KZ has become one of the main indicators of the invisible but important prevention efforts that UNICEF and the MedSupport Team carry out every day. “It’s a job that every doctor is obligated to do. In medical school we were taught, ‘You’re not just a doctor, you’re now a teacher for life. You teach your patients,” Botagoz says. This way they believe, doctors will gain the trust of their patients. “If a parent trusts doctors, they will willingly protect their child,” - Akmaral concludes.