Our Global Ambassador covering the Eurasia region is Prof Metin Önerci. We wanted him to shed some light on ENT in the countries of Central Asia – this is an area of the world that we in the west hear relatively little about. He gave us some fascinating information on these countries, but we started by having a chat with him more generally about ENT, IFOS 2023 and his home country, Türkiye.
Congratulations on winning the bid to host IFOS 2026 in Istanbul.
Thank you. When we celebrated our win, we celebrated with all our friends, and we promise to represent all of them - countries from Malaysia all the way to America, South America and Europe. When you look at the countries supporting us, it shows that science isn’t about politics - we don’t have anything to do with politics.
Tell us a little about the countries of Central Asia.
These countries are very much developed in art and in music. They have wonderful operas. They have wonderful literature. For them, moving away from the post-USSR situation has been long time coming. These countries are moving up and they want to be a part of the modern scientific world.
How is the medical specialist training structured in these countries?
Each country has its own residents and different training programmes, but now when they finish their training programmes and residencies, they come to Türkiye for six months or a year and we help them with their accommodation and other aspects. We are about nations. I am a Turkish man, but I think globally. The aim is to help these people. How? By training their physicians. If you help one person, that’s a big service; a service to humanity. So, the world should be global and all of us should work together to improve the quality of life of all the people in the world. This is our aim, our purpose.
I understand that historically cancer has been managed very differently in these countries than elsewhere in the world. Can you tell me about that?
In the past, oncology surgeons would have managed these patients, not ENT surgeons. This has now changed in Azerbaijan, so now a general surgeon cannot treat laryngeal cancer. Things are also changing in Uzbekistan, but it takes time. They need an otorhinolaryngologist, so they’re changing because otorhinolaryngologists have not learned how to perform surgeries in these patients. Now they’re learning. We have many Uzbek, Kazakh and Tajik surgeons coming to us in Türkiye to learn new methods. They also go to Europe. Some of them go to the US to train, or Korea. Korea is also very important - robotic surgery is very developed there, and countries like Kazakhstan and Uzbekistan have very close relationships with Korea.
Are you able to give us a flavour of the culture in some of these countries?
The people are so friendly, and their culture is so developed because they are used to living together. People from China, Korea, Kazakhstan, Uzbekistan – all these people can live together, no problem. The purpose for them is to be happy in the world. The main idea is you should never lie, never harm other people. You should respect your neighbour. You should help poor people. Rituals are secondary; they’re not so important. The most important thing is what kind of person you are and how you treat other people. They’re very tolerant, very democratic, not autocratic, very nice and very good people.
You should visit each country yourself! If you go to Kyrgyzstan, you’ll stay in a tent and it’s wonderful. When I was in Kyrgyzstan, they took me to a tent near the river. Also in Kazakhstan, for example, they take you to the mountains where they have wonderful houses in all the greenery. It’s something unexpected and a thing you should experience yourself.
Kyrgyzstan is located in Central Asia with an area of 199,951 km2. Its capital is Bişkek. The population of Kyrgyzstan is around six million; 34.4% of this population is 0-15 years old and 6.2% is 65 years old and over. In Kyrgyzstan, 63.9% of the people live in cities and the rest in rural areas, with 29 people per square kilometer. There are 150 ENT doctors serving in Kyrgyzstan. There are four big universities and five state hospitals in Bişkek, three of which provide resident training. The president of ENT Society is Professor Dr Nasyrov Vadim Aliyarovich .
Kazakhstan is an independent state in Central Asia. With an area of 2,724,900 km2 (as much as Western Europe), it is the ninth largest country in the world. It is the largest of states in terms of area, and the richest in terms of natural resources. The population of the country, is around 19,000,000. In 1997, the government moved the capital of Kazakhstan from Almaty to the capital Astana. On March 23, 2019, Astana was renamed as ‘Nur-Sultan’, in honour of the former president, Nursultan Nazarbayev. Kazakistan has more than 1100 ENT specialists. The president of Kazakh ORL Association is Professor Dr Azhenov Talapbek Maratovich.
Turkmenistan is an independent state in Central Asia. The capital of the country is Ashgabat, which is also its most developed city. With a population of six million, Turkmenistan has the lowest population among the Central Asian republics. The area is 488.099 km2. The city of Merv is one of the oldest oasis cities in Central Asia and was one of the most important points on the Silk Road. Owezberdi Owwadov is president of the Turkmenistan ORL Society which has more than 100 members.
Azerbaijan Republic has a population of 11 million and Azerbaijan Otorhinolaryngological Society has 600 ENT specialists. There are departments of otorhinolaryngology in three medical universities that play a role in the education of both students and residents, and provide their exceptional services in the postgraduate education of otorhinolaryngologists. The president of the society is Professor Dr Nazim Huseynov (above) and the general secretary is Assoc Professor Ramil Hashimli. The society plays a significant role in uniting otolaryngologists.
The Republic of Uzbekistan is located in the heart of the mainland, in Central Asia, between the Amu Darya and Syr Darya rivers. The permanent population of Uzbekistan has grown to 35 million people. Uzbekistan ranks 43rd in the world in terms of population. Residents of Uzbekistan have free access to medical care provided through a network of State medical institutions - polyclinics, first aid stations and state hospitals. The Department of Otorhinolaryngology of the Association of Doctors of Uzbekistan unites more than 1300 otorhinolaryngologists. Since 2014, cochlear implantation of deaf and hard of hearing children has been carried out based on a regular state programme at the expense of funds allocated annually from the republican budget. The leading clinics of the republic have established high-tech surgical operations and modern diagnostic research methods. The President of the Otorhinolaryngology Society of the Association of Doctors of Uzbekistan is Professor Khalida Shaykhova.
The Republic of Tajikistan, is a country in Central Asia with a surface area of 143,100 km2 and an estimated population of more than nine million people, of which more than 40% are children under 15 years old. Over 73% of the population live in rural areas. Currently, 515 otorhinolaryngologists are registered in the country, which is almost twice as much as in 2000. Provision of the population of the republic with otorhinolaryngological beds per 10,000 people is 0.8 for adults and 0.3 for children. The President of the Society of Otorhinolaryngology of the Republic of Tajikistan is Professor Makhmadamin Makhmudnazarov.
Problems
- Otorhinolaryngological departments should be provided with modern medical and diagnostic equipment and tools, including endoscopic equipment, as much as possible.
- For the early detection of congenital hearing loss and deafness in newborns, diagnostic tools in maternity hospitals should be more widespread.
- The support of Ministries of Health and Social Protection and of the governments should be established for the infrastructure of the cochlear implantation.
- The education systems require revision, and the training should be done more effectively. More regular exchange of knowledge and skills of ENT specialists through advanced courses should be organised at the ENT centres of Russian Federation, Central Asia and Türkiye.
