Khorog, the regional capital of Gorno-Badakhshan Autonomous Oblast (GBAO), sits at an elevation of 2200 meters among the beautiful but rugged and isolated Pamir Mountains, where some people live at elevations of 4000 meters or more. In this resource-limited region, the Soviet-era healthcare system differs markedly from that of the United States.
Khorog, the regional capital of Gorno-Badakhshan Autonomous Oblast (GBAO), sits at an elevation of 2200 meters among the beautiful but rugged and isolated Pamir Mountains, where some people live at elevations of 4000 meters or more. In this resource-limited region, the Soviet-era healthcare system differs markedly from that of the United States.
Aga Khan Medical Centre in Khorog (AKMC, K) is a private hospital run by Aga Khan Health Services (AKHS) with the mandate to provide compassionate, accessible, cost-effective, and high-quality care to the people of the Badakhshan region of Tajikistan and cross-border areas of Afghanistan.
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| Photo courtesy of Noormahal Kabani. |
In March 2020, in the middle of the COVID-19 pandemic, healthcare professional volunteers were asked to assist in the management of COVID-19 and other complex illnesses. Plans for volunteer in-person visits were deferred, so AKMC, K and the Ismaili Health Professional Network (IHPA) turned to technology-based assistance.
Noormahal Kabani, MD, a pulmonary/critical care physician, IHPA volunteer, and director of SCCM’s FCCS course, proposed implementing the FCCS course to train hospital staff to treat critically ill patients using expert-developed learning. Staff and leadership enthusiastically greeted this proposal. Thanks to support from many donors, SCCM was able to provide funding for this course so the learning journey could begin.
Even though the online course is designed for self-learning, the faculty quickly realized that language was a barrier for many participants. They spoke Russian, Tajik, and Shughni. Their English language classes had been interrupted due to their increased workloads during the pandemic, so several online sessions were conducted by the FCCS instructors, along with course consultant Muhammad Jaffar, MD, FASA, FCCM; Dr. Kabani; and instructor candidate Ashifa Moledina DNP, ACNP. Translation assistance was provided by local physicians.
In addition to the FCCS sessions, AKMC, K’s medical director and other course participants held group sessions to help each other understand concepts in their specialties as the group went through the online modules. Their enthusiasm for learning was amazing and inspirational to course faculty.
In addition to the language barrier, participants faced prolonged interruptions in Internet access due to regional political disturbances. During these interruptions, they used the eBook in their group sessions. Once Internet access was restored in August 2022, review sessions and skill stations were conducted online.
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| Photo courtesy of Noormahal Kabani. |
Course participants included internists, anesthesiologists, surgeons, neurologists, obstetricians, pediatricians, and emergency medicine physicians. A total of 32 participants were enrolled. Eighteen physicians and six nurses have completed the course and passed the posttest. Additional participants plan to complete the course in the coming year.
AKMC, K is a very young institution. All physicians on staff are required to care for acutely ill patients when on call. The FCCS course has provided them with a systematic way to increase clinician confidence and safely care for patients, regardless of physician specialty.
