-Respiratory support devices, oxygen cylinders, tools and supplies were distributed to several hospitals. What was the need for equipment at hospitals?

The health sector is regularly supplied with essential equipment. Nevertheless, we had a shortage of respiratory support equipment. Prior to the proliferation of COVID-19, there was no shortage of respiratory support devices. Due to the strong wave of COVID-19, we received an enormous number of patients who had respiratory failure and we realized we couldn’t really provide enough oxygen to treat critical care patients. Right at that time, we were provided with essential equipment by the project. In addition, our doctors, nurses and biomedical engineers were trained and advised on how to operate, maintain, check and repair the equipment. An oxygen ecosystem was also set up for direct supply to wall outlets in aimag central hospitals.

Although the government provided similar medical oxygen plant, it was not possible for government to meet the needs of all hospitals at the same level in such a short time. With the support of this project, we were able to achieve equitable levels of oxygen supply. The project was also far-sighted as it has left a long-lasting impact. It laid the foundation for a sustainable and reliable mechanism in the health sector, contributing safe equipment as well as coaching in maintenance and service.

We are now prepared, both in terms of equipment and personnel, for an emergency situation such as COVID-19, flu-like and flu symptoms. Our doctors, nurses and engineers are well-trained and educated to use, maintain and repair the equipment, so we will be able to put it to good use into the future.

-Several other trainings have been organized as part of this project. Why is training necessary for biomedical engineers?

Teamwork is very beneficial. Previously, engineers were trained separately by region. But in this case, the doctors, nurses and engineers from all provinces were able to learn from each other and master the same level of content and competence. Our country is not sustainable in terms of its human resources. There is a high turnover in all industries, including health care. There is no assurance that the people who participated in this workshop will not leave their jobs, although the ministry is introducing procedural regulations to reduce the rate of turnover. So it’s important that the skills acquired by senior participants be updated and passed on to newly hired younger participants. 

-Intensive care doctors from provinces and districts were trained as trainers under the project. Additionally, all nurses and doctors from all soums have been trained to handle the clinical triage of the pandemic and provide rapid first aid. We would like to ask you to share with us how effective these trainings have been?

Attending training organized by foreign experts that develops national trainers is a real advantage for us. National trainers are key as they know the weaknesses and strengths of their communities and are able to put into practice and localize the skills learned from the experts. The Ministry of Health prefers to prepare national trainers on an ongoing basis at all levels because of the high turnover that I mentioned earlier.

Traditionally, it was thought that a trainer or expert from the central hospitals should train others. However, soums also benefit from having their own trainers.

-As recommended by the Ministry of Health, 800 oxygen cylinders and related supplies were donated to 330 soum hospitals. Can you please explain more about the process by which you or the Ministry selected these soum hospitals?

Sure. The donations were to go to the places with the highest need. We based this on the supply data that came out of our needs assessment. We checked with the central hospitals in all provinces to find out whether all 330 soum hospitals had oxygen cylinders. We then checked the situation by phone with several soum hospitals. Soums are classified into A, B and C by population. We allocated more oxygen cylinders and supplies to category A because soum hospitals in category A perform surgeries and first aid. Each soum was assigned four cylinders, with 2 cylinders to be used as the main oxygen source and the remaining 2 for mobile service. A major advantage of our health system is its centralized structure, i.e., the Ministry of Health, the referring centers, the health divisions and central hospitals of provinces and the primary healthcare facilities of soums all work closely together. This centralized mechanism enables us to collect information at the primary level of health care to promote the work. It is my pleasure to confirm that the cylinders and attachments are on their way to the targets we selected together and some targets have already received and used the cylinders.

Thank you for talking with us.