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RISHI SHRIDHARAN: So today is March 7th, RISHI SHRIDHARAN: 2023, and this is an interview with Doctor Nugmanova. RISHI SHRIDHARAN: Hi Doctor Nugmanova, how are you? ZHAMILYA NUGMANOVA: Hello, Rishi. I'm fine, thank you so much.

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ZHAMILYA NUGMANOVA: Yes. RISHI SHRIDHARAN: It's a pleasure to be chatting with you today. RISHI SHRIDHARAN: And I guess to start off, would you mind please, walking us through your career RISHI SHRIDHARAN: journey until your current leadership position and what?

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ZHAMILYA NUGMANOVA: Oh, you mean what I did after graduation from medical ZHAMILYA NUGMANOVA: school? RISHI SHRIDHARAN: Exactly, yes. RISHI SHRIDHARAN: How did you get here?

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ZHAMILYA NUGMANOVA: It's a long kind of a path, but ZHAMILYA NUGMANOVA: okay. I graduated from medical school in Almaty in ZHAMILYA NUGMANOVA: 1972. And then I ZHAMILYA NUGMANOVA: started to do my research right away.

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ZHAMILYA NUGMANOVA: In the past, we had two level ZHAMILYA NUGMANOVA: of research degrees in the former Soviet Union. ZHAMILYA NUGMANOVA: First, it was first Candidate of Medical Sciences and then Doctor of Medical ZHAMILYA NUGMANOVA: Sciences. So I did both of those during Soviet

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ZHAMILYA NUGMANOVA: times. First, in 1975, I defended ZHAMILYA NUGMANOVA: my candidate, thesis, and in ZHAMILYA NUGMANOVA: 1988, my doctoral thesis, and I defended my doctoral ZHAMILYA NUGMANOVA: on immunology in Kiev,

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ZHAMILYA NUGMANOVA: State Medical University in ZHAMILYA NUGMANOVA: Ukraine. And at that time it was one country. ZHAMILYA NUGMANOVA: So it was easy to do so no signs ZHAMILYA NUGMANOVA: of any war or tension.

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ZHAMILYA NUGMANOVA: And since then I worked at Research Institute of ZHAMILYA NUGMANOVA: Epidemiology, Microbiology and Infectious Diseases as a ZHAMILYA NUGMANOVA: senior researcher, then as scientific secretary for ZHAMILYA NUGMANOVA: that institute.

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ZHAMILYA NUGMANOVA: And after I defended my doctoral thesis, I was ZHAMILYA NUGMANOVA: invited as the chair of Department of Food of Immunology and ZHAMILYA NUGMANOVA: Food Allergy at Research Center of Nutrition, where ZHAMILYA NUGMANOVA: I spent about four years.

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ZHAMILYA NUGMANOVA: And then in 1993, I was ZHAMILYA NUGMANOVA: invited as Deputy Secretary ZHAMILYA NUGMANOVA: General of the National Academy of Sciences of Kazakhstan in ZHAMILYA NUGMANOVA: Almaty. And, but I used to be there not very long

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ZHAMILYA NUGMANOVA: because at that time ZHAMILYA NUGMANOVA: AAHA, appeared ZHAMILYA NUGMANOVA: in our part of the world and former Regional Director, ZHAMILYA NUGMANOVA: young man Matt Lipstadt, he needed some kind of

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ZHAMILYA NUGMANOVA: medical advisor. ZHAMILYA NUGMANOVA: So I joined him as a medical advisor, working part time ZHAMILYA NUGMANOVA: in September 1993. ZHAMILYA NUGMANOVA: And when Matt moved to to

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ZHAMILYA NUGMANOVA: Slovenia as a director for, I think, ZHAMILYA NUGMANOVA: Eastern Europe, I was offered a position of Regional Director for ZHAMILYA NUGMANOVA: Central Asia. ZHAMILYA NUGMANOVA: And since 1995, I

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ZHAMILYA NUGMANOVA: worked as a regional director for Asia until 2006. ZHAMILYA NUGMANOVA: And then the funding was over. ZHAMILYA NUGMANOVA: And, I established the ZHAMILYA NUGMANOVA: Department of HIV Infection and Infection Control.

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ZHAMILYA NUGMANOVA: Why? Because HIV infection became a big,issue ZHAMILYA NUGMANOVA: for Central Asia and Eastern Europe in general. ZHAMILYA NUGMANOVA: And in 2006, we had a terrible outbreak ZHAMILYA NUGMANOVA: of HIV among hospitalized children in southern

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ZHAMILYA NUGMANOVA: Kazakhstan. And when Ahhah program was ZHAMILYA NUGMANOVA: over, I was thinking that something should be done. ZHAMILYA NUGMANOVA: So I worked with Institute for Continuing Medical Education to ZHAMILYA NUGMANOVA: establish a department of HIV and Infection Control,

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ZHAMILYA NUGMANOVA: because it was clear to me that [pause] ZHAMILYA NUGMANOVA: HIV can be, you know, transmitted ZHAMILYA NUGMANOVA: through medical care. ZHAMILYA NUGMANOVA: And I worked at that Institute

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ZHAMILYA NUGMANOVA: for Continuing Medical Education until January ZHAMILYA NUGMANOVA: 2011. And then I was invited ZHAMILYA NUGMANOVA: all our department, actual faculty members, we were invited ZHAMILYA NUGMANOVA: to Kazakh National Medical

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ZHAMILYA NUGMANOVA: University Asfendiyarov Kazakh ZHAMILYA NUGMANOVA: National Medical University. ZHAMILYA NUGMANOVA: So since January 2011, I'm ZHAMILYA NUGMANOVA: working, at that, university

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ZHAMILYA NUGMANOVA: as a chair of, of division of HIV Infection and Infection ZHAMILYA NUGMANOVA: Control. Why we agreed to move to the university, ZHAMILYA NUGMANOVA: because that university ZHAMILYA NUGMANOVA: provide teaching.

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ZHAMILYA NUGMANOVA: For medical student, not just ZHAMILYA NUGMANOVA: for postgraduate as part of postgraduate education. ZHAMILYA NUGMANOVA: So. And I'm still there. RISHI SHRIDHARAN: I mean, this is a wonderful career trajectory and thank you for walking us through this.

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RISHI SHRIDHARAN: So just for clarification, when you established the Department for RISHI SHRIDHARAN: the specific targeting of HIV and infectious disease, this is RISHI SHRIDHARAN: not with the support of AIHA? ZHAMILYA NUGMANOVA: No, no, at that time, AIHA

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ZHAMILYA NUGMANOVA: was over in Central Asia because funding was over. ZHAMILYA NUGMANOVA: But within AIHA there was a ZHAMILYA NUGMANOVA: project, prevention of mother to ZHAMILYA NUGMANOVA: child transmission of HIV.

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ZHAMILYA NUGMANOVA: So, and through that project, we train ZHAMILYA NUGMANOVA: some infectionists in Almaty. ZHAMILYA NUGMANOVA: We let them go ZHAMILYA NUGMANOVA: to Odessa, Ukraine, because in Odessa, Ukraine,

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ZHAMILYA NUGMANOVA: the first outbreaks of HIV happened in the former Soviet Union ZHAMILYA NUGMANOVA: and in Odessa maternity hospital, they already ZHAMILYA NUGMANOVA: had a well developed program for ZHAMILYA NUGMANOVA: prevention of vertical transmission of HIV.

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ZHAMILYA NUGMANOVA: Yeah. RISHI SHRIDHARAN: And understood. RISHI SHRIDHARAN: Understood. So might you speak to how you got interested in public health? RISHI SHRIDHARAN: How what drew you to this kind of general field?

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ZHAMILYA NUGMANOVA: Yes. ZHAMILYA NUGMANOVA: My background is definitely medicine ZHAMILYA NUGMANOVA: and more specifically immunology. ZHAMILYA NUGMANOVA: But, working for AIHA, it became clear

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ZHAMILYA NUGMANOVA: that to make ZHAMILYA NUGMANOVA: a higher impact, it should be ZHAMILYA NUGMANOVA: more than just, you know, treating one patient. ZHAMILYA NUGMANOVA: It should be kind of bigger

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ZHAMILYA NUGMANOVA: activities to protect public health, not just ZHAMILYA NUGMANOVA: individual health. RISHI SHRIDHARAN: Gotcha and backtracking even from this. RISHI SHRIDHARAN: What prompted you to get involved with AIHA in the first place?

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ZHAMILYA NUGMANOVA: Why AIHA? ZHAMILYA NUGMANOVA: Well. ZHAMILYA NUGMANOVA: You know, if you were here at that time, you would never ask this ZHAMILYA NUGMANOVA: question. Because in

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ZHAMILYA NUGMANOVA: 1993, the former Soviet ZHAMILYA NUGMANOVA: Union collapsed. ZHAMILYA NUGMANOVA: Economy was very bad. ZHAMILYA NUGMANOVA: Salaries were not paid on time.

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ZHAMILYA NUGMANOVA: And it was like international organization at least ZHAMILYA NUGMANOVA: monthly. You were able to get ZHAMILYA NUGMANOVA: some you know, some income. ZHAMILYA NUGMANOVA: But after that, gradually, when we started to

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ZHAMILYA NUGMANOVA: develop, AIHA projects, I ZHAMILYA NUGMANOVA: was, like, truly amazed by all these projects, ZHAMILYA NUGMANOVA: by, their impact on ZHAMILYA NUGMANOVA: individuals. And I was really.

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ZHAMILYA NUGMANOVA: Are surprised in a nice way while talking ZHAMILYA NUGMANOVA: to some representatives of Houston Semipalatinsk Partnership ZHAMILYA NUGMANOVA: today. That the legacy is still ZHAMILYA NUGMANOVA: there. And this is true not only for Semipalatinsk, but it's

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ZHAMILYA NUGMANOVA: this is true for Almaty, US ZHAMILYA NUGMANOVA: and other Central Asian countries. RISHI SHRIDHARAN: That's a perfect segue, actually. ZHAMILYA NUGMANOVA: Yes. That, you know, concept of

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ZHAMILYA NUGMANOVA: like, kind of peer to peer ZHAMILYA NUGMANOVA: activities, partnership between health care providers in the US ZHAMILYA NUGMANOVA: and in the countries of former Soviet Union. ZHAMILYA NUGMANOVA: It was truly a great idea

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ZHAMILYA NUGMANOVA: because when Soviet Union collapsed, it was clear ZHAMILYA NUGMANOVA: for some maybe bright minds in the US that they cannot ZHAMILYA NUGMANOVA: do traditional USAID programs like in ZHAMILYA NUGMANOVA: Africa or Asia because

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ZHAMILYA NUGMANOVA: people in Soviet Union, they were better educated. ZHAMILYA NUGMANOVA: And because of that, you know, this consultancy ZHAMILYA NUGMANOVA: program may not be working well. ZHAMILYA NUGMANOVA: So through this program, we communicated with

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ZHAMILYA NUGMANOVA: their counterparts in the US and actually partners ZHAMILYA NUGMANOVA: themselves decided what kind of project to implement. ZHAMILYA NUGMANOVA: Okay. It was not like USAID telling people what to do ZHAMILYA NUGMANOVA: and how, but partners themselves decided, like Doctor

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ZHAMILYA NUGMANOVA: Weinberg, for example, when he came to Semipalatinsk, it was ZHAMILYA NUGMANOVA: clear to him and ZHAMILYA NUGMANOVA: his colleagues from Houston that ZHAMILYA NUGMANOVA: nuclear testing site and radiation is something

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ZHAMILYA NUGMANOVA: that should be somehow addressed. RISHI SHRIDHARAN: Yeah. So this is actually a perfect segue. RISHI SHRIDHARAN: So if we can discuss what you mentioned about the Houston Semi partnership, how were RISHI SHRIDHARAN: you involved? And since that partnership, what other partnerships have you been

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RISHI SHRIDHARAN: involved in? ZHAMILYA NUGMANOVA: Actually, as a regional director for Central Asia, ZHAMILYA NUGMANOVA: I coordinated all partnerships. ZHAMILYA NUGMANOVA: We had like in Kazakhstan initially

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ZHAMILYA NUGMANOVA: we had partnership Almaty, Tucson, Arizona, then Houston, ZHAMILYA NUGMANOVA: Semipalatinsk. A little bit later, ZHAMILYA NUGMANOVA: it was Astana, Pittsburgh. ZHAMILYA NUGMANOVA: We also had partnerships in Uzbekistan,

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ZHAMILYA NUGMANOVA: in Tajikistan, Turkmenistan and Kyrgyzstan. ZHAMILYA NUGMANOVA: And then we had some regional activities, like we ZHAMILYA NUGMANOVA: established Council for deans ZHAMILYA NUGMANOVA: of all Central Asian Medical Schools to address medical

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ZHAMILYA NUGMANOVA: education reform. ZHAMILYA NUGMANOVA: And, deans of medical school were exposed to ZHAMILYA NUGMANOVA: the US model of medical education. ZHAMILYA NUGMANOVA: They visited WAMC, they visited

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ZHAMILYA NUGMANOVA: that council of medical examiners. ZHAMILYA NUGMANOVA: They saw the practical skills training centers. ZHAMILYA NUGMANOVA: And that was the actually the ZHAMILYA NUGMANOVA: motivation for deans here

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ZHAMILYA NUGMANOVA: to start medical education reform. ZHAMILYA NUGMANOVA: It's just one example. ZHAMILYA NUGMANOVA: Also, there was regional, activities ZHAMILYA NUGMANOVA: related to nursing and nursing education.

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ZHAMILYA NUGMANOVA: One of the projects of Houston Semi Partnership, ZHAMILYA NUGMANOVA: but, in Almaty, Tucson, for example, Tucson partners, ZHAMILYA NUGMANOVA: they were the first actually to start nursing education reform ZHAMILYA NUGMANOVA: to introduce

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ZHAMILYA NUGMANOVA: nurses with higher education. ZHAMILYA NUGMANOVA: In the past during Soviet Union, they we had no nurses ZHAMILYA NUGMANOVA: with four year education. ZHAMILYA NUGMANOVA: It was just two and a half and three year and

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ZHAMILYA NUGMANOVA: nursing association in Semipalatinsk addressed ZHAMILYA NUGMANOVA: the same issue, but they were focusing more on practical ZHAMILYA NUGMANOVA: skills for nursing services. RISHI SHRIDHARAN: Yeah, these are great examples.

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RISHI SHRIDHARAN: If we can just zoom in on the Houston semi partnership. RISHI SHRIDHARAN: What role did you play. ZHAMILYA NUGMANOVA: Mhm. ZHAMILYA NUGMANOVA: Okay. You know, us partners, they

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ZHAMILYA NUGMANOVA: came periodically from time to time, ZHAMILYA NUGMANOVA: right? They cannot stay very long. ZHAMILYA NUGMANOVA: In between their visits. ZHAMILYA NUGMANOVA: We our regional office, we try to

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ZHAMILYA NUGMANOVA: provide follow up so that the ZHAMILYA NUGMANOVA: activities were going okay. ZHAMILYA NUGMANOVA: So we also worked with the ZHAMILYA NUGMANOVA: partners here encouraging them, you

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ZHAMILYA NUGMANOVA: know. To continue working, ZHAMILYA NUGMANOVA: have helping them to overcome some ZHAMILYA NUGMANOVA: issues. Like, for example, in Astana, partners ZHAMILYA NUGMANOVA: from Pittsburgh with partners in Astana agreed

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ZHAMILYA NUGMANOVA: that family medicine is one of the major focus. ZHAMILYA NUGMANOVA: And they agreed to establish the model family ZHAMILYA NUGMANOVA: Medicine center. ZHAMILYA NUGMANOVA: But there was no facility for that center.

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ZHAMILYA NUGMANOVA: And. It was me ZHAMILYA NUGMANOVA: who sent letters to the mayor of ZHAMILYA NUGMANOVA: Astana, to vice mayor of Astana. ZHAMILYA NUGMANOVA: And after many, many

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ZHAMILYA NUGMANOVA: letters and attempts, they just provided free standing, ZHAMILYA NUGMANOVA: two story big building for that family medicine ZHAMILYA NUGMANOVA: center. They called it de Mayo, which is treatment ZHAMILYA NUGMANOVA: or so such kind of

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ZHAMILYA NUGMANOVA: activities. Okay. ZHAMILYA NUGMANOVA: And then, because, you know, being ZHAMILYA NUGMANOVA: part of, of this health care community here, I, ZHAMILYA NUGMANOVA: I knew.

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ZHAMILYA NUGMANOVA: Who is kind of ZHAMILYA NUGMANOVA: progressive thinking individuals ZHAMILYA NUGMANOVA: who are worth of investing ZHAMILYA NUGMANOVA: in, in them, you know, who should be invited to the US, who should

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ZHAMILYA NUGMANOVA: be exposed to that ZHAMILYA NUGMANOVA: experience because not everyone ZHAMILYA NUGMANOVA: can, upon return, implement ZHAMILYA NUGMANOVA: something. Okay.

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ZHAMILYA NUGMANOVA: It should be just bright individuals like doctor ZHAMILYA NUGMANOVA: Tumanova. Doctor Jumadilov, for example. ZHAMILYA NUGMANOVA: Doctor doctor Spivak. ZHAMILYA NUGMANOVA: Eliahu being a doctor, she actually, shifted her

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ZHAMILYA NUGMANOVA: activity into nursing, and she established the nursing ZHAMILYA NUGMANOVA: association and was in charge of nursing association for many ZHAMILYA NUGMANOVA: years. RISHI SHRIDHARAN: This is these are wonderful examples, and I'm going to ask you about them a little bit

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RISHI SHRIDHARAN: later. But if we can look at this for a moment with a bird's eye view, I'm RISHI SHRIDHARAN: curious to hear how you think contributions from international RISHI SHRIDHARAN: collaborations in general, how how have these been effective and RISHI SHRIDHARAN: what things have not been as effective?

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RISHI SHRIDHARAN: And do you see any commonalities in the things that have been effective RISHI SHRIDHARAN: as kind of lessons for the future? ZHAMILYA NUGMANOVA: All right. As I said, this medical partnership ZHAMILYA NUGMANOVA: was pretty unique for USAID.

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ZHAMILYA NUGMANOVA: Because traditional used model is to ZHAMILYA NUGMANOVA: invite consultant and ZHAMILYA NUGMANOVA: actually they worked on certain projects ZHAMILYA NUGMANOVA: but medical partnership, it was like healthcare

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ZHAMILYA NUGMANOVA: professionals who volunteered their time and their efforts and ZHAMILYA NUGMANOVA: their knowledge. ZHAMILYA NUGMANOVA: They just shared it for free. ZHAMILYA NUGMANOVA: Actually, they just provided

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ZHAMILYA NUGMANOVA: transportation for partners to visit ZHAMILYA NUGMANOVA: each other. ZHAMILYA NUGMANOVA: And, because of that, ZHAMILYA NUGMANOVA: because partners from Kazakhstan, for example, or from

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ZHAMILYA NUGMANOVA: Central Asia, while visiting their partners in the ZHAMILYA NUGMANOVA: US, they witnessed first hand. ZHAMILYA NUGMANOVA: They learned by themselves what we were talking about. ZHAMILYA NUGMANOVA: Okay. And it it had a very big

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ZHAMILYA NUGMANOVA: impact into individuals. ZHAMILYA NUGMANOVA: Like I spoke with Doctor Spira, who is who was in charge of ZHAMILYA NUGMANOVA: nursing association today. ZHAMILYA NUGMANOVA: And she said because of that partnership, because of that

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ZHAMILYA NUGMANOVA: visit, I became a different ZHAMILYA NUGMANOVA: person. Through these visits, I expanded ZHAMILYA NUGMANOVA: my mind. ZHAMILYA NUGMANOVA: I actually changed my mindset.

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ZHAMILYA NUGMANOVA: I started to understand that nurses and nursing is ZHAMILYA NUGMANOVA: a very important profession. ZHAMILYA NUGMANOVA: And and she said, after so many ZHAMILYA NUGMANOVA: years after the partnership was over, we are still

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ZHAMILYA NUGMANOVA: remember that experience and we are still implementing ZHAMILYA NUGMANOVA: whatever possible until ZHAMILYA NUGMANOVA: now. And some projects like this, ZHAMILYA NUGMANOVA: nursing and nursing education, it changed dramatically.

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ZHAMILYA NUGMANOVA: The nursing in general, we started to ZHAMILYA NUGMANOVA: have nurses with high education. ZHAMILYA NUGMANOVA: We have masters in nursing and PhD in nursing now. ZHAMILYA NUGMANOVA: And in the past, nurses was just

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ZHAMILYA NUGMANOVA: assistant to physicians. ZHAMILYA NUGMANOVA: They never were a separate specialists until ZHAMILYA NUGMANOVA: this activities through ZHAMILYA NUGMANOVA: AIHA. In terms of medical education, for example.

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ZHAMILYA NUGMANOVA: This Like multiple choice ZHAMILYA NUGMANOVA: questions. For example, all this testing system, ZHAMILYA NUGMANOVA: then centers for a ZHAMILYA NUGMANOVA: clinical practice training that was absolutely

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ZHAMILYA NUGMANOVA: something new. ZHAMILYA NUGMANOVA: Then standardized patients, for example, these are all ZHAMILYA NUGMANOVA: new concepts. ZHAMILYA NUGMANOVA: And now we use them everywhere in each medical

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ZHAMILYA NUGMANOVA: school in Kazakhstan. RISHI SHRIDHARAN: Okay, there's another example of the kind of collaborations that happened during Houston RISHI SHRIDHARAN: semi were, of course, the cancer registry aspects. RISHI SHRIDHARAN: I'm curious if, you know, how did this progress and whether collaborations in this

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RISHI SHRIDHARAN: front were maintained. ZHAMILYA NUGMANOVA: Right. You know to answer your ZHAMILYA NUGMANOVA: question, I contacted today with Doctor Jumadilov, ZHAMILYA NUGMANOVA: who used to be vice rector or vice dean of Semipalatinsk

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ZHAMILYA NUGMANOVA: Medical School, and he was very actively involved ZHAMILYA NUGMANOVA: with Houston Semi Partnership. ZHAMILYA NUGMANOVA: Very bright individual. ZHAMILYA NUGMANOVA: He used to be a surgeon, but I think

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ZHAMILYA NUGMANOVA: through this activity, through this cancer register ZHAMILYA NUGMANOVA: activity, through working with Doctor Weinberg. ZHAMILYA NUGMANOVA: He actually went beyond this ZHAMILYA NUGMANOVA: partnership because he wanted to learn about health

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ZHAMILYA NUGMANOVA: effects of radiation. ZHAMILYA NUGMANOVA: And after Partnership was ZHAMILYA NUGMANOVA: over. He contacted researchers from ZHAMILYA NUGMANOVA: Japan and they did very sophisticated research.

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ZHAMILYA NUGMANOVA: They actually took a biopsy of thyroid glands ZHAMILYA NUGMANOVA: and researchers in Japan. ZHAMILYA NUGMANOVA: They did very complicated, sophisticated research trying ZHAMILYA NUGMANOVA: to find out chromosome aberration in individuals

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ZHAMILYA NUGMANOVA: exposed to radiation. ZHAMILYA NUGMANOVA: And Doctor Jumadilov he published ZHAMILYA NUGMANOVA: many articles in peer reviewed ZHAMILYA NUGMANOVA: journals and actually one book.

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ZHAMILYA NUGMANOVA: And I asked him and he promised to send me a list of ZHAMILYA NUGMANOVA: his publications. ZHAMILYA NUGMANOVA: So my sense is ZHAMILYA NUGMANOVA: that being exposed to

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ZHAMILYA NUGMANOVA: partnership activities on cancer register. ZHAMILYA NUGMANOVA: He. Actually continue to work ZHAMILYA NUGMANOVA: on on this, but expanded it studying ZHAMILYA NUGMANOVA: impact of radiation on on

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ZHAMILYA NUGMANOVA: health of individuals exposed to it. ZHAMILYA NUGMANOVA: Currently he's in Astana working for Nazarbayev ZHAMILYA NUGMANOVA: University and he stopped his ZHAMILYA NUGMANOVA: surgery career is like full

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ZHAMILYA NUGMANOVA: time researcher right now doing some sequencing ZHAMILYA NUGMANOVA: analysis, etc. ZHAMILYA NUGMANOVA: So that's one example. ZHAMILYA NUGMANOVA: As for cancer register, itself, I

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ZHAMILYA NUGMANOVA: also spoke with doctor Sandy Abiyev ZHAMILYA NUGMANOVA: Marat. Maybe you haven't heard about him, but I'm ZHAMILYA NUGMANOVA: sure, Doctor Weinberg and Sara, they remember ZHAMILYA NUGMANOVA: him because at that time Sandy was

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ZHAMILYA NUGMANOVA: deputy chief doctor of oncology dispensary in ZHAMILYA NUGMANOVA: Semipalatinsk. Okay. ZHAMILYA NUGMANOVA: Then he became the director of that dispensary, ZHAMILYA NUGMANOVA: and he transformed it.

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ZHAMILYA NUGMANOVA: Let me just check my ZHAMILYA NUGMANOVA: notes. He he that ZHAMILYA NUGMANOVA: dispensary is now ZHAMILYA NUGMANOVA: called, Institute

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ZHAMILYA NUGMANOVA: of Institute of Nuclear ZHAMILYA NUGMANOVA: Medicine and Oncology. ZHAMILYA NUGMANOVA: And that center, they were the first in Kazakhstan ZHAMILYA NUGMANOVA: started to radionuclide therapy

00:26:24.760 - 00:26:42.940

ZHAMILYA NUGMANOVA: of cancer patients. ZHAMILYA NUGMANOVA: Then, here ZHAMILYA NUGMANOVA: the last summer he was promoted as the head of ZHAMILYA NUGMANOVA: regional, health department.

00:26:43.960 - 00:27:01.030

ZHAMILYA NUGMANOVA: Which is like number one, health care provider ZHAMILYA NUGMANOVA: in Abyei region. ZHAMILYA NUGMANOVA: Okay. And, moreover, ZHAMILYA NUGMANOVA: he said that maybe you've heard that on March

00:27:01.900 - 00:27:21.400

ZHAMILYA NUGMANOVA: 19th, there will be election into Kazakhstani ZHAMILYA NUGMANOVA: parliament. So he wants to be a member of the ZHAMILYA NUGMANOVA: parliament, and now he is involved in this election ZHAMILYA NUGMANOVA: campaign. And even if he is with this Parliament,

00:27:22.330 - 00:27:37.990

ZHAMILYA NUGMANOVA: he, you know, has this vision. ZHAMILYA NUGMANOVA: He understands that that, ZHAMILYA NUGMANOVA: you know, Semipalatinsk nuclear testing site is, ZHAMILYA NUGMANOVA: very unique place in terms

00:27:37.990 - 00:27:56.220

ZHAMILYA NUGMANOVA: of, you know. ZHAMILYA NUGMANOVA: Opportunities to do research, because ZHAMILYA NUGMANOVA: what Doctor Jumadilov did is just a little little ZHAMILYA NUGMANOVA: thing that can be done there.

00:27:56.820 - 00:28:16.140

ZHAMILYA NUGMANOVA: And I actually said, because now we have a new ZHAMILYA NUGMANOVA: minister of science and higher education, and ZHAMILYA NUGMANOVA: they promote now, like affiliation ZHAMILYA NUGMANOVA: of the US universities in

00:28:16.140 - 00:28:33.540

ZHAMILYA NUGMANOVA: Kazakhstan, like in northern Kazakhstan. ZHAMILYA NUGMANOVA: They opened affiliation, I believe, of Arizona State ZHAMILYA NUGMANOVA: University. And it turned out a great success ZHAMILYA NUGMANOVA: because it's in northern Kazakhstan, meaning that

00:28:34.800 - 00:28:55.440

ZHAMILYA NUGMANOVA: young people from northern Kazakhstan, instead of going to ZHAMILYA NUGMANOVA: Russia to get higher education, they stay in Petropavlovsk. ZHAMILYA NUGMANOVA: And even young people from ZHAMILYA NUGMANOVA: Russia came and to be enrolled

00:28:55.440 - 00:29:11.100

ZHAMILYA NUGMANOVA: at that university. ZHAMILYA NUGMANOVA: And this is what they want to do everywhere. ZHAMILYA NUGMANOVA: And doctor Sandy wife was very supportive to this idea, ZHAMILYA NUGMANOVA: saying, yes, we have first they have medical school

00:29:11.550 - 00:29:29.970

ZHAMILYA NUGMANOVA: there. And also he feels like in Kochetov, you know, ZHAMILYA NUGMANOVA: that a little town next ZHAMILYA NUGMANOVA: to, testing site, that center ZHAMILYA NUGMANOVA: center of nuclear,

00:29:29.970 - 00:29:44.680

ZHAMILYA NUGMANOVA: how it is called, it is ZHAMILYA NUGMANOVA: called ZHAMILYA NUGMANOVA: Nuclear center. ZHAMILYA NUGMANOVA: So that place can be as a

00:29:45.310 - 00:30:00.010

ZHAMILYA NUGMANOVA: as a place for future research. ZHAMILYA NUGMANOVA: Actually to learn about health ZHAMILYA NUGMANOVA: effect of radiation. ZHAMILYA NUGMANOVA: Of course, those reconstruction is still a big

00:30:00.280 - 00:30:19.670

ZHAMILYA NUGMANOVA: issue, but maybe through this research with the ZHAMILYA NUGMANOVA: Japanese scientists, they somehow ZHAMILYA NUGMANOVA: managed to find out something. ZHAMILYA NUGMANOVA: So. But this is something you should talk with

00:30:19.880 - 00:30:31.830

ZHAMILYA NUGMANOVA: Doctor Jumadilov. ZHAMILYA NUGMANOVA: And as soon as I got a list of his publications, ZHAMILYA NUGMANOVA: I forwarded them to you. RISHI SHRIDHARAN: Yeah, that would be wonderful.

00:30:31.830 - 00:30:46.320

RISHI SHRIDHARAN: Yeah. These are striking examples that you bring up. ZHAMILYA NUGMANOVA: Right. And in terms of cancer ZHAMILYA NUGMANOVA: register per se. ZHAMILYA NUGMANOVA: Galea said that now we have like National Cancer

00:30:46.950 - 00:31:06.030

ZHAMILYA NUGMANOVA: Register, which was actually and ZHAMILYA NUGMANOVA: Cancer Register in semi was a prototype for this National Cancer ZHAMILYA NUGMANOVA: Register. Now, as doctor Sandy Bay said, it's not just ZHAMILYA NUGMANOVA: for cancer diseases, but

00:31:06.030 - 00:31:17.460

ZHAMILYA NUGMANOVA: it's just the overall National ZHAMILYA NUGMANOVA: Register for all like ZHAMILYA NUGMANOVA: socially determined diseases. ZHAMILYA NUGMANOVA: It's cancer.

00:31:17.460 - 00:31:35.920

ZHAMILYA NUGMANOVA: It's TB, for example, and others ZHAMILYA NUGMANOVA: and every outpatient ZHAMILYA NUGMANOVA: clinic, every ambulatory has access to that registry. ZHAMILYA NUGMANOVA: And they are able to

00:31:35.920 - 00:31:53.210

ZHAMILYA NUGMANOVA: to do data entry. ZHAMILYA NUGMANOVA: Which is kind of ongoing ZHAMILYA NUGMANOVA: system collecting all type of ZHAMILYA NUGMANOVA: information. So actually, we

00:31:53.210 - 00:32:09.560

ZHAMILYA NUGMANOVA: can say that this cancer register established ZHAMILYA NUGMANOVA: with support of partners from Houston, transformed ZHAMILYA NUGMANOVA: into National Cancer ZHAMILYA NUGMANOVA: Register and beyond.

00:32:09.560 - 00:32:21.800

ZHAMILYA NUGMANOVA: Actually, it is now electronic ZHAMILYA NUGMANOVA: National Register. RISHI SHRIDHARAN: Mhm. That's terrific. RISHI SHRIDHARAN: That's really good.

00:32:21.800 - 00:32:39.470

RISHI SHRIDHARAN: Wonderful to hear. ZHAMILYA NUGMANOVA: Right. And also doctor Sandy Bay said that there's ZHAMILYA NUGMANOVA: a center or institute for ZHAMILYA NUGMANOVA: medical radiology where Doctor Gusev used to be

00:32:40.090 - 00:32:58.990

ZHAMILYA NUGMANOVA: director and now there's another person in charge. ZHAMILYA NUGMANOVA: But doctor Sandy Bay said that within that center it ZHAMILYA NUGMANOVA: is called now Institute of Medical Radiology and ZHAMILYA NUGMANOVA: Ecology. They have registered for individuals

00:33:01.340 - 00:33:18.470

ZHAMILYA NUGMANOVA: affected by radiation. ZHAMILYA NUGMANOVA: It is part of the overall register ZHAMILYA NUGMANOVA: registry, but specific part of it, ZHAMILYA NUGMANOVA: just data base for individuals affected by radiation,

00:33:19.460 - 00:33:32.470

ZHAMILYA NUGMANOVA: which is pretty good I think. RISHI SHRIDHARAN: Yeah. ZHAMILYA NUGMANOVA: They opened the rehabilitation department ZHAMILYA NUGMANOVA: for 40 beds.

00:33:33.980 - 00:33:46.170

ZHAMILYA NUGMANOVA: To provide some, you know, treatment rehabilitation ZHAMILYA NUGMANOVA: for affected individuals. RISHI SHRIDHARAN: Yeah. This is amazing. SPEAKER3: Mhm.

00:33:47.440 - 00:34:03.150

RISHI SHRIDHARAN: And I'm curious if you might also speak to, were there any changes or developments within RISHI SHRIDHARAN: family medicine? ZHAMILYA NUGMANOVA: Family. Maybe first regarding nursing. ZHAMILYA NUGMANOVA: No. You want family medicine?

00:34:03.570 - 00:34:18.900

RISHI SHRIDHARAN: So we can also talk about the nursing association, because I know you mentioned RISHI SHRIDHARAN: this, and it's a striking story. ZHAMILYA NUGMANOVA: To tell because I spoke with doctor Gallia, and ZHAMILYA NUGMANOVA: she also you know, told me amazing story.

00:34:19.890 - 00:34:39.870

ZHAMILYA NUGMANOVA: She was in charge of that nursing association. ZHAMILYA NUGMANOVA: And because they were very successful in 2001, ZHAMILYA NUGMANOVA: I believe they received grant on a competitive ZHAMILYA NUGMANOVA: basis from an organization called Counterpart

00:34:40.710 - 00:34:55.760

ZHAMILYA NUGMANOVA: Consortium. US organization ZHAMILYA NUGMANOVA: effective at that time. ZHAMILYA NUGMANOVA: They received grant to travel for ZHAMILYA NUGMANOVA: ten nurses to travel to Lithuania.

00:34:56.550 - 00:35:11.230

ZHAMILYA NUGMANOVA: They visited Vilnius and Kaunas there. ZHAMILYA NUGMANOVA: It was about nursing there. ZHAMILYA NUGMANOVA: And you know, it's Baltic countries. ZHAMILYA NUGMANOVA: They're more kind of advanced in terms of

00:35:11.800 - 00:35:29.800

ZHAMILYA NUGMANOVA: in terms of more ZHAMILYA NUGMANOVA: democratic because, you know, they were part of, of ZHAMILYA NUGMANOVA: Europe before they joined the US, ZHAMILYA NUGMANOVA: only before the Second World War.

00:35:30.130 - 00:35:49.780

ZHAMILYA NUGMANOVA: And then they were the first to to leave the US. ZHAMILYA NUGMANOVA: So, Galia, and ten nurses, they went to Lithuania ZHAMILYA NUGMANOVA: to share their experience and also to learn what ZHAMILYA NUGMANOVA: nurses were doing in Lithuania.

00:35:50.080 - 00:36:09.230

ZHAMILYA NUGMANOVA: And then there's another very ZHAMILYA NUGMANOVA: interesting story in ZHAMILYA NUGMANOVA: 1914, I believe. ZHAMILYA NUGMANOVA: The organization from Ireland

00:36:09.380 - 00:36:29.430

ZHAMILYA NUGMANOVA: called Stronger Than Chernobyl. ZHAMILYA NUGMANOVA: They came to see me and constructed a two story ZHAMILYA NUGMANOVA: building for palliative care. ZHAMILYA NUGMANOVA: Yes, they just constructed that

00:36:29.430 - 00:36:46.640

ZHAMILYA NUGMANOVA: facility. But, you know, because of ZHAMILYA NUGMANOVA: horrible bureaucracy. ZHAMILYA NUGMANOVA: You cannot just build a house or anything without ZHAMILYA NUGMANOVA: permission, without all the paperwork, etc., but,

00:36:47.600 - 00:37:04.870

ZHAMILYA NUGMANOVA: partners from Ireland, from that organization, ZHAMILYA NUGMANOVA: strong adventure novel. ZHAMILYA NUGMANOVA: They just constructed that facility without any paperwork. ZHAMILYA NUGMANOVA: And it was just standing there for

00:37:05.410 - 00:37:22.900

ZHAMILYA NUGMANOVA: almost two years. ZHAMILYA NUGMANOVA: And then Galia was invited to the head of City ZHAMILYA NUGMANOVA: Health Administration and then of this health administration saying, you can ZHAMILYA NUGMANOVA: do this, Doctor Spira, do all the paperwork and

00:37:24.100 - 00:37:43.360

ZHAMILYA NUGMANOVA: open this center for palliative care. ZHAMILYA NUGMANOVA: And now, because she retired as the ZHAMILYA NUGMANOVA: head of public health administrator, she is now ZHAMILYA NUGMANOVA: the chief doctor of that palliative care center in

00:37:43.360 - 00:37:58.190

ZHAMILYA NUGMANOVA: Semipalatinsk. ZHAMILYA NUGMANOVA: Yes. It was this was that was you ZHAMILYA NUGMANOVA: know, for me, it was also such an amazing experience ZHAMILYA NUGMANOVA: because I am in Almaty.

00:37:58.190 - 00:38:13.700

ZHAMILYA NUGMANOVA: Of course, I have no time to talk with them always. ZHAMILYA NUGMANOVA: But, you know. RISHI SHRIDHARAN: Yeah, this was fantastic. RISHI SHRIDHARAN: And I really appreciate that you were able to sync back up with them to hear about the

00:38:13.700 - 00:38:24.260

RISHI SHRIDHARAN: updates that have happened. ZHAMILYA NUGMANOVA: Right. That's. ZHAMILYA NUGMANOVA: Otherwise, how can I answer your questions? ZHAMILYA NUGMANOVA: You know I cannot

00:38:24.260 - 00:38:38.410

ZHAMILYA NUGMANOVA: improvise. Okay. ZHAMILYA NUGMANOVA: I always want facts. RISHI SHRIDHARAN: I appreciate that, I appreciate that very much. RISHI SHRIDHARAN: So kind of shifting gears a little bit, I'm interested in

00:38:38.410 - 00:38:53.770

RISHI SHRIDHARAN: understanding more from the cultural economic RISHI SHRIDHARAN: standpoint, how you have seen Kazakhstan change between the engagement at the time of RISHI SHRIDHARAN: Houston Semi and the present day. RISHI SHRIDHARAN: So this is, I guess, from the cultural standpoint and also from the sense of

00:38:53.770 - 00:39:08.820

RISHI SHRIDHARAN: because this, this all ties into the economic question, the pharmaceutical RISHI SHRIDHARAN: development that have happened since the USSR collapsed. RISHI SHRIDHARAN: So thinking about, for example, Rahmat. RISHI SHRIDHARAN: How? How have you seen these things come together?

00:39:10.530 - 00:39:30.000

ZHAMILYA NUGMANOVA: You know, frankly speaking, I haven't heard about Rahmat at all. ZHAMILYA NUGMANOVA: But I learned from Doctor Toumanova ZHAMILYA NUGMANOVA: and also from doctor Sandy Baev and from Galina ZHAMILYA NUGMANOVA: that Rahmat, they moved to Pavlodar.

00:39:30.090 - 00:39:46.430

ZHAMILYA NUGMANOVA: It's another city. ZHAMILYA NUGMANOVA: And then they received ZHAMILYA NUGMANOVA: many l ZHAMILYA NUGMANOVA: ike loans from banks.

00:39:47.460 - 00:40:03.090

ZHAMILYA NUGMANOVA: And then they either couldn't pay these loans or ZHAMILYA NUGMANOVA: something. So as you said, doctor ZHAMILYA NUGMANOVA: or I don't know if she's doctor or pharmacist. ZHAMILYA NUGMANOVA: Marina moved to the US, but her husband stays

00:40:04.440 - 00:40:19.920

ZHAMILYA NUGMANOVA: in Kazakhstan trying to pay ZHAMILYA NUGMANOVA: this money borrowed by them. ZHAMILYA NUGMANOVA: This is the only thing I learned from ZHAMILYA NUGMANOVA: from those doctors I spoke with.

00:40:19.950 - 00:40:33.870

ZHAMILYA NUGMANOVA: That's it. According to them, there's no Rahmat ZHAMILYA NUGMANOVA: anymore, unfortunately. RISHI SHRIDHARAN: Gotcha. Okay. So then looking more broadly at the cultural changes that you've RISHI SHRIDHARAN: seen.

00:40:34.290 - 00:40:49.760

ZHAMILYA NUGMANOVA: Well, In the mid 90s. ZHAMILYA NUGMANOVA: We were in pretty bad economic ZHAMILYA NUGMANOVA: situation because of collapse of. ZHAMILYA NUGMANOVA: Soviet Union.

00:40:49.760 - 00:41:07.130

ZHAMILYA NUGMANOVA: All the economic ties were, ZHAMILYA NUGMANOVA: like ruptured or I don't know how to say. ZHAMILYA NUGMANOVA: And then gradually. ZHAMILYA NUGMANOVA: It became better, but not that much,

00:41:07.130 - 00:41:26.150

ZHAMILYA NUGMANOVA: because maybe you've heard that our, first president ZHAMILYA NUGMANOVA: right now, we learned a lot about the corrupt system he ZHAMILYA NUGMANOVA: established how he and his family ZHAMILYA NUGMANOVA: are fantastically rich.

00:41:27.110 - 00:41:43.070

ZHAMILYA NUGMANOVA: And now we are almost ZHAMILYA NUGMANOVA: back to this. ZHAMILYA NUGMANOVA: 30 years as 30 years ago, almost. ZHAMILYA NUGMANOVA: Economy is not a very good then

00:41:43.070 - 00:42:00.090

ZHAMILYA NUGMANOVA: because of that war between Russia and Ukraine ZHAMILYA NUGMANOVA: and because Russia forced. ZHAMILYA NUGMANOVA: Kazakhstan to help them with the you ZHAMILYA NUGMANOVA: know, to use Kazakhstan as a transit country.

00:42:01.530 - 00:42:18.570

ZHAMILYA NUGMANOVA: To avoid sanctions and the threat ZHAMILYA NUGMANOVA: of secondary sanctions for Kazakhstan. ZHAMILYA NUGMANOVA: So. I don't know what ZHAMILYA NUGMANOVA: happens. We believe that our current president,

00:42:20.220 - 00:42:39.210

ZHAMILYA NUGMANOVA: because of his background because he's educated ZHAMILYA NUGMANOVA: individuals speaking English, Chinese ZHAMILYA NUGMANOVA: and some other languages, well educated individuals. ZHAMILYA NUGMANOVA: So we are hopeful that things

00:42:39.360 - 00:42:54.500

ZHAMILYA NUGMANOVA: would be better. ZHAMILYA NUGMANOVA: Unless, of course, the war will ZHAMILYA NUGMANOVA: continue. It is very difficult for Kazakhstan from the ZHAMILYA NUGMANOVA: very beginning to be located between Russia and China,

00:42:54.920 - 00:43:11.540

ZHAMILYA NUGMANOVA: right? Is long ago. ZHAMILYA NUGMANOVA: Long ago, when we just started partnership, one ZHAMILYA NUGMANOVA: representative from Kazakhstan answered this question. ZHAMILYA NUGMANOVA: It's very difficult to live between

00:43:11.540 - 00:43:24.460

ZHAMILYA NUGMANOVA: Chinese dragon and Russian bear. ZHAMILYA NUGMANOVA: Okay. ZHAMILYA NUGMANOVA: So we are still here between those ZHAMILYA NUGMANOVA: two countries.

00:43:27.150 - 00:43:37.790

RISHI SHRIDHARAN: Yeah. That's beautiful. ZHAMILYA NUGMANOVA: I don't know if it's beautiful, but you cannot change your geography for ZHAMILYA NUGMANOVA: sure. RISHI SHRIDHARAN: Quite, quite fair.

00:43:38.330 - 00:43:50.110

RISHI SHRIDHARAN: All right. I think that's all the questions that I had for you. ZHAMILYA NUGMANOVA: Okay. RISHI SHRIDHARAN: And it's a very poignant point that you made. RISHI SHRIDHARAN: The last question that I asked.

00:43:50.110 - 00:44:04.580

RISHI SHRIDHARAN: So before we conclude this interview, I wanted to ask you if there's any RISHI SHRIDHARAN: questions or anything that you wanted to mention that I have not RISHI SHRIDHARAN: asked you. ZHAMILYA NUGMANOVA: Okay, now, first my question is about that museum.

00:44:05.930 - 00:44:19.700

ZHAMILYA NUGMANOVA: Is it like going on that project? ZHAMILYA NUGMANOVA: Are you working on establishing a museum or what ZHAMILYA NUGMANOVA: type of museum? ZHAMILYA NUGMANOVA: And actually, what do you want to accomplish through these interviews?

00:44:21.120 - 00:44:31.040

RISHI SHRIDHARAN: Ah, so the purpose of the interviews as a whole. ZHAMILYA NUGMANOVA: Yes. RISHI SHRIDHARAN: So the idea is a kind of digital museum, if you will. ZHAMILYA NUGMANOVA: Okay.

00:44:31.820 - 00:44:42.710

RISHI SHRIDHARAN: In the sense ZHAMILYA NUGMANOVA: Meaning just this interview sitting somewhere and everyone ZHAMILYA NUGMANOVA: can get access to it. ZHAMILYA NUGMANOVA: Or what is digital.

00:44:42.710 - 00:44:58.620

RISHI SHRIDHARAN: Yes, in the hope that because this lives on the internet, anyone who is RISHI SHRIDHARAN: interested would be able to access this and they'd be able to understand, RISHI SHRIDHARAN: as you tell it in your words. RISHI SHRIDHARAN: The different, different aspects of what we've covered.

00:44:58.620 - 00:45:08.920

RISHI SHRIDHARAN: So for instance, we talked a good bit about the various partnerships that have RISHI SHRIDHARAN: happened in Central Asian countries. RISHI SHRIDHARAN: And so the focus of this would be. RISHI SHRIDHARAN: Sorry.

00:45:10.200 - 00:45:15.300

ZHAMILYA NUGMANOVA: You spoke with who? RISHI SHRIDHARAN: With you. ZHAMILYA NUGMANOVA: Oh I see. SPEAKER3: Okay. Yes.

00:45:15.300 - 00:45:28.380

RISHI SHRIDHARAN: So because of this, if anyone was interested in the history of the RISHI SHRIDHARAN: Central Asian partnerships or the way they have panned out to the present day, they RISHI SHRIDHARAN: could use this as a sort of reference. RISHI SHRIDHARAN: That's the hope.

00:45:29.220 - 00:45:39.300

SPEAKER3: Okay. RISHI SHRIDHARAN: And it's also because there is such an elegance to the way you tell this, and RISHI SHRIDHARAN: there's meaning in the way that you're phrasing this and the way you're choosing to RISHI SHRIDHARAN: state these ideas.

00:45:40.000 - 00:45:54.310

RISHI SHRIDHARAN: It's fantastic because it provides a window into understanding your RISHI SHRIDHARAN: perspective on these issues. RISHI SHRIDHARAN: And that's arguably the most important thing that we're hoping out of these interviews. ZHAMILYA NUGMANOVA: Okay okay okay.

00:45:54.310 - 00:46:07.030

ZHAMILYA NUGMANOVA: Good good good. ZHAMILYA NUGMANOVA: Actually, Doctor Spivey promised to send me some ZHAMILYA NUGMANOVA: photographs. So if she she will, I would forward ZHAMILYA NUGMANOVA: whatever I get from them.

00:46:07.030 - 00:46:11.680

ZHAMILYA NUGMANOVA: I'll forward to you. ZHAMILYA NUGMANOVA: Okay. RISHI SHRIDHARAN: That would be fantastic. RISHI SHRIDHARAN: That would be fantastic.

00:46:11.680 - 00:46:25.780

SPEAKER3: Right. ZHAMILYA NUGMANOVA: And I want actually to emphasize once again, the role ZHAMILYA NUGMANOVA: of Doctor Weinberg and other partners ZHAMILYA NUGMANOVA: from Houston for their wonderful contribution, for their

00:46:25.780 - 00:46:40.340

ZHAMILYA NUGMANOVA: commitment and just tell them that their legacy ZHAMILYA NUGMANOVA: is still here. ZHAMILYA NUGMANOVA: Okay. And people are very ZHAMILYA NUGMANOVA: appreciate their help and support.

00:46:42.260 - 00:46:49.630

RISHI SHRIDHARAN: Absolutely. Yeah. RISHI SHRIDHARAN: Okay, so, I have.