In late 2010, Médecins Sans Frontières (MSF) launched a programme treating cardiac emergencies in Grozny, Chechnya, in response to the inadequacy of cardiac healthcare in the region.
Within a few months of its implementation, the teams had treated nearly 700 patients.
A population at risk
Smoking, poor diet, lack of exercise, hypertension, diabetes, and especially the stress of years of war have meant the Chechen people are more susceptible to cardiovascular disease, which affects one person in six.
In the absence of equipment and specialised medical staff, these diseases are responsible for more than 62 percent of deaths in the Republic. The national average is lower, at 56 percent.
In 2009, the Republican Emergency Hospital (REH) in Grozny registered 1,555 patients who had suffered a heart attack, with 33 percent of the cases fatal.
At that time, the cardiology and intensive care unit had no functional defibrillator, ECG machine or Holter monitor and there was no way of carrying out specialised biological examinations or fibrinolytic treatment.
The only way to treat a patient with cardiovascular disease was if they travelled to Moscow, a distance too great for the most urgent cases.
Emergency heart care
At the end of 2010, MSF opened a cardiology and intensive care programme in the surgical and cardiovascular intensive care unit of the emergency hospital in Grozny.
Given the weaknesses in the health system and the gaps in the knowledge of the field of cardiology, the aim of MSF was to improve the ability of Chechen cardiologists to diagnose and treat emergency cases.
The first few months were devoted to developing equipment, supplies and medicines, and to training staff on treatment methods specific to cardiology.
Consultations with the patients then followed.
Since February 2011, the emergency unit in the cardiology department recorded almost 700 admissions, with more than 100 patients resuscitated using defibrillators.
Fibrinolysis is a process to dissolve a blood clot before it reaches the heart, which without treatment is fatal. The first fibrinolysis took place in early July, and teams have carried out 15 since.
"Before the arrival of MSF, this procedure had never been done here. We did not have the necessary equipment or drugs," says Dr Madina Saidarkhanova, the head of the cardiac intensive care unit.
A first in MSF history
Aside from medical issues, there have been some challenges.
"This is the first time that MSF is implementing a project for cardiac emergencies. This is a highly specialised medical activity. However, based on preliminary results, it is a success," says Vladimir Najman, MSF head of mission in Russia.
By the end of 2011, the mortality rate had fallen to 7.82 percent.