Special program fosters export of Czech medical aid and products around the world

29-05-2019

Czech doctors and medical experts are helping abroad. Within the government program MEDEVAC they provide urgent humanitarian aid in countries such as Jordan and Ukraine. You can also find medical devices Made in Czechia all over the world. This small country is definitely punching above its weight on the global scene when it comes to health expertise and technology.

Michal Burian, photo: archive of Michal BurianMichal Burian, photo: archive of Michal Burian MEDEVAC is a humanitarian program run by the Czech government. It provides medical help to vulnerable groups of the population in regions affected by conflict or natural disasters. Urgent health care is provided for free and exclusively to civilians.

Doctor Michal Burian is an orthopaedist from Bulovka Hospital in Prague and has repeatedly taken part in the MEDEVAC program in Jordan:

Michal Burian, photo: archive of Michal BurianMichal Burian, photo: archive of Michal Burian “There is a general shortage of orthopaedists in that country. Many children are born with deformities that should have been diagnosed and treated in early childhood. Since they lack such primary orthopaedic care, the deformities are becoming worse and worse and they require care of specialists and because there are so few of them in Jordan, other countries try to help. And we are among those doctors able to treat such diagnoses.”

Is it difficult to communicate with patients and colleagues in an environment that is quite different from Czechia?

“Yes, it is difficult. Jordan is a Muslim country with a completely different culture and mentality. There is a high level of illiteracy, especially in rural areas. Patients speak English very rarely. Doctors, by contrast, are very well educated. They are quite confident and speak English very well, so they nearly always translate for us and the patients. We actually met a Jordanian orthopaedist who had studied in Czechia. That makes things much easier: we can discuss the diagnoses with him even in very specialized Czech.”

Programs such as MEDEVAC are beneficial for all participants:

“It is not just help and a contribution to Jordanians – it is useful for us, too. For me personally it is a valuable experience. We see and treat diagnoses that we study only theoretically in books here in Czechia. Each and every such case is a challenge and lesson for us.”

So paradoxically, flaws in the Jordanian health care system help Czech doctors learn and practice something that they otherwise only read about:

“Exactly, systematic postnatal care is almost entirely absent in Jordan. We have met adolescent or even adult patients who are seeing a medical doctor for the very first time. If orthopaedic deformities are not treated as soon as possible they become stiff and grow bigger and worse. Inevitably, the treatment then requires much more invasive and complex open surgery and longer post-operation care. Sometimes they simply cannot be returned or corrected into the original anatomical state.”

“For example: We have to deal most often with clubfoot – where one or both feet are rotated inward and downward. If it is not treated immediately after birth, the child starts walking on the sides of its feet. This makes healthy development and normal walking impossible. Any movement on the legs and feet becomes painful. Treatment of such cases is a great challenge: the more the foot is deformed, enlarged and twisted, the more complicated the operation becomes. It is not just about correcting and getting the foot into the right position, there are also nerves and blood vessels that have to be carefully moved. If they do not function properly after the operation, it might have catastrophic consequences.”

“It is a very complex operation requiring very specialized post-operation care. Casts have to be used for several weeks and since we usually come only for twelve days at a time, we leave when the children we have operated on still have these casts on their feet and legs. So, we keep in touch with the local Jordanian doctors via Whatsapp, Facebook or some other video chatting applications, consult and decide on follow-up care.”

Petra Nováková with her Jordanian colleagues, photo: archive of Petra NovákováPetra Nováková with her Jordanian colleagues, photo: archive of Petra Nováková But it is not just doctors who take part in Czech humanitarian medical missions. Petra Nováková is a physiotherapist from the General University Hospital in Prague. She had been sent to Jordan and to Ukraine:

“These are two principally different projects. We travel to Ukraine with a team of physiotherapists, occupational therapists, and doctors from the General University Hospital of Prague. We train our Ukrainian colleagues and help to build their Rehabilitation Department. So far we have been working with the public hospital in Kiev. At the same time, we are trying to support the education and training of their own staff, directly in the hospital.”

“I was in Jordan a member of a trauma team from our hospital. So I was providing physiotherapy to patients who had been operated on by our team. And some others who had not been operated on but simply needed physiotherapy. In Ukraine, on the other hand, we train our colleagues and provide practical demonstrations at the state hospital we work with. We also invite some of them for training in the Czech Republic. Right now we have five specialists here in Prague who came from universities in Ukraine. We have prepared a program that should help them both practically and theoretically, providing them with more professional experience in the field.”

Of course, there are many other countries trying to help alleviate the suffering of civilians in war-torn or otherwise afflicted regions of the world. What do the Czech experts, in particular, have to offer in a not so distant country like Ukraine?

“We have a very elaborate system of training and teaching. In Ukraine, they are now gradually moving physiotherapy training from sport-oriented schools to the medical field. That is something where we can help with our experience because we went through the same process in the past three decades. We can help them not to make the same mistakes that we inevitably made.”

When it comes to health care, the Czech Republic has more to offer than just doctors and therapists. It has a thriving community of producers that specialize in medical devices. Jana Vykoukalová heads the executive board of the Association of Manufacturers and Suppliers of Medical Devices. I asked her why most of the Czech production is exported:

“The Czech market is relatively small and there are quite a few producers. Our association alone has over 100 members and it is the biggest of its kind. So Czech companies are looking for markets outside of the country and Europe. Most of them export more than 50 percent of their production, some of them as much as 80 or 90 percent. This is a continuous trend.”

The competition in this field is fierce. So what makes a successful medical device?

Jana Vykoukalová, photo: archive of Association of Manufacturers and Suppliers of Medical DevicesJana Vykoukalová, photo: archive of Association of Manufacturers and Suppliers of Medical Devices “Generally, we can say that successful products are innovative. Of course, there is fierce competition, especially from Asia. Companies in that part of the world can provide solid basic quality. The only way to compete with them is to provide something special, innovative and unique. For example, the Czech company Medin produces what is called a “c-nail“, which is used for heel reconstruction. There is a great demand for this particular product even in Germany, where the market is quite protectionist.”

In other words, it is not lower labour and other costs that make a successful medical device manufacturer, rather the ability to apply the latest research and development results:

“Exactly, medical devices production is mainly about innovation, high added value. You have to be able to offer something special and at the same time perfect training for the personnel that will be using it. It is not enough to sell a product – you have to persuade the customers that they will get world-class training and service because human health and lives are at stake. So you have to provide a complete package of products and services.”

Of course, medical devices are a product of business and industry. The humanitarian missions that we talked about in the first half of this report are undertaken by a small minority of Czech doctors and medical experts. Nevertheless, successful exporters and programs like MEDEVAC show that when it comes to health care Czechia has a lot to offer to the world.

29-05-2019