In this regard, AKIpress referred to an archived interview with Kasymbek Tazabekov, recognized as the founder of pediatric orthopedics in Kyrgyzstan, a distinguished physician, and the creator of the "Healthy Children" Foundation. The conversation took place in 2005, and its topics remain relevant today.
Kasymbek Tazabekov is the author of over 70 scientific papers and 10 books, and he is also the founder of the Kyrgyz school of traumatology and orthopedics. In the interview, he emphasizes the importance of early diagnosis of hip joint dysplasia, stressing that without timely intervention, this condition can lead to hip dislocation and disability. In 2025, a conference titled "Current Issues in Pediatric Traumatology and Orthopedics" was held in honor of Tazabekov's 90th anniversary, gathering specialists from various countries, including Germany, Kazakhstan, China, the Netherlands, Russia, the USA, and Uzbekistan, to discuss modern approaches to diagnosis and treatment.
According to Tazabekov, if dysplasia is detected in the first weeks of life, treatment is successful in more than 90% of cases, often without the need for surgical intervention. Training medical staff and parental attention to early symptoms of the disease remain key factors.
From the 2005 archive:
According to data from the Information Center of the Ministry of Health of the Kyrgyz Republic for 2005, out of 299,000 newborns over three years, 3,218 children had congenital anomalies. Of these, 1,496 cases, or 46%, were congenital hip dislocation, diagnosed in 5 newborns out of 1,000. This serious orthopedic condition affects motor functions and is often a consequence of the more common diagnosis of hip joint dysplasia, which can be considered an early stage of the problem that is easily treatable.
Hip joint dysplasia is the most common pediatric orthopedic disease, occurring in 16-18 children out of 1,000.
If timely diagnosis and treatment of dysplasia are not conducted, it can progress to hip dislocation, leading to severe disability.
Treatment of this pathology is quite complex and lengthy, requiring surgical intervention and does not always yield positive results.
Cases where treatment and surgeries turn out to be virtually useless are not uncommon.
The health of children is a serious trial for parents. The merciless diagnosis of "Your child is disabled" becomes a heavy burden. In such cases, many lose hope, and life seems hopeless. When we see a mother with a disabled child on the street, we often turn away, either shamefully or with sympathy. And, we confess, we are relieved that it has not happened to us.
However, meeting with Kasymbek Tazabekov, a well-known orthopedist in Kyrgyzstan and an associate professor at the KGMIIPP, instills hope that fewer parents will hear such diagnoses, as dysplasia can be effectively treated. There is no need to create large-scale programs or implement structural reforms in healthcare, which require time and resources. Can something be changed, and what is needed for that?
The answer turned out to be simple. It is important that at least one person sincerely wants to help, possessing knowledge, experience, and organizational skills, as well as minimal financial resources. In 2002, Kasymbek Tazabekov founded the "Healthy Children" foundation with the support of DFID and local companies, and began implementing a project for the early detection of hip joint dysplasia and training doctors in maternity hospitals to recognize its signs. The results were impressive — the cure rate exceeded 90%. We met with Kasymbek Tazabekov and asked him to talk about the causes of the disease, its manifestations and treatment, as well as the successful project.
- Kasymbek Tazabekovich, please tell us about the disease itself. When does it manifest and what are its dangers?
- Children are most often born not with hip dislocation, but with hip joint dysplasia, which is not critical if the disease is detected in time. However, if the pathology is not diagnosed, it can progress to hip dislocation, which requires prolonged and complex treatment. Treatment at an older age, when the disease is advanced, may be ineffective and sometimes even useless. Unfortunately, due to a lack of knowledge among doctors and inattention from parents, children with congenital hip dislocation end up in clinics at an age when walking begins, making conservative treatment impossible. Therefore, it is crucial to identify such children in maternity hospitals within the first days or at least weeks of life.
Even starting treatment in the second year of life does not guarantee success, as anatomical changes in the joint begin to progress and can ultimately lead to severe disability. If the disease is detected at early stages, that is, in the first days of life, recovery is observed in almost 100% of cases. Of course, there are other situations, but more than 90% of cases end with a successful outcome, and this can be achieved without surgical intervention and plaster casts.
- When did you organize the foundation?
- The "Healthy Children" foundation was established in 2002 with the aim of identifying disease hotspots and finding new methods to combat it. I visited all the problematic areas and examined 8,442 children from 644 maternity hospitals in regions such as Kochkor, Kemin, Suzak, Aksu, and others. As a result, 564 children were identified with suspected dysplasia, of which 428 cases were dysplasia and 136 were hip dislocation. This year, 449 out of 564 children were treated.
- Did you identify them in maternity hospitals, in the first days after birth?
- Yes, precisely in the first days. This is extremely important, as early diagnosis prevents the development of dysplasia into dislocation. Of the 564 children, 65 still need further treatment. The main task is to train the medical staff of maternity hospitals to recognize the disease and know its symptoms.
- Are there specialists in maternity hospitals who can determine if a child has suspected dysplasia?
- Unfortunately, there are no such specialists in maternity hospitals. Most clinics and hospitals do not even have orthopedic surgeons. Currently, family doctor groups have been created in clinics, which include general practitioners who are not familiar with the early clinical diagnosis of hip joint dysplasia. Often, they do not pay attention to this pathology. Therefore, my task was to train micro-pediatricians, neonatologists, obstetricians-gynecologists, and even nurses in maternity hospitals on what to pay attention to and what the signs of the disease are.
We placed clinical signs of the disease in both doctors' offices and delivery rooms so that not only doctors but also mothers themselves could closely monitor the symptoms of the disease. It is important that no child is discharged from the maternity hospital without a preliminary orthopedic examination.
In each maternity hospital, it is necessary to train 3 neonatologists and 1 orthopedic surgeon from among pediatric surgeons. I understood my task as transferring knowledge to these doctors, conducting lectures and practical classes on proper treatment. Treatment at an early stage is relatively simple. The first thing to do is to swaddle the child correctly; we call this wide swaddling or "envelope" swaddling, where the child's legs are in an abducted position. Swaddling should last for 3-4 months, after which the child fully recovers. Children with clinical signs of the disease should not be discharged from the maternity hospital without an envelope or without training the mother in wide swaddling. After discharge, these children need to be monitored to observe the recovery process.
Therefore, I traveled every two months not only to identify new patients but also to check how the treatment of already identified children was progressing.
- What results have been achieved?
- As a result of the treatment, no hip joint dysplasia in the specified maternity hospitals progressed to hip dislocation. Even in 136 cases of clinically and radiologically identified hip dislocation, 70 children were discharged from the registry after recovery. The remaining 65 continue treatment, and results will be known in 1-1.5 years. There are difficulties in treatment, which I attribute to parental negligence. In rural areas, especially during seasonal work (harvesting or pasturing), treatment is not conducted as parents simply do not come for follow-up consultations and treatment adjustments, causing the children's condition to worsen.
- This seems to be a Kyrgyz specificity — the hope that it will pass on its own. Parents start to worry only after the child turns 1 year old when they begin to walk?
- Yes, it is not noticeable before the age of 1. But when the child starts walking, it becomes obvious that they are limping, and parents begin to worry. Sometimes it is too late.
- What are the causes of the pathology?
- The causes can be consanguineous marriages, which often lead to such pathologies. For example, in the Aksu district, there is a lineage of sart-kalmak who, to preserve their lineage, engage in consanguineous marriages.
- Do nutrition and living conditions affect the occurrence of the disease?
- Certainly, this matters, especially for the child's mother. Harmful factors such as smoking and alcohol also play a role. For instance, in the Issyk-Kul region, women often consume alcohol, which can affect the child's health. Inadequate nutrition, lack of vitamins, poor living conditions, and poverty also negatively impact the future child. In Kyrgyz families, having many children is common: as many children are born, they are raised. As a result, some families have 10-12 children. I know one person who lives in Bishkek and has 24 children — 12 from one marriage and 12 from another. Frequent births, when the female body does not have time to recover, lead to anemia and pathology.
- What consequences can the disease have, besides limping?
- Not only limping; subsequently, such children become disabled. From the third year of life, such children are recognized as disabled by government decree.
Our task is to prevent disability, treating until the child is one year old, while they do not know what limping is. Recently, cases of the disease have become frequent among Dungans and Tajiks. If the disease is not detected in time, complex surgical intervention will be required at 1.5-2 years — children spend years in the hospital. And what does surgery mean for a child? It involves anesthesia, instruments, fixations, and prolonged suffering. Of course, we perform surgeries and keep pace with Russian doctors, but the results are not always impressive, not because the surgeries are performed poorly, but because the child comes in an advanced state.
- So, if the doctor diagnoses the disease in time, there will be no severe consequences? We just need to train the doctors?
- Training doctors is only part of the solution. They also need to be financially incentivized. I trained micro-pediatricians, district doctors, and surgeons. Depending on the possibilities, in addition to their main salary, we paid 500 soms a month. When a doctor receives additional payment, they are motivated not to miss the disease and to thoroughly examine the child. If a year later, a child with such a diagnosis is found in their area, I will ask, where are the results? The funding for these doctors was provided by the foundation, which included major businessmen. But now these funds are exhausted, and I cannot continue working in these areas. However, the interest of doctors remains. Parental support is needed to avoid transporting such children to Bishkek and subjecting them to prolonged and complex treatment. Much depends on the conscientiousness of the doctor and how thoroughly they examine the child. Excuses are possible, and the child may remain limping for life.
- Kasymbek Tazabekovich, where in Kyrgyzstan is this disease most prevalent?
- In studying this problem, I concluded that congenital hip dislocation is unevenly distributed in Kyrgyzstan. There are endemic areas where the disease occurs more frequently and places where it is virtually unrecorded.
Unfortunately, this problem was not addressed for a long time. 10-12 years ago, I traveled all over Kyrgyzstan and examined areas with the highest expression of pathology. It turned out that the disease is prevalent in the Suzak district of the Jalal-Abad region, Kochkor and At-Bashy districts of the Naryn region, as well as in some areas of the Issyk-Kul region. In Suzak, for example, according to our data, this disease occurs in 12-15 cases per 1,000 newborns, while the average rate in the country is 5 children per 1,000.
I became interested in why the Suzak district is most affected by this disease. It turned out that the Kogart River flows through the area, which has very low iodine content. Iodine deficiency causes not only goiter but also the pathology I am studying.
What is the statistics in other countries?
- In Kyrgyzstan and the CIS countries, the statistics range from 3 to 5 children per 1,000 births, or 0.3-0.5%. These are average figures, but in the Suzak district (Kogart zone), this percentage reaches 1%, meaning that 10-12 sick children occur per 1,000 children.
In the Kochkor and At-Bashy districts, the rate is 0.7-0.8%, which means 8-9 cases of the disease per 1,000 children. In the Chui and Issyk-Kul valleys, the rates are within average figures. There are places where the disease is virtually unrecorded.
For example, in Talas. In the CIS, the highest prevalence of the pathology is observed in North Ossetia — up to 17 children per 1,000 births. These are also mountainous areas. They use national cradles for caring for newborns, similar to our beshik, where the child is tightly swaddled in a given position of the legs for 6-7 months. There are northern areas, such as the Selkup district and Chukotka, where a high frequency of pathology is also observed. Among 1,000 examined, there are 70-80 limping children. Do you know why? These ethnic groups were isolated, and there was a mixing of blood. The heredity of the disease is more often transmitted through the mother. As a result, if the father has limping and the mother does too, then the child will be limping. Their nutrition also played a significant role — they only learned about bread in 1953. Vitamin deficiencies, improper nutrition, and blood mixing led to a high frequency of the disease.
- Is the Ministry of Health aware of your project?
- The Ministry of Health is aware, the chief surgeon is informed, our institute also knows about the project, and articles have been published. We are implementing a new method of early detection and treatment.
We discuss this problem on television, radio, and in print, but there has been little progress so far. This work needs to continue. According to the neonatologists themselves, until recently, they did not know enough about this pathology and hardly engaged in early detection and treatment. We have covered the Jalalabad region and some areas of the Naryn and Issyk-Kul regions, but cases where the disease remains undetected still occur. Even in the prosperous Chui region and in the city of Bishkek. Any diseases are easier to treat at an early stage. The main thing is to correctly and timely identify the disease and start treatment as soon as possible.
Thus, complications and surgical interventions can be avoided. This is also more economically feasible.
- Do you plan to continue your work?
- I have dedicated my whole life to this cause and intend to continue as long as I have the strength. Every healed child is a reward for my work. I have now managed to find a way to continue the work of the foundation. Six district maternity hospitals have already gained experience in diagnosis and consultations and can provide real assistance to mothers in treating their children.
This experience, which I consider successful, I would like to spread to other maternity hospitals.
Thank you for the interview and we wish you success!
