Brief History of Plastination in Kyrgyzstan

Georgii Belov, MD, PhD, Professor, Department of Pathologic Morphology, Kyrgyz-Russian Slavonic University, Dinara Idarova, Institute of Polymeric Technologies, Bishkek, Kyrgyzstan.

Toledo 7/23/2011 1 Reasons for Locating the Centre for Plastination in Kyrgyzstan.  Secular society structure.  Unusual burial traditions.  Strong level of medical education compared to regional standards.  Low labor cost for medical doctors.

Toledo 7/23/2011 2 Secular society structure

 Majority of Kyrgyz people identify with Muslim religion.  Christianity is the second most common religion.  However, the societal and political structure is very secular.  Traditions, rather than religion, define behavior.

Toledo 7/23/2011 3 Burial Traditions in Kyrgyzstan  Historically, bodies of the deceased were not buried.  Remains were kept in ceramic vessels.  Burana tower, main shrine of Kara-Khanids of Balasugan, holds many such vessels from 9-13th centuries A.D.

Toledo 7/23/2011 4 Burial Traditions of Kyrgyzstan  In Muslim traditions, bodies are buried on the day of death before sunset.  By contrast, nomadic Kyrgyz people awaited relatives of the deceased to come to the funeral.  Kyrgyz people employed primitive embalming methods and death masks. Golden death mask of Shamsin clad. Toledo 7/23/2011 5 Medical education in Kyrgyzstan

 ~2,500 Medical Doctor graduates per year for a population of ~5,000,000.  Many graduate leave Kyrgyzstan for better opportunities.

Toledo 7/23/2011 6 Medical system in Kyrgyzstan

 Majority of medical doctors are employed by the state.  State salary for a pathologist is $1200 per annum (2002).  Kyrgyzstan was deemed a favorable location for the Centre for Plastination.

Toledo 7/23/2011 7 Soviet Legacy Kyrgyz Medical Academy has a history of scientific work pertaining to medical displays/museums.  Yuri Lopuhin, graduate of Kyrgyz Medical Academy and later at Moscow Medical Institute of Pirogov, was responsible for care of Lenin’s mummy in Red Square.

Toledo 7/23/2011 8 Recent History of Plasitinaion

 New developments in morphological specimens are associated with the plastination methods developed and patented by Dr. Gunther von Hagens.  Centre for Plastination in Kyrgyzstan was opened in 1997, at the department of topographical anatomy, State Kyrgyz Medical Academy .  Many medical doctors and biologists were trained for preparation of plastination specimens.

Toledo 7/23/2011 9 Recent History of Plasitinaion

 In 1998, the first hall of the Plastination Museum was opened.  In 2000, the second hall was opened.  This has been the largest investment project in medicine in Kyrgyzstan. The newest technologies of sectional, 3-dimensional and corrosion anatomic specimens developed by Dr. Gunther von Hagens have been introduced for teaching and research process.

Toledo 7/23/2011 10 The Museum of Plastination in Bishkek

The Museum of Plastination established in Bishkek has more than 1500 plastinated specimens, including 15 whole anatomic bodies.

Toledo 7/23/2011 11 The Museum of Plastination in Bishkek

 Teaching specimens plastinated in Kyrgyzstan.  Focus on detailing of nervous, circulatory, and muscle system.

Toledo 7/23/2011 12 The Museum of Plastination in Bishkek

 Initially, the plastination process was done by the existing staff in the morphology department and even medical students (Centre of Plastination).  Later, the Institute for Morphology and Polymer Technology was created and separate staff was engaged for the Institute. Management, bookkeeping, and museum professionals were hired.  I, Georgii Belov, was the Director of the newly created Institute.  I worked in that function from January 2002.

Toledo 7/23/2011 13 The Museum of Plastination in Bishkek

Toledo 7/23/2011 14 The Museum of Plastination in Bishkek

 The Museum became a place for training of first year students, but also for practicing physicians and surgeons.  Mobile training sessions on several topics were organized for students of other universities, schools, and colleges.  Many foreign guests, physicians and laypersons, people of different faiths expressed their delight.

Toledo 7/23/2011 15 Survey: Need for the Center for Plastination to the Medical Education

 Visitors to the museum in 2003 were surveyed anonymously. 1% 2%  500 visitors: 234 – medical students 74 – other higher education students 83 – high school students 40 – medical doctors

34 – other medical 97% professionals 35 – unrelated to medicine Yes No chose not to answer.  As seen from the graph on the right, 486 visitors agree to the need for the museum for medical education, 4 disagreed, and 10 chose not to answer.

Toledo 7/23/2011 16 Survey: Attitude Towards Utilization of Plastinated Specimens

 90% showed positive 3% 7% response.  7% were neutral.  3% were against. 90%

positivt against neutral.

Toledo 7/23/2011 17 Multiple Response Survey: Preferred tools for Independent Learning Anatomy.

 88% favored human anatomical specimen (including plastinated specimens).  3% were against using liked artificial models of organs human specimens. also favored other graphic tools  17% also favored anatomical atlases. also favored anatomical atlases  12% also favored other against using human specimens graphic tools. favored human anatomical specimen  16.5% also liked artificial models of organs. 0 20 40 60 80 100

234 medical students from the original data were surveyed.

Toledo 7/23/2011 18 Plastinated Human Specimens versus Other Human Specimens  7% of medical students (surveyed in the previous graph) did not favor plastinated sepcimens over traditional preparations.  This is due to the fact that the Department of Pathological Anatomy at the State Medical Academy has a unique collection of specimens. These specimens were collected over a long period of time and represent very unusual pathologies.

Toledo 7/23/2011 19 Multimple Response Survey: Benefits of Plastination Specimens over Specimens Prepared in Formalin  Lack of smell and other undesirable sensory inputs (touch) – 54.7%.  Longevity and ease of use – 49.5% No benefits  High illustrative quality – 33.2% Higher tolerance  Higher tolerance, among first-year students, allowing High illustrative quality to overcome the psychological barrier–29% Longevity and ease of use

 No benefits – 2.6% Lack of smell and other undesirable sensory inputs Same sample set of 234 medical 0 10 20 30 40 50 60 student visitors. Survey allowed for multiple responses.

Toledo 7/23/2011 20 Multiple Response Survey: Recommendations/Comments for the Plastination Museum  95.3% recommended periodic renewal/addition of specimens.  71% wanted direct involvement in preparation of specimens.  92% agreed that visits to the Museum increase awareness about healthcare among general public.  73.8% agreed that the Museum should be open to general public.  Only 9.4% believed that access should be limited to medical profesionals and academic visitors.

Toledo 7/23/2011 21 Survey: Attitude Towards Donation of Body (Not Specified Use).  21% of non-medical professionals visitors were open to body donation.  11% of non-medical professionals were against.  8% of medical professionals were open to body donation.  15% were against.

Toledo 7/23/2011 22 Involvement of Politicians  The legal basis concerning anatomic specimens in Kyrgyzstan was imperfect in the early 2000’s.  President (rector) of the State Medical Academy in Kyrgyzstan was also a senator in the Kyrgyz Parliament.  He actively questioned the misuse of the money provided by the World Bank for the medical reform in Kyrgyzstan.  Retaliatory involvement of politicians in research and teaching process broke off all activity on plastination.

Toledo 7/23/2011 23 Politicians Involvement in the Centre for Plastination

Senior Advisor to the Representative to the Kyrgyz Parliament, Leader of Afgan War President (1999- Veterans Party (2000-2010). 2005) Currently arrested and being O.I. Ibraimov prosecuted for corruption.

Chief of Stuff, President’s Office President of the (2002-2005) State Medical K. D. Djanuzakov Academy Currently arrested and being I. Akylbekov prosecuted for corruption. Died 01/16/.2010

 Senior advisor wanted the President of the Medical Academy removed due to his activities as a senator, questioning grant allocations.  The Centre was used to the remove the President of the Academy through criminal proceedings on organ trafficing.  The Centre was accused of acting as a front for stealing and exporting human organs to Germany.  After the President of the Academy was removed and the Centre was closed, criminal proceedings halted. Toledo 7/23/2011 24 Current State of Education Using Human Specimens.  Use of human organs, including surgical amputated material and placenta, are restricted by health legislation.  Quality of teaching and learning the anatomy has It isn’t work for visitor decreased.  The sanitary and technical state of morgues has worsened, and problems of temporary storage and burial of unclaimed corpses remain unsolved. Toledo 7/23/2011 25 Current Focus on Animal Specimens.

 Some of the trained personnel are currently working on a private enterprise with a focus on animal specimens.  Technologies by Dr. Von Hagens are being used and further developed, but only with animal specimens.  Scientific work is focused on perfecting corrosion-based plastination methods.  Historically, animal species were used as models for human diseases. This technology furthers this tradition but allows for superior and unmatched illustrative quality.  Focus on animal species is not limited to anatomy. Specimen developed with this technology can be employed in evolutionary biology, experimental pathology.

Toledo 7/23/2011 26 Specimens of Animal Origin

Toledo 7/23/2011 27 Specimens of Animal Origin

Toledo 7/23/2011 28 Thank You!

Georgii Belov

Toledo 7/23/2011 29