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Painting a verbal picture of post-Soviet health care in Tajikistan has earned medical student John van Bockxmeer the Alan Charters Elective Prize for 2009.

The sixth-year medical student said the collapse of the USSR and the recent war on terror had adversely impacted on health in Central Asia. He was awarded $1000.

The runners-up, who each received $250, were Priscille Ern Zhi Tan for “Holistic health in the remote villages of Palawan, Philippines” and Vinav Javaraian Menon for “Haraka haraka Africa! (Hurry, hurry Africa!): homegrown development in Tanzania”.

Mr van Bockxmeer said Tajikistan was a unique but little known nation. Life in the ex-Soviet health system meant erratic power supply, an incredible number of parasites and surgeons who did their own anaesthetics.

His time was spent in a tertiary surgical hospital in the capital, Dushanbe, the national TB hospital and a regional ophthalmological clinic.

“I was adopted by the surgical team and we would meet in the mornings where patients would file into the office to be examined,” he said. “I would assist with ordering tests and scrub into surgery when needed. I spent the majority of my time seeing surgical patients whose illnesses were directly related to the social and economic circumstances of the nation. In particular, removal of parasites (Echinococcus granulosus) from patients’ lungs or abdomen were a daily occurrence. There was also a great deal of trauma and farming accidents from the region bordering Afghanistan.”

Mr van Bockxmeer said during Soviet times there was mandatory immunisation and health screening for the entire population but following the dissolution of the USSR, infectious disease rates had escalated. “This was apparent with the high rates of hepatitis B and diphtheria,” he said. “Since the dissolution of the USSR, diphtheria has increased throughout the area by 54 times.”

He took with him pulse oximeters, IV cannulas and diathermy instruments donated from the LINCS program which are all used in the hospital.

Mr van Bockxmeer said he felt a little out of his depth as many Tajik students his age would be in charge of whole wards six months after graduation.

During his time in Dushanbe, he also volunteered at the languages centre, helping students with their English. “I made a number of friends here and one weekend I visited one of their home towns in the mountainous interior,” he said. At 3,700m, temperatures can drop below minus 10 rapidly.

“The Tajiks have never had an outsider to the village before and I am completely humbled by their hospitality. There is no scheme power so over candle light my friend’s family treats me to a traditional meal.”

Mr van Bockxmeer said medical electives were an amazing opportunity for personal growth, discovery and cultural understanding.

The Alan Charters Award is in honour of Dr Alan Charters, who taught and practiced medicine in WA and East Africa and had an enduring interest in tropical medicine and parasitology.

The sponsor of the first prize was Dr Miles Beaman of Western Diagnostic Pathology and the sponsor of the runners-up was Olivia Watson of MDA National.