ESTABLISHMENT OF MEDICAL AVIATION

Back in 1784 after the Montgolfier brothers' demonstrations of balloon flight, doctors began to consider the opportunities that their patients could gain from hot air ballooning. The history of air medical transportation dates back to the evacuation of 160 wounded soldiers by balloon from besieged Paris in 1870 during the Franco-Prussian War.

The earliest cases of the evacuation of the wounded in unequipped military fighters were described in the French army during the First World War in 1917.

In 1917 in Australia John Flynn, pilot and missionary, implemented the idea of combining radio, aviation and medicine to create the prototype of the Australian Royal Flying Doctor Service, which is an important part of Australian life today.

In 1920-1930 "medical aviation" was developed in almost all countries where there was aviation. The main purposes of the medical aviation were the evacuation of ill and wounded persons from remote and hard-to-reach areas, the transportation of doctors for emergency medical care, the transportation of medical supplies.

The history of the development of the ambulance and emergency medical care service in the Kazakh SSR begins in the late 1920s - early 1930s. On February 5, 1928, by order of the Zhetysu Provincial Department of Health, an ambulance station was created at the city hospital of Almaty, which had only two ambulance horse carriages. Only later, gradually, cars, airplanes and helicopters began to become available at the disposal of doctors...

Medical aviation in the USSR was established on the initiative of the Russian Red Cross and Red Crescent Society, which announced in 1925 a raising of funds for the construction of ambulance aircraft.

What should an ambulance aircraft be like? The need for it arises always unexpectedly - hence the need for its constant readiness for flight. The urgency of providing medical care dictates the need to land in the immediate vicinity of ill or wounded person. In this case, it is possible to use unprepared sites, which imposes great restrictions on landing speed, mileage and takeoff run, as well as chassis strength. In turn, the grave condition of the patients transported by the plane suggested the creation of some comfort for their accommodation with the possibility of providing necessary medical care directly in flight.

Already at the stage of preliminary design it became clear that the operational capabilities inherent to the design of a serial aircraft fully satisfy the picky doctors. However there were some difficulties with the layout of the sanitary compartment of the cabin. Where and how to carry the stretcher? Where to put it in flight? How to accomodate a doctor and place medical equipment? Young engineers sorted out option after option, but there was still no acceptable solution. The direct development of the project was carried out by engineer A.N. Gratsiansky. “And then one morning,” recalls A.N. Gratsiansky, “having barely crossed the threshold of the Design Bureau, I hurried to Konstantin Alekseevich: I had so much desire to show another version. I suggested extending the door to the salon in the horizontal direction and placing it in the aft fuselage. And the stretcher should be attached to special pendants of the system of Dr. A.F. Lingart, senior physician of the medical service of the Red Army ... The chief looked, thought for a minute or two and pronounced the "verdict": - Well, that seems to be exactly what is needed...".

The first Soviet ambulance aircraft K-3 designed by K.A. Kalinin, capable of transporting one medical worker and two patients on a stretcher, was built in the USSR in 1927 and was transferred in 1928 to the Air Force to provide medical assistance to patients in need of evacuation over long distances. It was then that the first requirements for the equipment of an aircraft were made. In subsequent years hundreds of ambulance aircraft of various types were built, which made it possible to evacuate tens of thousands of wounded and sick, both in peacetime and in difficult times of war.

The photo shows the first aircraft of the USSR medical aviation K-3.

On March 4, 1928, K-3 as part of the squadron "Our Answer to Chamberlain" was solemnly handed over to representatives of the Air Fleet at the Central Aerodrome in Moscow. The aircraft was given the name "ROKK-1" (Russian Red Cross Society), having determined the place of service in the transport-expediting station of the medical service. In 1928-1930, 30 people were taken to hospitals from hard-to-reach areas. Then it was regarded as a great achievement.

In early 1928 Kalinin began to create the next K-4 aircraft. The work consisted of further improving the already created samples. It was carried out under an agreement with the Central Committee of the Russian Red Cross Society, which provided for the construction of three medical airplanes of the K-3 type in an improved version. However, the result of the work was actually a new car. Its scheme repeated the previous Kalinin's aircraft, and the dimensions were almost the same as the K-3.

In 1928, one copy of the K-4 was exhibited at the International Aviation Exhibition in Berlin and was awarded the Gold Medal of the exhibition.

The photo shows the K-4 ambulance aircraft at an exhibition in Berlin (1928).

The K-3 aircraft, like its lightweight and modernized version of the K-4, was successfully used in the USSR medical aviation. The aircraft Sh-2 by V.B. Shavrov, S-1, S-2, S-3, Po-2S and Po-2L by N.N. Polikarpov, AIR-6 by A.S. Yakovlev, SAM-5A by S. Moskalev were also in use.

In May 1929 the K-4 aircraft began to arrive in Kazakhstan and Central Asia. The first of these aircraft was named "Gift of Ukraine to Kazakhstan". Thus, it can be assumed that the full-fledged beginning of medical aviation in Kazakhstan was laid in May 1929.

In total more than a dozen K-4s arrived in the Central Asian region of the USSR (how many of them are medical is not known). In total 22 aircraft of various modifications were produced. K-4 aircraft were intensively used for passenger transportation, delivery of necessary instruments to topographers and surveyors, providing urgent medical assistance to shepherds and geologists, and ensuring the construction of Turksib.

An outstanding example of light aircraft was the U-2 biplane built in 1927 under the leadership of N.N. Polikarpov. For this aircraft fate has prepared a long life in aviation. The car turned out to be reliable, unpretentious and simple to operate. This two-seater aircraft has found wide application as a training, ambulance, agricultural, transport, communications aircraft. It was produced until the early 1950s. In total about 33 thousand copies were produced in various modifications. The U-2 (from 1944 - Po-2) had no analogues in terms of production time and versatility.

The history of medical aviation in Kazakhstan, as a service providing qualified medical care to residents of remote areas, began in the second half of the 1930s. This year, the Kazakh Directorate of the All-Union Association of the Civil Air Fleet of the USSR was established, renamed in 1934 into the Kazakh Territorial Directorate of the Civil Air Fleet of the USSR.

Initially some aircraft were identified in the structure of the People's Commissariat for Health of the Kazakh SSR to solve problems in the field of ​​medical aviation (created on August 26, 1920). These aircraft carried out anti-plague and anti-malaria treatment of the area, transportation of medical personnel and seriously ill patients, medicines. The development of air routes by aviators took place in difficult conditions - in fact, there were no navigation and communication facilities, meteorological support for flights, and technical bases. The flights were carried out using landmarks and a magnetic compass. The landing sites were selected by the pilots visually.

One of the first persons who performed medical aviation flights in the Kazakh sky was pilot Mikhail Medov. Back in 1935 he performed medical aviation flights in the West Kazakhstan region. Flying for seriously ill patients to settlements in the region, Medov picked up landing sites from the air, made a description of them, and drew plans. It came in handy when opening local airlines...

In November 1937 medical aviation was transferred from the USSR People's Commissariat of Health to the Main Directorate of the Civil Air Fleet of the USSR, which also occured in the Union republics. This transfer has greatly simplified the system of flight and technical operation of aviation equipment.

IN THE YEARS OF WAR

Medical aviation developed most intensively during the war years.

In the battles near the Khalkhin Gol river, which lasted from spring to autumn 1939 on the territory of Mongolia between the USSR, Mongolia, on the one hand, and the Empire of Japan, together with Manchukuo (State of Manchuria), on the other, the enormous importance of medical aviation transport in the system of staged treatment with evacuation by appointment was revealed. Twin-engine aircraft and TB-3 bombers were used there, on which 700 wounded were evacuated to Chita. Somewhat later, the converted Douglas aircraft, which could accommodate 18 wounded on stretchers, began to be used as ambulances, and up to 24 wounded persons could be transported on Li-2 aircraft.

During the Soviet-Finnish war, from December 10, 1939 to March 20, 1940, civil aircraft of the USSR medical aviation transported more than 21 thousand wounded, more than 1000 medical personnel.

During the Great Patriotic War of 1941-1945, as well as during the First World War, material resources were reoriented to the front. A large number of medical workers left for the front. For example, in 1941-1945 two-thirds of each issue of Kazakh Mining and Metallurgical Institute was sent to the active army.

The role of the medical aviation during the Great Patriotic War was exceptionally great. Ambulance aviation was then represented by transport aircraft of the Air Force and Civil Air Fleet. In 1942, separate medical aviation squadrons and medical aviation regiments were formed. In 1943, separate medical regiments were created, which were subordinate to the chiefs of the medical departments of the fronts.

At the expense of the forces and means deployed on the territory of the Kazakh SSR, the following were formed:

• The 662th mixed aviation regiment, a military unit of the Armed Forces of the USSR in the Great Patriotic War, was formed as the 662nd light bomber aviation regiment since November 1941 in Alma-Ata on the basis of the 22nd aviation school, was armed with U- 2, as part of the active army from January 31, 1942 to March 5, 1943 (52 and 14 Air armies);
• The 991st Night Bomber Aviation Regiment, a military unit of the Armed Forces of the USSR in the Great Patriotic War, was formed on the basis of civil aviation units, on November 1, 1942 in the reserve of the Central Asian Military District, from November 21, 1942, the regiment began combat work on the Kalinin Front ( 211 nbad 3 VA), later renamed the 991st night light bomber aviation regiment, armed with U-2 aircraft;
• The 992nd Night Bomber Aviation Regiment, a military unit of the Armed Forces of the USSR in the Great Patriotic War, was formed on the basis of civil aviation units, on November 1, 1942 in the reserve of the Central Asian Military District, it is known that for successes in the fight against fascism it began to be called - The 992nd night light bomber Cherkassk orders of Suvorov and Bogdan Khmelnitsky aviation regiment (part of the 312th nbad), 992th regiment (as well as 662 and 991) took an active part in the battles for the defense and liberation of Leningrad.

In addition to the above units in the Kazakh SSR in December 1941 the Chuguev Military Aviation School of Pilots (CHVASHP), the 728 Fighter Aviation Regiment was formed from the instructor pilots who were in evacuation in Shymkent (Central Asian Military District).

The aviators of the Civil Air Fleet ambulance squadrons worked with extreme strain. During the Great Patriotic War civilian aviators evacuated about 347 thousand seriously wounded, delivered to the front more than 2 thousand tons of canned blood and about 1700 tons of medicines.

In addition to the daily work of evacuating the wounded from the medical battalions, they transported the wounded from the front-line hospitals to the rear of the country. In the course of major offensive operations, when the number of wounded increased sharply, and other types of transport were completely switched to supporting the combat operations of the troops, the crews of transport aircraft from the front-line units of the Civil Air Fleet came to the rescue.

The photo shows the С-2 (PO-2) aircraft with cassettes on the wings designed by G. Bakshaev.

At the end of the Great Patriotic War, a clearly organized system of using aviation for the evacuation of the wounded took shape. On small ambulance planes, which did not require special runways the wounded were transported from to hospitals in the army and front-line rear services, and on medium-sized and at that time large aircraft of the Li-2 type the wounded were evacuated far inland. The requirements for pilots and navigators of medical aviation were extremely strict, since the flights were mostly carried out at night, landings had to be done on completely unfamiliar and small areas, there was a high probability of encountering with enemy aircraft.

DEVELOPMENT OF MEDICAL AVIATION

Together with military aviation in the postwar years, the rapid development of civil aviation began, which made possible more extensive use of aircraft in the interests of medical aviation. Medical aviation, as a union of two fields - medicine and aviation, in the post-war years covered almost all regions of the USSR.

Battle-hardened and experienced in treating the wounded, frontline medics made a significant contribution to the development of medicine and health care in the Kazakh SSR in the postwar years. They took an active part in specialized and emergency medical care to the population, the opening of new educational and research institutions, clinics and hospitals. Many of them not only returned to practical work, but also engaged in teaching activities, their military experience was, of course, valuable for students. Among them are academicians B.A. Atchabarov, I.K. Karakulov; doctors of medical sciences, professors S.R. Karynbaev, A.A.Terlikbayev, R.K. Makasheva, A.R. Chokin, E.A. Azarova, K.K. Makashev, R.I. Samarin.

In 1950 the Karaganda Medical Institute was opened. It was created due to the population growth, including those involved in the development of the coal industry, non-ferrous metallurgy, and the construction industry. To provide patronage assistance from KazGMI to KMI, sets of textbooks, laboratory instruments, methodological manuals and recommendations, scientific literature were sent. Teachers from KazGMI traveled to the new medical university of Kazakhstan to read lecture cycles, conduct seminars for teachers. The republic was interested in training new doctors. In accordance with the planning directives of the development of the USSR for 1951-1955, the growth of the main indicators of health care in the Kazakh SSR was ensured: the number of sick beds increased by 19,890 (by 50%), the number of doctors by 3100 (by 50.4%). The growth rate of hospital beds in rural areas in Kazakhstan was 2.6 times higher than the average for the USSR.

In 1963 medical aviation was reintroduced to the Ministry of Health. Many hospitals have established emergency and routine counseling departments. The doctors of these departments made up the medical aviation brigades. By 1968, there were 164 hospitals in the USSR, to which medical aviation planes and helicopters were assigned.

The Yak-12С, Yak-12M and Yak-12A aircraft by A.S. Yakovlev, An-2S by O.K. Antonov were widely used in medical aviation.

The photo shows the Yak-12 aircraft performing a mission for medical aviation in Tselinograd (1950s).

The photo shows An-2 on a medical assignment in the village of Atbasar, the aircraft commander (on the left) with the head of the Atbasar airport Nikolai Antonov (probably 1960-70s).

It is impossible not to mention the plane An-2. The project of a multipurpose aircraft was proposed by O.K. Antonov, future chief designer of the Antonov design bureau back in 1940. However then, in the pre-war years, the creation of combat aircraft (or transport aircraft for performing military tasks) was at the forefront and Antonov's project was rejected due to a fairly low flight speed (no more than 300 km/h).

Works continued at the end of 1945 and already on August 31, 1947, the aircraft which was later named Antonov-2 (An-2), made its first flight from the airfield of the Chkalov aircraft plant in Novosibirsk. It was an agricultural version of the aircraft, but later the number of versions produced increased significantly.

The initial stage of creating the aircraft and launching it into production was complicated by the fact that a number of high-ranking officials and aviation specialists considered this project archaic. After all, the aircraft being created was a braced biplane, and the time of biplanes by the end of the forties seemed to have passed. Today, without offering an alternative replacement, there are also calls from some "specialists" to stop the operation of the existing An-2 aircraft.

In total, more than 18 thousand An-2 aircraft were built, and as of the end of 2012 about 2300 such aircraft are operated in 26 countries in the world. Most of them (about 1400 pieces) are located in Russia. Most of these aircraft are currently in storage (about 1000 pieces). The largest number of An-2 biplanes were produced in Poland. Since 1958 the rights to manufacture this aircraft were transferred to Poland and the procedure for selling it in the USSR was determined. At the WSK PZL-Mielec plant in the Polish town of Mielec, full-scale production was maintained until the end of 1992 and individual small series were produced until January 2002. In total 11,915 copies of the An-2 aircraft were produced in Poland, of which 10,440 were delivered to the USSR (and further to the CIS after the collapse of the USSR). In addition, this aircraft was produced under license in China in various versions named Shijiazhuang Y-5 and Nanchang Y-5. The PRC remains today the only country in the world where the production of An-2 continues to this day.

And the An-2 itself has already entered the Guinness Book of Records as the only aircraft in the world whose production has not stopped for over 60 years. Such longevity is determined by the excellent capabilities and characteristics of the aircraft in its class, and numerous extremely positive reviews from the flight crew only confirm these qualities.

The photo shows the An-2 plane.

The An-2S ambulance plane accommodates 6 lying (on stretchers) and 1-2 sedentary patients or 10-12 seated patients. Today in the Republic of Kazakhstan 12 An-2 aircraft with an equipped passenger compartment are used to transport 2 lying (on a stretcher) patients, accompanied by a mobile brigade of medical aviation. It is possible to increase the number of An-2 aircraft used by the medical aviation up to 15 units. In the Kazakh SSR there were about 400 An-2 aircraft of various modifications, in 2013 their fleet was 135 units, according to various experts, by 2017 the An-2 aircraft fleet is expected to decrease to 70-80 units.

The system of ambulance service in the USSR continued to develop. In 1956 Professor Boris Kuleshevsky at the XIV Congress of Physicians in Moscow, put forward the idea of creating specialized ambulance teams taking into account modern ideas about nosology, which later became an important stage in the development of the ambulance and emergency care system in the USSR. The pioneer of anticoagulant therapy in the USSR, B. Kuleshevsky, like no one else, understood that the time factor (as they say now - "golden hour") plays a decisive role in acute manifestations of coronary artery disease. Therefore, he turned to the ambulance as the most mobile link in healthcare.

To train qualified medical personnel in the Kazakh SSR, medical universities were opened in Semipalatinsk (1953), Aktyubinsk (1957), Tselinograd (1958), Shymkent (1979) and the Almaty State Institute for Advanced Medical Studies (1963). A number of research institutes were opened: the Kazakh Research Institute of Oncology and Radiology (1960), the Research Institute of Pediatrics (1972), the Institute of Nutrition (1974), the Republican Research Center for Maternal and Child Health (1975), the Research Institute of Cardiology (1977).

The Kazakh Territorial Administration of the Civil Air Fleet of the USSR in 1965 was transformed into the Kazakh Administration of Civil Aviation of the Ministry of Aviation of the USSR.

In the late 1970s, the number of medical aviation flights in the Soviet Union exceeded 100,000 per year. Almost every region of the USSR was provided with light ambulance planes and helicopters.

The first ambulance helicopter in the USSR was a variant of the Mi-1 light helicopter. It had two easily removable gondolas suspended on the sides of the fuselage for transporting patients (one on a stretcher in each gondola). The gondolas were connected through a tunnel to the cabin, which housed a table for tools and medicines. Similar gondolas were used on the ambulance versions of the Ka-15M and Ka-18 helicopters by N.I. Kamov. On the ambulance versions of the Mi-2, Mi-4, Mi-8T, Mi-17 and Ka-25K helicopters, patients were accommodated inside the cockpit, and the cockpits of the Mi-8TM and Mi-17 helicopters were equipped as operating rooms.

The photo shows the Mi-2 and Mi-8 helicopters (with open ramp doors).

In 1980 the Antonov Design Bureau created the An-26M ambulance aircraft with a surgical ward, an intensive care unit and a medical staff compartment. At the same time the An-28, Tu-104, L-410 aircraft were reequipped for medical needs.

A further development of the massive use of aircraft for the evacuation of the wounded and sick was marked by the war in Afghanistan. During the offensive 90% of the wounded were evacuated from the battlefield by helicopter (74% in 1981 and 94.4% in 1987). The number of wounded evacuated in the first three hours after being wounded in field or army hospitals increased from 48% in 1980 to 53.1% in 1987. The proportion of those who were evacuated 12 hours or more after injury fell from 19% in 1980 to 5% in 1987.  

From 1980 to 1988 about 40,000 patients were transported by air in Afghanistan (wounded accounted for 42.1%, ill persons for 57.9%). Another 78,000 patients (of whom 26% were injured) were transported from army hospitals in Afghanistan to 340 District Military Hospital in Tashkent for further treatment. The evacuation system made it possible to provide highly specialized assistance to the wounded in need of it. More than 40% of the wounded were treated in the Soviet Union.

In 1983 in the Soviet Union at the Ilyushin Design Bureau on the basis of the Il-76MD military transport aircraft the Il-76MD Scalpel flying hospital was developed and put into operation. In the fuselage of the aircraft, three large container modules were installed, electrified and interconnected. The first of them contains two operating tables, artificial lung ventilation devices, suction, lamps - all the devices necessary for a surgical operation. In the second, the intensive care unit, two beds, equipment for maintaining artificial respiration, and an X-ray room. The third module is designed as a purely transport one, designed for 12 suspended stretcher beds. All 3 modules, together with the power substations attached to them, were equipped with wheels so that, if necessary, they could be removed from the aircraft using a winch and deployed in the field. The "scalpel" was widely used to evacuate the wounded during the war in Afghanistan, interethnic conflicts in the territory of the former USSR in the 1990s. This unique hospital-aircraft is not currently in operation.

In Kazakhstan, in the 1970s-1980s, the total number of small aircraft such as An-2, Yak-12, Morava was about 700 units, some of them were also used to transport patients, women in labor and medical personnel. Moreover, more than 400 airfields of local airlines were in operation.

CRISIS YEARS

By the end of 1990, the USSR medical aviation service had 189 specialized aircraft, including 95 airplanes and 94 helicopters, with the help of which medical assistance was provided to more than 200 thousand patients annually. For the transportation of medical personnel and patients, passenger and transport aircraft of a wide network of local airlines were also widely used.

1990 was the last year when medical aviation was widely used in the USSR. The collapse of the Soviet Union, negative phenomena in the economy, changes in the management system, significant underfunding of health care led to a protracted crisis of medical aviation. At that time, in most of the former Soviet Republics, aviation was not used at all to provide medical assistance.

These problems have not spared Kazakhstan either. The aircraft fleet was shrinking, the number of local airlines was dwindling. This process dragged on and then we could not even think about the development of medical aviation.

Already in 2010 208 aircraft were decommissioned in Kazakhstan due to non-compliance with flight safety requirements, the number of airlines was reduced from 69 to 53.

In 2011 58 aircraft were involved in passenger traffic, performing regular flights, including 41 of western production. Irregular (charter) and business flights were carried out by about 40 aircraft of the Tu-54, Tu-134, Yak-40 types, as well as 15 Western-made aircraft such as Cessna 650, Challenger CL-850, etc. Aviation work was carried out by about 233 aircraft, of which 156 airplanes, mainly Soviet-made (An-2, Yak-18, Yak-52) and 77 helicopters (Mi-8, Mi-2), as well as Western-made Agusta Westland, BELL, MD-500 and other types. In total, as of 2011 358 aircraft were in operation in Kazakhstan.

Concerning medical aviation, only a few flights were carried out. For this purpose, An-2 aircraft and Mi-2 helicopters were involved in a number of regions.

In April 2013, during the Government Hour, Chairman of the Committee for Economic Reform and Regional Development of the Mazhilis of the Parliament of the Republic of Kazakhstan Seitsultan Aimbetov said: “To date 497 civil aircraft are registered in the state register. According to experts, the depreciation of the aircraft fleet is more than 80%, and their service life is more than 20 years, while the established service life of an aircraft is no more than 30 years”. In turn, the Minister of Transport and Communications of the Republic of Kazakhstan Askar Zhumagaliyev said that in 2012 Kazakh airlines purchased 16 aircraft, and in 2013 they would purchase 14 more aircraft. Until 2020 our domestic companies plan to purchase approximately 56 aircraft. Thus, the situation began to turn towards the development and renewal of civil aviation.

Taking into account the territory size of the Republic of Kazakhstan, the length and condition of land transport routes, the importance of medical aviation in our country can hardly be overestimated.

On January 28, 2011, the President of the Republic of Kazakhstan N.A. Nazarbayev delivered a program message to the people of Kazakhstan, in which he identified an important direction for increasing the level of human potential to increase the availability and quality of medical services. To this end, N.A. Nazarbayev instructed the Government to ensure the production of at least 16 helicopters for the needs of medical aviation until 2015.

This assignment did not arise from scratch. The agreement on the establishment of a joint venture with the participation of JSC National Company Kazakhstan Engineering and the French company EUROCOPTER was signed on October 27, 2010 in France on behalf of the head of state. It should be noted that 11,300 EUROCOPTER helicopters are used in 149 countries around the world.

Large-scale assembly of EC-145 helicopters began, for the needs of the Ministry of Defense, on the territory of an aviation military unit with a parallel construction of a helicopter plant. The first Kazakhstani helicopter took to the skies on December 1, 2011.

The assembly and maintenance plant of EC-145 helicopters - Eurocopter Kazakhstan Engineering LLP was inaugurated in Astana on June 29, 2012.

According to the plan for the implementation of the objectives set by the President, in April 2011 the RSE “Kazaviaspas” of the Ministry of Emergency Situations was transformed into the joint-stock company “Kazaviaspas” with 100% state participation in the authorized capital, and in July of the same year the Republican Coordination Center for Medical Aviation was created. The main task of the Center is to organize, coordinate and improve the provision of emergency medical and consultative assistance to the population of the Republic of Kazakhstan using medical aviation transport. From the first days of its creation, the Center carried out its activities in close cooperation with the Ministry of Emergency Situations through “Kazaviaspas” JSC, other state bodies and aviation companies.

The photo shows a specialized helicopter ES-145.

A new milestone in the history of medical aviation was the creation of the Republican State Enterprise on the right of economic management "Republican Center for Sanitary Aviation" of the Ministry of Healthcare of the Republic of Kazakhstan on the basis of the Decree of the Government of the Republic of Kazakhstan dated December 28, 2012 No. 1724.

Already in 2013, the medical aviation of Kazakhstan had 14 EC-145 helicopters and two Ka-32 helicopters equipped with modern medical equipment. Flight and technical operation of these helicopters is carried out by the flight and engineering personnel of JSC “Kazaviaspas”. In addition 7 private airlines operate as medical aviation by helicopters: ES-120V, ES-135, Mi-8, MD-600N, Vo-105 and aircraft: Yak-40, An-24, An-28, An -2. Thus, about 25 aircraft of more than 10 types are being used today in the medical aviation of the Republic of Kazakhstan.

In 2011, the RCSA performed 323 flights, in 2012 - 1005, in 2013 - 1355, in 2014 - 1874, in 2015 - 2149 flights. The lives of our saved citizens are behind these figures. Almost 50% of all flights are operated to save children.

The photo shows the Yak-40 ambulance aircraft.

On its way of development, the National coordination center for emergency medicine overcomes many difficulties, among which there are general problems of medical aviation typical for all countries and there are home-grown problems. Let's list the most significant ones that experts talk about:

• the state of the infrastructure for the use of helicopters and aircraft on local airlines;
• difficulties in interaction between organizations, departments;
• complexity of tariff setting (it must be admitted that 1 hour of flight time is quite expensive);
• the state of the material base of the National coordination center for emergency medicine, the development of branches and of a coordinating network.

The development of medical aviation in the Republic of Kazakhstan to some extent contributes to the development of civil aviation in general.

By Decree of the Government of the Republic of Kazakhstan dated January 24, 2019 № 12, the Center was renamed into the Republican State Enterprise on the right of economic management "National Coordination Center for Emergency Medicine" of the Ministry of Healthcare of the Republic of Kazakhstan (hereinafter referred to as NCCEM).

NCCEM ensures the provision and development of urgent and emergency medical care to patients in the form of medical aviation in order to increase the availability, timeliness and safety of medical services provided.

The work of NCCEM in the field of medical aviation is carried out in the following main areas:

• transportation of patients;
• holding consultations;
• participation in the organization of operations;
• organization of remote medical services (including for patients with COVID-19 by expert groups);
• transportation of donor organs (tissues) and biomaterial.

The photo shows the Pilatus PC-12 ambulance aircraft

Also, the function of coordinating the activities of ambulance organizations is assigned to the NCCEM.

Educational activities are carried out to provide emergency medical care, as well as to provide urgent medical care according to international standards.

With the aim of developing remote medical services, improving the quality and efficiency of management decisions, preventing and eliminating crisis and emergency situations, operational analysis, modeling, forecasting the development of situations in 2020, a Situation Center was created on the basis of NCCEM.

During the COVID-19 pandemic, the specialists of the Situation Center of the NCCEM provided consulting support to medical specialists of all hospitals of the Republic of Kazakhstan where patients with COVID-19 coronavirus infection are located, as well as continuous monitoring of the condition of severe patients in intensive care units.

Currently, the Situation Center of the NCCEM provides round-the-clock monitoring of patients in serious and extremely serious condition, who are in intensive care units of hospitals in the Republic of Kazakhstan.

The photo shows the helicopter ЕС-145

In November 2020, NCCEM was accredited for compliance with the requirements of national quality standards in the healthcare system. I qualification category was confirmed.

Educational and training center NCCEM is accredited by the Independent Agency for Quality Assurance in Education (IQAA).

In 2019, the NCCEM performed 2 369 flights, in 2020 – 2 185, in 2021 – 2 586, in 2022 - 2 357 flights.

The photo shows the Pilatus PC-12, Yak-40, ЕС-145 ambulance aircrafts

• Organization of emergency medical care to the population of the Republic of Kazakhstan using air transport (medical aviation);
• Organization and coordination of activities of regional medical aviation departments;
• Development of emergency medicine in the Republic of Kazakhstan based on international standards;
• Coordination of the ambulance service in the Republic of Kazakhstan.