Night Shift of Almaty Trauma Doctors: Life and Challenges

On the snowy night of December 3 to 4, our photo correspondent went to Almaty City Clinical Hospital No. 4 to see what kind of intensity was unfolding there. After all, icy roads and heavy snowfall were expected to affect the health of the city’s residents! But the night shift in the trauma department turned out to be surprisingly calm. At least for the doctors: «only» a few dozen patients. It turns out that in such weather, Almaty residents stop driving recklessly and prefer to stay at home. But what the doctors considered routine seemed very unusual to our photo correspondent, Karlygash Nurzhan, because right here, in the very heart of the hospital, the pulse of life beats every night.

City Clinical Hospital No. 4 is located on Papanin Street and provides medical care to residents of the Turksib, Zhetysu, and partly Almaly districts of Almaty (photo from the hospital archive). 23:55. A woman with a dislocated shin has arrived. Head of the admissions department, Baurzhan Rakhimbekov, carefully examines the leg. The X-ray will show how serious the injury is.

00:00. An elderly man tripped in his yard and broke his wrist.

The doctors perform a closed reduction — returning the bone to its place after a fracture. «Grandpa, I will start pulling your wrist now to set the bone, please relax your hand, don’t tense it,» says the trauma surgeon, Toleyball Ayanbekov.

The splint is applied by plaster technician Mamed Kaliev.

The doctors warn the patient that if he does not stay in the hospital, the bone may shift and heal incorrectly. But the man refuses outright: he has many chores at home, and his grandchildren are waiting. According to the doctors, 60 percent of those admitted to the trauma unit refuse hospitalization. Many want to return to their usual life as soon as possible, even though treatment in the hospital is completely free.

00:08. Another patient refuses hospitalization: his 85-year-old mother is waiting at home and there is no one to care for her. A woman sitting nearby covers her face and admits that her husband beat her, but she does not intend to file a complaint.

«The bone is in place, but when the swelling goes down, the cast may loosen and the bone may shift,» says Baurzhan, shaking his head while examining the X-ray of the man rushing home to his mother.

Artem Panfilov is only 22 years old, and he is doing his internship at this hospital. Despite his age, his older colleagues describe him as a capable young doctor. «There is no evidence of bone trauma on this image. The bone tissue looks normal,» Artem says confidently while examining the X-ray of the battered woman.

00:13. Paramedics bring in a limping woman, who is immediately taken for an X-ray.

«You have a heel spur, that’s what’s bothering you. On Monday, go to the clinic for physical therapy and that’s it — there is no trauma-related danger,» explains Baurzhan. A heel spur is a bony growth on the sole bone, and if properly treated, surgery may not be necessary.

«I was treated with Chinese medicine for a year and a half… I thought it was gone,» the elderly woman sighs.

00:39. A typical explanation from a patient: «I fell, I don’t remember anything.»

00:45. A woman explains how she injured her leg: «A car ran into me…»

Where is the exit? Corridors upon corridors — but no way out!

«No smoking!» drawls a drunken homeless man. His feet have second-degree frostbite.

Most of the doctors’ time is spent filling out paperwork and registering patients.

Maria has been working at the hospital for six years. «The good team keeps me here,» she says. «And I love the work!»

01:23. According to the young woman, she fell and injured her hip.

But the doctors rarely believe «accidentally fallen women.» Most of the time, the cause of trauma is domestic violence. An hour later, this woman quietly slips out of the hospital without telling anyone.

At that moment, paramedics bring another young woman — beaten by her brother. The reason is unknown.

She has numerous injuries all over her body. Meanwhile, Maria is searching for the missing patient with the fractured hip.

02:14. A woman tried to stop a stream of boiling water with her hands and ended up with first- and second-degree burns on both palms.

It is almost 2:30 a.m. on the chief trauma surgeon’s watch, but patients continue to arrive.

Four minutes later, paramedics bring a woman who attempted suicide.

She refuses to show her face.

Her wrist is deeply slashed with a razor. «I wanted to show everyone that no one needs me. I thought it would be easy… Doctor, will it hurt a lot?» the woman asks Artem as he approaches with a needle and thread.

«I’ve stitched many wounds,» Artem says. «This is an easy case. Sometimes drunk people pull their hands away, won’t let us stitch them, and then the whole room is covered in blood…»

According to the law, if a person attempting self-harm is intoxicated or under the influence of psychotropic or narcotic substances, they are not transferred to law enforcement. If sober, they are placed under psychiatric supervision. The woman was drunk, so she was sent home.

03:20. Friends bring in a man who has been beaten. He has a concussion and multiple bruises, but, as usual, refuses hospitalization.

Until 5 a.m., there is a lull.

05:30. A woman with a severe shoulder injury arrives. Baurzhan examines her X-ray.

A couple of hours later, two workers with severe burns are brought in. A fire broke out in their dormitory while they were sleeping. One has burns covering 25 percent of his body, as well as damaged airways.

The fire also severely burned his face and hands. He is rushed to the ICU.

His co-worker is more fortunate — only 12 percent of his skin is burned. Mainly his palms and feet are affected.

According to the doctors, both men will survive.

08:00. The night shift reports all admitted patients to the new team of doctors.

«Sixty-five patients were brought in over the past 24 hours, 15 were hospitalized,» Artem reports.

Morning briefing: the night wasn’t too difficult, but everyone is still tired.

A police officer waits for the briefing to end so he can obtain a report on the two construction workers who suffered burns.

09:00. After a frosty night, the streets are covered in ice.
«From experience, I can say: the sun will warm up, the weather will get mild, and elderly women will go to the bazaar. After that, they will start coming to us with hip and wrist fractures,» says Baurzhan Rakhimbekov, watching the ambulance drive away. In an hour, he has surgery. His workday is far from over…

The original version of this material was published on Voxpopuli.kz (before its closure in 2023). The author restored the text and photos from a personal archive to preserve documentary and historical materials