“Domla” and his 52 mentees

Speeches Shim

Monday, July 18, 2022

Dr. Zarifjon Rakhimov was born in Rishton city, one of the oldest cities in the Fergana valley. Rishton was once a stop on the Great Silk Road— the main trade route from China to Europe in ancient times. For centuries, craftsmen in the area have prided themselves on passing culture, experience and knowledge down from generation to generation, from mentor to student. Even today, Rishton is known for being the home to master ceramicists of Central Asia. Dr. Zarifjon is continuing this tradition of mentorship, although he isn’t an artisan in the traditional sense.  

For 20 years, Zarifjon has worked in the laboratory at the Fergana Regional Phthisiology and Pulmonology Center, commonly referred to as the Fergana Tuberculosis (TB) Center.

From his early days as a medical student, Zarifjon wanted to help TB patients. During medical school, he worked night shifts at the Fergana TB Center, nursing patients in the department of bone surgery. In addition to TB, Zarifjon had a passion for laboratory work.  

In 2003, Zarifjon graduated from medical school and took a job as a lab assistant at the TB Center, combining his passions. In 2008, Zarifjon was promoted to director of the Fergana Regional TB Bacteriological Laboratory, located within the TB Center.

Zarifjon now leads a team of 10 laboratory assistants in the central laboratory and 42 who work in district laboratories across the Fergana region. Zarifjon is a mentor to them all.

Laboratory tests are crucial to the fight against tuberculosis. They determine whether a patient has active TB and provide information about drug sensitivity. This information tells doctors which commonly-prescribed TB medications will and will not be effective in treating a particular case. In countries with high rates of drug-resistant TB, like Uzbekistan, sensitivity testing improves expected treatment outcomes for the patient and reduces the risk that the patient will spread drug resistant TB in the community.

The type and complexity of TB testing conducted by his laboratory has constantly changed and evolved during Zafirjon’s tenure. One of Zarifjon’s main tasks is to ensure his laboratory team’s knowledge and professional capabilities keep pace with improvements in TB treatment and the latest in testing. He strives to support each of the 52 laboratory assistants in implementing new skills and knowledge in their daily work.  He also instills in them the ultimate goals: reducing the spread of TB and getting patients cured.

Alisher Juraev is one of the many team members mentored by Zarifjon.  Alisher leads the Fergana region’s most remote TB bacteriological laboratory in Besharik village, a 125 km drive from Fergana city. He reflects on the enormous influence that his mentor Zarifjon has had on the region’s laboratory staff, noting that “a good mentor is one who makes you develop and motivates you to improve even when he is not with you.

As he speaks, Alisher refers to his mentor as Domla, an Uzbek honorific which conveys respect for an individual’s knowledge. As Zarifjon jokes, "I have 54 children – two of my own and 52 laboratory assistants throughout the region."      

To improve the skillset of his team, Zarifjon collaborates with the USAID Eliminating TB in Central Asia activity. USAID supports Uzbekistan’s National TB Program in enhancing the skills and knowledge of local specialists to improve detection and treatment of drug-resistant TB. Over the past two years, USAID has trained 20 laboratory specialists in the Fergana region on using GeneXpert molecular testing machines. These machines allow the laboratory to determine whether a sputum sample contains TB bacteria and whether it is resistant to rifampicin, one of the most prescribed TB drugs, in under an hour. Prior to the arrival of GeneXpert machines in Uzbekistan, testing and diagnosis used to take up to two weeks.  USAID also trained four lab specialists on implementation of the internationally-recognized Quality Management System to ensure universal access to high-quality laboratory diagnostic services.

This year, USAID arranged an exchange visit across laboratories in Uzbekistan to train medical professionals on the use of new approaches to improve the quality of laboratory test results. Participants, including Zarifjon, were able to learn from the practices of other regional laboratories, including laboratory information systems; transporting, receiving and registering samples; switching to primary diagnostics using the GeneXpert method; and testing to determine the level of drug resistance in TB bacteria.

After the study tour, Zarifjon explained, "I compare our regional laboratory with a child who learns to rollover, crawl, keep its balance and take his/her first steps. During the 20 years of my career, I have never before seen an approach which strives to improve the qualifications of laboratory specialists, provide them with a huge quantity of valuable information and ensure they understand and can use the information. USAID does all of this.”

The knowledge transfer and skills development provided by USAID and other donors in cooperation with Uzbekistan’s National TB Program have enabled Zarifjon to build his competencies, develop his team, and plan for the future: “Upon return from the study tour, I now know exactly how and in what direction the activities and development of the Fergana Bacteriological Laboratory shall move.”

Zarifjon’s next step is creating a learning center at his own laboratory that he can use to train his teams and ensure improved services for the population. Zarifjon is devoted both to his patients and to his team.  He knows that as his team gets stronger, services for TB patients across Uzbekistan’s Fergana valley will also improve.

Last updated: August 26, 2022

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