University of Pennsylvania student volunteers cover enormous distances for charitable missions during the summer, and in the past several weeks a group of four has included Kazakhstan in the list. 

For three weeks, the underclassmen – Alonso Gerbaud, Sarah Kho, Lawrence Wu and Christina Atterbury – worked exclusively in the Nur-Avicenum clinic, a medical facility founded by cardiologist Vladimir Kraisman.

They were assigned to the hospital in this former Soviet republic by Penn International Business Volunteers, a social-impact, student-run organization founded almost nine years ago. 

“Our mission is to leverage the long-term impact of NGOs across the developing world,” Katie Simon, president of PIBV, says. “We use our financial, management and marketing skills and resources to provide business solutions.”

PIBV sends undergraduates to consult for nonprofits and non-governmental organizations in developing countries. Once there, the students develop the infrastructure needed for sustainable organizational growth and long-term advancement.  

This summer’s travel to the clinic, located in Taldykorgan in Kazakhstan’s southeastern Almaty Province, was a repeat mission. 

Amy Tang, a member of the first Penn group to visit Kazakhstan, explains that the clinic was an ideal choice for a PIBV program: Nur-Avicenum “has been praised by many around the world for its unique health-care model and efforts to equalize access to healthcare.”

Kraisman and his staff of 26 doctors and 35 nurses provide care at very low cost -– and often, at no price.

Alonso Gerbaud, a rising junior in Penn’s Huntsman Program in International Studies and Business and trip leader, says he chose the Nur-Avicenum venture simply because of Kraisman: “I talked to the first team that went there and they told me that the doctor was an amazing person. I knew it would be a great adventure to work for him and learn from him.”

Kraisman was chief medical doctor of internal medicine for the Soviet Government Hospital of the Almaty Oblast during the Soviet era, but, as the Soviet system started to collapse, he developed a construct for private medical care, one that would revolutionize Kazakhstan’s approach to treatment.

Christina Atterbury, a rising junior majoring in Russian, explains that Kraisman was truly at the forefront of reform.

“People said it wasn’t possible to have a health-care system without the government of Kazakhstan,” she said. "Dr. Kraisman was going in the complete opposite direction.”

“Nur-Avicenum has remained true to its promise of treating all regardless of income or ability to pay and has yet to turn away an individual in need of health-care,” Tang says.

But, in order to ensure that Kraisman’s clinic will remain, PIBV sent the second group of Penn underclassmen to Taldykorgan to remedy the still existent financial deficits.

Gerbaud says the students worked for nine hours each day in the clinic where he notes that all socio-economic classes are represented in the patient population.

“You have the entire spectrum, the very poor and the very rich. Anyone who can pay, pays. If you can’t pay, [Kraisman] gives you care free of charge,” Gerbaud explains.

Atterbury notes that the client base also includes a fair number of young women and children due to the hospital’s pediatric-cardiology services, which she says is a rare commodity in the area.

Lawrence Wu, a rising junior with an economics major and an interest in health care, explains that the group based their assessments and recommendations on the model created by Devi Shetty, a pioneer in health-care reform.

“His hospital system is based on applying economy of scale,” Wu says, “which is a health-care model particularly relevant in developing countries.”

With Shetty’s model in mind, the students created a database to note the resources of the clinic and make purchase suggestions, such as oximeters and treadmills. The team also established a revised accounting system, training the employees on Excel use and the auditing of books.

Sarah Kho, a rising sophomore in Penn’s Wharton School, says that a fair amount of the work occurred separately from the clinic staff.

“We brainstormed by ourselves on what we thought we should give them and worked independently to achieve that, although the staff was always willing to answer our questions,” she says. 

The Penn team included a cost-reduction analysis as well, hoping to limit expenditures. But with the recommendation of targeted marketing toward medical equipment and pharmaceutical companies, the students created an investor portfolio for Kraisman.

Wu emphasizes the importance of the investor portfolio because he says that NGOs often rely too heavily on donations.

“An investor portfolio gives medical companies a reason to invest in the hospital,” Wu explains. “With business partnerships, you’re much more insulated from financial crises. Business partnerships are the way to go for long-term sustainability.”

Gerbaud says there were differences in perspective when it came to fund-raising.

“We had to understand that our philosophy was not aligned with [that of Kraisman]. As a Wharton student, my priority was naturally to find ways to increase revenues, but Dr. Kraisman would not allow any changes that would burden his patients,” he says.

Kho says that NGOs know they need help but aren’t often sure which issues to tackle first.

“It was difficult to identify how we could best help the hospital.”

Despite this range of obstacles, including a language barrier, the students felt their trip was a success. 

“Understanding who we were helping was the most rewarding part,” Gerbaud says. “I thought learning how to lead a consulting team would be the most rewarding. But now I just want to go back and give [Kraisman] all the help I can.”

Wu says he has been debating between business and medicine for the past several years, but after his trip to Kazakhstan, he is sure he wants to go the latter route.

“It would be an honor to accomplish half of what Dr. Kraisman has,” he says.

Atterbury puts the work in a larger context.

“Our projects were simultaneously growing with the clinic and the country of Kazakhstan itself.”

The students say Nur-Avicenum plans to unveil a new 13-unit dialysis center later this summer.