Научная статья на тему 'MEDICAL ASPECTS OF THE DEVELOPMENT OF HEALTH TOURISM IN THE REPUBLIC OF KAZAKHSTAN'

MEDICAL ASPECTS OF THE DEVELOPMENT OF HEALTH TOURISM IN THE REPUBLIC OF KAZAKHSTAN Текст научной статьи по специальности «Фундаментальная медицина»

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Ключевые слова
HEALTH TOURISM / SPA TREATMENT / MEDICINE / HEALTH

Аннотация научной статьи по фундаментальной медицине, автор научной работы — Yessim Ayana Kazbekkyzy, Yessimova D. D., Bitter N. V.

The article substantiates and describes the role of the sanatorium industry in the development of health tourism in the Republic of Kazakhstan. The authors have established that the territory of Kazakhstan has the necessary elements forthe development of medical and recreational tourism and affects the placement ofmedical and recreational and tourist-recreational facilities on this territory. The stateof health of the population of Kazakhstan, life expectancy is analyzed, the role of thehealth system of the Republic in improving these indicators is revealed. The authors'study of the sanatorium-resort industry allows us to state its sustainable development.All stages of the development of the health resort and tourism and recreational industry have all the resources for the development of health tourism. The current stage ofdevelopment and formation of the supporting framework of the urban and suburbanterritory of the city can be used as a basis for the development of medical and healthtourism. The results obtained allow us to visualize the popular sanatorium-resort institutions of the Republic of Kazakhstan and identify problem areas where appropriate measures need to be taken to ensure the dynamic uniform development of healthtourism.

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Текст научной работы на тему «MEDICAL ASPECTS OF THE DEVELOPMENT OF HEALTH TOURISM IN THE REPUBLIC OF KAZAKHSTAN»

3. Upravlenie Altajskogo kraja po razvitiju turizma i kurortnoj dejatel'nosti. -URL: https://www.altairegion22.ru/gov/administration/stuct/tourism22/upravlenie-turizma.php./

4. Zakon Altajskogo kraja ot 03 aprelja 2018 goda № 14-ZS «O turizme v Altajskom krae». - URL: https://docs.cntd.ru/document/446673582/

5. Postanovlenie pravitel'stva Altajskogo kraja ot 23 marta 2020 goda № 125 «Ob utverzhdenii gosudarstvennoj programmy Altajskogo kraja «Razvitie turizma v Altajskom krae» v red. ot 26.04.2021 № 139. - URL: https://docs.cntd.ru/ docu-ment/570717387?marker/

Авторская справка.

Булатова Галина Алексеевна, к.э.н., доцент, Алтайский государственный университет (Барнаул, Россия). E-mail: bulatovg@mail.ru

Bulatova Galina Alekseevna, сandidate of Economics, Associate Professor, Altai State University (Barnaul, Russia). E-mail: bulatovg@mail.ru

MEDICAL ASPECTS OF THE DEVELOPMENT OF HEALTH TOURISM IN THE REPUBLIC OF KAZAKHSTAN

Yessim Ayana Kazbekkyzy1, Yessimova Dinara Dautovna1, Natalia V. Bitter2

!NAO "Toraigyrov University (Pavlodar, Kazakhstan) 2Altai State University (Barnaul, Russia)

Abstrakt. The article substantiates and describes the role of the sanatorium industry in the development of health tourism in the Republic of Kazakhstan. The authors have established that the territory of Kazakhstan has the necessary elements for the development of medical and recreational tourism and affects the placement of medical and recreational and tourist-recreational facilities on this territory. The state of health of the population of Kazakhstan, life expectancy is analyzed, the role of the health system of the Republic in improving these indicators is revealed. The authors' study of the sanatorium-resort industry allows us to state its sustainable development. All stages of the development of the health resort and tourism and recreational industry have all the resources for the development of health tourism. The current stage of development and formation of the supporting framework of the urban and suburban territory of the city can be used as a basis for the development of medical and health tourism. The results obtained allow us to visualize the popular sanatorium-resort institutions of the Republic of Kazakhstan and identify problem areas where appropriate measures need to be taken to ensure the dynamic uniform development of health tourism.

Keywords: health tourism, spa treatment, medicine, health.

МЕДИЦИНСКИЕ АСПЕКТЫ РАЗВИТИЯ ОЗДОРОВИТЕЛЬНОГО ТУРИЗМА В РЕСПУБЛИКЕ КАЗАХСТАН

Есим Аяна Казбеккызы1, Есимова Динара Даутовна1, Наталья В. Биттер2

!НАО «Университет имени Торайгырова» (Павлодар, Казахстан) 2Алтайский государственный университет (Барнаул, Россия)

Аннотация. В статье обосновывается и описывается роль санаторно-курортной отрасли в развитии оздоровительного туризма в Республике Казахстан. Авторы установили, что территория Казахстана обладает необходимыми элементами для развития лечебно-оздоровительного туризма и влияет на размещение лечебно-оздоровительных и туристско-рекреационных объектов на данной территории. Проанализировано состояние здоровья населения Казахстана, ожидаемая продолжительность жизни, выявлена роль системы здравоохранения Республики в улучшении этих показателей. Проведенное авторами исследование санаторно-курортной отрасли позволяет констатировать ее устойчивое развитие. Все этапы развития санаторно-курортной и туристско-рекреа-ционной индустрии располагают всеми ресурсами для развития оздоровительного туризма. Современный этап развития и формирования опорного каркаса городской и пригородной территории города может быть использован в качестве основы для развития медицинского и оздоровительного туризма. Полученные результаты позволяют нам визуализировать популярные санаторно-курортные учреждения Республики Казахстан и выявить проблемные зоны, где необходимо принять соответствующие меры для обеспечения динамичного равномерного развития оздоровительного туризма.

Ключевые слова: оздоровительный туризм, санаторно-курортное лечение, медицина, здоровье.

Introduction. Kazakhstan has a great recreational potential for the development of health tourism, accumulated experience in the development of sanatorium treatment in Soviet times. Currently, it is necessary to bring the level of tourism and its infrastructure, which includes sanatorium-resort tourism to a qualitatively new level. The conditions in which the facilities of the sanatorium-resort complex function have changed dramatically - the problems of ensuring the competitiveness of health resorts, improving the material and technical base, promising ways of their development have come to the fore. In this regard, this direction of medical and health tourism is especially relevant. Today, this direction of tourism is becoming relevant, this is primarily due to the attention of state bodies and the President of the Republic of

Kazakhstan, who focuses on the need for the development of health and wellness and medical tourism. There has been an increase in domestic tourism, tourists visiting domestic health resorts. The purpose of the study is to identify the specifics of the influence of medical aspects on the development of health tourism.

Research methods. Statistical, comparative methods, and system analysis were used in the research process.

Research results and their discussion. Kazakhstan inherited from the Soviet period a healthcare system organized on the basis of the Semashko model. The healthcare system in this period was owned by the state, operated on the basis of centralized planning, and one of the key principles was universal and free access of the population to medical care. Before gaining independence, the Ministry of Health of Kazakhstan pursued a policy established in Moscow, which was ensured by a centralized hierarchical management structure, from the republican level to the level of regional and city administrations, which in turn were subordinate to the health authorities of the district level [2].

After gaining independence in 1991, the country had to develop its own health policy and planning system. There were frequent changes in the leadership of the Ministry of Health and in its organizational structure. Many functions were decentralized and transferred to the jurisdiction of the regions, the regional health departments had a significant degree of independence. The rights of patients are still poorly developed and practically not legally fixed.

Despite the increase in the share of expenditures on primary health care, the majority still falls on the provision of inpatient care. In 1996-1998, a health insurance system was introduced in the country, but now Kazakhstan has returned to the model of budgetary financing of healthcare. In 2004, a program of state guarantees for the provision of free medical care to the population was introduced, which includes free drug provision for preferential categories of the population when providing outpatient care. But the program is declarative in nature due to the fact that it is financially secured by 65%. There are three main sources of healthcare financing in the country: the State budget, official patient payments and informal payments. Since 2005, financial resources for healthcare have been accumulated at the regional level, and regional health management bodies perform the functions of a single payer.

As for the health of the population, Kazakhstan is characterized by the following problems: low life expectancy, high infant and maternal mortality, high incidence of tuberculosis, the developing HIV epidemic/AIDS [2]. According to official statistics, in 2020, the life expectancy of men was 60.1 years, and women - 70.5 years (Table 1).

Table 1

Life expectancy: official data and WHO assessment, 1990-2020

Years Life expectancy at birth (years) Life expectancy at birth, male (years) Life expectancy at birth, women (years) Life expectancy at birth, WHO estimate (years)

1990 68,81 63,9 73,4 62,49

1995 66,85 58,93 72,5 61,3

2000 65,75 60,18 71,65 63,00

2005 65,89 60,4 71,23 -

2010 63,56 60,3 71,2 -

2015 62,32 60,2 71,1 -

2020 61,5 60,1 70,5 -

In addition, men's life expectancy in the first half of the 1990s fell much more than women's: from 63.9 years in 1990 to 58.93 years in 1995. The greatest proportionate increase in mortality was observed among men of working age. Between 1990 and 1995, mortality rates among men aged 30-44 years more than doubled, and among men aged 34-54 years increased by more than 75%. Indicators of life expectancy in different regions of the country vary significantly. The most prosperous regions are Almaty and Nur-Sultan (Table 2).

Table 2

Average life expectancy of the population of the Republic of Kazakhstan for 2020

Region Total Urban populations Rural area

Both sexes men women Both sexes men women Both sexes men women

Kazakhstan 67,11 61,91 72,43 66,69 60,83 72,34 67,72 63,20 72,55

Akmola 64,96 59,21 71,29 64,70 58,27 71,89 65,48 60,12 71,62

Aktobe 67,61 62,31 73,06 66,66 60,95 73,32 68,98 64,49 73,96

Almaty 67,52 63,04 72,34 65,13 59,11 71,49 68,43 64,43 72,78

Atyrau 67,42 62,26 72,54 67,40 61,82 73,11 67,34 62,43 72,49

West Kazakhstan 67,30 62,12 73,15 66,68 602,72 73,35 67,91 63,38 72,91

Zhambyl 67,39 62,41 72,68 66,24 59,76 72,37 68,30 64,03 73,10

Karaganda 64,64 62,41 72,68 66,24 59,76 72,37 68,3 64,03 73,1

Kostanay 65,59 59,62 71,87 65,5 58,91 72,1 65,63 60,38 71,58

Kyzylorda 67,48 63,2 71,78 66,08 61,15 71,5 68,22 64,51 72,43

Mangystau 66,78 61,87 72,02 63,86 61,91 73,13 69,92 66,02 74,44

South Kazakhstan 67,9 63,8 72,19 65,84 60,99 70,81 69,22 65,96 73,02

Pavlodar 66,48 60,82 72,26 66,37 60,28 72,56 66,88 61,87 72,23

North Kazakhstan 65,41 59,67 72,03 64,32 57,33 71,99 66,23 61,12 72,24

East Kazakhstan 65,81 60,21 71,73 65,22 58,77 71,86 66,66 61,96 72,00

Almaty c. 73,75 70,78 78,18 0,00 0,00 0,00 0,00 0,00 0,00

Nur-Sultan c. 70,35 64,82 75,20 0,00 0,00 0,00 0,00 0,00 0,00

The decline in life expectancy in Kazakhstan in the 1990s was mainly due to an increase in mortality from cardiovascular diseases, especially among middle-aged men. The indicator of life expectancy in 2020 in Kazakhstan is higher than in the CIS and Russia, and more children are born than in many countries of the world and the CIS, but infant mortality remains high.

Today, the internal environment of the healthcare system of Kazakhstan is:

- more than 3,500 medical organizations, including 2,133 independent outpatient clinics, 524 hospitals; 134 private hospital organizations;

- more than 756 hospital beds per 100,000 population;

- more than 378 doctors per 100,000 people.;

- over 9.5 thousand pharmacies.

The country's healthcare system has an extensive network of research institutes and research centers, 6 higher educational institutions and 23 medical colleges, an institute for advanced training of doctors, 65 scientific and industrial associations of a medical nature, public medical academies [1].

We have already noted above that today in Kazakhstan great attention is paid to the development of medical and health tourism, which is one of the important items of the republican budget revenues. Therefore, modern health resorts are being created in the picturesque regions of Kazakhstan, which specialize in providing a wide variety of medical services. In particular, the priority areas are traditional oriental medicine, orthopedics, treatment of cardiovascular diseases and gynecology.In addition, thanks to the attraction of foreign capital, a fairly extensive network of private dental clinics with a European level of service has been created in Kazakhstan today, where prices are much lower than in the USA, Russia or EU countries.

Currently, as part of the restructuring of the healthcare system in Kazakhstan, work is underway to create a "National Medical Holding" that will unite the country's leading state clinics. It is planned to invite experienced managers from Europe and the USA to manage it, which will not only significantly increase the level of public services, but also develop medical and wellness tourism in Kazakhstan at a fundamentally new level.

In the meantime, foreign tourists can only count on emergency medical care or service in a few private clinics, where, by the way, organ and bone tissue transplants, artificial insemination by IVF are successfully performed today, oncological and cardiovascular diseases are treated [4].

In the strategy of development of Kazakhstan until 2050, the Head of State indicated that the country will become one of the leading Eurasian centers of health tourism. One of the strategic objectives of the government is to increase the life expectancy of Kazakhstanis to 80 years and above. According to research, the economic efficiency of the sanatorium-resort treatment allows on average to reduce inpatient

treatment by 25%, the number of visits to outpatient clinical institutions for diseases by 10.8%. In general, there is an increase in the number of sanatorium-resort and rehabilitation organizations in the republic. At the same time, it is important to improve the quality and efficiency of providing sanatorium-resort assistance to the population.

The services of domestic sanatorium and rehabilitation organizations must comply with international standards.

This statement confirms the fact that a considerable number of well-known sanatoriums and rest homes are located on the territory of Kazakhstan, which are actively in demand both in the field of treatment, rehabilitation, and in order to recuperate during the holidays.

Medical tourism is becoming more and more popular in Kazakhstan every year. According to the analysis of past years, it was revealed that tourists prefer to be treated in Kazakhstan than in other CIS countries. The most popular services are selected: spinal hernia treatment, in vitro fertilization, heart surgery and many other medical services.

The level of service is growing every year, training and retraining of specialists of Kazakhstan in the field of medicine is carried out. Assistance in this matter is provided by JSC "National Medical Holding". Tourists come to Kazakhstan even from foreign countries. The largest number of tourists arrived in 2013 from England, the USA was in second place, visitors were also from Turkey, Kyrgyzstan, Russia, Bulgaria and even from the Philippines.

One of the reasons for the influx of tourists to the country is the pricing policy for medical services in Kazakhstan, which is much cheaper than in other countries. For example, bone marrow transplantation in Kazakhstan will cost 50 thousand dollars, and in Russia - 90 thousand dollars [4].

There are a considerable number of resorts, sanatoriums and rest homes providing medical services in Kazakhstan. Basically, as everyone knows, these enterprises are visited by residents of Kazakhstan, less often by tourists from CIS countries, in particular from Russia. At the same time, Kazakhstan has a good base for the development and increase of tourist flows not only domestic, but also from the countries of the near and, especially, far abroad. The following are some of the most famous and popular companies providing medical and wellness services to tourists.

The climatic and therapeutic resort "Borovoe" (Fig. 1). The history of the resort dates back to 1910. An interesting fact is known from the history of its foundation. After the successful treatment of his son with tuberculosis of the lungs, the doctor of medicine V.N. Yemelyanov in the Borovoye tract area in 1910 opened the first Siberian kumysolechebny sanatorium for 30 patients. The sanatorium existed until 1919, in April 1920 Borovoye was nationalized and recognized as a resort of national im-

portance. To date, the main indication for treatment in Borovoi sanatoriums is the presence of tuberculosis (including in open form) and respiratory diseases.

Figure 1. Climatic and therapeutic resort «Borovoye»

For the opening of the kumys sanatorium in the north of the Republic, the Borovoye recreation center was chosen, by order of the head of the resorts of the Central Medical Center, on the basis of which a kumys sanatorium for tuberculosis patients was opened on May 31, 1936.

The place of the kumys sanatorium was not chosen by chance. The abundance of sunny days, the forest-steppe, the area is rich in irrigated reservoirs, clean air are exceptionally favorably combined here, in addition, it was taken into account that there is a large farm for recreation to supply patients with kumys and food.

According to archival data, from 550 to 600 people from Kostanay and other northern regions of our Republic improved their health in the Kumys sanatorium during the season.

In addition to kumys, decoctions of pine buds, needles, rosehip, strawberry leaves were used in the treatment of patients, physical education, therapeutic gymnastics, sun and air baths were widely promoted, since at that time the lake was clean, water procedures and boat trips were prescribed to patients. At that time, there was a large boat station at the kumys sanatorium.

By the order of the Deputy head of the Department of Hospitals of the Central Medical Service of the Kazakh SSR No. 211 dated 8.06.1942, the kumys sanatorium "Borovoye" was renamed into the Borovoye tubsanatorium [8].

Sanatorium "Sosnovy Bor" (Fig. 2). it is located on the territory of the Arakara-gai forestry of Kostanay region, 45 km from the regional center of Kostanay. The history of the sanatorium begins with the beginning of construction in 1969 of a typical holiday home "Sosnovy Bor".

In April 1971, after a survey of natural and therapeutic factors conducted by the Institute of Regional Pathology of the Academy of Sciences of the Kazakh SSR, the rest house was converted into a balneological sanatorium.

The decision on profiling is justified by the fact that the waters of two wells drilled to feed the lake, on the shore of which the Sosnovy Bor recreation center was being built, turned out to be therapeutic.

According to the conclusion of the Central Research Institute of Balneology and Physiotherapy (Moscow), the waters of these wells are similar in composition to the waters of the resort of Feodosia, Essentuki. These waters are used in the treatment of diseases of the gastrointestinal tract, liver, biliary tract and metabolism, as well as in the Kostanay region, mud lakes with large reserves of therapeutic mud have been identified, which can be successfully used in the treatment of diseases of the muscu-loskeletal system and peripheral nervous system.

Currently, the sanatorium is designed to improve the health of a wide range of people. Conditions have been created not only for treatment, but also for recovery, as well as for active recreation (Sanatorium "Sosnovy Bor").

Sulfide-silt mud is widely used in the treatment. Due to the unique combination of organic substances, mineral salts and trace elements, it is effectively used for diseases of the spine, joints, muscles, peripheral nervous system, gynecological and uro-logical diseases.

Figure 2. Sanatorium «Sosnovy bor»

The Sary-Agash resort is located in the South Kazakhstan region of the Republic of Kazakhstan and is famous for its unique mineral water of the Sary-Agash thermal spring.

Natural slightly mineralized therapeutic table water "Sary-Agash" is a classic representative of Saryagash "soda" mineral waters and belongs to a unique group of nitrogen acrotherms widely used in balneological practice. The balneological signifi-

cance of the Saryagash waters was proved by the balneologists of Kazakhstan and Uzbekistan back in the 50-70s of the XX century.

In 2002, a wonderful sanatorium-dispensary "Altyn Bulak-R" of CJSC "Kaz-TransOil" and LLP "Reizstroy" was built on the territory of the existing resort at the source "Sary-Agash" in the forested area on the shore of the lake.

The sanatorium-dispensary "Altyn Bulak-R" (Fig. 3) is located 130 km from Shymkent and 20 km from Tashkent, from where you can get by regular transport or pre-order a car from the sanatorium.

Therapeutic profile: diseases of the gastrointestinal tract, diseases of the genitourinary system, metabolic disorders and diseases of the endocrine system, osteochon-drosis, skin diseases, diseases of the female genital organs, occupational diseases.

Figure 3. Sanatorium «Altyn-Bulak»

Sanatorium Moiyldy (Fig. 4). The sanatorium is located 9 km from the regional center of the city of Pavlodar (Pavlodar - Uspenka highway) [6].

With the advent of Soviet power, the resort was transferred to the Pavlodar City Health Department in 1922 and it constantly began to transform. A mud clinic with a capacity of 50 people per day was rebuilt. After that, in 1928, the resort turned into a health resort of Republican significance and its capacity began to increase rapidly [9].

The long-term and lasting fame of the Moiyldy resort is known not only in Kazakhstan, but also far beyond its borders. The exceptional effectiveness of treatment lies in the fact that the sanatorium has a natural lake "Moiyldy", containing highly mineralized silt mud and salty brine, giving a powerful healing effect in diseases of the musculoskeletal system, peripheral nervous system, diseases of the female genital area, uroandrological diseases and many other concomitant diseases, gastrointestinal diseases, respiratory diseases, diabetes mellitus of mild, moderate severity, skin dis-

eases and more.The application of therapeutic mud is carried out in the form of various procedures: general procedures of mud wraps, local mud applications, intra-cavity tampons and electroplating procedures.

No less valuable in the system of wellness procedures are Mineral underground waters located on the sanatorium's territory, used for the treatment of gastrointestinal, nervous system diseases, metabolism and endocrine system, occupational poisoning with heavy metals, skin diseases and many other diseases. Mineral water is used in the treatment both for internal use in the form of drinking, and for external balneotherapy in the form of baths, showers and irrigation. In addition to the main treatment, the sanatorium offers a variety of additional paid medical services, such as therapeutic massage, hydrocolonotherapy, phytotherapy, water procedures-underwater shower massage, shower "Charcot", circular shower, antler and selenium baths, laser therapy, laboratory examination (UAC, OAM, biochemistry), hirudother-apy, complex treatment of urological and gynecological diseases and pharmacy [6].

Figure 4. «Moiyldy» Sanatorium

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The Alma-Arasan resort is located in the Almaty region of the Republic of Kazakhstan, just 26 kilometers from the capital Almaty (Fig. 5). It is located in the Al-ma-Arasan mountain gorge, at an altitude of over 1800 meters above sea level. The Alma-Arasan resort has also received an interesting historical development.

Almost 600 years ago, the springs of the Alma-Arasan resort enjoyed wide medicinal fame among the peoples who succeeded each other in the Priili province. Only in 1931, in June, the Alma-Arasan Warm Springs resort was opened, renamed Alma-Arasan resort in 1932

Today, you can relax at the Alma-Arasan resort at any time of the year, the resort is famous for its healing mineral springs, as well as thermal springs with hot water. The treatment of the musculoskeletal system, respiratory and nervous systems, gynecological diseases is practiced. In addition to medical procedures, cycling

and hiking, hunting and fishing, picnics can be enjoyed at the resort. In addition to hotels and boarding houses, there are equipped places for camping and recreation with tents [11].

Kapal-Arasan Resort is a resort located on the northern slopes of the Dzungar Alatau mountain, on the banks of the Bien River 110 kilometers from Taldykorgan at an altitude of 975 meters above sea level (Figure 5). This is the first resort in Kazakhstan. It was opened at the end of the XIX century (in 1886) [7]. (Fig. 5)

Kapal-Arasan springs were famous even among the Dzungarians and the Kazakhs who occupied this area. In 1853, the life-physician Zalugovsky described the balneological properties of the springs, made chemical analyses.

Today, the complex of treatment at the Kapal-Arasan resort includes: water procedures (bath, shower, irrigation), physiotherapy, phytotherapy, mineral waters, physical therapy, terrenkur and other procedures in accordance with the prescriptions [7].

Figure 5. Sanatorium «Kapal-Arasan»

Republican Educational and Wellness Center (RUOC) "Baldauren" created on behalf of the Head of state N. And.Nazarbayev similar to the International children's center "Artek" (Fig. 6).

"Baldauren" is a Republican scientific and methodological center for the organization of educational and recreational activities, as well as the location of children's national and International cultural, scientific and practical activities. It is located in one of the most picturesque corners of Kazakhstan, in the Borovoye resort area on the shore of Lake Shchuchye.

Currently, Baldauren is the only such Center in the CIS countries and the Central Asian region for organizing recreation, improving the health of children and adolescents, creating the necessary conditions for the development of their creative abilities.

The center operates all year round and accepts up to 350 children in one shift. The duration of shifts in the summer period is 15 days, during the school year -20 days.

Modern comfortable conditions for learning and living are provided for children. All rooms are well-appointed, each has hydro-massage showers. Children are offered 5 meals a day, complex meals, preventive and wellness activities: massage, water treatments, therapeutic baths, saunas, cocktails, clean coniferous air.

The total area of the Center is 8.62 hectares, the area of useful development is 15,288 sq.m. There is a school, a six - storey dormitory building, where the 1st floor is a school, 2 - 3 - 4 the floors are sleeping, the 5th floor is administrative and household, the 6th floor is gaming halls. Five - storey medical complex. Sports two -storey building. Three - storey administrative and household building. Indoor swimming pool. Boiler-laundry and motor transport facilities.

Vacationing children are provided with medical and wellness procedures, equipped physics and chemistry classrooms, language labs, a computer class with an electronic board "Active Screen". A high-calorie five-course meal rich in vitamins from fresh vegetables and fruits is organized. Diet tables [5].

Figure 6. Republican educational and wellness center «Baldauren»

Sanatorium dispensary named after Saken Seifullin (Fig. 7). The sanatorium is located in the forest of Shchuchye district near Lake Katarkol, Akmola region of the Republic of Kazakhstan. The health resort of a multidisciplinary direction, works all year round, performs the functions of sanatorium treatment of people with cardiovascular diseases, diseases of the respiratory tract and digestion, as well as the musculo-skeletal system. The complete modernization of the sanatorium was carried out in 2003. Medical equipment has been updated, major repairs have been made. It is also worth noting the high level of service for vacationers.

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The main directions of this sanatorium are climatic and mud treatment. The Katarkol zone of the resort, where the Sakena Seifullina sanatorium is located, is located in the south-east of the Burabai Park, which has a state-national status, it is well known for its stunning landscapes and therapeutic climate. The lake called Katarkol, near which the sanatorium-dispensary is located, has a higher priority compared to other local lakes. Mud and water in the lake with balneological properties, which are used in the prevention and treatment of many diseases.

The main types of medical procedures in the sanatorium of Saken Seifulin: hy-drocolonotherapy, mud therapy - galvanic mud of a therapeutic local lake, baths -saline and coniferous baths of Zalmanov, therapeutic saunas, dentist's office, medical room with infrared magnetolaser, physiotherapy, therapeutic massage department, pressure chamber, physical therapy room, phyto-treatment.

Figure 7. Sanatorium dispensary named after Saken Seifullin

In conclusion, we note that the main centers of health and wellness tourism in Kazakhstan are sanatoriums and rest homes that provide tourists with not only rest and basic services, but also treatment, as well as natural resources, depending on the location of a particular sanatorium or rest home. It should be noted that the sanatorium and resort industry of the Republic of Kazakhstan has great recreational resources for the development of health tourism.

References

1. The state health development program for 2020-2025. appointment of the Government of the Republic of Kazakhstan from December 26, 2019 No. 982.

2. Kulzhanov M., Rechel B. Kazakhstan: Health system review. Health Systems in Transition, 2007; 9(7): 1-158.

3. Resort "Borovoe". URL: http://borovoe.kz/item/457-lechebnyj-sanatorij-imeni-sakena- sejfullina-v-kazakhstane

4. Will Kazakhstan's medicine attract tourists from abroad? // Portal on tourism" Tourpravda". URL: http://tourpravda.kz/razvitie-v-kazaxstane-medicinskogo-turizma/.

5. Republican educational and health center "Baldauren". Electronic resource: http://baldauren.org/obshhaya-informatsiya/Санаторий electronic resource "Sosnovy Bor". URL: http://sosnovyibor.com/o-sanatorii/.

6. Sanatorium" Moyyldy". URL: http://www.moiyldy.kz.

7. Tourist portal GoTur.kz. URL: http://www.gotur.kz/oteli/kazakhstan/ al-matinskaia-obl/taldy-kurgan/71 -sanatorii-kapal-arasan.html.

8. Abdrakhman O. Health resorts and healing springs of Kazakhstan. Sanatorium "Borovskoe". 2005. Pp. 193-194.

9. Abdrakhman O. Health resorts and healing springs of Kazakhstan. The Sanatorium «Moiyldy». 2010. - 402 p.

10. Abdrakhman O. Health resorts and healing springs of Kazakhstan. Anatoly Dernovoy - history of Sanatorio-resort development in Kazakhstan. 2012. - Pp. 63-64.

11. Abdrakhman O. Health resorts and healing springs of Kazakhstan. Anatoly Dernovoy - history of Sanatorio - resort development in Kazakhstan. 2012. - Pp. 64-65.

Авторская справка.

Yesim Ayana Kazbekkyzy, undergraduate student, Toraighyrov University (Pavlodar, Kazakhstan). E-mail: avana_esimova99@mail.ru

Yessimova Dinara Dautovna, Associate Professor, PhD, Toraighyrov University (Pavlodar, Kazakhstan). E-mail: dika-73@, mail.ru.

Bitter Natalia Viktorovna, Associate Professor, PhD, Altai State University (Barnaul, Russia). E-mail: valeolog@yandex.ru

Есим Аяна Казбеккызы, студент-магистрант, Торайгыров университет (Павлодар, Казахстан). E-mail: avana_esimova99@mail.ru

Есимова Динара Даутовна, ассоц.проф., к.п.н., Торайгыров университет (Павлодар, Казахстан). E-mail: dika-73@mail.ru.

Биттер Наталья Викторовна, ассоц. проф., к.п.н., Алтайский государственный университет (Барнаул, Россия). E-mail: valeolog@yandex.ru

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