THE CALL OF THE BLOOD

Thalassemia remains one of the most pressing challenges in Azerbaijan with up to 500 children born with congenital thalassemia annually, more than one million carriers and almost 7-10% of the population suffering from heterozygous beta-thalassemia.

What are the causes of thalassemia? How can one prevent the propagation of the disease? Professor Asya Akhundova is considered the founder of thalassemiology in Azerbaijan thanks to her numerous discoveries and scrupulous research works among the children suffering from anaemia. This outstanding woman, who devoted her life to the research of thalassemia and saved many children in Azerbaijan, was born 100 years ago. Researches on the propagation of thalassemia in Azerbaijan have begun more than sixty years ago.

Noble bloodline

No one but the Almighty knows the life path of a new-born. Asya Akhundova was born on December 26, 1919 in the family of engineer Sultan Mahmud-bey and Zahra-khanym Akhundovs, a famous family from Baku. Her father was a rare specialist—before the revolution, he had been the manager of Musa Naghiyev's oil fields; in the Soviet years he had worked as an engineer at Azneft led by of Alexander Serebrovsky; in 1922, Sultan Mahmud-bey was appointed the head of department at the Ministry of Health responsible for the construction of sanatoriums and hospitals in Azerbaijan. Sultan Mahmud was a descendant of beys—a noble family of chieftains or rulers of various sized areas, but the Bolsheviks did not touch him because he was a high-class specialist. The newly established Soviet state urgently needed such professionals. Four of his four brothers and three sisters—Aghalar, Tamara, Surkhai and Safura—became doctors, Sima was a teacher, while Huseyn and Rustam, like Mahmoud, received a technical education, graduating from the Kiev Polytechnic Institute. Unfortunately, Rustam passed away very young, leaving his parents—Aliheydar-bey and Rugiya-beyim Akhundovs—in sorrow and grief.

Mahmud-bey's family was large with five children: two sons and three daughters. When Asya, the eldest of his daughters, decided to become a doctor, he did not object. Since Asya spent her childhood among the relatives who would often discuss all issues medicine in her presence, she has soon become so fascinated that decided to be a doctor. At the early 20th century, the professions of a doctor and an engineer were prestigious and honourable. To continue the dynastic traditions of the Akhundovs, in the second half of 1930s Asya Akhundova became a student of the Nariman Narimanov Azerbaijan State Medical Institute. No one could imagine then that a day would come and this girl would become a famous scientist and researcher.

Professional development

Asya loved to study. She loved her institute, her fellow classmates and teachers. She studied easily and enthusiastically, delving into all the subtleties and details of the profession. It soon became clear that Asya would be a scientist, whose important discoveries related to blood diseases would make her famous in Azerbaijan and internationally. In 1942-1944, Asya Akhundova, already a graduate of the Baku Medical Institute, worked as the principal of evacuation hospital in Ryazan, Russia. After demobilisation in 1944, the Ministry of Health appointed Asya-khanum as the head of a rural hospital in the village of Nij, Gutgashen District (now Gabala) of Azerbaijan.

Everyone was going through a tough time. But the situation was further complicated by the outbreak of malaria, which afflicted that area, leading to severe anaemia. This period of practical researches was perhaps the first step in the scholar career of the 26-year-old young scientist. In 1946, Asya-khanym was dispatched as a general practitioner to the garrison infirmary of the Western Group of Forces in Poland, where her husband, Colonel of Medical Service, Enver Ismayilzade, also worked. In 1948, the couple returned home, and Asya Khanim was immediately appointed as a resident doctor at the department of hospital therapy of the State Medical Institute, where she has worked until 1951. Then she was transferred to the Haematology and Transfusionology Research Institute, where she would be serving her fellow citizens till the last breath.

Scientific activity

We can only guess when and why Asya Akhundova began thinking of blood as the most important component of human body, as we have no letters or diaries at our disposal. But there are biographical facts and studies that give reason to believe that this did not happen all of a sudden. Thanks to the inquiring mind of researcher, Asya Akhundova had replenished her database for years with facts from her practical experience. In 1956, she defended her thesis for Ph.D. (Medicine) under the guidance of Prof. Fuad Efendiyev, whom she would remember until the last days as her teacher and mentor. In 1959, Akhundova was appointed the head of clinical and haematological department. From that moment on, she has devoted all her strength, knowledge, and practical experience to the study of haemolytic anaemia. She travelled a lot to various regions of Azerbaijan, each time discovering and studying new congenital forms of this disease. After a thorough clinical and laboratory examination, she concluded that the disease common in some parts of the globe and called thalassemia is also found in Azerbaijan and has a pandemic character. (Thalassemia is also known as Cooley's anaemia as a tribute to Thomas B. Cooley, an American doctor who discovered and defined the disease in 1925).

Before and after

Perhaps it would be appropriate to study the professional life of Asya Akhundova in two distinct periods: before the detection of Cooley's anaemia in Azerbaijan and after that. The map compiled by Akhundova and showing the spread of Cooley’s disease in Azerbaijan, as well as the hereditary factors and family marriages practiced throughout the republic to this day, gave a real picture of the long-standing problem. She has voiced the problem repeatedly at various conferences and congresses held in Baku and Moscow, as well as in 1961 at the 8^th European Congress in Vienna, where she represented the Soviet haematological school. The experience of Azerbaijani medicine has piqued the interest of specialists from many European countries. For example, in Poland, the textbook on thalassemia mentions the practical experience of Asya Akhundova, who first proposed removing the spleen from patients having thalassemia, as blood transfusion had not given the expected results. For foreign colleagues, the method of removing the spleen was a complete revelation. Experts from many European countries, especially from Italy, asked to report the fate of the operated children, because Italians had been well aware of the problem due to family marriages so popular in the country. In 1962, the first thalassemia clinic in Azerbaijan was opened at the blood transfusion station at the urgent demand and initiative of Asya Akhundova. In 1964, Akhundova included an entire chapter on the study of thalassemia in the districts of Azerbaijan in her dissertation thesis. This attracted the attention of many scientists of the Soviet Union, who recognised Akhundova's pioneering contribution to the study of this complex blood disease. In 1966, Asya Akhundova successfully defended her doctoral thesis, which was based on many years of clinical and laboratory researches.

The family

Asya Akhundova was a reverent wife and sensitive mother, a loving daughter and sister, a very reliable and devoted friend, a careful aunt for all her nephews. She had two brothers and two sisters. She loved them and took an active part in their lives and the lives of their children, her nephews. She equally loved the nephews of her husband Enver Ismailzade, treating them as her own relatives. Asya Akhundova generously shared her love not only with her three children—Kamala, Fikret and Farida—but also with the children of her numerous relatives. For each of them, she had her own approach; she knew how to utter words in time so as not to offend the children, but to encourage them and empower them with strength, which will be enough for the rest of their life! She found time to read books for her children and nephews, help her daughter Farida learn music, go with her children to visit Granny Zara (she respected family traditions above all and instilled them in her children too), take a walk along the boulevard and eat ice cream together. Asya-khanym loved to receive guests and her students in her house and accepted as if she were a housewife, and they were the most dear guests. And even the home apron, which she, putting on treats to guests, put on over a suit, did not spoil her appearance at all. On the contrary! He gave a special charm. Nephews called her both Aunt Asya and mother Asya. And even now, many years later, when she is not there, some of them are still calling her Mother Asya.

Her legacy

Son Kamal Mirzazade is an engineer and lives in Baku; son Fikret Ismayilzade is a professor of medicine, acupuncturist, who lives in Poland; daughter Farida Ismayilzade is a Ph.D. (Medicine), acupuncturist, senior researcher at the Research Institute of Medical Rehabilitation, who also lives and works in Baku. Prof. Akhundova has many grandchildren and great-grandchildren. She has published more than 150 scientific papers. Her numerous students have become Ph.Ds and MDs under her guidance. She has rescued the lives of many children with thalassemia.

Epilogue

Not only was Asya AKhundova a great scientist, an excellent doctor, mentor and teacher but she was also a very sympathetic, kind and compassionate person. Throughout her life, she has remained the same person caring of others a lot. She was against alienating people because of the social differences. She considered any human being an individual carrying the blood of the same colour. If someone needed her help, she would help at any time of the day, in any weather and in any circumstances. She used to say that ' a patient, first of all, is a person who needs help, and it does not matter whether he occupies a ministerial chair or sweeps the streets.' She would also say that 'the main achievement of doctor is to see happiness and gratitude in the eyes of patients and their relatives.'

Prof. Azer Kerimov, Deputy Director of the Institute of Haematology and Blood Transfusion, remembers Prof. Akhundova as follows: "Unfortunately, I have known her for a few years only. I came to the institute in October 1979, and professor A. Akhundova died in November 1983, when she was only 63 years. I remember the shock that we experienced the moment we learned about the sudden death of Prof. Akhundova (almost immediately after the death of her mother). Many did not want to believe in it, they said that it was not Asya-khanym but her mother who died. There were many people, including doctors, nurses, relatives, friends and strangers, at the farewell ceremony. Director of our institute, Prof. B. Eyvazov, asked me to say the mourning speech on behalf of the students of Prof. Akhundova..."

After a short pause, Prof Kerimov recalls his speech on the 80th anniversary of Asya Akhundova. At that time, he was the director of the institute. "How fast time flies! It is difficult to believe that we celebrate the 100th anniversary of Asya-khanym. They say that 'a person dies when the last memory of him dies.' I must say that Asya Akhundova left an indelible mark on my memory. There are individuals who appear in our lives the moment we most need their knowledge, experience and energy that they share with us generously. For me—a doctor who came to the institute from practical medicine and wanted to seriously engage in science—the moment that changed my life completely was the moment when I first met Asya-khanym," professor said.

"Prof. Akhundova was an extraordinary person, who had always remained grateful to her teachers and leaders. She had repeatedly underlined the influence that many luminaries of medicine of the past had on her development as a haematologist. Moreover, she was very careful of her own students," Prof. Kerimov remembers.

Like many other prominent doctors of medicine, he also keeps an array of sweet memories about his mentor. After all, Asya Akhundova has left an indelible mark in Azerbaijani medicine. When she was young, she read a legend about a golden carnation that saved the life of a terminally ill boy. Thus, she had been searching for her own 'carnation' throughout her life. One that could be a remedy against thalassemia. And she did it. Her discoveries have popularised discussions and works on the thalassemia problem in Azerbaijan contributing a lot to the lives of patients. Asya Akhundova has compiled the results of her researches on thalassemia into a book titled 'Thalassemia', which is still relevant and demanded by the new generation of specialists. 'Thalassemia' was first published in Russian in 1972. But it requires a reprint and publication in Azerbaijani. This should not be regarded as a tribute to the scientist who glorified Azerbaijani science far beyond Azerbaijan. Rather it should become an instrument, which will help to restore a fair balance in the dissemination of necessary knowledge.