You can imagine the knob turning when airlines used to go into Mexico City (7316 above MSL) using QFE.
I don't understand why you say meters and QNH don't go together. They work fine together. They're just numbers. You have to make sure you and the controller are using the same system. It's been 6 months since I was last in Almaty but I don't recall anything strange. Jepp charts show the QNH altitudes in feet and QFE in feet and meters. Almaty knows us and just gives us the QNH settings.