Category Archives: healthcare

EDITORIAL: Potemkin Putin Exposed before the Russian Nation


Potemkin Putin exposed before the Russian Nation

Dr. Ivan Khrenov

Meet Dr. Ivan Khrenov.

On November 9, 2010, Russian dictator Vladimir Putin visited the hospital in Ivanovo where Khrenov works in cardiology.  Then days ago, Khrenov was selected as one of the questioners in Putin’s latest installment of his annual propaganda festival, where he pretends to respond to issues phoned in by ordinary citizens.  But Khrenov threw Putin a curve ball, and departed from the pre-arranged script to ask Putin whether he was aware that his visit to the hospital had been rigged, a total sham, a Potemkin village designed to deceive.

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Monstrous, Drunken Russia ravages its Children, Heroic Americans rescue Them

The New York Times reports:

Hundreds of adopted children, most of them Russian, have come here to northwest Montana to live and perhaps find healing grace with the horses and cows and rolling fields on Joyce Sterkel’s ranch. Some want to return to the families that adopted them, despite their troubles.

Others, like Vanya Klusyk, have seen far too much of what the world can dish out.

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Putin puts Hospitals in the Crosshairs

With the Russian economy in tatters, Vladimir Putin needs a source of ready cash to continue his cold-war aggression.  The Moscow Times reports on his latest source:

While Washington plans to pump unprecedented sums into what critics call a government takeover of health care, Moscow is moving in the opposite direction by backing legislation that could force hospitals and other public institutions to go commercial or close.

A bill scheduled to be approved by the State Duma in a third and final reading Friday aims to overhaul the financing for medical, educational, cultural and scientific institutions by giving them for the first time a free hand in how they spend state subsidies.

But opponents warn that the “anti-socialist” reform also could lead to a drop in state subsidies, forcing hospitals, schools and even libraries to increase their numbers of paid services or reduce work hours so as to make ends meet. They say this free-market approach could ultimately hurt the population, especially in poor rural areas.

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Putin sticks it to the Russian Nation

Hero journalist Yulia Latynina, writing in the Moscow Times:

During his visit to Murmansk on Saturday, Prime Minister Vladimir Putin demonstrated his concern for the people by “spontaneously” popping into a pharmacy unannounced to see if Arbidol flu medicine was available and at what price.

Putin’s Arbidol visit was broadcast throughout the day and evening on national television news programs, which will surely boost the product’s sales more than the best advertising campaign could ever do.

Arbidol is made by Pharmstandard, with headquarters in the Moscow region. Why did Putin act as an advertising agency for the company, going out of his way in Murmansk to mention Arbidol by name?

Here is a short chronology of events behind Arbidol’s miraculous success:

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EDITORIAL: Russia and its Appalling Matricide


Russia and its Appalling Matricide

A recent study by the British medical journal The Lancet reveals that 34 of every 100,000 Russian women who give birth lose their lives in the effort.

That figure ranks Russia a stunning #62 out of 181 world nations studied, behind Ukraine and just barely ahead of Georgia.  Bulgaria, Romania and Estonia all have far lower rates of maternal mortality than Russia, and Russia’s rate is more than double — that’s right, more than double — that of the United States.

Russia’s rate of maternal mortality has improved over the past couple of decades, but that means absolutely nothing because it’s merely part of a worldwide trend and Russia’s rate of improvement lags far behind the world’s pace.  Russia’s rate fell 1.9% per year, but that was easily exceeded by places like Dominican Republic and Papua New Guinea and Haiti.  Russia’s rate of improvement places it a shocking #98 on the list of 181 nations.

Let’s repeat that:  more than half of all world nations did better than Putin’s Russia in decreasing their rate of maternal morality.  Combine that with the fact that one Russian woman is murdered outright by her husband every 30 minutes, and you have an abject disaster for which there is only one proper descriptive term:  holocaust.

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EDITORIAL: Russian kids Smoke themselves into the Grave


Russian kids Smoke themselves into the Grave

In today’s special issue, we argue once again that Russia must be divested of the 2014 Olympic Games.  A jaw-dropping recent report in the Moscow Times newspaper highlights the innumerable social problems that plague Russia, problems from which the Olympics is diverting essential resources at the cost of Russian lives.

The mighty MT reports that Dr. Leonid Lazebni, the Russian Surgeon General, announced that Russian children face a “catastrophe” because, in Moscow at least, three out of four boys and two out of three girls smoke cigarettes.  This contrasts with an overall smoking rate in the capital city of 24.6%.

These figures are truly shocking, of course, but even more stunning was the Keystone Cops manner in which the utterly clueless Lazebni made his presentation and in which the assembled government officials responded.

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EDITORIAL: Russia’s Secret Starvation


Russia’s Secret Starvation

According to Ilya Dashkovsky of the Russian publication Krestyanskiye Vedemosti and other sources cited by the ever-brilliant Paul Goble in a recent post, in 1990, as the Soviet economy collapsed into ruin, an average Russian consumed 75 kilograms of meat.  Today, he consumes 61.

According to Dashkovsky, in 1990 such a Russian consumed 387 kilograms of milk products, but today it’s just 247 kilograms.

Then, 297 eggs. Now, 256.

Russians are replacing these key proteins with bread, potatoes and sugar in order to maintain their body mass.  The exclusion of basic food groups from the Russian diet leads to secret starvation and malnutrition.

And the “average” Russians are the lucky ones.

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Russian Barbarians smoke themselves into the Grave

Radio Free Europe reports:

Five minutes on Moscow’s streets would be enough to convince any visitor that smoking is a way of life here. Every second person seems to be holding a cigarette.

Waiting to cross the street at a traffic light, cigarette in hand, Sergei Golikov says people should feel free to light up wherever they want.

“It’s everyone’s personal decision,” he says. “If he wants to smoke fine, if not, fine. No one’s forcing anyone to do it.”

Russia has one of the world’s highest smoking rates. The government says 44 million Russians smoke. That’s a third of the population, including more than 60 percent of all males.

It’s having a major effect on the country’s health. Up to 400,000 Russians die each year from tobacco-related causes. But as health campaigns in the West encourage growing numbers of smokers to give up the habit, Russia is becoming increasingly important for international tobacco firms, and the number of Russia’s newest smokers — women and teenagers — is skyrocketing.

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Russia has cure for Swine Flu!

The next time you are wondering how Russia can have such a horrifyingly high mortality rate, despite being able to launch a rocket into space, that it does not rank in the top 125 nations of the world for adult lifespan and loses up to 1 million people from its population every year, just reflect on this news report about how a Russian government doctor is advising his citizens to respond to the outbreak of swine flu:

According to Russian doctors, spicy Indian curries could prevent swine flu and common cold just like any prescribed medicine available with the chemists. “You can strengthen immunity by consuming spicy foods like curries, as spices like turmeric, ginger and zeera also posses excellent therapeutic effect,” an unnamed official of Moscow city sanitary and anti-epidemics committee was quoted as saying by RIA Novosti.

According to PTI, as panic grips Muscovites over the spread of seasonal influenza and swine flue in the eastern parts of the country and neighbouring Ukraine, authorities are focusing on prevention and have ordered the use of masks at work place. Besides the intake of spicy food, people have been advised to consume raw onions and garlic, which also are said to contain good anti-viral properties.

EDITORIAL: “Living” in Russia



“Living” in Russia

The image above, courtesy of the Moscow Times, is a photograph taken from the Moscow subway.  It shows two advertisements plastered on the wall next to each other.  The one on the left is an ad for “Domestos” cleaner, and boasts that it wipes out germs of every kind, including those that cause the dreaded Swine Flu.  It warns gravely: “Don’t economize on the health of your child!”  The one on the right comes from the Moscow City Council, and urges voters to turn out on election day, October 11th.  It advises voters that “City Council will decide how to guaranty health and safety” and that “Moscovites will decide who sits on the City Council.”

The juxtaposition is profound. 

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EDITORIAL: Putin lies as the Nation Dies


Putin lies as the Nation Dies

Once again, instead of facing a dangerous threat to the health of the Russian people, the Putin regime’s only response is lies and coverup. Well, what else can we expect from a clan of proud KGB spies whose forefathers have liquidated far more Russians than any foreign enemy ever dared to dream of doing?

The Wall Street Journal reports:

A top Russian virologist’s charge that health authorities are drastically understating the number of cases of H1N1, or swine, flu — a claim that senior health officials fiercely rejected — has raised questions about Russia’s claims to be relatively unaffected by the pandemic. The controversy started late Sunday, when state television carried an interview with Dmitry Lvov, head of the government’s Institute of Virology, who reported what he said was Russia’s first death from H1N1 influenza, saying his institute had tested a sample from the victim. Dr. Lvov, one of the country’s most prominent health specialists, also said there were “tens of thousands” of H1N1 cases in Russia, far more than the 381 the government officially reports.   In his TV interview, Dr. Lvov accused Dr. Onishchenko’s agency of trying to cover up the scale of the outbreak to conceal the failure of their efforts to keep it out of Russia. Dr. Onishchenko rejected those allegations.

Tens of thousands.  Once again, just to be clear:  Tens of thousands. And the government has reported what?  381.

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Tuberculosis ravages Putin’s Russia

The Washington Post reports:

Russia’s severe tuberculosis problem is about to get much worse, increasing the risk that the dangerous drug-resistant strains that are common here will spread, causing outbreaks elsewhere, local health officials and other experts warn.

Preliminary surveys have recorded an uptick in infections, which experts say could be the start of a surge fueled by declining living standards and deteriorating medical care resulting from the country’s worst economic slowdown in a decade.

But Russian officials and health specialists also blame the government’s failure to order supplies of key medicines last year, a blunder that could strengthen antibiotic-resistant forms of TB and threaten wealthier countries that have all but eradicated the disease.

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Russia’s Appalling Soviet Medical Legacy

There are some mendacious Russophile lunatics out there who will tell you democratic reform caused Russia’s demographic crisis.  Remind them that (a) Russia has yet to do anything seriously democratic and (b) the USSR caused Russia’s demographic crisis.  Then point them to economist Yuri Maltsev of the Mises Institute, writing on their blog:

In 1918, the Soviet Union became the first country to promise universal “cradle-to-grave” healthcare coverage, to be accomplished through the complete socialization of medicine. The “right to health” became a “constitutional right” of Soviet citizens. The proclaimed advantages of this system were that it would “reduce costs” and eliminate the “waste” that stemmed from “unnecessary duplication and parallelism” — i.e., competition.

These goals were similar to the ones declared by Mr. Obama and Ms. Pelosi — attractive and humane goals of universal coverage and low costs. What’s not to like?

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EDITORIAL: An Ugly American Visits the Dentist

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 An Ugly American Visits the Dentist

buck-teethSo, it seems some American idiot named Kyle Keeton has married a Russian babe and moved to Russia, setting up an inane blog called “The Windows to Russia” to record his experiences. 

He doesn’t speak Russian, so it’s dubious for starters as to how much of the country he’s actually experiencing.  Here’s a disturbing example of the embarrassing consequences when one is that oblivous of his surroundings, as our friend Mr. Keeton spends a day at the Russian dentist’s office.

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Heroin Nation

The BBC reports:

Russia says it has become the world’s biggest consumer of heroin.

The head of Russia’s anti-narcotics service, Victor Ivanov, said that seizures of Afghan heroin were up 70%. Speaking ahead of a meeting in Vienna of the United Nations Commission on Narcotic Drugs, he called on the UN to do more to fight the problem. Mr Ivanov, a former KGB officer and senior Kremlin official, said the flood of the drug from Afghanistan posed a threat to Russia’s national security. He painted a grim picture, says the BBC’s James Rodgers in Moscow. He said the drug was partly to blame for rising crime and a fall in Russia’s population. Afghanistan is thought to be the source of 93% of the world’s heroin

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Annals of Russian “Healthcare”

Global Voices translates a post, styled as an “unsent letter to the president” which recently caused a sensation in the Russian blogosphere:

There is a town called Yelets in Lipetsk region. And there is the City Hospital #1 in the town of Yelets. There is a department of hemodialysis and gravitational blood surgery in this hospital. The only one in the whole town, by the way. Up until recently the department had its own room for its patients and was open 24 hours a day. Because of this, doctors and nurses were paid some extra money, in addition to their primary salaries: for working night shifts, holidays and weekends. Imagine how much the total bill ended up being. Too much money, horrible. […]

And so in summer (before any official news of the crisis, by the way), Lipetsk Regional Health Care Department found a way to save the Motherland some money. First, they took away the hemodialysis department’s room, then canceled night shifts as well as Sunday and holiday shifts.

Of course, those irresponsible sick people started complaining right away. Like, they are having attacks of acute kidney failure not only on workdays from 8 AM to 5 PM, but at night, too, and even on holidays. And they started screaming that a person with kidney problems, who is having an attack on a Saturday evening, is unlikely to survive until Monday morning without hemodialysis. And they cited the recent death of a 20-year-old woman as an example. To make everyone feel sorry for them, of course…

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EDITORIAL: Russia, Scorched by Global Warming, Ravaged by AIDS


Russia, Scorched by Global Warming, Ravaged by AIDS

Some Russophiles might be inclined to imagine that the phenomenon of “global warming” might be good for frigid, frozen Russia because it might thaw out vast swaths of unproductive territory and make them more fertile and habitable.

One problem with such a theory, of course, is that Russia’s population is dwindling by the day, expected to fall by one-third in the next half-century or so.  Which means that Russia can hardly manage to populate the territory it has now, much less new territory uncovered by global warming.

And now, scholar Paul Goble is reporting that in fact the whole notion is bogus.  He states:   “the Russian Federation will be more profoundly and negatively affected by global warming over the next 40 years than will any other country, a projection that Russian experts and officials say make it critical that Moscow take the lead both domestically and internationally to combat this trend.”

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Russia’s Drug Problem

Paul Goble, writing on Georgian Daily, reports:

Three “drug” problems – the increasing inability of many Russians in the current economic crisis to pay for scarce medications, the rising number of Russians using illegal drugs, and mounting suspicion that illegal immigrants are involved in this traffic – are all hitting Russian society hard, Moscow officials say.

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EDITORIAL: A Heedless Putin’s Russia, ravaged by AIDS


Heedless Putin’s Russia, ravaged by AIDS

Russian dictator Vladimir Putin hasn’t mentioned his nation’s HIV infection rate in more than four years.  Apparently, he thinks it’s no longer an issue. Either that, or he’s simply given up on the problem and, in classic neo-Soviet fashion, is sweeping it under the carpet.

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EDITORIAL: “Healthcare” in Vladimir Putin’s Russia


Healthcare in Vladimir Putin’s Russia

Global Voices has translated a series of Russian blog posts dealing with the quality of healthcare provided in Vladimir Putin’s Russia.  The story they tell is truly horrifying, and not only because of the grotesque disregard for individual human life that is shown by the regime but also because of the craven cowardice displayed by the Russians who confront it.

The story begins in 2006, when a blogger’s mother is taken to the hospital with an injured leg.  She spent her entire period of treatment languishing in a hallway along with hundreds of other patients helplessly waiting (basically, begging) for treatment in the packed confines of the facility.

Jump ahead to this year, when the mother’s condition worsens and she needs specialized surgery.  There’s a gigantic two-year waiting list, and the only way the woman can get on it is to obtain a specialized permission to enter the list. This requires a ghastly encounter with the bureaucracy.  Global Voices translates what happened next:

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Advice of the Day on Russia: Don’t Drink the Water!

You’d think that faced with epic problems like AIDS, air safety, fire safety, highway safety, smoking, drinking, toxic water supplies and the plummeting population they cause, Russian dictator Vladimir Putin would have better things to do than go around provoking wars with tiny neighbors. But it seems not. Paul Goble reports on yet another tourist advisory where Russia is concerned: Don’t drink the water!

Russia has the largest amount of fresh water of any country on earth, but much of the water coming out of taps in that country’s cities and towns contains so many harmful substances that many people there are turning to filters and bottled water, two choices that experts say do not always work as intended.

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AIDS Ravages Russian Women

The Moscow Times reports:

When Moscow photographer Serge Golovach decided to present portraits of beautiful women for an HIV/AIDS awareness project, he was revealing a startling truth about AIDS in Russia today — it is quickly becoming a problem with a woman’s face.

At the beginning of the AIDS epidemic in Russia, those infected were predominantly male. Unlike in much of the rest of the world, the vast majority of AIDS cases in Russia and the CIS were the result of intravenous drug use — a behavior usually associated with men. But of the 415,000 people infected with AIDS in Russia today, 135,000 of them — 32 percent — are women, according to the latest figures from the Federal Consumer Protection Service. A higher percentage of cases among women can be found only in Moldova or in African countries. In Moscow, the situation is even worse. Out of the 28,000 cases of HIV registered in Moscow as of January 2008, more than a half were women — up 14 percent from last year, according to the Moscow branch of the consumer protection service. More disturbing, most of the newly infected women are young and in their best reproductive years, from ages 20 to 29. Around 5,000 of these women found out that they were infected while undergoing blood tests as part of prenatal care.

The ongoing feminization of the AIDS epidemic in Russia will no doubt affect the health and future of the nation. An increasing number of HIV-positive children born to these women are the predictable result. But there remains the disturbing question of why more Russian women are becoming part of this epidemic. Experts say it is a result of both the changing nature of HIV transmission in Russia and changes in gender-based social norms and sexual customs. While officials say intravenous drug use remains the main way of transmitting the virus, contracting HIV as a result of heterosexual intercourse is rising. The Moscow AIDS Center’s web site says 86 percent of new cases of HIV are the result of intercourse. This change suggests that HIV is now affecting the general population rather than the marginalized elements of society, such as prostitutes or drug addicts, who have long been considered at high risk for acquiring HIV.

Of course, it remains true that mass unemployment and economic insecurity in the depressed regions of Russia sometimes force women into commercial sex work, which contributes to the rising numbers of HIV-positive women. Surveys of regional Russian cities show that most sex workers are between the ages of 17 and 23 and that condom use among these prostitutes is erratic at best.

But what makes the changing situation alarming is that ordinary women are increasingly at risk in a country where sexual coercion and gender inequities are tolerated, and double standards make it acceptable for men to have multiple sexual partners. While using condoms could be a solution in many cases, condoms have traditionally been extremely unpopular among Russian men. This is especially the case among the segments of the population with lower income and educational levels, where HIV is spreading most rapidly. The economic dependency of some women on their husbands and sexual partners leaves them with little bargaining power when it comes to negotiating condom use.

“Some women suspect their husbands have many sexual partners but fear to be abandoned or beaten if they resist their husbands’ sexual demands,” says Maria Ivannikova, the head of the informational department of the nongovernmental association AIDS Information Service.

Since women are biologically more vulnerable to acquiring HIV, it is two to four times more likely that a woman will contract HIV from a man than a man from a woman. The explanation is that women have a large surface area of reproductive tissue that is exposed to their partner’s secretions during intercourse, and semen infected with HIV typically contains a higher concentration of the virus than a woman’s sexual secretions. Specialists say young women are especially at greater risk, because their reproductive organs are immature and more likely to tear during intercourse, specialists say. Women also face a high risk of acquiring other sexually transmitted diseases, which increases the risk of contracting HIV 10-fold when left untreated.

The female condom could be a solution, since it is the only safe and effective HIV prevention option available that is completely controlled by women, but at the moment the method is mostly unknown in Russia. And even when women are familiar with female condoms, they have a hard time finding them. Pharmacies do not stock them because of their relatively high cost and a lack of demand, according to Igor Peskarev, the director of Humanitarian Action, a UNAIDS partner NGO in St. Petersburg.

“You may find women’s condoms only in sex shops in our city, and the price will be around 3 or 4 euros, more than 100 rubles. It’s relatively expensive for a one-time use item,” he said.

Microbicides, which can be applied in the vagina for the prevention of HIV and other STDs, are still in the developmental stage, although Russian scientists are working along with others around the world to develop an effective one.

Every day, more than 100 new cases of HIV appear in Russia, and if current trends continue, women will soon make up a majority of the victims. And the fact that Russia is currently in the midst of a serious demographic crisis compounds the problem. According to data from the Center for Strategic and International Studies, the combination of falling birth rates and rising death rates from chronic and infectious disease means that by 2025, Russia’s population will fall from about 144 million to about 125 million. Add to that 5 million to 15 million excess deaths from AIDS, and the country may lose 20 percent of its citizens over the next 20 years.

In an attempt to raise awareness of this problem and help lift the stigma of people with AIDS, UNAIDS recruited 25 famous women from Russia and Ukraine who agree to be photographed. By displaying the photographs of women who are well-known and in the news, the organization hopes encourage both public and private discussions about HIV/AIDS, particularly among women. The exhibit, which will run for two weeks in Moscow, will then tour the country, and a selection of the photographs will be published as a 2009 calendar to be launched on Dec. 1, World AIDS Day.

EDITORIAL: Russian Healthcare — Now That is Sick


Russian Healthcare — Now That is Sick

Russia is a nation with yearly medical doctor salaries that average $5,160 to $6,120 while nurses make an average of $2,760 to $3,780 annually. That means a top-end doctor, like a surgeon, is only making about $500 per month, less than the national average of around $650 (the “average” isn’t a useful indicator of actual income, however, because it’s skewed by the bizarre level of income paid to Russia’s super-rich oligarchs). As a result, many Russian physicians turn to corrupt practices like selling drugs on the black market and demanding bribes from patients in order to make ends meet.

Given that background, you will not be surprised to learn that Russia has only 200,000 of the 600,000 physicians it needs as a nation. Who would want to enter the profession on those terms? Russia “spends only three percent of its GDP on health, a figure that is only half of what it should spend and one that puts Russia near the bottom of developed countries” according to scholar Paul Goble, translating a Russian report by Leonid Roshal, the director of the Moscow Research Institute on Emergency Pediatric Surgery and Traumatology. And of that measly 3%, up to a third will be siphoned off by corruption before it ever reaches those it was intended to support. “Today is a favorable moment for Russia. There are both money and the chance to do something,” says Roshal. Goble reports: “But on the basis of Moscow’s recent actions, he lamented, there is little reason for anyone to expect that any significant increase in funding will occur any time soon.”

Roshal understands that Russia’s dictator Vladimir Putin would rather spend the nation’s fossil fuel proceeds on buzzing America with strategic bombers and helping Iran go nuclear. He knows that a major investment by Putin in healthcare would only create a more vibrant population, one more capable of organizing protest actions against his draconian crackdown on democracy. Putin prefers for Russians to stay weak and sick, thus easier to control, freeing even more funds for his crazed reinvigoration of the cold war.

Incidentally, the situation in the legal profession is little better. Goble points to a recent interview by Igor Trunov, head of the Central Bureau of Lawyers in Moscow, condemning the level of preparation of the country’s lawyers in light of a recent announcement by Moscow State University, the Russian Harvard, that “the diplomas of lawyers trained at the University’s law faculty after 1992 may be declared invalid because of shortcomings in training they received there.”

When we gape at the epic scale of this disaster, which epitomizes the utter failure of the Putin administration, and then remind ourselves that in public opinion polls and elections nearly 70% of Russians support Putin, we achieve a moment of clarity as to why we became “russophobes” in the first place. What “enemy” of Russia could have hoped to inflict a more devastating injury upon Russia as a nation than these actions of the country’s own government?

We reported on Wednesday that Putin had stated at the NATO summit that Ukraine is “not a state” and has no right to existence independent of Russia — basically the same attitude he takes towards Chechnya. Only a madman would make such a barbaric claim in the midst of NATO powers trying to decide whether Russia was dangerous or not, unless of course he actually wanted to provoke the world’s most awesome military alliance into conflict. And that’s clearly what Putin does want, even as his own nation is literally going extinct because of illness it has no ability to treat. The world’s journalists need only get out of bed to be confronted by examples of Putin’s belligerence, but they can search the live-long day and not find a single example of Putin demanding a rise in doctor salaries.

It’s monstrous.

Annals of Russian "Healthcare"

The Washington Post reports:

When a new cardiac unit opened at the municipal hospital here last month, Russian Health Minister Tatyana Golikova sent a letter of congratulations, calling the new facility a “vivid example” of the medical community and private donors working together to improve the lives of ordinary Russians.

The good feeling didn’t last long.

Three days after the unit’s opening, Tarusa’s mayor fired the hospital’s head doctor and sent in the police to check for possible fraud in the refurbishing of the hospital, all of which had been financed privately.

Doctors at the hospital said the crackdown was the culmination of a two-year campaign by local officials to wrest control of tens of thousands of dollars that were to transform the once-crumbling hospital into a model of preventive medicine in a rural community.

The hospital funding was a bright example of the growing philanthropy of Russia’s wealthy. But it was also a window into the stifling role Russia’s bureaucracy can play, even in a sector deemed a national priority by President-elect Dmitry Medvedev.

“Every improvement caused difficulties,” said Maxim Ossipov, a Moscow cardiologist who works three days a week at the Tarusa hospital. “Bureaucrats have to fight for their existence, and if they don’t control something, then they are no longer bureaucrats. They are a real disaster for today’s Russia.”

Tarusa is a river town of 9,000 people about 85 miles south of Moscow. Popular with Muscovites, such as Ossipov, who maintain second homes in the region, the town’s summer population swells to 80,000.

In an interview, Ossipov said he started volunteering at the 135-bed hospital in 2005 as a route back into regular practice, which he had abandoned in the 1990s to open a medical publishing company in Moscow. He had old ties to the town — his grandfather, also a doctor, was exiled there after a prison camp term during the repressive rule of Joseph Stalin.

“By Western standards, it was not a hospital at all,” said Ossipov, who was a research fellow at the University of California at San Francisco in 1991 and 1992.

Ossipov said he began turning to friends and colleagues for equipment, such as defibrillators, and even basic drugs to improve the quality of care. At the same time, the Russian government’s $6.5 billion spending plan to improve health care brought a much-needed ambulance and pay increases for the hospital’s medical staff.

The effects were quickly apparent, doctors at the hospital said. Its mortality rate was halved, and the death rate in Tarusa from heart attacks, a major killer in Russia, was cut by five-sixths, according to regional government figures.

“I have problems with my heart and I remember when they couldn’t help me here and they would immediately sent me to Kaluga,” the provincial capital, said Pyotr Dovbnyak, a 65-year-old pensioner. “Now they call me on the phone and invite me in for examinations.”

In 2006, the hospital was offered a new X-ray machine through the “national projects” led by Medvedev. But the hospital’s electric wiring was unable to support the new equipment. Mayor Yury Nakhrov refused to upgrade the hospital’s power supply, the doctors said. Irina Oleinikova, the head doctor, reluctantly turned down the X-ray machine.

Nakhrov was reprimanded by the regional administration for “frustrating” the national projects, and he, in turn, reprimanded Oleinikova for “safety violations” and for failing to properly treat a patient. Oleinikova appealed to the courts and the reprimands were overturned, which she said infuriated the local administration.

Nakhrov was not available to answer a reporter’s questions; officials in his office said no one else could comment.

In the meantime, Valery Balikoyev, a Moscow businessman, committed approximately $130,000 to renovate one of the hospital’s wings for the new cardio-therapy unit. According to the doctors, Nakhrov told Oleinikova her “sponsor” should visit him to introduce himself. She declined to make the introduction. Nakhrov also told her she should move the town’s pharmacy — which was located on a prime piece of real estate — into the hospital. She again refused.

In another example of bureaucratic pressure, Ossipov said that an official, whom he wouldn’t name, suggested overbilling — doubling the amount on an invoice for some new equipment that another wealthy sponsor was willing to buy, so that the balance could be used for other purposes. Ossipov declined.

Researchers at the Russian Academy of Sciences have estimated that corruption absorbs about 35 percent of all health-care spending in Russia. Ossipov said the hospital deliberately never accepted cash donations, only equipment or physical improvements, to avoid any suggestion that its personnel could benefit financially.

“My language is as impossible for them to understand as theirs is for me,” Ossipov said of the local officials who, by his account, found it hard to believe that the doctors had no personal stake in the improvements.

Local officials eventually tried to close the hospital on grounds of fire safety violations, according to Oleinikova, but a higher court blocked the effort.

On March 3, Mayor Nakhrov fired Oleinikova and ordered a criminal probe into the construction of the cardiac unit. Ossipov, Balikoyev and others appealed to the regional governor, who ordered a separate investigation. He also recommended that that the local council fire Nakhrov, but it refused.

The mayor later checked into a Moscow hospital where he could not be reached by either investigators or the news media; Oleinikova was reported Thursday to be headed back to her job after the investigation by the regional government.

“We are taking the whole thing as a slap in the face,” Ossipov said. “Small bureaucrats don’t believe in philanthropy and they can’t stand any independence on their own territory.”

Annals of Russian "Healthcare"

The Chicago Tribune, showing itself to be a world leader on Russia coverage, continues its series exposing the sick underbelly of Russia:

Health care is supposed to be free in Russia, but Russians know that every hospital has its under-the-table price list.

That’s why the family of Khazerya Ziyayetdinova, a 70-year-old woman suffering from severe bedsores, brought cash every time they visited her at Hospital 67 in Moscow. To have Ziyayetdinova recover in a room instead of the hallway, relatives slipped an orderly $300. They paid nurses $20 to give injections, change bedpans and unclog catheters. Every chat with Ziyayetdinova’s doctor cost $40.

“Our health-care system is still in the Middle Ages,” said Vera Pavlova, Ziyayetdinova’s daughter-in-law, sitting in her home in this small town 54 miles southwest of Moscow. “There’s low professionalism, corruption — it makes me very worried about finding myself in a situation where I might need medical treatment.”
Russia is an unhealthy nation, and its health-care system is just as sick. Its hospitals are understaffed, poorly equipped and rife with corruption.

The biggest reason Russia’s population plummets at a rate of more than 700,000 people each year is not that its birthrate is so low, but that its death rate is so high. The average life expectancy for Russian men is 59. In the U.S. it’s 75; in Japan it’s 79.

Alcohol and smoking are major culprits. Both are linked to heart disease, and in Russia, the rate of men ages 30 to 59 dying from heart disease is five times that of the United States, according to researchers at Columbia University.

Prevention and better health care can help reverse that trend. The Russian government is pumping $6.4 billion into revamping health care; much of that money is paying for the construction of eight high-tech medical centers across the country, new X-ray machines, electrocardiograms and ambulances at hospitals, and raises for family doctors.

But doctors and nurses in the Russian Far East city of Amursk are still waiting for the overhaul to reach their hospital. In January 2007, the hospital ran out of syringes and asked patients to bring their own, said Olga Cherevko, a nurse at the hospital. Even something as fundamental as keeping pharmacies stocked can prove problematic for Russia’s beleaguered health-care system. A bureaucratic breakdown in late 2006 led to a severe shortage in government-supplied prescription drugs.

Russians with enough money were able to buy medicine privately. But hundreds of thousands of Russians with high blood pressure, diabetes, asthma and other diseases had to do without the drugs for weeks.

Russian officials have promised that the errors that led to the drug shortage won’t happen again. They can’t be as reassuring when it comes to corruption that demands bribes for everything from surgery to clean sheets.

Researchers at the Russian Academy of Sciences’ Open Health Institute estimate that corruption siphons off as much as 35 percent of money spent on health care. Low wages perpetuate the problem; yearly doctor salaries in Russia average $5,160 to $6,120. Nurses make an average of $2,760 to $3,780 annually.

Pavlova estimates that Ziyayetdinova’s family shelled out nearly $5,000 in bribes during the time Ziyayetdinova was hospitalized.

At a skin clinic in Moscow, nurses charged $20 each time they applied ointment to Ziyayetdinova’s bedsores. One of her sons began sweeping up her ward during visits because a nurse said room cleanup was the responsibility of patients or their families — not hospital staff.

The money never really helped. Ziyayetdinova died. Doctors said she died of a heart deficiency, but Pavlova and Ziyayetdinova’s sons are convinced the indifference and neglect Ziyayetdinova endured during her hospitalization contributed to her death.

“It was as if their goal wasn’t to save someone’s life,” Pavlova said, “as if they thought their role was to be a last stage before death. To be a place that prepares a person to die.”