Little things that I wish to share because of the warm-enlightening flash felt includes some insight I’ve received from listening to a lecture held by the CSIS (Center for Strategic and International Studies). The CSIS hosted a conference in 2010 about the current mortality crisis in Russia. Many of the factors that contribute to the demographic crisis in Russia are relevant to Ukraine, though alcohol and narcotic use is much less severe in Ukraine. In both countries, finding men over the age of 60 has an almost Where’s Waldo quality to it. My vocabulary on cardiovascular disease and high blood pressure is quite advance.
The part of the conference that I found the most revealing was a session on healthcare in Russia. Ukraine (as well as Russia) has always played a captivating role of not being quite Western nor Eastern. The cultures in this region of the world are a blend of several influences. The debate on West versus East causes a lack of an undisputed center. One way this dispute bares itself is in healthcare practices and how health/proper care is perceived by people in Ukraine (particularly conversations I have in my village).
There is no right answer, but often what I’m ordered to do in the name of my health causes me to tilt my head to the side like a confused dog. Sure, eating heaps of garlic, onions, lemon, and honey will help fight against colds. However I’m not so sure that eating lard will “help clear my blood transport system”, sitting on a cold surface will freeze my ovaries, genetically modified foods will leave me sterile, or that leeches are good for cleaning blood (though I’ve read that this practice is all the rage in Europe).
According to the CSIS lectures, healthcare in Russia and Ukraine has changed very little in the last 20 years. Hospitals are used for acute diseases and traumas, little attention paid towards prevention. Typically people don’t have a specific family doctor, they only interact with a doctor at a hospital or clinic.
Up until the 1960s, Soviet healthcare was on par with Western Europe and the United States. One of the lecturers, Martin McKee, mentions that in the 1960s Western pharmaceuticals started to produce drugs for hypertension, Parkinson’s, mental disorders that lead to the “mass medication” of the diseases of aging. This didn’t happen in the Soviet Union. The Soviet Union never produced a modern pharmaceutical outlet, and in any case didn’t have an efficient way of distributing medications. This is in part why preventative care is so limited today in Ukraine. Medication is reserved for severe treatment; for example blood pressure medicine is only taken after an episode in some communities like mine. The lack of monitoring and safety concerns of pharmaceuticals sold today in Ukraine is a whole other issue.
Another interesting fact mentioned in the lectures was that the Soviet Union never administered random trials or study groups to measure the effectiveness of treatment. In a way, this allowed people in charge to never have to admit how ineffective their system was. Therefore, “treatments” were performed (and still are being performed) that have no benefit such as magnetic therapy, light therapy and so on. This was highly functional for the regime and doctors because they could charge informal payments for these things (unlike drugs taken at home). Patients enjoy these treatments because they often take place at spas or sanatoriums for weeks at a time. A few weeks off work displaces the thought that the treatment might be ineffective. Besides the lack of funding and loss of talented professionals due to low salaries, care in Ukraine looks uninviting and scary to me. A birth of a child which in the U.S. calls for a day of recover in a hospital takes two or three weeks in Ukraine. Outbreaks of TB and cholera are common.
There is some light. The medical professionals I’ve met love what they do. In the past few years groups like Peace Corps and the WorldBank have promoted healthy lifestyles through campaigns in schools, public places, and the media. Hopefully with economic growth and the filling of the information gap Ukraine will become healthier.
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