More on the medical situation

A recent article in the Kyiv Post highlights the growing problem with hospitals and medical care in Ukraine. In a former blog post I mentioned some of my impressions upon going to a Ukrainian hospital to visit - which is in high contrast to a private clinic - which I also visited later for a check-up when I was sick for a week. The private clinic was amazing, modern, clean, friendly - and reasonably priced compared to American clinics. In the state hospitals - you have to buy your own bandages, bring your own sheets, pay for someone to wash you, to feed you, to change your bed pan. On top of that you may have to pay additional fees to the doctors - for what should be standard patient care - but at a monthly salary of $150 (just $50 more than a pension payment) what do you expect the doctors to do - they are trying to live and support their families too. Compassion is a hard commodity to come by all over the world, but compassion in the midst of your own discomfort is even rarer.

From the Kyiv Post: http://www.kyivpost.com/nation/29162/
Health care deteriorating, physician shortage likely to grow
by Anna Poludenko, Kyiv Post Staff WriterJun 25 2008, 18:26
Health care professionals in Ukraine fear that a severe doctor shortage is imminent because of low wages and poor working conditions. They are calling on the Ukrainian government to improve the government-financed health care system before it deteriorates further.
Doctors have recently formed a new association called the Ukrainian Medical Union, which is aimed at protecting the rights of doctors and pushing for new working standards. So far, the group has at least 150 members.
“With present working conditions, it is very hard to do your job – sometimes even impossible,” said Volodymyr Zagorodniy, vice head of the Chief Administration on Health Protection of the Kyiv City Administration. “It is not a secret that medical workers have the lowest of salaries.”
The shortage could become particularly acute for specialists treating tuberculosis, one of the main diseases plaguing Ukraine, Zagorodniy said.
With 30 doctors per 10,000 people, Ukraine has the lowest number of doctors in Europe, according to the Ministry of Health. As recently as 2006, according to Ukraine’s State Statistics Committee, there were 48 doctors per 10,000 people.
With chronic low wages, young people living in Ukraine are turned off from studying medicine. Enrollment in medical schools has been dropping since 2005.
And some young talented doctors are leaving for more lucrative business careers, such as in pharmaceuticals.
Medical specialists say the nation urgently needs another 15,800 doctors and that the number could grow within the next five years in the nation of 46 million people.
Yuriy Poliachenko, a surgeon and member of the Ukrainian Medical Union, said political leaders need to take action. Being a doctor is no longer prestigious, Poliachenko said, noting declining enrollment in medical schools.
Enrollment has been dropping since 2005, he said, but he hopes the new union will be able to reverse the trend.
Currently, doctors in Ukraine get paid an average of Hr 711 ($153), less than teachers, who get paid Hr 855 ($184). Industrial workers get paid Hr 1,485 ($320). In March 2008, members of Parliament’s Committee for Health Care created a law that would, if passed, increase salaries by 25 percent. The law however, has not been passed by members of Parliament.
Such conditions have forced doctors to supplement their meager incomes and provide patient care by charging unofficial fees.
“We have a practice of bribes in medicine and that is not a secret, but starting from autumn this year, when we start using medical insurance, I think this will be the first step of fighting it in our society,” Poliachenko said.
But even the off­the­books income supplements apparently aren’t enough to prevent many doctors from leaving the profession.
“Their salaries don’t provide a normal existence,” said Ihor Oliynyk, health counselor at the World Bank’s office in Kyiv. “At the same time people have to study for eight years to get a degree — six years of university and two to get a PhD in medicine. A person has to spend eight years of his life to become a doctor and to work for that little money. It’s not even enough to survive.”

Financial woes not the only problem
Doctors in rural villages often lack proper medical supplies, said Yuriy Gaidayev, a member of Parliament’s Committee for Health Care.
Practicing medicine can also be dangerous in Ukraine, with reports of patients assaulting doctors. According to news reports, for instance, a doctor was shot in Donetsk by the boyfriend of a young girl being treated for alcohol poisoning.
The result, medical experts such as Poliachenko said, is patient care suffers – with sometimes fatal results – if treatment is refused because of lack of payment. Overworked or unskilled doctors also might misdiagnose health ailments, although Poliachenko said the nation keeps no statistics on the problem.
Oleh Musiy, head of the All­Ukraine Doctors’ Union, said that “all these reasons for poor social support of doctors influence drastically the level of treatment.”