Gift Basket For Man In Hospital

Doctors in Russia face myriad problems, well qualified and eager they are quickly disappointed

To understand some of the problems facing the medical professionals in Russia this century, we need to step back in time…back to the 1980’s when Russia employed nearly 5 million doctors, nurses and paramedics countrywide and there were nearly 4 million hospital beds,the ratio of doctors to patients was the highest in the world.

See inside a Russian hospital and read more about the “system”. The Soviet system was heavily state controlled and funded, although it still retained elitist healthcare for certain sections of the population deemed worthy, notably politicians, senior government employees etc…Following the collapse of the Soviet Union in 1991 and the birth of a new country, the Russian Federation, state funding for health dropped markedly from nearly 4% to under 2%, and has continued to this day.

As with many countries that have had a history of communism and heavy state employment followed by a general feeling of economic instability, being employed by the government has its benefits. Government jobs traditionally pay less than the private sector, and in Russia there is a very poorly developed private sector, but they are regular, more secure and less subject to the irregularities in the economy of an emerging nation. Therefore, for the new generation of university students, becoming a doctor is still considered a good move, more so when you consider that, with homologation, a doctor can work in most countries in the world, with relatively few problems.

In Russia, being a doctor often runs in the family with generation after generation choosing this profession. This causes problem as well for the younger doctors, because they inherit the working practices of their relatives and older friends, and so the system stays the same as the world around them changes.

At the moment there isn’t the political determination, the money ,the incredible perseverance or a new governmental policy aimed at rebuilding the health system of such a vast country, and so the system continues.

Since 1991 and the collapse of the Soviet Union, the wages of medical personnel have dropped considerably, and when the wages of any sector of employment drop, then the workers look elsewhere for additional income, and of course bribery and corruption are close bedfellows to poor income, poor conditions and a lack of respect.

The average monthly salary for a fully qualified doctor specialising in a chosen field after 6 years of study and 1 year practice in 2010 is appoximately 8 – 10,000 Russian Roubles ( 328 USD $, 255 Euros E, 210 GBP £ ) against an average national salary of about the same amount for most occupations.

Bribery, corruption and crime are sadly endemic in Russian society, the doctors are merely working within this system, to take a stand for principles and honestly will leave you poor and hungry, that’s if you keep your job.

It is still extremely common practice to bring a doctor a small box of chocolates or similar in return for good service, a better referral perhaps or just a better bedside manner. Whether this is bribery or not is open to interpretation and many Russian people would disagree that chocolate donations are bribery, just a gift as a way of saying thank you is the usual explanation. The problem to westerners is that a gift after the service is a thank you and a gift before the service is a bribe.. a thin line exists between one and the other.

Nobody minds a box of chocolates here and there, a generation ago it was a basket of vegetables, or a dead chicken for my mother in law ,but unfortunately it does not stop there. At the medical institutes it’s possible to buy the results of your exams every year for 6 years, on the Moscow underground it’s possible to buy a genuine diploma issued by the correct authority… this is where the rot sets in, very early on in a doctors career.

Sooner or later the system gets worse, drug rationing on the basis of whether a patient can afford to pay more and not due to medical necessity, better beds and conditions in hospital, and even the difference between a painful tooth extraction or a painless one. In my interviews I was amazed to hear that one man was asked by his dentist to supply his own anaesthetic or use one from the government issued cheap list ( a list of drugs that medical professionals are allowed to use based on cost and supply ). This information was repeated to me several times with different people at different times in different locations.

Western drugs are expensive, way out of reach for ordinary people, Russia has no recognisable developed manufacturing industry of pharmaceuticals and the former Soviet Union countries that do supply drugs to Russia require cold hard currency nowadays, no longer happy to accept trade or Roubles, putting more strain on the dwindling health ministry coffers.

Doctors in Russia face a daunting future, at every turn they face this system in many varied manifestations, is it any wonder that the burden of a 40% black economy and the constant pressure and temptation from within, tears apart the very fabric of a state health system which should provide health care for its people regardless of their financial status.

Senior doctors in Russia often need to attend seminars, conferences or training courses to prepare for examinations, the results of which will “protect their diploma” and maintain the steady but small increase in salary. No protection and the salary stays the same while inflation rises year on year.

Medical professionals across Russia struggle daily with insufficient funding for equipment, sterilisation techniques, state of the art drugs and the lack of ultra expensive laser technology that is found in the West. It’s the equivalent of excavating a football field with a teaspoon, and no doubt just as frustrating.

It is unfair to blame the doctors in Russia for the failings of the system, most of them work long hours in poor conditions for low money, often taking life or death decisions at the end of a shift, they are after all, the symptoms and not the causes of the root problem. The health system in Russia will improve, of that I and my colleagues have no doubt, but with the largest country in the world, nothing will happen overnight, it may take several generations to repair several generations of damage, neglect and under investment….respect for a tarred and battered occupation may take a little longer.

On a final note, I have used the Russian medical system many times both for routine testing required by the authorities and for fairly serious accidents and illnesses, I have been treated well and badly. I am the last person to criticize the individual when it is the system that is at fault. For a thorough understanding of Russian medical institutional practice and related Russian information, you may wish to read more …..

About the Author

When I met my wife on the internet 7 years go I didn’t follow the usual path of bringing her to my European country, I wanted to understand her background, her views and lifestyle…I moved to Siberia and still live here. The experiences need to be seen to be believed but you can read about them at www.rurev.com

If you want to understand your partner, understand Russia, start by looking at some real photographs and then read all about Russia at www.rurev.com

Kittelberger Florist & Gifts in Rochester, NY