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Sunday, February 17, 2008

No Country for Bold Men



They called me because I'm in the donor database, and they asked me to donate blood for a kid suffering from cancer. I went there and spent two hours standing in line just to take a blood test — to find out if I’m a good match for this kid as a donor. And you know why? It’s because the moms there told me what kind of conditions they have in that miserable oncological center at Lomonosov St — how they live there in gloom, how they are purposefully mistreated — and that the impression it creates is that they [hospital personnel] do it to get as many kids as possible dying and freeing up beds. Otherwise, expedient donation would have been streamlined in this country a long time ago.

Instead, everything is being done to make the person who came here in the morning to take a blood test never come back — so that the moms will never find those donors, because there’s hardly a person who can afford to spend more than two hours just to take a half-minute blood test. They still make handwritten medical records there. Can’t the Ministry of Health Care scramble up 200 bucks for a vintage PC? Can’t this country have a computerized database? What else is there to think but that hidden cannibalism is at work? For…where do these people go? Nobody wants them.

Our authorities care about hospitals only when some other Kushnaryov dies at Izyum rayon (county) hospital. Short of that, nobody cares about it, because if the Health Care Minister’s kid gets cancer, he will not be treated at Lomonosov St. He will be treated at the world’s best clinics. That’s how we live.

— lawyer and activist Tetyana Montyan

Tetyana Montyan surprised everyone when she chose to represent Vasyl Tsushko in court. She obviously places a high value on her time, but the case she makes in this report has stood the test of time.

Our men would rather take part in breakaleg “free Rudy” rescue raids than take a trip to the nearest public hospital and see what it’s like.

We know that Rudy and Shufry have private clinics at their disposal. But what about those countryside folks, whose villages NUNS promised to equip with ambulances? How many ambulances have been delivered?

Video uploaded from: http://censor.net.ua/go/offer/ResourceID/75890.html

17 comments:

Anonymous said...

Cool - very cool - I like Montyan. You can tell that she bucks the system in Ukraine. Does she have a blog/website???

Thanks.

Luida

Orest said...

The Ukrainian State of The Nation.
Dismal health care.

This is why the population of both Ukraine and Russia is falling big time. Poor health care. Its lucky if most men live until 60.

Srebrenica Genocide Blog Editor said...

Kosovo is finally independent!

Anonymous said...

News stories about Rudkovsky and appeal to PACE.

http://www.ukranews.com/eng
/article/103221.html
Rudkovskyi's Lawyer Boniuk Asks PACE Monitoring Committee To React To Violation Of Rudkovskyi's Rights During His Arrest

http://www.ukranews.com/eng
/article/103295.html
Rudkovskyi's Lawyer Boniuk Complains To Prosecutor's Office And Corrections Department After Doctors Denied Access To Rudkovskyi

http://www.ukranews.com/eng
/article/103304.html
Doctors Put MP Shufrych’s Foot In Plaster Cast After Party Of Regions’ MPs Fight With Special Forces Taking Rudkovskyi From Kyiv Clinic

Outrage to EU, "battle scars", etc. all to defend a healthy, top Socialist politician who enjoys riding around in an Aston Martin and hobnobbing with beauty queens on government money while kids and regular citizens die every day because of lousy medical care and lack of services.

Luida

Taras said...

Luida,

She blogs in Ukrainian at http://mentbuster.livejournal.com. Ment is slang for cop.

Thank you for the links! It’s about time that Socialists like Rudkovsky got used to a lifestyle of paying their bills — or serving prison terms. Enjoy my latest post on the subject!

Orest,

According to the Human Development Index, the average life expectancy in Ukraine is 66.7 years. By 2050, Ukraine’s population is expected to plummet by 33 percent.

Poor living standards. Poor health care. A dying nation.

Daniel,

It looks so! I’m happy for the Kosovars, who have suffered so much under Serbian rule. I’m waiting for news updates!

Srebrenica Genocide Blog Editor said...

Taras quote:

"I’m happy for the Kosovars, who have suffered so much under Serbian rule. I’m waiting for news updates!"

Then check out my blog !

I love you! You are wonderful human being! Time for celebration now!

elmer said...

Ok, real cool, Montyan. She has been villified on many forums in Ukraine by many rooskies.

Sooooo - what's the solution?

One $200 personal computer ain't gonna do it.

Cross-matching blood donors for blood type is one thing.

The entire health non-care system of Ukraine is quite another.

What are the mechanisms to fix this?

Do you have any idea?

Way cool Montyan kvetching about it on TV, and people talking about how cool Montyan is kvetching about it on TV, ain't gonna do it.

Taras said...

Elmer,

Having NUNS deliver on their campaign promise would be a good place to start. And Montyan is doing a good job raising public awareness.

As long as we have politicians who rarely make good on their promises, and use government funds for personal purposes, we’ll never have a healthy health care system. If we tolerate this social contract, we’ll never have “one law for all.”

What else can I say?


Thank you Daniel! I’ve already dropped a few lines over at blog!:)

After pillaging Kosovo, Serbian adventurism has gotten the final lesson it deserved. Milosevic lost his gamble.

Of course, some countries, including Ukraine, have legitimate security concerns that Kosovo may set a dangerous precedent for their troubled regions. (In Ukraine’s case, it’s Crimea.)

But, hell, didn't Ukraine face a similar situation in her own independence bid? In fact, Washington has recognized Kosovo’s independence much faster than Ukraine’s.

Following weeks, if not months, of “wait and see” tactic, the “chicken Kiev” Bush administration of 1991 did not recognize Ukraine until Dec. 25, 1991. (Ukraine had declared her independence on Aug. 24 and had held a referendum on Dec. 1.)

Anyway, congratulations, Kosovo:)!

elmer said...

OK, Taras, delivering health care, especially to rural communities, without government funds being diverted into bureaucrat pockets was something that was openly and specifically debated on TV during the 2006 parliamentary elections.

Raising awareness is one thing - actually doing something is quite another.

Why can't the hospital and the doctors take matters into their own hands, if the government does not respond - and it has been proven time and time again that the government does NOT respond.

Ukrainians are very used to getting around the government, and keeping their heads down to avoid the sharks in government.

Soooooo - how about this?

In the 1940's, doctors in the US banded together to create Blue Cross/Blue Shield. It was a voluntary organization, not a government organization. It was a way for doctors and hospitals to get paid.

Members - ordinary citizens - signed up, for modest premiums, in return for which specified health care services were paid for.

The snakes in the Ukrainian government ain't going to do a thing - their fingers are permanently glued in the money-government pie, and it will take radical surgery to get them out.

Now, I know it might be difficult for ordinary Ukrainian citizens to pay insurance premiums, but there's more than one way to get around the government.

I believe that raising awareness is important, and I am not in any way criticizing Montyan.

I am sure that Ukrainians can come up with something better than a lawyer suggesting, in a cool video, a better way to type match blood for blood donation.

This is, after all, the 21st century.

Taras said...

Elmer,

Yes, it’s the 21st century. Still, it’s easier said than done.

For Ukrainians, there’s nothing new about getting around the government. In a public Ukrainian HMO, you’re not getting any health care at all until you tip all the doctors and buy all the meds. It’s normal practice to pay one’s way through the “free” health care system.

The idea of insurance-based health care has been nursed for years, but nothing has come out of it. One can’t be sure of collecting the coverage most insurance companies promise when they collect those premiums. Once you need that coverage, it’s a hurdle at best.

At the end of the day, there’s no getting around corrupt government and corporate practices.

My idea is to saturate our politicians with more "moments of truth" like Yatsenyuk’s road rage experience. We need our politicians — of all colors — to come into closer contact with the caste system they created. We need them to get a taste of all the stabilnist they created.

The more they taste that stabilnist, the more they will be inclined to change it.

elmer said...

Taras, I don't understand.

If Ukrainians have to pay for "free" health care, why not set aside the government and pay for - actual - health care?

Aren't there doctors and nurses who are sick of the current government system? Aren't there patients who are sick, and appalled, at the current system?

Isn't there someone smart enough to say - "look, the thugs in government are interested only in Porsches, and building mansions. Forget about government - here is our reliable HMO."

What if the doctors and nurses simply left the government system en masse - into a system organized by them on an economical basis that actually does something?

Aren't there people in Ukraine who can say "this is broken, and the thugs in government are simply going to build their own mansions - this is our solution."

Wouldn't doctors and nurses and patients be better off in a non-government, non-corrupt system that actually works?

I think there is a way to get around corruption - don't rely on government, where the corruption exists.

I can't see wishing and hoping and praying for corruption to end, maybe some day down the line, no one is sure when.

Обіцяли кожух - теплі їхні слова.

Otherwise, people go on paying for a "free" system - that doesn't work.

I don't know about anyone else, but I don't like paying for something that doesn't work.

Taras said...

Elmer,

This would require nothing short of an Orange Revolution in health care.

But as you know, the folks here are too disenchanted, disorganized and stabilnist-minded. They don’t take to the streets as often as they do in Europe and America. We have fewer strikes in the entire Ukraine than they have in Hollywood alone.

The rule of thumb that comes with our “free” health care is “не підмажеш — не поїдеш,” or “no mon, no fun.”

In other words, if you’re going to a public HMO, you take some cash with you. If you have more cash, you can go to a private HMO. Unfortunately, that’s it.

Therefore, the more VIPs get trapped in the rough reality of public infrastructure, the more reinvention will get done.

elmer said...

OK, Taras, I understand.

But I'm not talking about going out into the streets.

I am talking about organizing.

That doesn't mean demonstrations or going to the streets.

It simply means doing something.

What if a doctor opened his own clinic with a few other doctors, on a community basis?

Don't the doctors in Ukraine have a medical association?

What if people organized write-in campaigns, letters to the editor, letters to (as hopeless as it may sound) the President, to the Minister of Health, and the legislators?

In the President's case, he wouldn't have to talk about gas (and defend RosUrkEnergo, poor guy).

What if more people posted videos or pictures and stories of the decrepit health care system?

What if people demonstrated how things could be better?

There is a forum called "activist" in Ukraine. Do they actually do anything?

It doesn't take demonstrations or riots in the streets.

It takes some focused, organized action.

Are the doctors happy with the current state of the health system?

Taras said...

Given Ukraine’s economic freedom and income distribution, regular rallies would do us no harm.

In Ukraine, being smart does not mean being successful, and vice versa. Ukraine is not America. Nor is she Italy, or Spain, or Portugal — some of the countries to which Ukrainian medics have been fleeing en masse.

A degree in medicine is a ticket to poverty unless you leave for some other country or have connections. That’s the fight-or-flight situation our medics face. Ukraine is the land of opportunity for the well-connected.

Top talent serve the top 5 percent of the population. Some talent can be found in public HMOs, where they make a living by extracting "tips" from patients hovering slightly above the poverty line.

The rest are poor and depressed. You won't find a lot of “Ukrainian Dream” material among them.

elmer said...

So if all the doctors, except Raisa, are leaving Ukraine, don't people get concerned about that?

And why wouldn't they be motivated enough to help the doctors do something about it?

Taras said...

You’re right, Elmer. It’s all about motivation.

Most of Ukraine’s demotivation stems from her social depression. The reverse can also be true. What we have is a vicious circle powered by the dog-eat-dog world of post-communist anomie. People just don’t care about each other. Crony capitalism, a product of nomenklatura communism, messed up their hearts and minds.

Unlike the rest of Eastern Europe, whose institutions have benefited from the virtuous circle of NATO and EU membership, Ukraine remains a country of Eurasian, not European, institutions.

Our government, our courts, our police, our military, our health care are killing us — literally.

The doctor-patient relationship reflects this reality. In public HMOs, this relationship often lacks due care and mutual respect.

A significant proportion of public HMO personnel have obsolete skills, bad work attitudes and deficient ethics.

As a former gynecologist, Raisa Bohatyryova could use her leverage to do something about the health care system. (If only she cared about the health of Ukrainians as much as she cares about her own.)

She could give birth to some kind of embryonic plan to help Ukraine out of the demographic crisis. So far, I haven’t seen any such effort.

In a depopulating country like Ukraine, health care should be a top item on the national security agenda.

elmer said...

"Been down so long it looks like up to me."

"Pulling oneself up by one's own bootstraps."

If Yushchenko wasn't so worried about protecting Firtash, or about having little side/secret agreements on gas with Putin, and whether Yulia is going to upset the RosUkrEnergo apple cart, maybe he could provide some leadership here.

Taras, where is the "can do" attitude from the Orange Revolution?

A leaky roof doesn't fix itself - one has to get up and fix it.

Otherwise, one gets caught in a Catch-22 - when it's sunny, it doesn't need to be fixed, and when it's raining, you can't fix it.

Surely Ukrainians are smarter than that.

One has to start somewhere.