Russia: "Unsent Letter" on Health Care

Global Voices Online
Monday, March 9, 2009

Below is a partial translation of a post (RUS) on health care in Russia - a caustic "unsent letter" to the Russian president, written by LJ user sobe-panek on Feb. 22. The post has made it into the Top 30 at Yandex Blogs portal and was picked up by some Russian media.

[...] 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...

Okay, so the woman died - failed to survive till Monday. And so what? The world has turned upside down?

Even if all the chronic patients of this department of the Yelets City Hospital die, the world isn't going to care. Because, truth be told, these patients are taking up space under the sun in vain. Judge for yourself, who needs those disabled people who are spending years waiting for kidney transplantation surgeries (which they'll never get) - no one needs them. Or those other patients of this department - drug addicts after an overdose. These are the scum of the earth, who needs them? And all those different poisoning patients? Mushroom poisoning or whatever. What do they need treatment for - it's all their fault: don't eat and drink indiscriminately.

And I'm not even talking about patients with chronic kidney failure, dear president. If these people led a healthy way of life, voted for United Russia, didn't attend the dissenters' rallies, didn't read all kinds of oppositional nonsense, didn't sign all kinds of letters (in defense and in protest) - would their kidneys fail? Of course, not.

So yes, in summer the medical staff of this department were relieved of their night shifts and of work on weekends and holidays. What would any normal person do in such a situation? Rejoice! And they - the medical staff - what are they doing? They are outraged. And are hiding behind their patients' interests.

Actually, what really got the medical professionals outraged were the salary cuts. What kind of cuts - ah, not a big deal at all.

Take my younger sister Anna, for example, who works as a nurse at this department, has 20 years of experience [...] - before the crisis [...] began, she was making about 5,000 rubles [approximately $200 a month at that time]. And now she is making 3,380 rubles [approximately $100]. What's the difference, right? No difference at all! She doesn't care whether she's making 3,400 or even 4,300, when the housing fee she has to pay is 4,200 [a month]. Even if she were making slightly over 5,000, she'd only have enough left to buy cat food.

If I were Lipetsk Regional Health Care Department, I'd be paying medical professionals no more than 1,000 rubles a month. Why would they need more? To survive till it's time for them to retire?

Look, dear president, how much money can be saved if we apply this nationwide. First, all medical professionals will die off, then all their patients will follow them. The state will at once get unbelievable profit on [...]: a) money saved from salaries; b) money saved from unpaid disability payments; c) pensions; d) free medications... (Yes, yes, free - and what did you think? I don't know about other departments of this hospital, but in this hemodialysis department chronic patients are treated for free!)

Let's keep on counting: equipment, different kinds of medical devices, gloves and syringes, square meters of buildings occupied by some unneeded departments or even whole hospitals.

Why does the country need oncology clinics if cancer is incurable?

Why should our double-headed bear - sorry, slip of the tongue again - our eagle - take care of all those chronically disabled people, if they are no longer of any use to the state? And why do we need sick children? Better to give birth to new ones. Healthy ones...

Dear president, [...], listen carefully to the opinion of the common folks. And pay attention to the progressive undertaking of Lipetsk Regional Health Care Department. And maybe we'll not just be able to overcome this damn crisis, but will come out of it with some profit.


UPD. I wrote this letter and was about to send it off (not in LJ, of course, but much further), but decided at the last moment to let my sister know.

So I called her. Warned her.

She says: "Are you crazy? They'll fire me!"

So what, I tell her, let them fire you. What are you losing? Three thousand rubles? It's not a salary, it's a humiliation. I'm ready to pay you 5,000, just to keep them from wiping their feet on you.

And my sister replies: You don't understand anything. I LOVE MY JOB VERY MUCH. I can't live without it. It has nothing to do with my salary...


The only thing left to do is [shrug]. It's also possible to be happy. For the country. For its president. And, separately, for Lipetsk Regional Health Care Department. And for Yelets medical professionals. And, of course, for Yelets chronic kidney disease patients...

P.S. Dear president, please, I'm begging you: cancel salaries for medical professionals all together. And please force some nurses (my sister, for example) to pay from their own pockets for the right to go to work. Because otherwise nothing will change in our country. Never.

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