Russia : Health, Too Many Failures
While Russia has one of the highest numbers of doctors and hospitals in the world per capita, the hospital mortality rate remains one of the highest. People regularly die due to the negligence of sanitary facilities often obsolete or in desperate need of suitable equipment
and because of the poor administrative organization of the health system. Despite the launch of a national plan for serious reforms in the care sector, much remains to be done to overcome the health failures, legacy of the USSR.
Care Centers That Do NotMeet The Standards
On 13 December 2015, a fire devastated a hospital in the Voronezh region (southwestern Russia), making twenty-three dead, the fire had been caused by a short circuit due to antiquated electrical installations. This sad episode is not an isolated case. Many people die every year due to lax security measures for its infrastructure dating from the Soviet era and left in poor condition.
"In April 2014, eight people died in a fire that destroyed a supportcenter for drug addicts in the Altai in Siberia.In September 2013, 37 patients had died in a fire at a psychiatric hospital in the northwest of Russia. In April of the same year, 38 people - mostly mentally disabled - were killed in a fire at a hospital in the Moscow region "(Le Monde)
The press described hospitals where the instruments are still sterilized in pots placed on electric coils, hot water no longer operating in some of them.
A Deficit In Pharmaceuticals And Poor Coordination Of Patient Care
News dated June 5, 2015, illustrates the lack of efficiency in the management of the care given to the patient and the barriers that families sometimes have to overcome when trying to get treatment. Macha Yantuganova, a six year-old girl living in the Republic of Bashkortostan (western Russia), was playing at home with Dima, her baby brother, when he tripped over the kettle power cable, which spillt onto the table. Before the water poured over him, Macha tried to protect her baby brother by jumping above him. She got third-degree burns on 60% of her body, while it was 40% for Dima.
When their mother, Tatyana, tryied to call emergency line, they were unreachable. She decided to borrow the neighbors' car and to go to the nearest hospital. Once there, she had to wait one hour before being received by a physician who then treated her son with ointment but said they did not have enough for her daughter. Tatyana then drive again with her daughter to another hospital, but Masha lost consciousness during the journey. Placed in intensive care, she died of her injuries soon after. "My son Dima was burned on 40% of his body, but he escaped death because he was treated. My daughter died because we did not receive the necessary help "(20 minutes, France)
This tragedy is one of the consequences of the Soviet period. In the 2000s, Russia's health system was still marked by the tendency of the Semashko model, that preferred hospital and specialized care. First aid care remains very much underdeveloped, both by its presence and by its quality ; and Russia is still spending about twice for hospital care compared to outpatient care.
Overall, the Soviet system also tended to neglect primary care. A university study published in 2013 shows that a significant proportion of patients come to the hospital without having visited previously a primary care center, the diagnostic tests are repeated unnecessarily (both at the health center and the hospital), and hospital doctors have a negative opinion on the value of care provided at the primary level. Moreover, coordination between primary care centers and hospitals is poor, so that continuity of care is very inadequate.
An OECD economic study conducted in 2006 reported that in 2002 Russia spent less health resources, in proportion to its GDP than most OECD countries. The household health expenditure being mainly devoted to the purchase of drugs and about 80% of hospital patients are forced to pay a portion of their drug costs. Families of patients are required to purchase their fresh bandages, syringes, saline bags and everything needed for a hospital stay.
The time for reforms
Health has become a national priority with the National Health Plan announced in 2005 whose stated objectives were improved first aid, building capacity screening, diagnosis and prevention, increase the salaries of doctors and nurses, better care for pregnant women and newborns, the development of high-tech medical care, and upgrading of medical facilities, including emergency equipment.
The government had planned to spend 3.2 billion euros on health care reform for the period 2008-2013. The hospital management was restructured and physician remuneration revised upwards. The number of Russians to receive sophisticated treatment has increased fivefold in recent years. But much remains to be done. "To reach the level of the European Union in 2020, Russia must increase its health spending by 15% every year," says Lev Iakobson, a Member of the HSE Academic Council . The government has allocated 460 billion roubles of additional investments in 2011-2012 (11 billion Euros). Already, the first effects were felt. Increased life expectancy (over 5 years since 2005), the opening of more high-tech centers, more medical equipment purchase.
"Russia is one of the only countries to have increased its financial efforts in the field of health during the crisis. Health is also the one who receives the most state aid in Russia. However, the main problems are less a question of money than management "supports Tatiana Golikova, MiMinister of Health and Social Development.
Sources: Le Figaro, Le Monde, Le Parisien, Cairn, 20 minutes, GIP International Health Social Welfare, WHO.
Translated by Ümit Dönmez