Sevastopol: Staying Alive

During the two and a half years of Russian life in Sevastopol, a lot has been said and written about the state of medicine. Hundreds, if not thousands of complaints flew to the Kremlin, and from there official delegations of high-ranking officials were sent to check and restore order. All these monitoring visits followed the same scenario: guests were received on weekends, taken along the same renovated corridor, shown medical equipment, either brought from all over the city or simply not used in the treatment of patients, and cheerfully reported on the “average temperature in the hospital " It turned out to be within normal limits and all inspection authorities retired to their important offices to solve more urgent problems. But the task of ordinary Sevastopol residents remained unchanged - “to stay alive.”

People need medicine not yesterday or tomorrow, but today. And the picture of today's medicine in Sevastopol does not have major shades. Exceptional minor.

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The main unit in the successful treatment of a person is the doctor. Doctor. No matter how cheerful the reports of the director of the city’s Department of Health may sound that “the shortage of doctors has decreased by 5%,” there is a catastrophic shortage of personnel in all medical institutions. There are neither narrow specialists nor ordinary local - children's and adult - pediatricians and therapists. In children's district clinics there are no orthopedists, endocrinologists, gastroenterologists or even surgeons at all. Those wishing to get a consultation with a specialist from district clinics are sent to the central clinic, where it is almost impossible to get a coupon to visit a doctor. In the electronic recording system, “coupons” appear once a week and disappear almost immediately. Like a mirage. A complete quest with an unknown ending is passing a mandatory medical examination when children enroll in school or kindergarten. There are not enough doctors for sick children - there is practically no medical staff in the neurology department at the central children's hospital, and there are not enough doctors in the emergency room.

In district clinics, pediatricians work “for themselves and for that guy” who is simply not at the site. The patient log is also posted for a couple of hours and all visits to the doctor are completed by parents of sick children within half an hour. Adults are in the same position. Calling a doctor to an adult’s home is a fantasy in Sevastopol, as is getting a sick leave certificate, because it’s unlikely that anyone will be able to predict in advance when they will get the flu or a cold.

Progress in the form of high-tech medical care did not reach Sevastopol for two years. It is practically impossible for both a child and an adult to be examined “here and now” within the walls of city clinics. Registration for a regular ultrasound is scheduled months in advance, and at the city forum people offer their “valuable” coupons to others if for some reason they cannot get to the doctor. Patients have great mutual assistance. Today I would like to ask the residents of Sevastopol a rhetorical question to medical officials: “How long should a patient with suspected pancreatitis wait if it hurts today, and an ultrasound scan is in a month?” It is in principle not possible to wait for examinations of a higher class than conventional ultrasound, for example CT or MRI. Patients to whom they are prescribed simply do not have the opportunity to wait for the “coveted coupon” due to the seriousness of the disease. And they go to paid medicine, private clinics and diagnostic centers. And this is thousands and thousands of rubles.

The same picture applies to the work of laboratories. “There are no coupons,” and those that exist are issued only to definitely and irrevocably sick children. The direct route is to private laboratories. In-depth analyzes are completely the province of private medical structures. For example, an analysis of gastrointestinal tract control for a child costs about 1500 rubles. And I won’t even remind you that the “average salary in Sevastopol” is about 20 thousand rubles.

Now about the logistics. It has already been said above that all ministerial commissions follow the same “Potemkin” route. And no one shows the condition of the building of the gynecology department of the central city hospital No. 1 and does not take “guests of the city from medicine” to the central hospital. By the way, the latter, although it was repaired according to documents, has not actually changed its appearance in any way since its construction in the last century. The reality for many sick Sevastopol residents is peeling walls, armored beds stretched out like hammocks, broken toilets, lack of showers and sockets, and other anti-achievement.

Those few doctors who still remain at their jobs, literally “on the front lines,” are unlikely to represent a standard and example of medical ethics. And this is understandable, but unpleasant. A person who comes to the hospital to see a doctor expects help and understanding, wants to be listened to and helped. In reality – rudeness at the reception desk, hours-long queues surrounded by the same unfortunate patients, a doctor’s appointment where in 5-10 minutes the patient doesn’t even have time to open his mouth – a dry survey and scribbling, scribbling, scribbling…”Next!” And you become somehow conscientious and don’t understand why you, sick and unhappy, are tearing a person away from work. The doctor has a conveyor belt of people like you. There is no time to treat, which means there is no time to get sick.

Here is a short story from my friend, a young woman, about how she was treated in the gynecology department of the central city hospital (the author’s text has been preserved): “The bleeding took about 3 hours. I got there on Friday evening and didn’t see the doctors until Monday. I went to the nurses for bleeding procedures myself from the 2nd to the 1st floor. The food tastes terrible and they don’t always invite you. Went there for the first time since Friday for lunch on Sunday. During the examination, the uzist asked displeasedly 3 times, why did I come to him, he put the gestational age a week less. Beds with armored mesh to the floor, bed linen - old, patched and patched, damp in the rooms, everything is shabby, tattered. The attitude of the staff is so-so. You lie there and feel that you are interfering with their work. At 7.20 I went to get some medicine, the nurses were coming from a smoke break and said come later, because It's their shift change and they're busy. But there is time to smoke.”

Of course, not all regions of Russia have pictures of hospitals from the TV series about Dr. House. But, according to Sevastopol residents who were lucky enough to visit medical institutions in other regions, for example, maternity hospitals, the difference in medical care is significant. For example, here is a review from a former resident of Sevastopol about medical care in Stavropol:

"You can get to a specialist without any problems. If you want, you go, take a ticket, wait for your turn, if you don’t want to wait, you go to the cashier, pay and go straight away without queuing. The cost is reasonable, ophthalmologist 150 rubles, dermatologist 200 rubles, ENT specialist 164 rubles. Everything is through the cash register. The clinic has an elevator (4 floors), which is useful for the elderly and pregnant women. You can make an appointment with a doctor at the reception desk, via the Internet, or through a self-registration terminal. The doctor gives shoe covers in the office. Just like disposable diapers, gynecological kits, etc. You get a coupon for an ultrasound from the doctor himself. You come up with directions, AGREE on a date and time convenient for you. During pregnancy, I was given vitamins - vitrumpregnance - three times. In addition to the register, there is also a “reception”, an information desk. Security. 

Everything you need to take with you to the maternity hospital is documents, pads, underwear, a robe, diapers, exercises. Everything else is given out. They bring a stack of diapers a day, about 30 of them. Swap, pad, do whatever you want. The mixture is given to everyone. Nutrilon premium. In individual bottles. If you want to feed, you want to eat yourself. All children receive a course of probiotics. Examination by a neonatologist twice a day. Shower and toilet in each room. In each ward, a lamp for jaundice is installed above the changing table. All medications are given. In my case, antibiotics for bronchitis and cough. Then they replaced the antibiotics with others intravenously and oxytocin. The birth itself - all that was needed was a bottle of water. She gave birth, they gave birth, they took the baby, let her rest, took her down to the postpartum room, showered there, ate, etc. , only then they gave me a small one. Flu, an ultrasound after childbirth is mandatory. The equipment is modern, banal - an automatic pistol with plastic cones for analyzing blood from a vein.

Children's Hospital. By appointment - if you want it for free, you’re too lazy to take a ticket and wait - go to the cashier, for an affordable price. You can come at any time; if your doctor is not seeing you, the person on duty will see you. The nurse calls and reminds you when the appointment is. He can send photos of tests to WhatsApp. Medicines for children are provided without any problems. Children's cuisine - mixture to choose from. If during the examination the pediatrician has any questions, they immediately write a referral and you go to a specialist without waiting in line. Also - two registration desks, like in the adult one, a help desk, security, and a children's playground. 

Dentistry. Free!!!!! The equipment is no worse than in a private clinic. I came in the morning, they took me in right away, they did everything, I paid 143 rubles for a special anesthesia, since I needed novocaine when I was pregnant, etc. it is forbidden.

For an inpatient hospital in a maternity hospital, free oxygen chambers, CTG, Doppler, ultrasound. All on the day of admission. It's convenient to have everything in one place. In one building, and not like ours, genetics at the complex, CTG at the maternity hospital. Here everyone is in one hospital. For pregnant women, everything is on one floor. My laboratory assistant. There is a separate registration for pregnant women, disabled people and veterans. More wardrobe. At the entrance. Look like that's it".

As you can see, the difference between how it is in Sevastopol and how it is in Stavropol is significant. With the same!!! salaries of doctors in the city of Federal significance and the capital of the region. This means that money does not bring happiness, and it is not the criterion for the success of urban healthcare? Maybe, after all, ministerial officials will walk along the right corridors and talk with ordinary doctors and patients, and not with the “hurray-reporting” chief doctors? We can only dream about this for now.

The dream remains to have good healthcare in the city of Sevastopol. No, not that good, but just normal. Because living to see good things may not be enough to be healthy. I wish I could stay alive.