Russia's Outdated Healthcare Mired in Corruption

By Alex Rodriguez, Chicago Tribune

March 15, 2008

Russia

Khazerya Ziyayetdinova, here with granddaughter Taisa, was hospitalized in Moscow with severe bedsores. Her family estimates they paid nearly $5,000 in bribes.

The system is outdated and underfunded, leading to graft and poor care and contributing to a population decline.

Healthcare is supposed to be free in Russia, but Russians know that every hospital has its under-the-table price list.

That's why the family of Khazerya Ziyayetdinova, a 70-year-old woman suffering from severe bedsores, brought cash every time they visited her at Hospital 67 in Moscow. To have Ziyayetdinova recover in a room instead of the hallway, relatives slipped an orderly $300. They paid nurses $20 to give injections, change bedpans and unclog catheters. Every chat with Ziyayetdinova's doctor cost $40.

"Our healthcare system is still in the Middle Ages," said Vera Pavlova, Ziyayetdinova's daughter-in-law, sitting in her home in this small town 54 miles southwest of Moscow. "There's low professionalism, corruption -- it makes me very worried about finding myself in a situation where I might need medical treatment."

Russia is an unhealthy nation and its healthcare system is just as sick. Its hospitals are understaffed, poorly equipped and rife with corruption.

The biggest reason Russia's population shrinks at a rate of 700,000 people each year is not that its birth rate is so low, but that its death rate is so high. The average life expectancy for Russian men is 59. In the U.S., it's 75; in Japan, 79.

Alcohol and smoking are major culprits. Both are linked to heart disease, and in Russia, men between the ages of 30 and 59 die from heart disease at a rate five times that of the U.S., according to researchers at Columbia University.

Prevention and better healthcare can help reverse that trend. The Russian government is pumping $6.4 billion into revamping healthcare. Much of that money is for the construction of eight high-tech medical centers across the country, new X-ray machines, electrocardiograms and ambulances at hospitals, and raises for family doctors.

Even something as fundamental as keeping pharmacies stocked with prescription drugs can prove problematic for Russia's beleaguered healthcare system. A bureaucratic breakdown in late 2006 led to a severe shortage in government-supplied prescription medications.

Russians with enough money were able to buy medicine privately. But hundreds of thousands of Russians with high blood pressure, diabetes, asthma and other conditions couldn't afford to buy the drugs, and had to do without for weeks.

Russian officials have promised that the bureaucratic problems that led to the drug shortage won't happen again. Researchers at the Russian Academy of Sciences' Open Health Institute estimate that as much as 35% of money spent on healthcare goes to corruption. Low wages perpetuate the problem; doctors' annual salaries average $5,160 to $6,120. Nurses make an average of $2,760 to $3,780 annually.

Pavlova, Ziyayetdinova's daughter-in-law, estimates that the family shelled out nearly $5,000 in bribes during the time she was hospitalized.

At a skin clinic in Moscow, nurses charged $20 each time they applied ointment to Ziyayetdinova's bedsores. One of her sons began sweeping up her ward during visits because a nurse said room cleanup was the responsibility of patients or their families -- not hospital staff.

When Ziyayetdinova died, doctors said it was from a heart deficiency. But Pavlova and Ziyayetdinova's sons are convinced that the indifference and neglect she endured during her hospitalization, despite the money they paid, contributed to her death.

"It was as if their goal wasn't to save someone's life," Pavlova said, "as if they thought their role was to be a last stage before death. To be a place that prepares a person to die." 

Copyright © Global Action on Aging
Terms of Use  |  Privacy Policy  |  Contact Us