KIEV, Ukraine -- One of the countries worst hit by the financial crisis is Ukraine, with its economy shrinking 21% in the first quarter of 2009. At the same time, the government has come to a virtual standstill, as politicians fight among themselves ahead of a presidential election. Amid all the turmoil, the country's healthcare system is suffering.
It is a sunny Saturday morning, and a group of volunteers, most of them foreigners living and working in Kiev, have given up their weekend to renovate a hospital ward.They are washing the walls, painting them, putting in new floors and bathrooms.After that, they plan to get to work on the operating theatre."We're doing a complete refurb on theatre one," says Dave Young, one of the volunteers."New flooring, new electrics, and new doors to make it sanitary and to make sure they can carry on giving decent levels of service."Mr Young runs a construction company in Ukraine. But, thanks to the economic crisis, there is not much work."Construction is near enough extinct in Ukraine at the moment," he says cheerfully. "It's heavily hibernating."But instead of laying off his workforce, he has decided to put them - and himself - to good use."We have crews who are keen to keep working, so we thought: 'Why not get some good out of them and get something worthwhile completed?'"The volunteers are paying for everything, including materials and labour. It is a good news story. Until you hear the bad news.'Condemned to death'Professor Yuri Orlov, the doctor in charge of this children's ward and Ukraine's most senior paediatric neurosurgeon, said his budget for medicines this year is one quarter of what it was last year. And there is worse."We've got nothing, not a kopek, not a dollar, not a pfennig - nothing for new equipment, for upkeep, or for buying the most elementary necessities," he said.And it certainly shows. The main bathroom on the ward is absolutely filthy.The walls are filthy, the toilet has an open cistern covered in mould, and by the door, there is a cardboard box lying on the floor for rubbish - an open dustbin with discarded rubber gloves, used syringes, dirty tissues and other bits of medical equipment.Marco Zecchinato, who deals with young cancer patients for an Italian medical charity, Soleterre, took a break from scrubbing one of the walls to give me the wider picture."In paediatric oncology, we have a rate of mortality that is double what it is in Europe or the US," he said."These children, just because they were born on the wrong side of Europe, 40% are surviving, 60% are condemned to death."He confirmed Professor Orlov's picture of an already underfunded healthcare system, squeezed further by Ukraine's economic woes.Expensive medicinesSince summer 2008, demand for Ukraine's main export, steel, has dropped dramatically.The national currency, the hryvnia, has lost more than a third of its value against the dollar.This is causing problems not only for the government, which is not getting the revenues it expected.It also directly affects individual patients.Because while, on paper, Ukraine has a system of universal free healthcare, in practice, you have to pay for almost every aspect of medical treatment, including supplying your own bandages, syringes and other medication.And imported medicines have effectively doubled in price - not because the pharmaceutical companies have put their prices up, but because people's salaries are worth half what they used to be in foreign currency terms.Defenders of the government point out that the situation in Ukraine is not unique."Health services across the world are to some extent underfunded," says Andrei Musienko, a former deputy health minister, now the director of one of Kiev's main hospitals."In our country the situation is the same. And of course at a time of economic crisis, medicine suffers along with all other social services."'Trying to survive'Back on the children's ward, nine-month-old Nastya is waiting for her operation.Her mother, Tanya, had to borrow money travel to the capital from their village in central Ukraine. Now she has nothing left to pay for things like blood transfusions or extra medicines.If there are complications, she says, she does not know what she is going to do.Professor Orlov says that the hospital does everything it can to help people like Tanya - that somehow they will get by.But he believes that for the government, healthcare simply is not a priority."The ministry of health is aware of the situation. But they are tied to the budget. And the health service in this country is financed according to the following principle - whatever's left over goes on health care.""There are many factors at play here - political instability, massive economic problems. I get the impression that [the government is] just trying to survive, rather than thinking about the future."In the meantime, people like Tanya and Nastya will have to survive only thanks to the charity of others.
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