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How Russia's regions organize healthcare for residents of faraway settlements

June 21, 11:36 UTC+3 MOSCOW
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© Vitaliy Nevar/TASS

MOSCOW, June 21. /TASS/. /TASS/. Residential areas hundreds kilometers from each other, no modern hospitals and a shortage of medical specialists - those are healthcare problems in Russia's northern territories. During the recent televised question and answer session, a young woman from Apatity (Murmansk region) Darya Starikova told President Putin about the lack of hospitals in the city, where people have to go to a neighboring city to see doctors.

Such problems are not exceptional for the northern territories. Diseases are growing in the lack of medical care. The Russian Healthcare Ministry monitored all the 876 settlements in the Arctic zone, and in 28 of them modern medical infrastructures will appear soon. TASS writes about what else could improve the situation in those areas.

Asking president for help

The woman, who called the president, suffers cancer, but for a long time before this diagnosis she received treatment from skeleton disorders, as there are no medical specialists in the city. In order

to have thorough examination, the woman had to travel for five hours to Murmansk, where cancer in the fourth stage was diagnosed finally.

The region's Governor Marina Kovtun confirmed the problem with shortage of doctors, saying the reason is that doctors there are paid only by medical insurance companies depending on the number of patients they serve. Two regional hospitals were merged a few years earlier.

In a response to a question about whether a hospital may appear in Appatity, the governor said the key problem is not in the building, but in having doctors of specific practices there. "The question today is in the people, who will work there, and the second issue is that today medicine - after the federal reform - is based on financing, which depends on the number of served patients. The payments to the medical insurance fund depend on the number of patients who come to hospitals. Having different doctors and then giving high wages to them - is a problem, which cannot be solved," the governor said.

A federal-level problem

In spring 2017, federal level officials "analyzed all the 876 settlements in the Arctic zone, and saw that medical infrastructures were lacking in 28 settlements," Russia's Healthcare Minister Veronika Skvortsova said. "This infrastructure would be ready within next 18-24 months."

TASS learned at the State Duma that people living in Arkhangelsk region's Solvychegodsk had addressed office of the lower house's deputy speaker, Olga Yepifantseva, as they could not agree with the local authorities which had decided to close down the therapy department of the local hospital thus optimizing the local medicine.

The people feared that re-organization would mean they would not have accessible medical assistance, though more than 5,500 people live in the town.

"As for medical services in the Arctic zone, the biggest problem there is the low population density," the deputy speaker told TASS. "The distances there are huge, and even initial medical assistance is not available everywhere."

"According to the information I have received from the regional healthcare ministry, over ten years, in Arkhangelsk region only, the number of initial medical assistance facilities reduced from 117 to 70, the number of patients at hospitals reduced by 4,465," she said.

"The disappointing result is that the morbidity level there grew over that time by 17.2%."

Heritage of the 1990s

Another problem of healthcare in the Arctic is the outdated infrastructure, experts say. Any improvements would be money-and time-consuming.

"The medical infrastructures are outdated and should be either reconstructed or built afresh. Most hospitals, especially in the districts, were built as wooden pavilions. Many of them do not have modern water supply and disposal systems. Only a few departments, even in the leading hospitals there, have modern ventilation or conditioning, thus making inefficient prevention of the hospital infections," Sergei Emmanuilov of Arkhangelsk's legislation said.

Another expert, a legislator from the Krasnoyarsk territory, Vera Oskina, said the problems of outdated medical infrastructures are old.

"We practically have not faced problems of medicine for two decades, and this is true not only about the northern areas. We have hospitals, which were built in the middle of last century. Certain progress began with implementation of the national Healthcare project, but medical technologies are developing and additional financing is required for the modernization," she said.

New construction sites

The local healthcare ministries report big construction, which will improve the situation. In the northern Krasnoyarsk territory, in Norilsk, a big perinatal center for 110 patients is under construction. Every year, it will serve up to 3,000 women from Taimyr and Norilsk. The investments are 3.3 billion rubles ($58 million), where 2.4 billion ($42 million) come from the regional budget and the rest - from the federal fund of medical insurance.

The construction began in 2015, but as yet it is behind the schedule. In October, 2016, the regional government reported poor-quality cement at the construction, and the work stopped. Besides, there were problems with contractors. In the long run, the federal authorities undertook control over the construction, and the regional construction authority told TASS the center would be ready before 2017 ends. A similar center is under construction in the Arkhangelsk region. It will serve 130 patients at a time, the construction cost is more than 2.5 billion rubles ($43 million). "In early 2017, we changed the contractor," the local healthcare ministry said. "An eight-storey building is ready now, and the heating and water systems are about to be ready."

"We plan to put it operational late this year," the ministry added.

The Nents Autonomous District reports too many facilities of initial medical assistance there, but despite the excessive number the authorities do not plan closing down any of them. "Besides, we plan to repair 18 facilities in villages, as most of them were built in 1950-80," the regional administration told TASS, adding they have plans to build a tuberculosis early treatment center and an infections department at the regional hospital.

The Murmansk region plans opening a new clinic in Kirovsk, an admission unit at the Murmansk hospital for children, and plans finishing renovation of the radiology department at the city's oncology early treatment center, and a children's clinic in Monchegorsk.

Sanitary aviation and remote medicine

Experts say sanitary aviation and telemedicine should be helpful in the distanced Arctic areas. "Along with construction and renovation of medical facilities in the north, it is necessary to develop the telemedicine infrastructures for offering consultations," the

Krasnoyarsk territory's legislator said. This position was shared by the legislator from the Arkhangelsk region, who said "the primary task is to develop sanitary aviation and to make sure all hospital departments have modern means of communication."

Russian regions have been working in this direction. The Russian Healthcare Ministry called the Nenets Autonomous District the best in the North-Western Federal District and among ten leaders in the country. More than 1,000 consultations via telemedicine channels are offered annually, and every third consultation is given to people living in faraway settlements.

Krasnoyarsk's authorities will allocate from the local budget to 2019 for development of sanitary aviation 1.7 billion rubles ($30 million), and another 500 million ($9 million) will come from the federal budget. The money will be used for two helicopter pads at Krasnoyarsk's two ski resorts.

Development of sanitary aviation is a priority for the Arkhangelsk region, which has been working actively on the federal project on emergency medical services for people living in faraway areas.

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