Doctors Fight Losing Battle For Life In Russia
Illawarra Mercury
Wednesday February 4, 1998
PITKYARANTA.- There are few places in the world that offer a sharper contrast than the border between Finland and Russia.
True, the natural landscape is mostly the same: a sea of fir and birch set in an archipelago of lakes, blue-green in summer, ice white in winter. It is a place of great natural beauty.
The human contrast, however, can best be expressed in black and white, and is not a thing of beauty.
Step across the border from Finland and, if you are a man, your average life expectancy drops by 14 years, from 72 to 58.
Step across the border and, if you are a woman, your prospects of a healthy pregnancy and trouble-free birth plummet to almost nil. Your life expectancy drops by nine years, from 80 in Finland to 71 in Russia.
Step across the border and you enter a world where well-meaning doctors struggle against losing odds in ill-equipped hospitals; where people eat poorly, smoke and drink heavily and rarely exercise; where disease runs rampant and death occurs almost routinely by accident or violence.
After more than two decades of slow decline, life expectancy in Russia plummeted in the first half of the 1990s: a drop so swift, so steep, that the Lancet, a respected British medical journal, said it was "without parallel in the modern era."
For the past five years, a group of Finnish public health experts has been working with Russian doctors in Pitkyaranta, trying desperately to reverse a public health disaster.
The Finns have valuable experience to offer. Twenty-five years ago, Finland had the world's highest rate of cardiovascular disease.
A mammoth public education campaign, which began in Finnish Karelia, just over the border from Russia, has been a huge success in getting Finns to adopt healthier habits. Between 1970 and 1990, the overall mortality rate in Finnish Karelia dropped by nearly 40 per cent.
The effort to duplicate that experience in Russia is still in its early stages. So far, what it has mainly demonstrated is that it will be a very difficult task.
"Unlike Finland, where they got very good results, we haven't yet gotten good results," concedes Dr Mikhail Uhanov, the head of the local hospital in Pitkyaranta, some 100km from the border with Finland.
"Living conditions in Russia are becoming worse and worse with every passing year. In such conditions, it's very difficult to solve the medical problems."
These are the conditions that Dr Olga Nikitina faces every day when she goes to work in the maternity ward of the Pitkyaranta hospital.
She stands in a dim hallway painted institutional pinkish-brown and smelling strongly of disinfectant. Only one in every four ceiling lights is working. There is no electronic monitoring equipment. Before babies are born, their fetal heartbeats are monitored with a wooden instrument that looks like a plain pine candlestick flared on either end. It is hard to believe the hospital is only 17 years old.
"I cannot tell you anything good about the health of women and children," Dr Nikitina says ruefully. "Maybe it is connected to the problems of the economy and our hard life, and our ecological problems.
"There are very few women - mothers - who are healthy. Even young women who are going to give birth cannot be called healthy. That's why there are very few babies who are healthy. We are worried."
The statistics for health in Pitkyaranta - and for Russia as a whole - are dismal. Even when you include Russian women, whose health habits are better than men's, life expectancy in Russia still ranks lower than any European country, the United States, Canada, the Middle East and most of Asia and Latin America.
© 1998 Illawarra Mercury