Saturday December 7, 2019

Resignations by Medical Staff Sweeping Russia’s Health Sector

They had wanted to attend a midweek press conference to demonstrate their support for a team of pediatric oncologists who have quit their jobs

Resignations, Medical, Staff
FILE - Protesters carry a banner reading "Together for decent medical care!" as they march in a street in Moscow, Russia, Nov. 30, 2014. VOA

The three Moscow mothers whose children are suffering from cancer were united in two things, their reluctance to allow their names to be published, and their mounting anger at the deterioration in Russia’s public health services, which they say threatens their children’s lives. Resignations.

They had wanted to attend a midweek press conference to demonstrate their support for a team of pediatric oncologists who have quit their jobs at a Moscow clinic, one of Russia’s best cancer hospitals, to protest overcrowded wards, pay cuts and an “optimization reform” doctors say is affecting their ability to treat patients.

However, guards at the Blokhin Cancer Research Center warned the mothers to stay away. The mothers say they fear the consequences of speaking out.

A dozen doctors so far have quit their jobs at the clinic — the latest in a wave of resignations by medical staff sweeping Russia’s health sector. The oncologists quit after posting a three-minute video on YouTube deploring overcrowded wards and reduced funding. They complained that the construction of new buildings had dragged on for two decades, and they painted a grim picture of a health care center falling into disrepair amid mismanagement.

Resignations, Medical, Staff
FILE – Protesters, some in wheelchairs, rally against what they see as failures in Russia’s health care system, in Moscow, Nov. 2, 2014. VOA

“For years, children with cancer have been treated in terrible conditions. There’s no ventilation, mold is eating through the walls, and the wards are overcrowded with sick patients,” the doctors say in the video. Cutbacks in services have meant some families are being turned away.

One of the doctors was fired after the video was posted, the others put in their resignations.

Parents say they support the doctors.

“When we came in June, we were surprised that the procedures had changed,” one of the mothers told VOA. “They said we didn’t need detailed checkups anymore and we were told we could visit the center just once a year. We were sent to our local hospital. The doctor there was honest and said she had seen just one case like ours and never at the fourth stage. She didn’t know the protocols and I had to interpret the analysis. I’m a mom without medical education. Why did these changes happen? I don’t know. I’ve heard there was an order from the Ministry of Health. But I have not found this order published,” she said with rising indignation.

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Maksim Rykov, a deputy director of the center and one of the doctors featured on the video, told VOA the oncologists had little option but to quit.

“There have been many ‘reforms’ which management calls an optimization. But the ministry and management has no clear plan. Their aim is to create a nice picture,” he said. “The problems here relate to a deep financial crisis. Clinics are overloaded. There’s a deficit of hospital beds. Patients feel abandoned,” the 39-year-old doctor said.

He thinks the ministry hadn’t “expected such attention from media,” and he fumes at the efforts made to block parents from talking to the press.

“When any journalists are in the center, guards come and lock the children with their parents in the rooms. They are not allowed to come out and talk to press. Why do they do that with parents and children? Closing them in rooms! It is barbaric,” he says.

Resignations, Medical, Staff
Oncologists Maksim Rykov (R) and Georgy Mentkevich describe the deteriorating conditions at one of Russia’s top cancer clinics (J. Dettmer/VOA) VOA

One reason for the official nervousness may be that Rykov and his colleagues have the backing of the Alliance of Doctors, a medical workers’ union supported by anti-corruption campaigner Aleksei Navalny, who has been helping to organize health care protests in Russia. The Alliance is growing and has branches in 20 regions. The director of the hospital, Ivan Stilidi, has alleged darkly that the oncologists are being “steered” by “forces outside the cancer center.”

Recent demonstrations against Russian President Vladimir Putin have been fueled by rising anger at deteriorating public services, incompetent municipal management and the feeling that Russia is going backward, transforming opposition protests from fringe events attended by a liberal elite into more broad-based expressions of frustration.

Nurses, doctors, ambulance staff and paramedics across Russia have been increasingly voicing their grievances by staging strikes and coordinating resignations. Anastasia Vasilyeva, head of the Alliance of Doctors, says the Russian health care system is broken, and that strikes and industrial action by medical professionals have been spreading across the country, from Siberia to Moscow.

The list of disputes is growing. Among them are the March announcement by doctors at hospitals in the Novgorod region in western Russia that they would only be working the bare minimum of their contractual hours; ambulance staff in Penza, a town southeast of Moscow, protested against wage cuts;  in July paramedics went on strike in Togliatti, east of Moscow; in August there was a mass resignation of nurses in Vladimir, east of Moscow, and all trauma doctors at the main hospital in Pyatigorsk in southern Russia quit.

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Rykov has over the months been informally surveying his patients, and says that 85% would prefer to get treatment abroad but cannot afford it. The reason, he says, doesn’t lie in the success rates at the Blokhin Cancer Research Center, but because of the cutbacks and lack of comfort.

Asked how the confrontation between the Moscow oncologists and the hospital administration will end, Rykov smiles and replies: “It looks like everything in our country depends on one person’s decision. We all know who he is. So it looks like the Ministry of Health is waiting for what he will say.” (VOA)

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Bariatric Surgery Leads To Nutritional Deficiency

Recipients of Bariatric Surgery may develop nutritional deficiency

Weight loss surgery can be a life changer but recipients may suffer from nutritional deficiency. Pixabay


Bariatric surgery can be a life-changer for severely obese teenagers, but the recipients may develop nutritional deficiencies years after treatment that can carry their own health risks if not properly managed, said health experts.

Lifestyle modifications and eating healthy food, along with exercise, might work, they added.

Bariatric surgery refers to a gamut of weight-loss surgeries often recommended to people suffering from chronic obesity and obesity-related health problems such as diabetes, hypertension, high cholesterol level and sleep apnea.

There are many types of bariatric operations, but surgeons commonly use three — Roux-en-Y gastric bypass, vertical sleeve gastrectomy and laparoscopic adjustable gastric banding.

By making changes to the anatomy of the gastrointestinal tract, including the stomach and digestive system, these surgeries help people lose weight by cutting down their food intake, or by reducing the absorption of nutrients, or both.

Weight loss surgery
Lifestyle modifications and eating healthy food, along with exercise is better than a weight loss surgery. Pixabay

However, the side effects of bariatric surgery may include infection, bone demineralisation, anaemia, diarrohea, nutritional shortages, gallstones, hernias, pregnancy complications for women and premature birth of babies.

According to Faizal Mumtaz, Senior Consultant, Department of Minimally Invasive Surgery, at Delhi’s Indraprastha Apollo Hospital, bariatric surgery or metabolic surgery is basically a weight reduction surgery, which has an additional advantage of correcting diabetes.

“It can either be restrictive, or a combination of restrictive and malabsorption. Restrictive bariatric surgery reduces the size of the stomach. This limits the amount of food that can be consumed and creates a feeling of fullness,” Mumtaz told IANS.

“A malabsorptive bariatric surgery limits the number of nutrients the body can absorb, and the patients has be provided supplements (iron, B1, B12, etc),” Mumtaz explained.

“Post-bariatric surgery, it is very important to make lifestyle modifications, eat healthy food and maintain a healthy regime. There’s no particular precaution, but the only thing to keep in mind is a maintaining a health and exercise regime,” Mumtaz added.

In a recent study published in the journal Clinical Gastroenterology and Hepatology, researchers found that Roux-en-Y gastric bypass surgery and vertical sleeve gastrectomy are linked to lower levels of vitamin B12 and iron deficiency.

People with B12 deficiency can not only suffer from anaemia, but can also experience symptoms of depression, irritability, cognitive slowing and forgetfulness. Severe deficiency can sometimes lead to numbness or tingle in extremities, gait problems and partial paralysis.

Post-bariatric surgery, it is very important to make lifestyle modifications, eat healthy food and maintain a healthy regime. Pixabay

“Though it is a common notion that nutrient absorption gradually decreases over the years post bariatric surgery, such procedures are highly beneficial to overweight patients above the age of 50 years,” R.P. Singh, gastroenterologist at Saroj Super Specialty Hospital in New Delhi, told IANS.

He however, added that teenagers must avoid such surgeries.

“Nutrient supplementation helps in providing the essential nutrients, but teenagers undergoing such gastric bypass surgery tend to lose essential nutrient absorption and become susceptible to conditions like anaemia due to lack of iron, copper and essential vitamins like folate and Vitamin B12 over the years,” Singh explained.

He added that iron deficiency causing anaemia is a concern in 5-20 per cent of the patients undergoing gastric bypass surgery as teenagers.

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“Through proper dietary follow-ups and supplements, their levels of micronutrients can be managed,” Singh concluded. (IANS)