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

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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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Let The World Move on, After Adding COVID 19 to List of Diseases

COVID 19 is the latest addition to rest of diseases in the world

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COVID 19
Today, it would look odd, if anyone would say that the world has over reacted to COVID 19 and sacrificed it’s social and economic interests. Pixabay

By N.S.Venkataraman

From historical times, human beings have been surviving,  inspite of  several types of diseases  confronting them.  In such conditions, medical science to safeguard  human beings from diseases have been developed due to the compelling need for survival of humanity.

Traditional medicines :

In ancient India, there were reports of several medicinal practices and development of  several types of drugs for treatment of different types of illness , which were mostly based on natural products  and not developed by synthetic process. Traditionally, such Indian medical practices have been termed as Ayurveda, Siddha etc.

In other countries too, such traditional medical practices have prevailed under various names such as homeopathy , Unani etc.

In short, the world have been living with diseases from time immemorial and has been responding to the diseases by developing appropriate medical procedures from time to time.

COVID 19
While the panicked world is still viewing COVID 19 with great fear and medical researchers are striving hard to develop treatment procedures. Pixabay

Development of new diseases :

With the changing life style of people, development of synthetic production processes for  cosmetics , chemicals,  fertilisers, pesticides,  etc. and  environmental hazards created by industrial operations and transportation, promotion of new food items etc. newer diseases have also  been steadily arising.

Efforts of medical researchers :

The medical researchers have not lagged behind and have been developing new drugs and vaccines to treat the new and emerging diseases.

Some of the synthetic drugs developed for treatment of diseases were also reported to have side effects , which cause more diseases and sickness .

Regulatory authorities have been from, time to time, imposing ban on some of these drugs, due to unacceptable side effects,  though the damage due to such banned drugs would have already happened.

COVID 19  latest addition :

 COVID 19 is the latest addition to rest of diseases in the world.

Huge international efforts have now been taken up to identify the root cause of COVID 19 and develop appropriate drug / vaccine to treat the disease.

Given the past success ratings of medical researchers in handling other diseases, one can be hopeful that before long,  appropriate drug / vaccine would also be developed to treat COVID 19 patients.

Limitations of medical research :

While the medical research have developed phenomenally , the medical research have not been able to prevent the occurrence of the disease , except in a few cases. Of course, in the case of  polio attack, vaccines given to the children at the right time have largely eliminated the polio disease in the world.

However, this cannot be said about several of diseases such as cancer, influenza etc. which continue to occur at very high level and are being treated.

Similar situation may prevail in  future in the case of COVID 19 too, with medical researchers unable to prevent it but only treat it.

Alarm due to COVID 19 :

In the case of COVID 19,  the world has reacted with huge alarm , as if the COVID 19  would wipe out the entire human race.

Several world governments have declared lockdown and brought the global economy nearly to a half , like of which it has never happened before in human history.

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While the panicked world is still viewing COVID 19 with great fear and medical researchers are striving hard to develop treatment procedures, certainly the day will come when the world would reconcile itself to the prevalence of COVID 19 , just as it has reconciled itself to the prevalence of diseases like cancer, flu etc. and would also be prepared to treat the disease with appropriate procedures.

Is there over reaction to COVID 19 crisis ?:

Possibly, after six months or so from now,  when COVID 19 crisis would settle down, the world community would look back at the COVID 19 crisis and would wonder whether the world has over reacted to the COVID 19.

The world would calculate the number of people infected by COVID 19, recovered and died. Then, after reading this calculations, the world would inevitably come to the conclusion that it has not been as bad at all  as it was feared at one time, as the world community would remain intact after COVID-19 crisis.

It is estimated that around 0.15 million people die in the world every day due to various reasons such as old age, cancer, heart attack, kidney failure, virus attack  etc. It translates to around 54 million people die in the world every year.

Till date, around 0.25 million people have died due to COVID-19 over the last four or five months.

Probably, when the COVID-19 crisis would end one day , the number of deaths due to COVID-19 could be just less than 1 million, considering worst scenario.

COVID 19
Probably, when the COVID 19 crisis would end one day , the number of deaths due to COVID 19 could be just less than 1 million, considering worst scenario. Pixabay

In future, after the end of present COVID-19 crisis  such scale of deaths due to COVID-19 are unlikely, in view of the development of appropriate drugs to treat it.

This projected death figure of just less than one million due to the on going COVID19 crisis, do not add much to the worldwide  death of 54 million every year in normal times.

Lives vis a vis livelihood debate :

Of course, death is natural and inevitable. It occurs for people in various age groups and due to natural / disease factors  and unnatural factors such as accidents, murders, war etc.   Every individual  has to reconcile oneself to the inevitable event of death that would happen one day for everybody.

In such circumstances, is it appropriate that the world economy should have been brought down to the level of stagnant or decelerating growth over several months in the year 2020, fearing COVID-19.

Due to such near global lockdown, billions of poor people have been put to hardships , large number of people have lost the jobs, many production centres are facing  closure and appears that it would take some time for the world to recover from this losses due to lockdown , fearing COVID 19.

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How future days would view COVID 19 crisis ?

Today, it would look odd,  if anyone would say that the world has over reacted to COVID 19 and sacrificed it’s social and economic interests.

As the days go by, perhaps, in the beginning of 2021  the world would realize that after all, it could have  been a case of over reaction by the world community with regard to COVID 19 crisis.

In future, the world would add COVID 19 to the list of diseases prevailing in the world , treatment procedures would be evolved and some people would succumb and some people would recover.

World will move on,  just as it has been moving on even as it is confronted with diseases like cancer, flu, kidney failure , heart ailment etc.

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What Should be Your “Priority” in Lockdown 3.0?

Fixing medical priorities in lockdown 3.0

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Indian lockdown coronavirus
We have entered the third phase of nationwide lockdown to contain the COVID-19 pandemic. Pixabay

BY DODUL MONDAL

So, we have entered the third phase of nationwide lockdown to contain the COVID-19 pandemic. The initial turbulence has now settled down to a great extent in terms of peoples’ acceptance and willingness to follow this lockdown. Apart from a few stray incidences of rule violations, India has been doing much better than many other countries in the world, better than many first world countries.

The rate of increase in active cases is also not very high and we have been hopeful to see a flattening of the curve in the near future. There is a steady increase in the total number of positive cases and death albeit at a slow pace. The time for doubling of cases is 11 days, and it is expected to increase further. Some places are having active spread of the infection and containment zones have been created based on the number of positive cases in that area.

The lockdown has been extended for another two weeks, and it is likely that it may last till May end. The new guidelines have relaxed the activities allowed in three zones — red, orange and green. Let us discuss from a different perspective and share my views. What should be the “priority” in this lockdown 3.0!

Indian lockdown coronavirus
The initial turbulence has now settled down to a great extent in terms of peoples’ acceptance and willingness to follow this lockdown. Pixabay

1. Resuming Non-COVID healthcare for acute illness: Although every health facility is trying their level best to provide adequate emergency care, it may not be equal to pre-lockdown state. I am concerned about thousands of patients with stroke, heart attack, acute surgical conditions, acute metabolic illness and many other emergency health problems! It is a growing perception among the medical fraternity that non-Covid healthcare is not getting adequate priority at this moment.

2. Resuming Non-COVID healthcare for chronic disease: As a cancer specialist, I can see the difference of care being received by cancer patients across the country compared to pre-lockdown time. Cancer patients require different types of treatments including surgery, radiation, chemotherapy, immunotherapy etc. Also, the treatment should start and finish in a timely manner to provide adequate benefit of treatment. I fear to see many premature deaths in cancer patients in the coming days whose cancer will progress to advanced stage or end stage in the absence of a timely treatment.

The same is true for other life threatening chronic illnesses like renal failure where patients survive depending on regular dialysis! People with hypertension or diabetes also need proper care to avoid untimely death due to sudden heart attack or stroke or renal failure or metabolic complications in the absence of regular supervised treatment.

Worldwide, 5.5 million kids under five years of age die because of malnutrition. This number can increase to a great extent after this pandemic is over. They also need priority to have access to food not only after lifting the lockdown, but also during this phase.

These patients also have the right to survive and this is just the tip of the iceberg!

3. Resuming treatment and prevention of communicable disease: In 2018, more than 1,40,000 people died of measles; in 2017, 13 lakh people died from tuberculosis (data source WHO website). Measles is a preventable disease with vaccination. Among tuberculosis patients, many are MDR or XDR who require intense monitored treatment. Many other deadly infectious diseases are preventable by vaccination only. Routine immunization, including that of pulse polio, is heavily hit due to lockdown. It is now important to safeguard millions of newborn kids and other people by resuming vaccination, providing treatments (like DOTS in tuberculosis patients or anti-retroviral treatment in HIV/AIDS patients) at the right time in the right manner. Otherwise, there is always a fear of seeing thousands of deaths from such conditions (many will eventually go unnoticed as not all of these are so rigorously screened or monitored for as in COVID-19).

Indian lockdown coronavirus
Medical emergencies will be of the utmost priorites during Lockdown 3.0. IANS

4. Resuming blood donation services: There is a crisis of blood and blood components. Enough number of blood donations is not possible during this lockdown due to fear of spread of infection. It will be important to resume such activities with priority. The demand for the same will be high after lifting the lockdown.

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5. Resuming industry connected with emergency care: Not only for money, industry and business need to run to serve people in many ways including manufacturing essential items, food, necessary machines for different sectors involved in emergency care and routine livelihood etc. There is already a staggered plan by the government. With time many more sectors will need to function. It is important to lay down the structure of such functions to avoid infection among these groups.

6. Restricted lifting of lockdown: Wuhan in China followed a restricted lifting of lockdown model to prevent further rise of cases. Public transports including rail, airlines should frame and implement physical distancing norms even after this lockdown is over. Meeting at public places, gatherings should be banned for even a longer time till the virus is under control. Necessary public awareness and preparedness campaigns should start beforehand to sensitize people.

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7. Encouraging work from home: This lockdown has proven that at least in few cases, work from home is a reasonably valid option. That will not only reduce the risk of infection but also reduce the load of cars and transport on road and subsequent pollution. Studies show that pollution worsens coronavirus outbreak. Let the world breath.

The world will not look the same after this lockdown is over. It will look good in a few aspects; it will look terrible in others. Priorities should be based on the need of a particular geographic area, their people, their lifestyle etc. However, few things remain basic as always. They have access to food, a roof over their head, clothes for modesty and medical services to save life. And we have to keep our compassion intact. Rest can wait. (IANS)

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ICMR Reports Conducting Over a Million COVID-19 Tests

Over a million tests done: ICMR

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India ICMR COVID-19
The ICMR said that it has conducted over a million RT-PCR tests for novel coronavirus so far. Pixabay

The Indian Council of Medical Research on Sunday said that it has conducted over a million RT-PCR tests for novel coronavirus so far. This is a COVID-19 news.

In a press statement the apex medical research body said, “A total of 10,46,450 samples have been tested as on May 3 till 9 a.m.”

India ICMR COVID-19
“Our figures are being reconciled with ICMR” said the Health Ministry, adding that 124 cases are being assigned to states for contact tracing. Pixabay

There are at least 310 government laboratories and 111 private laboratories in the country, conducting the tests for the diagnosis of novel coronavirus disease, said the ICMR.

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Meanwhile, the Union Ministry of Health and Family welfare on Sunday said that the total number of coronavirus cases stood at 39,980 with 28,046 active cases, 1,301 fatalities and 10,632 recoveries.

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“Our figures are being reconciled with ICMR” said the Health Ministry, adding that 124 cases are being assigned to states for contact tracing. (IANS)