Gennady Vinogradov was born in the small village of Sheshurino, northwest of Moscow. News that the authorities will be closing the village's only clinic has driven him and his neighbors to a breaking point.
"If they close this clinic, it will be a catastrophe. We pay our (compulsory) insurance fees and have a right to healthcare," the 76-year-old said, surrounded by two dozen of his neighbors. It seems as if the government "wants to kill us," he said.
AdvertisementWhile the consequences of Russia's economic downturn are less visible in the capital, remote rural communities like Sheshurino have been left to fend for themselves as the remnants of state support disappear.
Experts say recent attempts to reform Russia's healthcare system with a reduced budget have led death rates to rise from 13.5 per 1,000 in the first quarter of 2014 to 14 this year.
President Vladimir Putin last month ordered his government to take immediate measures against the "significant rise in mortality."
In Sheshurino, residents had just one request for Putin: to keep their clinic open and pay a local health worker to treat residents. The clinic has been demoted to a convalescent home for elderly patients but it remains the only place where locals can get medical care, whether for chronic conditions or emergencies.
Its head, Galina Lebedeva, gets no money to treat them and does so at her own risk. "People come to me for help and I help them even though I'm not supposed to," the energetic 41-year-old said.
"My boss calls me Mother Teresa," she said, referring to the Albanian-born nun, whose work among the poorest of the poor in the Indian city of Kolkata earned her the sobriquet "Saint of the Gutters."
Lebedeva was recently told "there is no more money" to keep her and her staff of 15, including nurses and care assistants, working in the village. She expects the facility to close by the end of this year. That means a loss of income for 15 families depending on salaries ranging from under $100 to $200 a month.
Sheshurino, which lies 400 kilometers (250 miles) northwest of Moscow, is quintessential Russia with its scattering of log houses along the edge of a picturesque lake looking much like it did in the tsarist era.
Alexei Kuropatkin, a local son and Russia's war minister under the last Tsar Nicholas II, built the clinic in 1908. The facility survived wars, the 1917 Revolution and the collapse of Communism.
Russia has 83,000 villages with less than 100 residents, making it difficult to retain doctors there, said Veronika Skvortsova, Health Minister, in June.
Instead, people could use Skype to consult health professionals, she said. Such a suggestion brings nothing but anger in Sheshurino, where promises to install a fiber-optic cable seem far-fetched.
"We don't have cell phone coverage here and landline phones only work every couple of days if the weather is good," Vinogradov fumed. The nearest hospital is at least two hours away by car, and when a local resident suffered a stroke recently, the ambulance took five hours to come. The only bus runs twice a week, while a taxi to the hospital costs more than $50.
In a Bloomberg ranking of healthcare based on life expectancy and costs, Russia was put in last place in a list of 51 countries. It spends 3.7 percent of the GDP on healthcare, and that budget is set to shrink during recession.
There have been attempts to make the system efficient, modernize hospitals and reduce in-patient treatment. But while some urban hospitals benefit from better equipment, poor Russians in the countryside are ending up with no care at all.
The country lost 90,000 health workers last year while medicines became more expensive, Russia's audit chamber said last month. A report by the Committee of Civic Initiatives, a group headed by former finance minister Alexei Kudrin, concluded recently that misguided reforms were the reason for the rise in mortality.
"Small villages have the highest mortality for middle-aged and elderly populations," the report said, with central Russia the worst-hit.
In Sheshurino, people are seeing their already hard lives becoming impossible due to the new policies. "The people who came up with them have never seen rural life, they don't know the reality of how people live, how they struggle to survive," said Lebedeva.