Russia: operating at subsistence level

Working twelve hours and driving at night to feed the family: everyday life for many doctors in Russia. Especially in state hospitals, the situation for medical professionals is often very precarious. And the displeasure grows.

Russia doctor Alexey Potapov (private)

In nostalgia, 45-year-old Alexei Potapov does not indulge when he thinks back to his time as a medical doctor. For 14 years he worked as a surgeon in various state hospitals. He usually had a 60-hour week. In the early 2000s he went to the far north of Russia, where doctors’ salaries are higher – 60,000 rubles (about 850 euros) per month, which is quite good for Russia. Seven years later, Alexei returned to his homeland, the Penza region. With the same workload, he received there but only half. His wife also worked as a doctor in the same hospital. But the money was not enough back and forth: “We literally had to fight for survival,” said Alexei.

But then the surgeon remembered his hobby: programming. Parallel to his job in hospital, he completed a distance learning programmer program, which he completed in 2014. For five years, he has been working as a developer for a large IT company in Moscow – for the triple salary. Alexejs wife gave up her job as a physician.

Russia doctor Alexey Potapov (private)Alexei Potapov – from medical doctor to IT developer

During the day in the operating theater, at night in a taxi

Many of Alexej’s former colleagues have switched to private clinics or are now working for pharmaceutical companies. “Those who stayed in the state hospitals drive taxis to earn some money,” he says.

Around ten percent of specialists turn their back on the Russian healthcare system every year. This has created an immense shortage of skilled workers. There are around 25,000 doctors missing in Russia. For example, in the Yamal-Nenets Autonomous Okrug in the far north of Russia, there are 43,000 inhabitants, but only one oncologist. Russia now spends 3.7 percent of its gross domestic product on health. In Germany it is 11.5 percent, in Belgium 10.5 and in the Netherlands 9.9 percent.

Not only experienced doctors, but also young doctors leave the state hospitals. Yelena and Yevgeny Tumasov (names of the ed.) Have completed their studies in Saint Petersburg two years ago. Actually, the young woman wanted to become a sports doctor. While still a student, she worked as a nurse in a municipal clinic.

“As a trainer in the gym I have earned more,” remembers Jelena. In addition, the working conditions in the hospital had been hard: There were hardly any breaks, overtime for it daily. Jelena decided therefore to a training as a stylist. Now she is taking her first steps in an industry that has nothing to do with medicine. Husband Yevgeny, too, returned to the surgeon of medicine after a successful education – after a total of 13 years. 

Russia Medic Elena Tumasova (private)Jelena is now working as a stylist

Health system in crisis

Especially away from the big cities, there are increasing reports that doctors are striking, canceling or writing petitions. In the spring, doctors from three regional hospitals in the Novgorod region protested. In August, all traumatologists of the Vladimir Region Hospital went on strike and in Nizhny Tagil, all surgeons left the city clinic. “People have been overworked for years, and their backups are burning,” says Andrej Konoval of the medical union Dejstvije.

Doctors’ salaries in state institutions should be doubled by 2018 and tripled in some regions. President Putin had already promised this in 2012 in several presidential decrees. But there is nothing happening. According to official Russian statistics, a doctor in Russia earns on average 79,000 rubles (about 1120 euros) per month. But many doctors see this information critically. Because in the calculation of the Russian statistics authority, the salaries of the hospital manager, which are many times higher than that of the normal doctors. According to a survey conducted by medical unions, the actual average salary of a doctor is 42,000 rubles (around 600 euros). Even couriers earn more in Russia.

Nurse becomes cleaner

In order to achieve the goals set by President Putin, the grievances were even aggravated. Physicians would simply be dismissed, nurses declared cleaners, or physicians reduced to lower pay scales. In many cases, according to the medical union, their working hours were simply reduced to paper. Thus, the low salaries of doctors were reconciled with Putin’s decrees and “legalized”. In reality, however, tons of overtime would be done.

Larissa Popovich, a health expert from the Moscow High School of Economics, says that despite the success of governors, a number of regions have managed to build a well-functioning system of normal salaries and working conditions. According to her, Russia lacks a long-term health care strategy. “The ministry acts like a fire brigade: problems are tackled locally instead of finding systematic solutions,” said Popovich.

Nevertheless, many young Russians are still pushing into the country’s medical colleges. Every year, up to 35,000 specialists graduate. But they are not looking for jobs in a state hospital, but prefer to go to private clinics and pharmaceutical companies – or even abroad.

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