When faced with the dismal prospect of getting treated in Ukraine’s severely underfunded and corrupt health-care system, people often first seek recommendations from friends or others.
When this isn’t an option, doctors say, people take the formal route and visit their local clinic or hospital or simply wait until their symptoms advance so far that they have to call an ambulance.
It’s far from ideal.
“We call it the grapevine because people will refer good doctors to others,” said Dr. Sergei Potashev, a cardiologist in Kyiv who is an assistant professor at the National Medical Academy of Postgraduate Education.
It’s a process that is described as “chaotic and uncontrolled” by Dr. Ihor Pokanevych, Ukraine country manager for the World Health Organization.
In most cases, the treatment routes that patients take often don’t correspondent with the severity of their disease, said Pokanevych.
Because patients usually first visit a secondary specialist, not a general practitioner with a wide array of medical knowledge, they run the risk of receiving improper treatment.
“A person with stomach pains will visit a gastroenterologist who usually won’t provide a full examination and who normally doesn’t know what the patient’s complete medical history is,” said Pokanevych.
The World Health Organization specialist said that 44 percent of patients in Ukraine seek direct specialized care and end up bouncing from one specialist to another.
The place to start, Pokanevych said, is with a family doctor or general practitioner who can act as a guide for comprehensive diagnosis and treatment.
“The health system is focused on treatment at the secondary level, but not on primary care,” said Pokanevych.
Potashev said there are several pilot projects under way in Ukraine that focus on introducing Western family care doctors.
According to Razumkov Center poll findings, Ukrainians on the average spend Hr 185 per hospital visit: Hr 157 on medicine, Hr 10 for travel and Hr 18 on gratuity for medical personnel.
However, there aren’t enough general practitioners and hospitals available to patients close to their homes.
The idea is to build consistency and familiarity with patients so that the primary care giver can decide where to refer a patient, Potashev said.
Government spending on health care is some 3 percent of gross domestic product, but Pokanevych said that primary care funding should be at least doubled.
As it is, patients often must pay for their own supplies and medicines.
According to Razumkov Center poll findings, Ukrainians on the average spend Hr 185 per hospital visit: Hr 157 on medicine, Hr 10 for travel and Hr 18 on gratuity for medical personnel.
Even the most rudimentary supplies like gauze, syringes and potable water have to be bought by the patient because the hospitals do not have the funding to provide them.
Costs rise exponentially for serious illnesses like chemotherapy treatment or invasive surgeries.
“Patients almost exclusively rely on their financial resources,” said Petro Holovetsky, a neurologist in Ivano-Frankivsk. “Most people aren’t covered by insurance, and the ones who are, often aren’t fully covered.”
And for an impoverished nation such as Ukraine where the yearly gross domestic product per capita is $3,610, the prospect of covering medical costs for chronic or life threatening illnesses can be daunting.
Potashev added that only 5-10 percent of the population can afford to visit private clinics where care is better.
However, doctors said there are specialized clinical and diagnostic centers within national research institutes of the Ministry of Health and the National Medical Academy of Medical Sciences that are up to date and can treat complicated illnesses. Potashev said they cooperate with leading medical practitioners in their fields and can provide quality care.
Tragically though, Pokanevych said patients in Ukraine often aren’t diagnosed on time so the survival rate for cancer, for example, is low.
“Unfortunately, people don’t regular go for medical checkups,” said cardiologist Potashev.
Why? Razumkov Center findings show that 40 percent of Ukrainians avoid regular check-ups and follow-ups because they don’t have enough money to cover treatment, the cost of paying off the doctor and buying needed medical supplies.
Kyiv Post staff writer Mark Rachkevych can be reached at [email protected].
