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Doctor Victor Yatsyk says Ukrainian medicine should make more emphasis on prevention.

While visiting Austria in April, I noticed that all television channels were discussing a new dangerous virus and its threats. Western airports were busy installing temperature detectors to monitor those arriving from the regions affected by an ongoing swine flu epidemic. A pleasant bonus from monitoring the Asian direction was in uncovering a significant contraband of cigarettes.

Ukraine, on the other hand, knew next to nothing of the H1N1 virus that was scaring the world. It thoughtlessly copied the airport measures in Boryspil, and crossed its fingers. No other significant prevention measures were on the agenda. But, as we can see, the epidemic arrived by a completely different route, from the western Ukrainian border.

It’s not that our medical institutions knew nothing about the disease. But their reaction reminds me of an old AIDS joke: Journalists from the capital arrive to a remote village and ask an old grandpa: “Have you got AIDS here?” Grandpa, not wanting to seem dumb and uninformed, said: “We do, but only a little and we keep it to ourselves.”

But it seems that nobody (even in the medical circles) could foresee such a rapid and massive spread of flu. Besides, the flu epidemic started a little earlier in the season than usual. And certainly, nobody expected such menacing manifestations of the disease: at least 80 people have died already this season from pneumonia and various strands of flu, and more than a quarter of a million of these diseases have been registered in the country lately.

So what problems have been uncovered from day one of the disaster?

Preventative measures could have been started ahead of time, in the same manner that many other European countries had done. The death toll may have been much lower. And the bill for the nation would almost certainly be smaller.

Ukraine should not have relied on foreign solutions of the potential problem. Like many other countries, it should have studied the problem by itself to develop a strategy and measures for prevention (possibly a specialized vaccine), as well as effective treatment measures.

Surprisingly, it showed that that the health system is still working, despite the chronic neglect and under-financing. We quickly received information on the disease, its causes, its symptoms, prevention measures and treatment. Many talk shows were devoted to the subject, and when the politicians took a break from speculating on the disease, we could receive valuable information from medical staff in full.

I agree with many doctors who say that quarantine measures on regional levels were justified, as well as countrywide ones, such as preventing contact in large groups such as schools, universities and mass gatherings. The seriousness of the problem is reflected in the high level of involvement on behalf of the leaders of the state.

There are debates about the use of anti-viral drugs and other preventative measures. But despite their dubious nature, the hullabaloo around face masks and certain medications have turned these relatively useful goods into extremely hard to get ones. Even in hospitals finding a face mask has been a difficult task.

There are many lessons to be learned here. Our country is not an isolated exception from global epidemics, and this factor has so far failed to be taken into account at the state level. This calls for creation of a modern anti-epidemic service with a strong material and technical base and staff. It will never do to continue having one employee in the national flu center, and having to send samples to London to determine the strand of flu virus to devise an effective treatment.

But in the last decade-and-a-half, the opposite has been happening. A whole range of new medical and biological universities opened up, mostly concentrating on the pharmaceutical aspect of disease treatment. But the simple ancient truth is that it’s easier and more effective to prevent the problem than cure it in the end.

There is a shift in the perception of vaccination and the related research is no longer there. But economizing on these sort of things is highly questionable from the long-term prospective. It requires preparation and cooperation with laboratories of the neighboring countries for preparation of our own vaccines and prediction of similar epidemics.

An information campaign is needed to explain to the society the need for prevention. This is not just a medical problem, it’s an issue of national security in the globalized world: When an epidemic hits, it’s often impossible to just put it out like a blazing fire.


Victor Yatsyk is a neurosurgeon and deputy head of the chief doctor at the Institute of Neurosurgery of the National Academy of Medical Sciences of Ukraine.