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Healthcare is not a priority for Abkhazian "politicians"
09/07/2010 12:08
Experts' club

About two weeks ago the issue of the healthcare system in the occupied territory was discussed in the parliament of the separatist Abkhazia. Head of department Zurab Marshania was called to answer questions and he told members of the "parliament" about deplorable situation in this area.

According to the Abkhazian press, no one anticipated anything special, as they were there to just listen to statistical information submitted by Marshania. Parliamentarians knew well that Marshania would not describe the real situation to avoid, God forbid, "pleasing the enemy," and would paint a happier picture than the real situation, without saying anything unnecessary. No one was especially interested in the situation in this area, except for some "parliamentarians". Moreover, some member of the "Parliament" even yawned and got ready to sleep - probably healthcare did not evoke special interest in "political figures". But in the end "MP" Batal Kobakhia could not bear it and unwittingly revealed a very interesting "secret". It turnes out there is just one neurosurgeon in the whole Abkhazia and he is priest Svirukhov". Is this normal when we have to distract him from conduction of religious service and to carry out an urgent operation? "- Asked Kobakhia.

Zurab Marshania began his speech with statistics and showered legislators with figures. According to him, it turns out that there are just some 600 physicians in the whole of Abkhazia which only covers 60% of needs. According to him, the situation is saved by the fact that almost half of them - 228 people - combine more than one specialty. (Imagine that traumatologist cures your vision, and ophthalmologist does the same with your radiculitis). There are other problems regarding healthcare in the rural areas. These are under-equipped village medical centres and obstetric units that are just 13 and 61 respectively in the entire region. The increase in their number (as in 2009 there were only 45 of them) did not lead to a sharp increase in visits paid to them as the best doctors can do is to measure pressure, temperature and use phonendoscope.

According to Marshania, number of cancer cases had increased and this is associated with the work being done to identify the illness. detection increased from 17-18% to 40%. In 2009, there were 665 people registered (against 406 in 2006) as sufferers of this illness and 454 were being treated in hospital. To fight TB there is a joint program with the international organization "Doctors without Borders". 100 out of 150 beds in the clinic are occupied while doctors also see those affected by the illness in out-patient reception areas.


With regards to neurological and cardiac patients minister said briefly that number of both types of patients are on the increase but the mortality rate decreases. Number of HIV-infected men and women became equal in recent years and sexual transmission has precedence over medical one. In 2009 117 new HIV cases were identified and 3.5 thousand people received treatment at the Center for AIDS (Nuzhnaya newspaper, № 23, 22.06.2006)


It should be noted that situation is really difficult in this sphere in Abkhazia. Besides the fact that there are not enough specialists, there are no people who could or would be willing to learn the profession. Doctors in Abkhazia somehow manage to cope with less serious illnesses, but as for serious illnesses residents of Abkhazia have to travel for treatment to Tbilisi or Russia. Given the fact that treatment in Russia costs them a fortune they prefer to be treated by Georgian doctors. We also note that cooperation between Georgian and Abkhazian doctors did not stop even for a moment during years after the 1992-1993 conflict.


According to our information, most recently one of the Russian firms brought French medical equipment for two resorts in Abkhazia. The equipment was modern, and therefore, it was necessary to find local professionals (minimum 60 people) and train them. Surprisingly, only two women throughout Abkhazia – ethnic Armenian and Georgian - appeared to be interested in training. The only Abkhazian who expressed his wish to work volunteered to be a driver. With this regard, the company had to remove equipment and take it to Sochi.

In this light, it would be appropriate to recall past and compare the current situation in the medical field in Abkhazia to that before the war. According to the Department of Statistics of Georgia, in 1991 in Abkhazia there were:

Physicians of all specialties - 2121
Nurses - 6033
Number of hospitals - 46
Number of hospital beds – 6400
Centers for out-patient care - 130


On average, per 1000 people there are:
Doctors - 40,6
Nurses - 117,5
Hospital beds - 122

Georgian Medical School and, in particular, medical centers of the republic made a great contribution to preparation of Abkhazian doctors. According to the 1950 data, healthcare system of Abkhazia employed about 10 doctors and several dozen nurses of Abkhazian origin. In the early 80-ies there were already about 100 doctors and more than 300 nursing staff of Abkhaz nationality in the Autonomous Republic.

It should be noted that the first pharmacy was opened in Sukhumi on the initiative of Kutaisi pharmacists in 1863. By 1990, there were 45 pharmacies and 111 pharmacy centres in Abkhazia.

Unfortunately, one cannot always avoid terrible truth. It consists in the fact that after the armed conflict in Abkhazia 1992 - 1993 Georgian doctors have become the main target for the separatists. The history of world wars does not know such barbarity with which Abkhazian armed gangs massacred people of most humane profession. Doctors have been punished for treating Georgian (and not only) troops. On September 27th, 1993 - the day of the fall of Sukhumi – armed Abkhazians brought out of the surgical unit and shot with automatic weapons director of the Lenin sanatorium of tuberculosis of Gulripsh, well-known public figure and doctor of medical science, Professor Shota Jgamadze. And they did it in front of family members. Famous gynecologist and chief physician of the maternity hospital of Sukhumi Kolbaia was shot together with his wife in his own house. The same happened to doctor Danelia and well- known balneologist in Gagra Baramia who was killed along with family members. Separatists killed the outstanding healthcare worker of the Abkhazian ministry of health Bidzina Mgaloblishvili with terrible brutality. About 60 healthcare workers were killed during the war in Abkhazia.


The above demonstrates what Abkhaz separatists got as a result of shooting and expelling of brilliant figures of Abkhazia in their pursuit of virtual independence. And it was the Georgian health workers of Abkhazia that were Georgia's medical elite. It is enough to remember famous neurosurgeon Napoleon Meskhia, who made an enormous contribution to provision of medical care to population of Abkhazia, including Abkhazians. Even after the end of hostilities in Abkhazia, he continued to perform complicated operations to all who needed his help there, on the other side of the Enguri River. Thus, Napoleon Meskhia saved dozens of lives of Abkhazian children. It is clear that today it is not a problem for the separatist leaders to send members of their family to be treated in Russia and in expensive hospitals. But for them it was never difficult that is why it was so easy for them to chop off this branch that Abkhazian public relied on. And in the end today in Abkhazia they do not have highly qualified doctors who can treat local population.


With this in mind it is not surprising that the staff shortage in this area is taking dangerous proportions. If this continues to be so, doctors will have to be transferred from Russia, which, in principle, is part of the policy pursued by the Kremlin on the occupied territory. We have repeatedly written that development of business, economy and other fields will require new professional staff that is absent among Abkhazians and it is unlikely that they appear in the near future. Therefore, resettlement of Russian specialists is inevitable and will happen sooner or later. Given the deployment of several thousand Russian troops there we can safely say that the Russian plan of annexation of the territory of Georgia is put in motion.

In the future the club of Experts will continue to pay particular attention to how much will be spent in Abkhazia on healthcare from the allocated billions of Russia and how this will be done. We believe that not very much will change, as Moscow has its imperial designs in connection with those billions, and it does not care whether or not population of occupied territories would get healthcare – this vital area - revived. And for the puppets who found themselves in the higher echelons of power, the main thing is not to bother themselves much with calls to fight against corruption and at the same time, taking into account errors of Kokoity, develop mechanisms for mastering Moscow allocated funds without "noise and dust". Of course, the opposition that remained on the sidelines tried to remind about themselves from time to time in order to raise their image in the eyes of people and within the boundaries of permissible from the top. But this cannot, of course, change the current situation. Therefore, while pragmatically part of the society in Abkhazia prefers to be silent and in the shadows, the puppet regime of Bagapsh and the Kremlin- controlled opposition will do anything to not offend their masters and fulfill directives of Moscow as closely as possible. Of course, at that to not forget about themselves and to improve their financial situation. The regime limits itself with calls to fight corruption while the opposition is just engaged in general criticism of the authorities. Together, they are trying their best to prevent the process of becoming closer between residents of Abkhazia with the rest of Georgia, which is also a part of the plans of the Kremlin. It is Russian border guards that create obstacles for those seriously ill requiring urgent medical intervention, and do not let them over the Enguri into the Georgian-controlled territory. Such cases are multitude. Therefore, most residents of Abkhazia have no choice but to be content with the current catastrophic situation and unprofessional service which is almost tantamount to death.
 


 
 
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