The fight against the coronavirus pandemic in Ukraine is entering a new stage. The entire territory of the country is now located in the "red" and "orange" zones, which means that the decree of the Cabinet of Ministers No. 641 comes into force, which actually cuts off some patients from assistance.
From Monday all over the country, it is forbidden to carry out all planned operations, hospitalizations in hospitals. Medical institutions accept only urgent patients, as well as those infected with the coronavirus.
The Ministry of Health is confident that the decision to introduce quarantine measures regarding visits to medical institutions can localize the threat. He is also approved by the presidential party. In particular, Lada Bulakh, a member of the National Health Committee and MP from the Servant of the People faction, considers him justified. According to her, by this decision, officials assumed not a restriction of Ukrainians in their right to health protection and medical care, but a reserve of beds and protection of doctors and nurses to provide medical care to patients with Covid-19.
Ukrainians have already experienced a similar experience this spring and summer in the "red" and "orange" quarantine zones. The promises of the Ministry of Health that all those in need will receive help were broken against the reality where people were simply denied treatment.
"I’ve broken my collarbone, I urgently needed an operation, and what do you think? I was refused," says Oleksandr from Kyiv.
The man notes that he called the ambulance several times and received the same answer: "Wait until the quarantine ends."
As a result, with the help of friends, Oleksandr found a private clinic, where they finally agreed to have an operation. The restrictions did not pass without leaving a trace for Ihor, the man has problems with the knee joints – the cartilage of the knee joint has almost collapsed, prosthetics is necessary:
"I’ve been waiting for my turn for more than three years. I passed all the necessary tests, underwent an expensive examination, and they called me and said that due to the fact that the city was in the "orange" zone, my operation was postponed since it was not an emergency."
New rules and diagnostics
Experts are confident that the actions of the chief sanitary doctor and the Ministry of Health indicate an actual inability to manage the situation and, moreover, ignorance of their official powers and responsibilities. After all, trying to resolve the situation with coronavirus infection, representatives of the Ministry actually forget about the existence of other dangerous and less dangerous diseases that Ukraine has been fighting for more than 20 years. In particular, we are talking about tuberculosis.
"This approach will negatively affect the availability of services for the diagnosis and treatment of tuberculosis patients. The Global STOP TB Partnership and the World Health Organization have recommended that all countries, in the event of repeated quarantine restrictions, put tuberculosis patients on the list of priority groups for the provision of continuous services," Stop tuberculosis. Ukraine" Partnership representatives states
They emphasize that if due to quarantine measures, the medical system does not respond in a timely manner to cases of morbidity, an outbreak of tuberculosis and an increase in mortality due to it will not belong in coming.
"We are already witnessing the negative impact of the first quarantine: a decrease in the number of identified patients by more than 40% during this period."
Cancer patients also found themselves in an equally dangerous situation due to quarantine measures, even though cancer treatment is on the list of priorities. Co-founder of the "Athena. Women Against Cancer" public organization Viktoria Romanyuk is concerned that in 2020 the number of preventive examinations has decreased greatly (as a result, untimely detection):
"This could lead to the fact that after the end of the pandemic, people will go to oncologists in the late stages of the disease because they did not find it in time."
This applies to many other diseases, where early detection and response can save a person from many years of treatment. To get an appointment with a doctor and still receive medical care, a planned patient will now need to either go to the category of urgent ones or quietly and peacefully wait for the end of quarantine measures.
A deplorable situation and directly with the hospitalization of Ukrainians. Many of them may be cut off from treatment.
Treatment of urgent patients
Most likely, in the conditions that the Ministry of Health suggested to Ukrainians, in order to get an appointment with a doctor and still receive medical care, the planned patient will either need to go to the urgent category or quietly and peacefully wait for the end of quarantine measures, hoping that in time his illness will not worsen. According to experts, given the consequences that may occur in the long term, the actions of the Ministry of Health are more like a planned genocide than forced quarantine measures.
But everything is not so simple for urgent patients. The Ministry of Health determined that patients who are not diagnosed with Covid-19 should be admitted to specially designated medical institutions that provide highly specialized care in appropriate conditions - the hospitals of the National Academy of Medical Sciences of Ukraine (NAMS).
These hospitals will accept patients with heart attacks, strokes, and any operations, and the total number of beds and, accordingly, patients to whom they can provide such assistance will be more than 4,000.
A few weeks ago, at one of the briefings, Kyiv mayor Vitaliy Klitschko noted that the capital is still coping with everything on its own, and the medical institutions of the National Academy of Medical Sciences still do not accept patients, "although they have a total of 11,000 beds and qualified personnel."
And sanitary doctor Viktor Lyashko assured that the medical institutions of the National Academy of Medical Sciences decided to treat patients with Covid-19 with concomitant diseases. And by order of the Presidium, the Academy of Medical Sciences even re-profiled 500 additional beds for the capital.
And where, then, are the remaining 6,500 beds of medical institutions of the NAMS, in a kind of "reserve?" Are they really idle? This issue is especially important in the context that maternity hospitals are forced to redesign one after another, endangering their own workers. For example, in Cherkasy, more than 250 workers are afraid of layoffs and losing the maternity hospital, because they do not know when everything will return to its place and whether it will return at all.
Moreover, it is unclear what an abundance of academic beds the head of the Kyiv City State Administration spoke about, if, according to President of the National Academy of Medical Sciences of Ukraine Vitaly Tsymbalyuk, the numbers are far from the ones announced.
"We have more than 4,000 beds in Kyiv and about 7,000 throughout Ukraine (36 institutes)," Tsymbalyuk comments.
Looking for a compromise
On the one hand, we have an insidious Covid-19, in which it is better to communicate at a minimum, stay at home and once again not visit places of accumulation of infections (in this context, the decision of the Ministry of Health does not seem so senseless - by reducing the number of hospitalizations, it will be possible to prevent outbreaks of coronavirus in hospitals), and on the other hand - well-known diseases waiting for their "finest hour."
So is a compromise even possible here? Indeed, not only are we missing other important "scourges of our time" due to the re-profiling of hospitals, but most doctors are also taken for coronavirus treatment, which means that there will be simply no one and nowhere to treat "ordinary" diseases and carry out operations. Yes, a compromise is possible, the recipe is as old as the world - officials must learn to listen to experts in a particular environment.
Can the government's decision be challenged?
A person can defend his rights, file a suit in court, try to compensate for the damage caused, but in view of the fact that the judicial reform has been going on in Ukraine for six years, it will be impossible to get a court decision quickly.
A sick patient has neither the energy, nor the time, nor the money for this. Therefore, it is often easier to give a bribe and ask for hospitalization from a doctor, especially since the Cabinet of Ministers itself, in a resolution regarding quarantine restrictions, created all the conditions for this - the doctor directly decides whether the patient needs surgery and whether he can wait with the operation. This was necessary so that the patient did not complicate the course of his illness, and the doctor, having weighed the risks, could protect himself and the patient from unnecessary body movements during unsafe quarantine times.
But what do we have in fact? Flourishing corruption and inequality in health care delivery. And this is not the worst thing, because those patients who have no money either for a bribe or for legal proceedings can only wait and believe in the best.