16 December 2009

Are Tourists Safe in Russia's Hospitals?

Often it seems that Americans make negative assumptions about life here in Russia.  I don't mind occasional negative comment about St Petersburg... but I do expect the  critic to compare  conditions here and in the US before painting a black picture.

Here is my letter of exception to Kerry Kubilius... in response to her article , "Important Health and Safety Tips for Russia Travel" 

Kerry has two degrees in her field and attended a language and culture immersion course at Tomsk University.  Her column appears in  About.com, a webguide owned by the NY Times. 

Here is the part that rankles me...

Tip #10     You do not want to go to the hospital in Russia. You may have to, but do try to avoid putting yourself in situations that may land you there.  Russia's hospitals sometimes do not meet basic standards for cleanliness, may not have modern equipment, and, in some cases, may not even have consistent electrical power.  

To avoid going to the hospital in Russia, get your shots updated before you go, avoid fights, watch your step, don't drink the water, bring your medications with you, and generally stay aware of your environment.

Here's my letter to Kerry...

Dear Kerry,

I liked much of what you wrote about staying safe in Russia.  You know your subject well, but I ask that you be careful generalizing about Russian hospitals.  When you do it would be fair to cite balancing problems in America.

We all have to be careful in our observations when we go from a specific situation to a general statement.

Hospitals everywhere have the potential to kill with infection during treatment, and may even have bacteria and viruses in dust and in ventilation systems.

I believe that overall the hospitals in St Petersburg are as clean and safe, maybe safer, than those in the United States.  They have good doctors and nurses who follow procedures to prevent patient infections.  The caveats about equipment and possibilities of power failures are irrelevant.

Iotrogenic deaths, those caused by medical treatment, are around 750,00 to a million each year in the USA.  Part of this group are 99,000¹  who die after contracting largely preventable hospital infections.  Another part are the 100,000 to 200,000 who die yearly because of doctor prescribing error.
¹Center for Disease Control 2008.  The other numbers represent estimates that I can not verify with a citation now.

To recap, you give three reasons to stay away from Russian hospitals... cleanliness, outdated equipment and uncertain electrical power. 

I have been hospitalized around nine times since 2000, and only once did I get an infection... after heart surgery.  It was promptly and carefully treated twice a day in a special sterile room, with cleansing lights deployed before we entered.  My doctors and nurses were precise and careful.

The step-mother of a man who died from a iotrogenic infection in America said that passivity kills.  It is essential to observe whether a doctor washes her hands, and if she puts on new treatment gloves for every patient.  You need to speak up no matter the country if you see evidence of unsanitary treatment.

Russians have an ingrained  habit to wash their hands on returning from outside and whenever they sit down for a meal.  It's part of their way of life. Americans, I think, are not as careful when it comes to this habit of personal cleanliness.

In Moscow and St Petersburg most of the major hospital equipment is relatively new, and comes from such countries as Russia, Germany, and Finland.  Some hospitals don't have electric powered beds, but is this  important?  Every hospital has a generator which can be started if there is a power outage.

In St George Cardiac in St Petersburg, and other hospitals, post-surgical patients use a pull rope which is tied to the end of each bed.  When I was debilitated from open heart surgery I could get in a sitting position by pulling myself up.  Good exercise... better than an electric bed.  The hospital routine required, once able, I should make my bed, walk to the patient dining room,  and was expected to stroll in the hallways.

Most Russian hospital and clinic doctors are intelligent, care about their patients, and take time to ask questions and refine their diagnoses.  A Russian doctor doesn't have an 'I am better than you' complex so evident in America. 

When I saw the sweeping generalization about Russian hospitals, I wondered if what you see and report has been affected by the American attitude  'We are the best... Nowhere else could be equal to or better than America!'

Let's put the shoe on the other foot...

How would you feel if...  A French writer suggested that tourists in America should avoid US hospitals, but rather fly to France where the care is better?

You leave yourself open to criticism by not balancing your view of Russian medicine with some comment about serious care problems in America. 

Some Americans have a knee-jerk negativity towards Russia, which I as a nine year expat find offensive.  I am touchy about glib criticism.  I write about the good and bad in Russia but I try to balance it by including a view of similar situations in the West.

Overall I like your column, and respect your knowledge of the Slavic region.  I recommend your blog and forum to my readers.

 Blog      http://goeasteurope.about.com/b/

 forum    http://forums.about.com/ab-goeasteurope

All best wishes,


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  1. I had a hard time finding the link to leave a comment!

    You make some good points here! I read a fascinating book called "Inside Russian Medicine," which explains the Soviet medical system from the point of view of an American doctor, putting a lot of the current customs into context. I definitely recommend it. My review: http://lizinstpete.blogspot.com/2009/01/look-back-at-soviet-medicine.html

  2. Hi Liz,

    I appreciated what you said in your comment, and meant to reply. My apologies. I recall that the book Inside Russian Medicine is at the library on Fontanka, right?

    Thanks again for stopping by.


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