The statistics say that in the first eleven months of 1999 childbirth trailed mortality by 358,700. Progressively fewer women take the risk of motherhood and those that do rate the Soviet title of Hero Mother even after giving birth to their first offspring. They take this risk expecting very little if anything by way of help from the state, meaning not only meager maternity aid. Maternity hospitals lack basic medications and equipment. The Day’s correspondent visited Maternity Hospital No. 2 in Rivne, considered if not the best then certainly not the worst in Ukraine.
What food can one buy on 79 kopiykas a day? Maybe a loaf of bread. Incredible but a fact: this is precisely how much an expectant mother receives a day at Maternity Hospital No. 2. And the daily menu typically includes breakfast (pearl barley porridge with thin gravy, white bread, and a cup of tea), lunch (vegetable soup or borscht, buckwheat porridge with thin gravy, and gray bread), and supper (barley porridge, stewed carrots, and a piece of bread). Naturally, such a ration is not enough for any adult, let alone a woman giving birth.
According to Hanna Chaika, Head Physician, the lack of funds has become chronic. Last year, a mere 20.1% of assigned subsidies was provided. One can only guess what the women would look like when signing out if not aided by husbands and relatives bringing food.
The problems facing Rivne oblast’s largest maternity hospital are aggravated by the fact that it accommodates patients not only from the oblast center, but also those with the most complications from all over the administrative territory, particularly Chornobyl-affected areas. Many women from remote villages scrape up enough to pay the fare to Rivne. The hospital has almost no medications, except emergency kits. In 1999, the government allocated only UAH 168,000 for medical supplies, one- quarter of what was due the hospital. And this is not all.
“The theater is said to begin with the cloakroom and our hospital’s problems start in the changing room. And special clothes present the biggest problem,” says gynecologist Viktoriya Kulchytska. “We have to sew and wash our gowns and this problem is particularly pressing in the surgical ward. Clothes must be changed especially often there. Medications? As a rule women being admitted bring the required medicines with them. Of course, some of them can’t afford it, in which case doctors have to work diplomatic miracles to persuade those that have them to share. And the lack of instruments and equipment is so common I just don’t feel like discussing it. This maternity hospital has only one ultrasonic scanner, an obsolete contraption which local geniuses manage to keep operational. Even such basic necessities as furniture, stationery (including ball-point pens) are in short supply. Each woman we admit has to undergo tests, meaning that we have to write out special orders, meaning in turn that we are supposed to have blanks, which we don’t.”
The medical staff believes that the Rivne authorities are doing their best to help the maternity hospital, but their possibilities are too limited. In fact, there is not a single large industrial enterprise working at full capacity in the oblast, meaning that the local budget is chronically in the red. The chief physician further told how Rivne Mayor Viktor Chaika called the bakery refusing to supply bread to the hospital because of arrears on payments and tried to have that decision canceled.
However no personal contacts can do anything about actual government subsidies. Keeping the maternity hospital effectively operational requires at least six million hryvnias a year. Last year, it was allocated UAH 1.3 million and far from all of that reached the hospital. Yet women continued to give birth.
COMMENTARY
Mykola HABER, chairman of Verkhovna Rada committee for legal regulation of motherhood, children, and demographic policy :
Of course, economic factors are primarily to blame for the outrageous situation in Ukrainian medicine, particularly in the sphere of maternity and childbirth. Only a stable reliable economy can secure sufficient financing. In the developed countries, healthcare expenditures, according to WHO recommendations, constitutes at least 6% of GDP. In Germany, it is 8% and in the USA 15%. There is no secret, however, that government subsidies for maternity hospitals are absolutely miserable in Ukraine. Last year’s budget stipulated 4% of GDP for health care. This year it is expected to drop to 2.8%, which can only be regarded as a national disaster. Only part of the medical institutions (clinics and institutes) are financed by the state budget, provided they are within the Health Ministry framework. The rest, including maternity hospitals, are maintained by local budgets whose capacities vary depending on the region. The law On Aid to Families with Children is carried out only in part.
