The Parallax Brief

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Unrepentant Subjectivity on Economics, Politics, Defence, Foreign Policy, and Russia

Taxi Firms as a Business Model for Russian Hospitals

Regular readers will be relieved to hear that Ms. Parallax Brief had her plaster removed last week. The visit to the hospital, the same pit of corruption and negligence she stayed in when the leg was first broken, was instructive.

During Ms. Parallax’s miserable week in traction in Room 101 ward 404 five weeks ago, the Parallax Brief’s views of the bribery and pared care pervasive in the hospital developed from seeing it as being a case of cheeky graft and apathy to be expected of low paid workers in a society where corruption is commonplace to viewing it as a brazen effort by wicked people to exploit for monetary gain their power of life and death, comfort and pain, and full recovery or chronic suffering.

The Parallax Brief felt obliged to play the game in the form of bars of chocolate, a bottle of bourbon and some hard currency while his good lady was under their care, but he now saw no reason to line the pockets of these racketeers for removing the plaster. If they assumed the foreigner in the shirt and tie would recompense them for a job well done because he slipped the odd bribe before, let them think that – no further services were needed, so disappointment for non-payment would not have repercussions.

But the plaster was removed, and farce ensued.

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Something is Rotten in the State of Russia

The corruption in Russia came as a shock at first. Of course, I know there is corruption in Britain, and that other emerging economies have problems, but it is difficult to grasp its pervasiveness in Russian society until you have lived here.

But just as I thought I had grown accustomed to the system, my girlfriend’s time in hospital after she fractured her leg delivered an ugly education in just how deep the rot has sunk.

The apathy and laziness of the medical staff in the hospital was mind-boggling. Rearranging bedding, resetting the traction for her broken leg, removing garbage, and maintaining cleanliness in the immediate area around her bed was left to me and her mother.

Nurses responded to requests with the slothfulness of a child made to tidy his bedroom. On one occasion, my girlfriend required serious pain relief early in the morning and pressed the emergency attention button. After a five minute wait, she wondered whether it was broken, so a lady in a neighbouring bed offered to press hers, only to find her bed had been arranged so the emergency button was out of reach. 45 minutes later a nurse appeared.

Doctors seldom visited.

The level of care was appalling enough, but it became horrifying when I was told by a friend it could be improved immediately not by transfer to a different hospital, or to a private ward, or even the purchase of private care, but by simple palm greasing – and, in fact, if I wanted my girlfriend to get better and walk without a limp, I had better open my wallet and buy some ‘gifts’.

In effect, the substandard treatment and care in the hospital was only partly due to incompetent, lazy staff; mainly it was the most subtle manifestation of the shocking modus operandi of many of the medical staff: the extortion of bribes.

Corruption is as systemic in the Russian health service as it is in the Russian traffic police, but I see a clear moral difference. It is one thing to take a bribe off a driver caught speeding, but it is quite another to demand money for medical treatment.

Two stories of my girlfriend’s stay in hospital to drive home the point: An old lady opposite my girlfriend in the small ward needed to use the bathroom late at night. She, like most of the others, was immobilized and had to use the bedpan. After she had finished, the nurse refused to clean her until a bribe of RUB100 (USD3) was paid. Now, I know that cleaning faeces from an old ladies bottom is not the most pleasant of tasks, but if you’re a nurse, it comes with the territory. And what kind of person is willing to let an old, immobilized person lie in her own mess all night until visiting hours if a bribe is not paid?

Second, a very tiny, frail old lady was admitted in the middle of the night with a broken pelvis. The nurses who brought her to the ward on the stretcher both refused to lift her onto the bed until a bribe was paid. They told her to move herself. Not being a doctor and never having broken my pelvis, I can’t say, but I imagine that moving from stretcher to a bed in that condition would be an excruciating task. And having seen the size of the poor lady, I would guess she weighed no more than 50KG (110lb, 8 stone). But wieght wasn’t the problem. They knew she was in agony and desperate, so it was a perfect opportunity for extortion.

Even worse stories can be read here, here and here.

The iniquity of these wicked people is beyond my comprehension, and they reflect badly on Russia and the Russian people.

That makes me sad to say, and isn’t really fair on the majority of Russians (or a minority of medical staff), but to be honest that hospital made me feel pretty pessimistic about the country.

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