BAKU, Azerbaijan (Dec. 12)
An expanding network of Jewish volunteer doctors is helping Jewish elderly in the former Soviet Union. “It is quite a big army of volunteers,” says Julia Karchevskaya, an ophthalmologist from Saratov, Russia, who began volunteering 15 years ago.
The volunteers, who work at local Hesed welfare organizations sponsored by the American Jewish Joint Distribution Committee in 12 former Soviet states, focus some of their efforts on preventive medicine — no small task in a region where the average life expectancy of men has declined to 57 and the lifespan for women is not much higher.
The biggest killers are cardiovascular disease, hypertension and complications from smoking and alcoholism — all diseases that can be curtailed with lifestyle changes.
But medicine in the region is hospital-based, with little preventative medicine involved.
“Unfortunately some medical problems cannot be solved by the governmental hospitals,” says Karchevskaya, who now coordinates children’s programs in the Volga region for the JDC. “To find the drugs they need or to find blood in case of an emergency, the patients ask the Jewish community.”
The JDC began supporting Jewish medical volunteers in the mid-1980s during perestroika, when the organization re-entered the Soviet Union after 50 years of exile.
At each of the 198 Hesed centers in the former Soviet Union, volunteer doctors provide consulting services and cheap drugs. In 2004, more than 49,000 people received medical consultations through Heseds, says JDC spokeswoman Rina Edelstein.
Many of the volunteers are retired physicians, living on the same tiny state pensions as their patients. Others, like Karchevskaya, are still working in the field.
Doctors in the region typically make $200 a month and are overloaded with patients, says Karchevskaya, pointing out that a single pediatrician can be assigned as many as 2,000 children.
“A lot of work is done for a very low salary, which is one reason the doctors want to get the benefits of their profession in the context of the Jewish communities,” she says. When they can spend more time with each individual patient at the Hesed, “people are thankful and the doctors can really see the results of their work.”
The Hesed doctors attend an annual conference funded by the JDC, held this fall in Baku, Azerbaijan, where they learn from international medical experts and network with colleagues from St. Petersburg, Moscow and more remote cities in Siberia or Georgia.
Dr. Ted Myers and his wife, Peggy, founded the conference 11 years ago as a way to improve the medical education of the volunteers.
“Up until the time of the collapse, if you were a Jewish doctor, or a Jewish anybody, you were isolated in your own community and we felt that it was important for these Jewish doctors to know each other,” said Ted Myers, 81, who began doing humanitarian work in Sudan and Ethiopia after leaving his San Francisco psychiatry practice in 1983.
“When we first started” in the former Soviet Union, “there was no opportunity to get the latest medical literature,” Peggy Myers said. “They were practicing medicine in Russia as we in the U.S. were practicing it in the 1930s.”
Due to the prevalence of drug resistant tuberculosis strains in former Soviet states, the 70 doctors at the Baku conference took a particular interest in a lecture on TB given by Dr. Gary Schoolnik, an infectious disease specialist from Stanford University. Eighty percent of the world’s TB cases are found in just 22 countries, according to the World Health Organization. Russia is 11th on that list.
“Look around the room and you will most likely see someone who has been exposed to TB,” Schoolnik said.
The dangers of HIV and TB co-infection are especially serious in the former Soviet Union, which, together with Eastern Europe, has the fastest growing HIV epidemic in the world, according to the U.S. Agency for International Development.
“We are facing a public health catastrophe,” said Schoolnik, “unless we can contain it before the catastrophe unfolds.”
Containing that catastrophe is just one of the many problems faced by doctors in the former Soviet Union, one Azerbaijani doctor says.
“As a doctor or scientist, you can’t make a living,” said Fakhriya Mehdiyeva, a 31-year-old physician who attended the conference in Baku. “But you also feel bad charging your patients for care.”
Those who cannot pay can go to the three-story Jewish community center in Baku. It houses a Hesed to dispense drugs, crutches and wheelchairs, a dining room where the elderly come for meals, a children’s center and an event hall where the conference was held.
Karchevskaya says working at the Hesed is a “good mixture of two values: the Jewish value of helping each other and the Hippocratic value of the occupation of a doctor.”