ON MEDICAL PROVISION OF THE RUSSIAN ARMED FORCES SERVICEMEN

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Last Sunday Russian healthcare sphere employees celebrated their professional holiday. Together with them the military doctors summed up results of their work as well. Despite the gallant appearance of the main Russian chief military doctor colonel general Ivan Chizh, these results are not so cheerful as the other spheres of the Armed Forces life.

Answering the questions of journalists, he pointed out that within the last two years special financing of the medical provision and resort servicing of the servicemen and members of their families, maintenance of kindergartens and other healthcare institutions of the Defense Ministry amounted to several percent of their minimum needs. This circumstance negatively influenced the military medical institutions equipment with the modern treatment and diagnostic devices, their provision with the necessary medicines, including such medicines like blood and blood replacing solutions, anti-bacterial means and vitamins. The available stores are being used, but they are not infinite.

It is pointed out that it is very difficult to maintain the military sanatoriums now. In some regions the number of kindergartens was reduced. Recently the number of places in them was reduced by 23,000. As a result some 100,000 children can not be placed into the kindergartens.

Meanwhile the military doctors say that the current system of medical servicing of the Armed Forces servicemen and members of their families still meets the necessary demands. It includes more than 1,2000 medical units and institutions. These are military hospitals, infirmaries, polyclinics, sanatoriums, resorts and other institutions. Overall some 6.3 million people enjoy the medical servicing of the Defense Ministry.

General Chizh assured that the Armed forces reduction will almost not influence the country’s military medical treatment institutions. More than 20,000 military doctors perform their professional duties in the Armed Forces, having a big experience of the medical and scientific work. Among them there are 7 correspondent members of the Russian Medical Sciences Academy, 216 professors, 399 doctors of medical sciences, more than 300 honorable doctors of Russia. Some 2,000 people are working in the Armed Forces medical service. 2/3 of them are servicemen. They account for some 25% of the total number of the military scientists of this category, and 10% of the Russian medical scientific potential.

As a rule, all these people are working industriously, considering the preventive work for preserving and strengthening of servicemen’s health, provision of the stable beneficial sanitary-epidemiological situation in the areas of the troops deployment to be the priority of their work. Maximum effective treatment is provided for the ill servicemen. For this purpose the vital objects of the medical service are maintained in the due condition and are being developed. Despite the scarcity of the allotted funds, within the last three years cardiological hospital for 300 people in the Main Military Clinical Hospital of N. Burdenko was put into operation, as well as the 9th Treatment-Diagnostic Center in Moscow, Gynecological Clinic in the Military Medical Academy in St. Petersburg. Besides broadening of the 3 rd Central Military Clinical Hospital of A. Vishnevsky on account of the treatment-diagnostic hospital for 600 people with the canteen and a club was completed.

During the last few years the organizational structure and technical equipment of the military polyclinics has been improved. They included the modern specialized departments, day hospitals, offices of the ultra-sound and endoscopic diagnosis. Besides, in the central polyclinics departments of computer and magnet-resonance tomography, ambulatory hemodialize, chemical therapy, laboratory infectious immunology and so on were included. On the basis of the district and central polyclinics 9 diagnostic policlinics and 3 modern treatment-diagnostic centers were formed. Optimization of the staff structure of the military hospitals is also being carried out.

The reform will not influence the military medical educational institutions. Medical specialists for the Armed forces are being educated according to more than 120 specialties in 5 higher mi9litary medical educational institutions of the defense Ministry. The main of them is the Military Medical Academy in St. Petersburg, being one of the oldest among the military academies and medical higher educational institutions in Russia. In 1998 it will celebrate its 200 th anniversary. Transition of the higher military medical education system to 7 years term of education caused the necessity of the accelerated development of the educational-material basis of the Military Medical Academy, military medical departments of the state medical universities.

Meanwhile, the task of the Armed Forces manning with the healthy conscripts still has a special state importance. Unfortunately, the physical development of the present conscripts causes a special concern. According tot he research, among them only 10% are healthy and fit for the military service. The number of teenagers, who received diagnosis of the drug addiction for the first time, grew by 200%, and number of drug addicts- by 50%. A modern young men weighs by 5-6 kg less than a young man of his age 5 years ago. 10-15% of the draftees are underweight, due to which they are unable to fulfill their service duties. The number of citizens, released from the draft grew in 1998 in comparison with 1997: according to venereal diseases- by 700%, alcoholism and drug addiction- by 300%, lung tuberculosis- by 50%. For example, last year 768 people were treated for alcoholism and 602- for drug addiction in the military hospitals. By now this parameter grew by 15% . Meanwhile, the fault of the doctors in this is just indirect. The system of early detection of people, apt to use alcohol and drugs is operating in the Armed Forces. Much is done for prevention of penetration and distribution of drugs in the military units. The measures are taken for strengthening of protection of the medicines, possessing the drug properties. Legal, medical and ideological measures are regularly taken, In the system of hygienic education the main stress is laid on explanation of the harmful influence of alcohol and drugs on the human organism.

However it is impossible to completely eradicate the reasons of alcoholism, because it has the social roots. Wages arrears, lack of assurance in the future represent the permanent background of the alcoholism and drug addiction in the Armed Forces.

We can say the same about the suicides in the Armed Forces. Military officials write that in 1997 there were 16.5 suicides for 100,000 people in the Armed Forces. However this is not true. Official data of the Defense Ministry, represented to different state structures, point out that in 1997 481 servicemen committed suicides. If we bear in mind that the authorized strength of the Armed Forces at the end of 1997 was 1.5 million, this will be 32.06 cases for 100,000 people. This is a huge digit. If we compare it with the previous years, we will see that despite the Armed forces reduction the annual statistics of suicides remains the same, or exceeds this level. For example, in 1993 there were 419 suicides in the Armed Forces.

This year the annual statistics of the servicemen’s suicides growth was preserved. Almost 40 suicides happen every month, which accounts for almost 25% of the number of people, who die in the Armed Forces. Along with this we need to point out that not only the active service soldiers commit suicides. The suicide level is very high among the officers and warrant-officers. If we compare the relative (for 1,000 people) parameters, the suicide level among the officers (warrant-officers) and privates (sergeants) is the same. However the motives of the officers and soldiers suicides are very different.

Among the people, who committed suicides this year, there were 60% of active service servicemen and 40% of officers and warrant officers.

Servicemen of the first year of service account for 70% of the total suicides number. In 40% the suicides were caused by personal and family problems, in 25%- by service problems and military service difficulties, in 10%- fear of the punishment for committed deeds, in 10%- alcoholism and other diseases, in 4.5%- hazing.

A serious reason of suicides is a lack of social protection, heavy socioeconomic situation. Doctors are doing their best to change the negative situation in the military units, to improve the micro-climate and support the people. Commissions for psychological preventive measures and traumas are working in the troops. They analyze every accident and emergency situation. Of course, the ,medical surveillance over the people, the psychic of which causes some concern, is also carried out. We will be able to enforce order in the military units and raise prestige of the military service only by cooperation of all officers, working in the troops and in the command organs.

Meanwhile, representatives of the Main Military Medical Department point out with optimism that so far the overall condition of the servicemen’s health provides for fulfillment of the Armed Forces tasks. Total number of the servicemen’s diseases remains stable, by 50-66.6% lower that the analogous parameter of the civil population. Within the last 3 years the number of diseases among the soldiers fell by 16.5%, and among the officers- by 15.5%. Number of lethal results of the diseases and traumas fell by 8%. The number of traumas fell by 23.8%.

It was possible to achieve relatively positive results in development of some directions of the sanitarium-resort servicing of the servicemen, members of their families, invalids and pensioners of the Defense Ministry. This was possible due to reorganization of the whole system of the sanitarium-resort provision, deepening of specialization of the military resorts, increasing of the number of places there, changing of the time of treatment and rest, which allowed to send additionally more than 20,000 servicemen tot he resorts. More than 30,000 children are going to resorts together with their parents annually.

Under conditions of underfinancing the search for inner reserves of the medical institutions provision with the medicines, medical devices and equipment remains the main concern of the military doctors. The property, which had been removed from abroad in the past, is being used for this purpose. For 4 years the accumulated emergency bandage materials store is being used. Payable services for medical treatment are introduced.

Along with this, we have to admit that the permanent underfinancing of the medical property purchase (by 45% annually) negatively influences activity of the military medical institutions of the Armed Forces. Low level of financing provides only for survival of the military healthcare. 600 million rubles, planned for the military healthcare in 1998, exclude the possibility of bringing its material basis into correspondence with the real needs.

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