Caritas Ukraine optimizes delivery of medical and social services for low-income Ukrainians


07.10.2013, Ukraine
According to the recent study conducted by the UNO there are almost 70% of citizens in Ukraine that are below the poverty line. Experts say that nearly 5 million Ukrainians are unemployed. Revenues of citizens are getting lower; respectively the number of low-income individuals is increasing. More and more people are addressing the state for help and subsidies, at the same time the amount of social benefits is shortening.

These circumstances complicate the access to qualified medical and social services for quite many Ukrainians in crisis living conditions. Today there is an acute necessity in optimization of cooperation of state establishments, civic organizations and foreign philanthropists to counter the mentioned problem. In the beginning of 2013 regional Caritas organizations in Odessa, Kolomyia and Novovolynsk started to implement project on creation of efficient support mechanisms for vulnerable population groups and medical and social institutions in small cities of Ukraine.

The aim of such activity is to shorten the way of rendering required aid to the specific clients that definitely need it. It is also expected to create a single data basis of recipients and their needs, and benefactors. It will help to secure advocacy and civic activities in the cities that were almost rejected by international sponsors, but, undoubtedly, in need of such support. Moreover, successful implementation of the project serves to enhance the partnership of Caritas Ukraine and its regional offices in fulfillment of other important humanitarian projects and local social programs that have been operating for many years: it could be done by lifting them to the higher level of joint projects that will be carried out with support of local authorities and in collaboration with healthcare bodies and social institutions on the ground.

The project is estimated for one year and foresees continuation; financial support is provided by the Rosa Luxembourg Foundation (Berlin, Germany). Project benefactors affirm that it is important for them to show local authorities that civic organizations and international community are open for cooperation which will be based on high-quality management and evidence-based dialogue.

Caritas Ukraine correspondent visited a round table in Odessa to get to know about practical side of the project and its development. This event gathered Viktor Goydyk, “AIDS center” Odessa oblast in-patient facility; Volodymyr Kravchuk, Odessa oblast psychiatric ward chief medical officer; Melida Eliseydis, deputy chief medical officer of Odessa oblast anti-tuberculosis clinical hospital; Fr. Vasyl Kolodchyn, Director of Caritas Odessa of the UGCC; Oleksandr Radionov, project coordinator; Oleksandr Slavskiy, lawyer, human rights activist and civil society leader.

What was the starting line of the “Creation of efficient support mechanisms for vulnerable population groups and medical and social institutions in small cities of Ukraine” project in Odessa?
Oleksandr Radionov:
Firstly, we had an objective to organize data collection among various vulnerable groups (disabled, those who suffer from HIV/AIDS epidemics, homeless and low-income people) on their needs in medical and social services. We had specially elaborated questionnaires that included 11 pages; there were 50 carefully checked respondents: Caritas clients and other civic organizations and state institutions.

Later on this study should be developed in complex generalization and regular monitoring of quality of social services delivery.  It is so-called ‘bank of needs to get help’ that will display requirements of establishments, organizations and private persons. In fact, such thing will assist foreign or national organizations involved in rendering aid to make up more precise schemes of social services delivery. This data will become background in the lobbying and advocacy processes in our region and other parts of Ukraine.  

How can you describe qualified medical and social services in Ukraine and particularly in Odessa today?
Oleksandr Radionov:
Qualified medical and social services are those that needful individual can receive in time, to the full extent and on the decent level. It means securing medicines; information, social and legal consultations; medical testing; household services; psychological support and even more, for instance, logistics to/from facilities where person can get what he/she needs.

How do you estimate the availability of medicines and material-technical resources in medical and social establishments of Odessa region?
Viktor Goydyk:
In fact, speaking in general, we lack medicines and there is a need in renovation of material and technical basis. But regarding “AIDS center” Odessa oblast in-patient facility our establishment is at 100% equipped with everything necessary. But not all things were received from the state. We are the state establishment targeted at solving social problems; and the situation is more or less fixed by civic and charity organizations of international community and Global Fund to Fight AIDS, Tuberculosis and Malaria.

Volodymyr Kravchuk:
Some people are afraid to say it loud, but I will note that it is not medical provision, it is simply existence. Speaking about psychiatric wards, state supplied us with required things only for 30%, while interest of private benefactors or civic organizations is pitiful.

Oleksandr Radionov:
Medical provision of Odessa regional hospitals is sometimes rather awful and if something is changing it’s not for better. I say ‘sometimes’, because medical establishments in Yuzhne city are provided with the most important things for 105%, and in Shyryaevo (village of the city type) or Kotovsk city for 20% from the needed point.

What is the quantative attribute of ‘demand-offer’ of medical and social services definitely in Odessa region?
Oleksandr Slavskiy:
To my mind, correspondence will be expressed in 2:5 – needs are greater, obviously. Informing citizens of their rights and possibilities can be considered as a rather significant problem.

Oleksandr Radionov:
Informing citizens on their rights and social protection in accordance with Ukrainian legislation is a rather considerable aspect. For example, among our clients only a few knows that family members of person with tuberculosis, HIV/AIDS or hepatitis should get social assistance in amount of 50% from the patient’s salary.

Is medicine developing in Ukraine? And particularly sphere you are working in?
Viktor Goydyk:
Lack of investment for education and development of healthcare is evident. But there are potential and brilliant skilled workers.
Speaking about AIDS-center, since 2009 our establishment received 7000 patients, quality and the scale of work is improving with time. In 2005 early treatment center was visited by nearly 180 individuals. In 2012 it received almost 750 patients, though center is tailored for 50 people. Moreover, at each relief we had only 5 employees: 2 ward maids, 2 nurses and one doctor. For 8 months in 2013 we have rendered over 300 consultations besides our early treatment center, by means of on-site medical examinations at homes, hot phone line, on-line assistance.

Melida Eliseydis:
Speaking about healthcare system in Ukraine, it is quite a good one, but it’s important to see how it works. First of all, poor people should have access to required examinations and services, qualified experts should receive decent salary not to go abroad, and insurance medicine should function. Because it is evident for everyone that medical qualification in Ukraine is declining – old personnel don’t get used to current challenges and needs, and young workers are undereducated or run away from the country.

Are Ukraine and Odessa region ready to counter epidemic of HIV/AIDS, tuberculosis and hepatitis? Are there enough resources?
Viktor Goydyk:
Yes, maybe, in case of Odessa oblast, and in case of Ukraine in general! We have enough financial resources, qualified experts, stock of knowledge, required experience and support of international community. We should wisely and in complex approach solving problems, combining efforts of the state and civic organizations and also business. It is needed to strengthen and broaden preventative measures, enhance material and technical basis, improve medical treatment and optimize quality of life for those who face HIV/AIDS, tuberculosis and hepatitis epidemics.

What are the statistic data on HIV/AIDS, tuberculosis, hepatitis epidemics in your region?
Oleksandr Radionov:
Ukraine takes the first place in Europe regarding the pace of hepatitis viruses spreading. At the beginning of 2013 in Odessa region 32,401 individuals are subjected to regular medical check-up, and 3,045 people were diagnosed for the first time (note – Caritas Odessa employees note that this number should be multiplied in 1,5-2 times to get real data, unofficial one). Speaking about tuberculosis, there are 6,910 people affected by the epidemics in Odessa oblast as of 14.08.2013.

Taking in consideration HIV-infection, as of 01.08.2013 in Odessa oblast there were 15,094 individuals subjected to regular medical check-up with HIV-infection diagnosis, out of them 3179 individuals are diagnosed with AIDS
(note – Caritas Odessa stuff say that this number should be multiplied in three times to get real data, unofficial one). After Donetsk and Dnipropetrovsk oblasts it is the third place in Ukrainian ‘top list’.

Each month nearly 1500-2000 people get infected by HIV-infection in our country. Since 1897 till the 1st of August 2013 236,047 our compatriots were infected: in 88,358 cases it happened by sexual transmission and there are 103,714 cases of prenatal HIV-transmission.

What are your expectations on project initiated by Rosa Luxembourg Foundation?
Volodymyr Kravchuk:
The most important for me is that this initiative won’t be non-recurrent. There is much work and other issues to be reformed in our system of medical and social services delivery. It is great that people in Germany are ready to share their experience, simplify our mechanisms, render financial assistance and teach required skills and methodologies.

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