Bellingham, Washington, April 9 (RFE/RL) - A visit to Moscow six years ago has changed the life of Juliette Engel forever.
This American doctor is by training a radiologist specialized in the use of ultrasound diagnostic technology in her work with expectant mothers and infants in the city of Seattle in the Pacific northwest state of Washington.
Engel's visit to the Soviet Union in 1990 was a professional one, encouraged at the time by a Soviet government that considered it a disaster that the birth rate had fallen below the death rate.
The visit brought together 150 American professionals and as many Russians. As a doctor working in prenatal care, Engel was taken by Russian specialists to see abortion clinics and "birth houses." She recalls today that the experience "stunned" her.
At the abortion clinic, she watched births being aborted at the rate of one every seven minutes. She saw a need on the part of Russian women for increased knowledge of birth control measures.
At the birth houses, Engel says she found "the most amazingly cold" approach to bringing children into the world. She saw women arriving at the birth houses already in labor for what she learned was often their first contact with medical specialists. These women, she says, were stripped of their possessions, showered, shaved and delivered of their babies six at a time in a setting with none of the diagnostic equipment or even human warmth that Engel was used to in Seattle.
Nor was there any attempt at "triage" - the process of evaluating and sorting patients by levels of urgency and treating the most needy first. The approach, she says, was "first come, first served."
Engel resolved to try to change that.
She sold her own medical practice in Seattle and spent the next three years organizing a team of specialists from Washington State University, where she got her medical training. She also sought funds to support what is now Mira-Med Institute, a non-profit organization with the goal of improving health care in Russia, with a special focus on women and children.
Engel threw herself into meeting the challenge. While she sought monetary support from the U.S. government and other sources, she began working with the staff at Moscow's Birth House 70. She gave talks on birth control and prenatal care. She conducted professional workshops and seminars. She met with Russian print and broadcast journalists to try to spread awareness of Mira-Med and the importance of prenatal health care and birth control.
By the time money came from the U.S. Agency for International Development (AID) three years ago, the institute had already opened, with privately raised funds and help from the Russian Ministry of Health and the city of Moscow, the Mira-Med Women's Center. Mira-Med also joined forces with Magee Hospital of Pittsburgh in the eastern state of Pennsylvania to run Saviors Hospital in Moscow.
This year, Mira-Med Institute and Magee Hospital surveyed their joint accomplishments so far. They found, she says, that they have worked with 12,000 Russian women, delivered 6,000 babies and trained 560 doctors in advanced prenatal health practices. In addition, Mira-Med has stocked four orphanages with their first medical supplies and clothing and toys for the children.
Now, Mira-Med's support from the U.S. government - never enough as it was - is coming to an end. So Engel is expanding Mira-Med's private fund-raising efforts in the United States. Among other things, the institute now conducts 12-day cruises between Moscow and St Petersburg for Americans interested in Mira-Med's goals to help Russian women and children.
So far, 60 Americans have participated in cruises. More are signing up this summer. Each participant, she says, brings two suitcases: one is for personal belongings; the other is filled with school and medical supplies - and clothes and toys for children living in orphanages along the Volga. There are plans to begin similar "Cruises for Children" next year on the Amur River in the Russian Far East.
Engel calls this "socially responsible tourism."
None of this has been easy, Engel concedes. But she says she has no regrets for having abandoned a thriving medical practice in Seattle for Mira-Med. What she does have, however, is plenty of frustration at the difficulty of gaining adequate support to provide children with the care they need.
"The child," she says, "is so undervalued."