Kyiv, 29 October 1997 (RFE/RL) - Dr. Nikolas Makucha points to the vintage 1950s Hungarian-made X-ray machine at Kyiv's Children's Hospital Number Two and wistfully recalls the state-of-the-art equipment he saw during a visit to a hospital in Philadelphia.
"If we only had half of what they have there, we could get the job done," Makucha told RFE/RL recently in the Ukrainian capital. "While American doctors have the luxury of modern technology, Ukrainian doctors have only their hands and minds to rely on."
Makucha's point is well taken. Since the collapse of the Soviet Union, Ukrainian doctors have had to make do with less. What once was a barely adequate universal public health service has only gotten worse.
The problems are legion. Doctors are grossly underpaid, with average salaries amounting to a far from princely sum of between $50 and $60 a month, making them more poorly paid than tram drivers. And in many cases, doctors go months without receiving those meager salaries as well.
Hospitals receive only a fraction of their scheduled federal funding, making it almost impossible to purchase much-needed equipment and even medicines, which, in many cases, patients are forced to buy on the retail market.
Furthermore, hospital care is slipping. A troubling 1996 Ukrainian Health Ministry report pointed to a rise in the spread of diseases that had been virtually wiped out in the Soviet era.
Adding to the woes are the after-effects of the 1986 disaster at the Chornobyl nuclear plant. Thousands of people who helped clean up after the accident are now classified as Chornobyl invalids and require regular medical care.
One way of contending with what seems as almost insurmountable problems is for Ukrainian health care professionals to forge links with their Western counterparts. One example of that is a partnership established in 1992 by Philadelphia's University of Pennsylvania and the Kyiv children's hospital. The program is funded by the U.S. Agency for International Development and is aimed at improving Ukraine's pre-natal health care still saddled with the Soviet legacy of minimal pre-natal care and family planning.
In its short history, the partnership has achieved a lot. Makucha is one of 86 doctors and nurses who too part in exchanges between the Left Bank Center for Maternal and Child Health Care, to which Children's Hospital Number Two belongs, and the Children's Hospital of Philadelphia, the oldest such facility in the United States.
According to the University of Pennsylvania, the program has attracted additional in-kind contributions of approximately $1.693 billion. These include donations of equipment and supplies, human resource volunteer contributions and other direct costs. A ten-bed daycare unit for women with high-risk pregnancies was opened in Kyiv in 1995.
Ukrainian doctors say prenatal mortality at their hospital has fallen 62 percent since the partnership began, thanks largely to new ultrasound equipment, fetal testing and labor and delivery services. As a result the hospital has become something of a model, attracting clients from other districts of Kyiv and additional funding from the government for the purchase of modern equipment.
U.S. First Lady Hillary Clinton visited the hospital in 1995, where she attended childbirth classes, still a novelty in Ukraine.
On a recent trip to Kyiv, three University of Pennsylvania doctors visited the Kyiv children's hospital to check on construction of Ukraine's first women's health center. The doctors also have plans to hold breast-cancer screening for hundreds of women who were evacuated from the region around Chernobyl.
The exchanges between the hospitals will continue. As one Kyiv nurse said: "Every time I travel to Philadelphia, I learn something new."