IRKUTSK, Russia – "In the beginning, our chief doctor came to us and said: 'Guys, let's get to work. We need to stand tall and get through this difficult time. We need to help one another,'" recalled Dmitry Malykh, an anesthesiologist at a private hospital in Irkutsk, about the initial wave of the coronavirus pandemic in the spring. "OK, we are good people; we are selfless people. We are ready."
But now another major spike in COVID-19 cases is sweeping over Russia, and the eastern Siberian region of Irkutsk has not escaped it. Malykh is one of many local medical workers who have told RFE/RL that their physical and psychological reserves are running dry.
"We recently had a typical situation," he said of the hospital where he works, Meditsina. "They brought in a victim of a traffic incident in life-threatening condition. All night the anesthesiologist and one nurse worked with the neurosurgeons in the operating room. And six other intensive-care patients were left in the care of just one nurse. We simply don't have the strength to pull through this."
Irkutsk medical workers say there has been an exodus of qualified professionals that dates back before the pandemic, when positions and bonuses were cut. Ambulance medic Valentina Monkhoroyeva said many of her colleagues left last year when supplemental payments for night shifts were eliminated.
As a result, she said, the region is now facing the COVID spike with ambulance crews frequently reduced to just one medic. "All the medics have been ordered to work by themselves," she said. "It isn't possible to do the job by yourself, particularly in times like these."
Like many countries around the world, Russia is in the midst of a major new spike in COVID cases. The official figures, which are widely suspected of understating the real situation, show the number of new infections nationally rising to more than 18,000 per day, up from about 5,700 cases a day in the first half of September.
In the Irkutsk region, 239 new infections were recorded on November 3, more than double the rate one month earlier. Eleven new deaths were reported that day.
"For some unknown reason, one of our doctors was sent to the far north of the region for a vaccination campaign," said Svetlana Burim, an emergency-room doctor at Meditsina. "Another one recently quit. One of my colleagues and I have fallen ill -- he has tested positive and my result was inconclusive, although I have COVID-like symptoms."
The administration of Meditsina declined to comment for this article. The regional Health Ministry said questions should be directed to Meditsina.
'Who Can Help?'
For several weeks now, social media in the Irkutsk region have featured posts from people complaining about waiting days or even more than a week for an ambulance, despite their severe COVID-like symptoms.
Irkutsk businessman Aleksei Zhemchuzhnikov posted on Facebook a direct message that he'd received that read: "We have two retirees, one 80 years old and the other 76, plus another woman who is 55. All of them have fevers of more than 39 degrees [Celsius]. We've been calling for an ambulance since last week."
Zhemchuzhnikov posted the message and wrote plaintively: "What can be done? Who can help?"
One local resident who is trying to help is Irkutsk businessman Vadim Kostenko. When he learned that many medical workers lacked vehicles to get to work or to visit patients, he and some colleagues tried to organize rental cars for them.
But when they were unable to raise enough money, they put out a public call for volunteers to show up with their cars. They used the money they had collected to pay for gas and the regular disinfection of the vehicles, as well as to buy meals for the medical workers.
"We don't want to lose any more relatives and loved ones to this infection," Kostenko told RFE/RL. "So after I myself recovered from COVID, I asked my doctor how I could help."
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"Now we have 261 volunteers working with doctors, and that is just in Irkutsk," he said, noting, however, that after only three weeks, the system was already showing signs of fatigue.
"I only sleep about three hours a day," he said. "The volunteers who are working with the doctors stay with them until the last patient. But the doctors themselves then work around two more hours filling out their reports. They end up working 15 hours a day. I do not understand why our officials -- who should be effectively organizing all of this -- are doing nothing.”
"The law and the orders of the federal Health Ministry obligate the government to make sure a doctor reaches a patient within a reasonable period of time," Kostenko said. "And that does not mean in five or six days."
Oksana Tokmakova is one of Kostenko's volunteer drivers. She said in the two weeks she had participated, she had worked up to 16 hours a day on weekdays and all day on Saturday as well. She never gets home before 8 p.m.
"Today we have had 10 calls for 15 patients so far," Tokmakova said. "Sometimes there are several patients at one address. It took 4 1/2 hours. That is normal for a working day. The maximum has been 20 calls a day. I can't imagine how they were doing this [before, without vehicles]."