13.12.2001 | Bogdan Kalinichenko

TB is advancing in Ukraine


The news is discouraging. Two years ago 700,000 TB cases were registered in Ukraine. Several months ago some mass media published the data that every 25 minutes one person dies of TB in Ukraine. Investigations at schools showed that the majority of Ukrainian children carry TB germs.

The Ministry of Health has recently informed that the rate of acquiring TB has grown by about 10% during the last year. Olga Bobyliova, the head of the Main sanitary inspection of Ukraine, said that it is twice more than in 1995. Ms Bobyliova regards low living standard of the population as one of the main factors. Pensioners and jobless are the most vulnerable layers. At the same time Ms Bobyliova criticized the closure of TB sanitariums and the slow implementation of modern methods of diagnostics and treatment. The needed medical equipment is in the great shortage. Several months ago Nikolay Zhulinskiy, the former deputy Prime-Minister, also pointed out that the medical infrastructure intended to fight TB has substantially diminished since the late 80s. According to him 11% of TB clinics and 44% of TB departments in general-purpose hospitals were closed. The number of TB sanitariums has diminished by 28%. If to do nothing, Ukraine may turn into a big TB barrack in several years.

It should be added that in recent years the number of AIDS-infected has grown dramatically and that the infected (and especially already ill) are most vulnerable with respect to catching TB. In some TB hospitals every third patient is simultaneously AIDS-infected.

The state in prisons, where it is very easy to catch the infection, is especially grave. That is why there are plans to release convicts ill with TB.

It seems quite plausible that the Ukrainian system of health protection is incapable to master the situation.

There was such a case: a young man from Kyiv caught TB and AIDS. He wanted to be treated, but the hospital, where he was directed, refused to treat him. If does not want to starve, he must work as long as he can, that is every day to use the public transport… Meanwhile, the number of TB carriers is unknown, since the corresponding medical examination stopped to be obligatory.

Provincial hospitals lack the most needed equipment.

Several months ago the Ukrainian Parliament adopted in the first reading the law on the fight with TB as a contribution to the strategy of fighting this disease worked out by the World Organization of Health (WOH). However, it is obvious even now that the financing for the needed medical drugs, equipment and for the diet nourishment for patients is unsatisfactory. Medical specialists in this disease, who run the risk to catch the disease from their patients with the open form of TB, cannot hope to earn any benefits.

On paper the treatment of the patients looks gratis, in the actual fact the situation looks quite contrary. Those, who want to be treated well, must pay, and the pay is higher that they can afford. On the other hand, parents take away their children from the TB sanitariums to save them from starvation.

Meanwhile the World Bank developed the program of crediting equal to 30 millions USD for fighting TB. Yet, the main financial burden must be taken by Ukraine. And this is becoming more and more difficult, since now the patient must be given not a single drug, as before, but the combination of drugs efficient even if the patient developed resistance to some of them.

There is one positive feature: the problem of the TB epidemics in Ukraine is not hush-hushed any more. Some communities, for example, Bavaria, which is connected with our country by the treaty on friendship, takes part in fighting TB in Ukraine in accordance with the WOH and the World Bank. Bavaria donated 300,000 DM from her budget for building the diagnostic laboratory in Ukraine. It is situated in Kyiv in a specialized TB hospital. It is a consulting center, being a part of the international network of similar laboratories. The aim of such laboratories is both the diagnostics and the investigation of the resistance to the disease, rendering aid in training specialists and the development of new methods of treatment. Technical and medical consultants came to Kyiv from Bavaria and delivered some lectures on new methods of examination for the personnel of the laboratory.

Now the laboratory has but a local importance, but soon TB patients from the provinces will also come there. Mr. Feldman, the head of the laboratory, clearly understands that the struggle for daily bread for many Ukrainians is more important than prophylaxis of the disease. This means that the Ukrainian government will have to give more money for struggling TB. As to the countries abroad, they must be prepared to spreading of the TB infection, since workers and tourists from Ukraine go abroad.

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