What’s Wrong with Ukraine’s Response to COVID-19
by Masha Shynkarenko, PhD Candidate in the Politics Department at The New School for Social Research
From the beginning of the epidemic in Ukraine, official rhetoric regarding the state’s efforts to prevent the spread of the virus were met with nervous laughter by ordinary Ukrainians.
While the entire world was anticipating an implacable toll on health care systems, Deputy Health Minister and the leading expert on infectious diseases Victor Liashko announced Ukraine’s full readiness to track COVID-19. In late February, just two weeks before the official lockdown and three days before the first COVID-19 case was registered in Ukraine, Liashko proudly declared that Ministry of Health had all the necessary tools to handle the outbreak: “Ukraine has 12, 000 beds in infectious facilities, around 2, 000 infectious disease doctors, and 5, 000 medical staff, there are isolation wards in Ukrainian hospitals. Also, there is no problem with virus testing”. This discourse has been daily reiterated by various public officials.
Meanwhile, almost immediately doctors from all around Ukraine pleaded for help, complaining they had no access to basic things like masks or protective uniforms let alone medicines. Statistics show healthcare workers in Ukraine are the most vulnerable group. Roughly 19% of all COVID-19 infections are among healthcare workers, a high rate compared to other counties: 2% in the US, 3,8% in China, 9% in Italy, 6% in Netherlands, 15% in Poland, 2% in Germany. In contrast, salaries of Ukrainian healthcare workers are among the lowest in the world – 250$ per month. Medical staff in Kyiv and Kharkiv called a strike and protested against a lack of protective suits and low wages. With public transport shut down in Kyiv, many were forced to quit their jobs as they could not commute. The Euromaidan Press reported the closure of Kyiv City Clinical Hospital No. 6 because all medical personnel in neurology, cardiology and different therapeutic wards had tested positive for COVID-19. Hospital staff maintains that no measures were taken to ensure adequate safety and the administration did not provide workers with protective suits, ventilators, gloves, and glasses.”
Just as healthcare workers bear the brunt of the virus, the COVID-19 patients and anyone with chronic diseases, tuberculosis, HIV/AIDS, autism, diabetes, cancer, etc. remain at an immense risk of medication shortage. It is estimated that already in September, 1 300 000 such patients, who rely on state-sponsored health-care, will not be able to have access to their vitally important treatment.*
What accounts for optimistic official rhetoric amidst such a horrendous situation?
Undoubtedly, there are many explanations as no state was prepared to face the crisis of such scale. In recent years the national healthcare system in Ukraine had been a hotbed of prevailing corruption, squandering resources, stifling innovations, delaying procurements, and neglecting infrastructure. The Health Minister Ulana Suprun, who launched a wide scale progressive reform and uncovered some grand corruption schemes, was fired by the current president despite the outcry of the medical and expert community. In fact, over the course of the quarantine, the Ministry of Health has gone through the hands of three different ministers with three different teams. One of them, Illia Yemez, openly blocked the efforts of an independent state medical procurement agency to obtain urgently needed protective gear for healthcare workers after the director refused to violate their employment protocol and appoint his protégé to a top deputy position. The current minister, Maksym Stepanov, who has no prior work experience in health care sector and is known to be a relative of a business partner and friend of Ihor Kolomoysky, an oligarch associated with Zelensky’s rise, continues to block pending medical procurements using various bureaucratic hurdles and corruption schemes, thus depriving both healthcare workers and patients of vital medical supplies.
Plunged into crisis, hospitals rely on local budgets, charity organizations, individual volunteers, and private socially responsible businesses to step in while the officials in charge are looking for loopholes and schemes to extract more state resources. For example, a well-known child cancer charity fund Tabletochki had to use donors’ money not on hospital renovations and medical staff training, as they planned, but on urgent purchase of vital medication that should have been provided by the state. With borders closed and flights cancelled, even charities and volunteers can only do so much to deliver the medication and protective gear.
The above example, viewed in the broader context of critical shortages of testing, criminal cases against activists, corruption scandals in the highest echelons of power, arbitrary firings and equally arbitrary and puzzling appointments – all this clearly points to a direct attack on the fragile progress achieved by the previous government and an attempt to use the momentum to take more power and further extract public resources. In a movie dedicated to the first anniversary of his presidency, Zelensky in a familiar fashion to distance himself from the failures of his colleagues, for the first time acknowledged the deplorable condition of the health-care system. And yet, he placed the blame on the pioneers of reform, who have started to eliminate corruption and inefficiency by optimizing financial flows, establishing transparent relationships between patients and doctors, launching accessible medication programs, and introducing the notion of public health. Perhaps, this could all have been averted if only the President had not initially chosen to undermine the badly needed healthcare reform, and if his cadre policy had focused on professionalism and competency rather than client-patron relations (perhaps that would make it less frantic, too).
This essay was originally published, along with the video version, on the DEES group page.
* official letter from Tabletochki to President of Ukraine