Hello again from Gary;

Today I have a short story to tell you about healthcare while traveling in Ukraine. It’s a true story that will give you some insight into the people of that country as well as a “heads-up” for you about medical treatment while traveling abroad.

On my second trip to Ukraine, Alla and I traveled to a small seaside resort town called Feodosiya on the far eastern side of the Crimean peninsula on the Black Sea. Our plan was to spend a couple of weeks touring the area and relaxing on the beach. I’ll describe more about the overall trip and its fascinations in a later post.

Our first few days in Feodosiya were great - - exploring, finding our way around, and learning the rhythm of the place . But after about day 4 Alla began to mention about a discomfort under her arm. She had developed some kind of a sore in her armpit which turned out to be an infected lymph node. I have no background in medicine and didn’t know what to make of it. But after another 2 days it became obvious that it was a serious problem. Without further complaint, she continued to perform the household activities of cooking and cleaning in our apartment until finally she informed me that she was in extreme pain and needed medical attention. The infection had evolved into an angry red lump the size of a quarter in height and diameter. So off to the hospital we go. But not so fast - -

First she had to self-diagnose what was wrong and how to treat it. Then, we went to the local “Anteka”. This is a drugstore in Ukraine and you’ll see them more frequently in Ukraine than you’ll see liquor stores in America. At the Anteka, Alla had to describe the treatment she needed and specify that she needed for this treatment a surgical kit including, a surgical knife, hypodermic needle, anesthesia, anesthetic, dressings, tape, gauze, and irrigation fluid. She purchased her kit (total cost $35) and we headed for the hospital.

At the hospital, we (she) found our way to a crowded waiting room and took our place in line to see a doctor. Those before us ranged from the very young to the very old, with problems ranging from very obvious to “don’t know, hope it’s not communicable”. There was no check in process, just get in line and when it was your turn, a nurse gave a short interview and people were then admitted through the locked doors to the doctor.

When it was Alla’s turn she described her problem and the nurse, after reading Alla’s i.d. papers, responded “you are not from this town - - you must go to your home town for treatment.” (A 2 day long, agonizing journey). To this Alla responded, “but I have a surgical kit and money”. Like magic, presentation of her kit and a C-note opened the door for her to be treated by the doctor. Her treatment was accomplished very competently thank heavens, and after three days of return visits to change dressings she had no further problems.

Now about that C-note - - Russian doctors, that is, doctors in Russia, Ukraine, etc., are paid (by the state), very low wages. And the custom is that a patient shall bring a gift to the doctor in appreciation for his/her services. But in a country like Ukraine where there is very little extra cash floating around, the gifts sometimes take the form of something made by hand, such as homemade baked goods or possibly hand knitted socks. If only a little money is available, the gift can be candy or chocolate. But ideally, the gift will be in cash. I suppose a doctor can somehow convert extra knitted goods into cash. But the extra candy, cookies etc., who knows what happens to them? So the point is that cash is treasured, especially U.S. dollars. It’s likely that Alla’s $100 was excessive, but so what. There were no further questions and the door to the doctor practically flew off its hinges.

(And by the way, that was not the first or last time I saw Alla turn a “no” into a “yes” with the help of American currency. But there is an etiquette to observe when applying this tool and it’s best done by a native.)

I’m not suggesting that you bring lots of extra socks to Ukraine in case you have medical needs while you are there. For one thing they’ll do you no good if you need hospitalization since for that you must supply your own food while in the hospital (on second thought, those C-notes would probably provide for you to have catered gourmet meals in the hospital. But forget the socks). And be aware that Ukrainian law requires you to purchase medical insurance for the duration of your visit (25 cents per day); and also, medical facilities there are not up to western standards. I recommend that you study the  U.S. Department of State consular information sheets for medical requirements of your destination country prior to visiting any foreign country.

Goodbye until next time. May you travel in happiness and health.

Gary.

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