How we conducted clinic in the Mykolaiv villages and in Cherkasy were pretty similar to what I have seen in US disaster settings. Not as much infectious disease, but the same in that the chronic care for the patients was severely disrupted.
Most Ukrainian physicians are state employees. Ukrainian citizens have universal health care, if they can get it The physicians are geographically distributed as the state sees fit. And many have been pulled into the war effort, especially the surgeons. This left basically no one available to care for the refugees and rural areas. This gap is what we were trying to fill. There is also a minority of physicians who are in private practice, but they only accept cash for services.
This is an issue as the internally displaced in Cherkasy and the farmers in the villages live in a near cashless society. Those in Cherkasy often escaped with little more than the clothes on their backs. If they escaped with their money, they wouldn’t be staying in the IDP buildings. Those in the villages are like small farmers in the states and use their funds to buy fuel for and to repair their farm machinery (they used their threshers to clear the mines in their fields!).
Medication is available in the pharmacies. Interestingly, many drugs, including many antihypertensives and anti cholesterol medications, are available over the counter in the pharmacies. If the patient can afford them. That is one of the critical reasons why GCF provides the medications free to all the patients. That means that we only provide a limited range and selection of medications, but it covers the large majority of the medical conditions.
In the future, we will be expanding what we can do in terms of medications and services. Thank you for supporting my contribution to what we do. And thank you for following along with me on this journey.
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