Community News

Thursday, November 19, 2009

Ukraine's outbreak of ineptitude

Michael Bociurkiw

Special to Globe and Mail Update Published on Tuesday, Nov. 17, 2009 6:54PM EST

Ukrainians are suffering from a double dose of fever: preparations for January's contentious presidential election, and what appears to be a massive outbreak of the potentially deadly H1N1 virus.

Since early November, more than 1.4 million Ukrainians have become ill, about 300 have died and more than 78,000 have been hospitalized. What began as a concentrated epidemic in the country's nationalistic west has now spread nationwide, forcing neighbours such as Moldova and Slovakia to close their borders.

If the deaths are confirmed to be H1N1-related, it would be one of the world's most serious outbreaks of swine flu. Little wonder that Yulia Tymoshenko, the normally unflappable Prime Minister, has reacted in a panic – ordering schools closed, banning public gatherings and cinema showings and even suggesting the quarantine of some western regions.

The epidemic comes at a bad time for Ms. Tymoshenko for two reasons. Her government was caught completely unprepared for an epidemic – there is not one dose of vaccine in the country and little in the way of preventative measures. And, if not handled wisely before January's voting, the crisis could severely damage the stylish front-runner, known for her trademark braided hairpiece.

It should surprise few people that the medical emergency has caught the government off guard. The ministries charged with social services and the well-being of Ukrainians (Health and Family, Youth and Sports) have been weakened under successive governments through major budget cuts and sheer neglect. It's not uncommon to walk into either ministry during the winter and see staff shivering in their coats.

As late as mid-summer, little information was available to the public on how to protect against H1N1. The government ignored many warning signs, including World Health Organization pleas to stockpile drugs, face masks and other flu-fighting materials. When the outbreak hit, Ms. Tymoshenko flippantly advised her people to protect themselves by eating garlic and lemons.

It isn't only H1N1 that has put Ukrainians' lives at stake. The Health Ministry has no contingency plans to replace the nearly nine million doses of expired measles, mumps and rubella vaccine that must be destroyed in coming weeks and months – themselves a legacy from an ill-fated United Nations initiative that got caught up in a miasma of bureaucratic ineptitude, manipulation and attacks from a well-financed anti-vaccination movement.

The government deserves harsh condemnation from neighbouring and European governments for its almost contemptuous handling of public health emergencies. Few would disagree, for example, that Kiev has catastrophically fumbled its response to HIV and AIDS, which is growing faster in Ukraine and Russia than anywhere else outside Africa. According to UNAIDS, Ukraine has the most severe AIDS epidemic in Europe. If progress isn't stepped up soon, the adult prevalence rate could reach a staggering 3.5 per cent by 2014. Young Ukrainians disproportionately bear the brunt of the epidemic: More than 80 per cent of those living with HIV are under 30. According to one estimate, almost 20 per cent of all new cases are children born HIV-positive.

So severe is the AIDS epidemic in Ukraine – it has claimed at least 22,000 lives – that some multilateral institutions say it's contributing to the country's demographic decline. The population has plummeted by about six million since the early 1990s, and according to a new World Bank study, Ukraine has the highest “depopulation rate” for all of Europe. Adult male deaths are at levels comparable to countries with less than one-fifth its per capita GNP.

When NGOs or donors try to help Ukraine, their well-meaning interventions are often stymied by red tape, bureaucratic ineptitude or corruption. Aid destined for needy Ukrainians is routinely delayed, misappropriated or stolen. It's a sad commentary on a country that gained such an enormous reservoir of goodwill in the aftermath of the Orange Revolution. Some people have compared it to a failed state. As one colleague put it: “It's like watching a long, painful sunset.”

Ukraine's challenge is to deal with the social and political issues that contribute to the spread of H1N1 and other epidemics. This includes strengthening ministries that deal with health issues – including boosting their surveillance capabilities and giving them the budgets to stockpile essential drugs. Humanitarian aid from Canadian and other donors needs to be cleared quickly and treated with the sanctity that it deserves. In short, Ukraine needs to behave like a responsible member of the international community by preventing the spread of diseases before they spread out of control and threaten its neighbours.

Canadian Michael Bociurkiw recently completed an eight-month humanitarian mission to Ukraine and is writing a book on the aid business. He is part of the management team of the HUM news agency.

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