It took time to think about what happened which is why I am writing about this event a while after it occurred. The shock was hard, and I felt I needed to speak with my friends, in the hope of understanding it.

If you watch what is going in Russia you know that Russia is definitely different to other countries. The number of new billionaires keeps increasing, healthcare and education budgets are scarce, the healthcare system is irrational, expenditure on weapons is going up, there is a culture of xenophobia—specifically anti American and anti UK sentiment, and there is support for regimes like those in Libya, Iran, and Syria. more…

President Medvedev recently signed a new healthcare law. This is the final step of enacting the legislation in Russia. It has taken 13 months to get from the first draft of the bill to it being signed in—a record length of time in Putin’s Russia, where laws usually run through the legislators’ house in a couple of months. The law was delayed because the draft was of low quality. The industry, physicians’ organisations, and patients’ unions all opposed many wrongly formulated, or senseless articles of the law. The text of the law was changed substantially, but not only in the interests of patients and the medical profession. The law is controversial and outdated in many ways. For example, the law initially states that healthcare interventions will only be provided after informed consent is given by the patient. But the article about terminal care explicitly forbids the discontinuation of interventions if a patient asks for it. more…

According to current Russian law, women can ask for an elective abortion up until 12 weeks of pregnancy. Between 12 and 22 weeks, an abortion can only be made on the basis of medical or so called “social” indications laid out by the government. Over the years, the government has dramatically decreased the number of reasons that women can qualify for a late abortion. For instance they have eliminated the right to perform a second trimester abortion if the parents are both unemployed. This has been done under the pronatalist pretext, though in practice the share of abortions made for medical or social reasons has never risen much higher than 2% and 3% of all abortions respectively. more…

Studies of biological rhythms used to be very popular. A quick check on Medline showed me that in 1964-1973, 2/10 000 publications were related to biorhythm studies and in 2001-2010 there were more – 8/10 000. The spectrum of publications is slowly changing in the collection reflected in Medline, but the number of studies of biorhythms is at least not decreasing. This is bad news for me as I do not actively do research in this field now. more…

Before Christmas I participated in an educational event for obstetricians and perinatologists from Kyrgyzstan, Uzbekistan, and Tajikistan. It was arranged by GTZ (German Technical Cooperation) as part of their project in the region.

Over the past few years, Central Asia has become the area for testing new approaches. First all the funding from donors was collected in one fund for coordinated technical assistance in healthcare development. Next USAID and GTZ initiated projects which are going to last for longer than before – each project is 9 years long. more…

Recently Russia celebrated the 200th birthday of Nikolay Pirogov. He is one of Russia’s most esteemed physicians, famous for his surgical skills and teaching, research in clinical anatomy, and especially for using “ice anatomy” — sections of frozen cadavers. He is also well known for carrying out experiments with ether anaesthesia, at the same time as the first experiments were done across the Atlantic. He was probably the first surgeon who used ether as an anaesthetic on the battle field and introduced many new technologies to the Crimean war. more…

Four hundred years ago on European maps the land that became Russia was called “Tartaria.” Now Tatarstan is a national republic in the Russian Federation. It is small by Russian standards — the size of Netherlands — economically stable, and has an educated population. Recently a conference took place at the local Medical Academy entitled QIQUM – Quality information for quality use of medicines. more…

WHO-Europe had its big meeting in Moscow this month. It was an amazing mixture of bureaucratic exercises, real health care politics, and interaction with local events. You may not find the details of this meeting on the WHO website, but if you wonder what it was about you may go to see the programme buried here along with wonderful documents like this major paper for the session “Addressing key public health and health policy challenges in Europe” – filled with the right words but making almost no sense, in my humble opinion. more…

The hot weather in central Russia this year has been unprecedented. It has been the hottest summer since records began in 1890, and as a result hundreds of forest fires have swept across woodland areas. Moscow, the most visible part of the country to the outside world, has been covered in a blanket of smog for some weeks. In reality, the forest fires are no more widespread this year than they were in 2009. Statistics show that in July 2009 the area of forest fires was about twice as big as this year. The difference? A year ago it was the forests in Eastern Russia that were burning. They are far away from Moscow and therefore out of the public eye. more…