Vasiliy Vlassov: In the name of Pirogov

Vasiliy VlassovRecently 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.

Pirogov’s name is everywhere in Russian medicine. He wrote papers arguing for the education of the poor, non-Russians, and women, and he also argued against early specialisation, and for the development of secondary schools. Before the October Revolution of 1917, Russian physicians were united in making Pirogov’s vision for society a reality. But like much else, this movement was banned by the communists. His vision was reinvigorated only after 1991 and helped in the transformation of the Russian healthcare system. Once the new Pirogov’s congress of Russian physicians (an open meeting which happens every two years) even managed to oust the federal minister of health from office. But the past 10 years have been different, and this last anniversary is particularly different.

This year Pirogov’s congress was held on 25 November in Moscow. At the opening ceremony six medical professional organisations signed the agreement to create “Pirogov’s movement.” The objective is to unify the forces for the reform of healthcare and provide professional expertise for the good of Russian society.

When Pirogov’s congress opened on November 25, not a single government official attended. When journalists contacted the office of the minister of health to find out why the congress was ignored, the comment was that “we were busy attending Pirogov’s conference at the Pirogov center.”

The Pirogov center is an amazing example of the frivolous use of the Russian federal budget’s resources. While he was health minister, General Shevchenko used state money to build this luxury healthcare centre, only to be made its director as soon as he left his ministerial position. A year ago he also became an orthodox priest. So, probably, we in Russia enjoy having a unique beast – an academic from the Russian Academy of Medical Sciences, director of a “medico-surgical centre,” and an orthodox priest, all in one.

The leaders of three opposition parties attended the congress and offered to collaborate, but the delegates rejected the offer. No members of the Academy of Medical Sciences joined the congress. The congress made me feel slightly optimistic, but I may be biased, because I acted on behalf of the Society of Evidence Based Medicine, and was one of the signatories for the movement.

Vasiliy Vlassov is a Professor of medicine at the Higher School of Economics, Moscow. His research interests are in epidemiology, evaluation of diagnostic tests, public health, and especially health care delivery with scarce resources. He is the co-founder and current president of the Russian Society for Evidence Based Medicine.