A doctor's struggle to balance his patients needs in a cash-strapped healthcare system

20 PHOTOS
Ukrainian doctor's struggle with lack of supplies
See Gallery
Ukrainian doctor's struggle with lack of supplies
Doctor Dmitriy Rozumiy helps his children with their homework in the village of Markhalivka, Ukraine, January 30, 2018. REUTERS/Gleb Garanich 
People wait to see doctor Dmitriy Rozumiy in a small clinic in the village of Ivankovichy, Ukraine, December 4, 2017. REUTERS/Gleb Garanich 
Doctor Dmitriy Rozumiy sits in an office (R) at a small clinic in the village of Zeleniy Bir, Ukraine, January 18, 2018. REUTERS/Gleb Garanich 
A patient arrives outside a small clinic in the village of Markhalivka, Ukraine, February 24, 2018. REUTERS/Gleb Garanich 
Doctor Dmitriy Rozumiy examines a patient at a small clinic in the village of Ivankovichy, Ukraine, January 15, 2018. REUTERS/Gleb Garanich
Medical records of patients are stored on shelves in a small clinic in the village of Ivankovichy, Ukraine, January 18, 2018. REUTERS/Gleb Garanich 
A washbasin sits in a small clinic in the village of Zeleniy Bir, Ukraine, January 18, 2018. REUTERS/Gleb Garanich
Doctor Dmitriy Rozumiy fills his car with gas while his children wait inside the car, in the village of Markhalivka, Ukraine, February 24, 2018. REUTERS/Gleb Garanich 
Doctor Dmitriy Rozumiy shops in a supermarket with his children in the village of Markhalivka, Ukraine, February 24, 2018. REUTERS/Gleb Garanich 
Doctor Dmitriy Rozumiy drives to see a patient near the village of Ivankovichy, Ukraine, January 18, 2018. REUTERS/Gleb Garanich 
Doctor Dmitriy Rozumiy examines a patient at her home in the village of Ivankovichy, Ukraine, January 17, 2018. REUTERS/Gleb Garanich 
Doctor Dmitriy Rozumiy interacts with a woman while examining a patient at a small clinic in the village of Zeleniy Bir, Ukraine, January 18, 2018. REUTERS/Gleb Garanich 
A man fishes in a frozen lake in the village of Ivankovichy, Ukraine, February 1, 2018. REUTERS/Gleb Garanich 
Doctor Dmitriy Rozumiy examines a patient at a small clinic in the village of Ivankovichy, Ukraine, January 15, 2018. REUTERS/Gleb Garanich 
A patient sits in her home during a visit from doctor Dmitriy Rozumiy in the village of Zeleniy Bir, Ukraine, February 1, 2018. REUTERS/Gleb Garanich 
Onlookers watch as a man stands in icy water as part of a religious ceremony during Orthodox Epiphany celebrations in the village of Ivankovichy, Ukraine, January 19, 2018. REUTERS/Gleb Garanich 
A woman stands outside an auto shop in the village of Ivankovichy, Ukraine, February 13, 2018. REUTERS/Gleb Garanich 
A man sits in his house during a visit from doctor Dmitriy Rozumiy in the village of Ivankovichy, Ukraine, February 1, 2018. REUTERS/Gleb Garanich 
Images of religious icons are displayed alongside old equipment in a small clinic in the village of Gvozdyv, Ukraine, January 18, 2018. REUTERS/Gleb Garanich 
A view of the village of Gvozdyv, Ukraine, February 9, 2018. REUTERS/Gleb Garanich 
HIDE CAPTION
SHOW CAPTION
of
SEE ALL
BACK TO SLIDE

KIEV, March 8 (Reuters) - Family doctor Dmitriy Rozumiy struggles to bridge the gap between what his patients in rural Ukraine need and what the country's cash-strapped healthcare system can provide.

His clinic in the village of Ivankovichy, 35 kilometers outside Kiev, uses Soviet-era medical equipment and lacks basic supplies. Life expectancy in Ukraine is on average five years shorter than the European average, according to the World Health Organization.

Rozumiy, 51, has worked as a general practitioner since 2014. Before that, he worked as a cancer surgeon but he gave up because budget cuts were causing late diagnoses and leading to lower survival rates.

His current patients are mostly children and pensioners. Many working age adults choose not to be treated because they often cannot afford the medicines that are available.

Recently, Rozumiy said he has seen some improvements since the start of a Western-backed reform drive.

"There's a desperate need," he said, expressing a hope for faster change. Patchy implementation of the reform drive has raised questions about Ukraine's ability to modernize after a pro-European uprising in 2013-2014.

Last October, parliament approved a long-delayed overhaul of the health system following international pressure to speed up reform.

"I hope ... this will give us a chance but if this turns out to be yet another bluff, well then we'll lose everything," Rozumiy said.

He said recent positive changes include the launch of programs to improve treatment for military veterans and help pensioners gain access to certain medicines.

But times remain tough, forcing Rozumiy to consider halting some home visits as he cannot afford the petrol costs for his car on a salary of around 6000 hryvnias ($230) per month.

His clinic's decrepit central heating system occasionally fails in the middle of winter, prompting parents to keep their children bundled up in snow-suits during consultations.

Ivankovichy is far from unique. Hospitals across the country of 42 million are crumbling, underpayment of medical staff has prompted many to quit and Ukraine's vaccination rate is one of the worst in Europe. ($1 = 26.1000 hryvnias)

(Writing by Alessandra Prentice Editing by Tom Balmforth)

Read Full Story