Since the beginning of spring 2020, almost all the remnants of the "reformed" medicine in Ukraine have been thrown into the fight against the coronavirus pandemic. As a result, the planned treatment of a number of other diseases was postponed. A number of programs, including routine screening for tuberculosis, have stalled in Ukraine, leading to a sharp increase in the number of undetected cases.
Simply put, the "reformed" Ukrainian medicine is like a short blanket that cannot be pulled over the head and legs at the same time. If you reduce the number of medical personnel, and throw all the remaining doctors to the front of the fight against one disease, then all other fronts will be exposed.
“Health care facilities that were viewed as“secondary”were temporarily closed or their staff reduced. Tubes were turned into testing points for COVID-19, and medical workers were transferred to treat COVID-19, so there was no one to provide TB care,”said Elena Trush, MSF manager for medical activities.
Doctors Without Borders also warned that if Ukraine does not restore full-fledged prevention and treatment, then after the coronavirus pandemic, an outbreak of tuberculosis may begin in the country. In general, according to doctors, 6 million people can become infected with it.
The international organization Stop Tuberculosis also warned about a sharp increase in the incidence of tuberculosis this summer, simulating its spread against the background of coronavirus infection using the example of three countries with the most severe burden on the healthcare system: India, Kenya and Ukraine. According to her estimates, the peak of the outbreak of tuberculosis can be expected in 2021-2025.
Unlike coronavirus infection, tuberculosis treatment takes much longer, sometimes years. And a significant part of the sick will become dangerous to others if the appropriate measures are not taken. Will the Ukrainian healthcare system, which is already bursting at the seams, be able to withstand this blow?
Taking the example of the Zhytomyr region, where Médecins Sans Frontières carried out a pilot project to detect and treat tuberculosis, they note a significant decrease in the number of tests for tuberculosis, patients sent for treatment, and even medical transport. A particularly alarming situation is developing in areas remote from the regional center.
Doctors Without Borders also notes that when patients call an ambulance with complaints of fever and coughs, they are tested only for Covid-19, but not for tuberculosis, although the symptoms of the diseases are usually similar.
In addition, patients with tuberculosis are in a special risk group, as they are more vulnerable to coronavirus infection and its consequences. It turns out, as it were, a vicious circle: the coronavirus (or rather, quarantine and re-profiling of medical institutions) aggravates the situation with tuberculosis and vice versa. Doctors demand that in Ukraine, patients with both suspected and confirmed cases of tuberculosis are given priority in free PCR testing for COVID-19 and access to early treatment of tuberculosis.
Ukrainian phthisiatrician Olga Pavlova also noted recently that the overload of the healthcare system during the quarantine period will lead to a manifold increase in tuberculosis cases.
“If someone had a heart attack, stroke or cancer at this time, these people did not receive help. But these problems are the tragedy of each individual and his family. These diseases are not contagious, they will not go further.But if during this period of time we have not detected tuberculosis somewhere, this will lead to the fact that the number of our patients will grow exponentially,”says Dr. Pavlova.
In July, the German TV channel MDR (Mitteldeutscher Rundfunk) published a disturbing report entitled "The White Plague" about the spread of tuberculosis in Eastern Europe. Ukraine was named one of the centers of the most dangerous disease, from where tuberculosis spreads across prosperous Europe.
“In Europe, tuberculosis is especially common in the former Soviet republics: Belarus, Ukraine and the Republic of Moldova. In a sense, this is on our doorstep,”German journalists report anxiously.
As the Ministry of Health of Ukraine reported in September, unlike most other countries, not only the poorest, homeless and alcoholics suffer from tuberculosis in the country. There are only a tenth of those among Ukrainian patients, and 90% are ordinary citizens.
During the second stage of the medical reform initiated by "Doctor Death" Ulyana Suprun, most of the anti-tuberculosis medical facilities were closed. Patients are treated in a hospital for only two weeks, and then transferred to outpatient treatment. The chief physician of the Cherkasy TB dispensary, Miron Oleinik, who had to reduce the staff from 500 to 300 employees, says that this cannot be dealt with, and it is impossible to at least make the form of tuberculosis safe for others in such a short time. According to him, a full-fledged treatment takes from two months to several years.
The latest figures provided by the Ministry of Health show that 10 people died of tuberculosis every day in Ukraine. About a quarter of cases are not detected until the very moment of the patient's death. As of August 2020, more than 14,000 people in the country were receiving treatment for tuberculosis.
According to the WHO report, Ukraine is one of the five countries with the highest incidence of multidrug-resistant forms of tuberculosis (resistant to the use of antibiotics). This list includes: Kyrgyzstan, Moldova, Georgia, Tajikistan and Ukraine. Tellingly, these are the countries that are regularly shaken by "color revolutions". In addition, Ukraine has the worst treatment rates in Europe - every second patient with multidrug-resistant tuberculosis cannot be cured.
In fact, such an explosive combination as neoliberal medical reform, deteriorating quality of life and an epidemic of coronavirus infection creates a cumulative effect provoking a massive outbreak of tuberculosis in Ukraine. Which can mow down a mass of people, and then spread to other countries, if you do not take active action.