Ukraine’s hospitals under strain, even with few virus cases

Medical workers in homeme protective masks and suits, with plastic bags over ir shoes. A hospital intended for 150 coronavirus patients w holding 250. A lack of filtration systems that forces autopsies to be done outside, under trees, inste of in hospital morgue.

Ukraine’s troubled health care system has been overwhelmed by COVID-19, even though it has reported a relatively low number of cases — 15,232 infections and 391 deaths as of Sunday.

where is problem more evident than in western city of Chernivtsi, with over 2,268 confirmed infections in city and surrounding region. It is considered a hot spot of contagion, along with ar western city, Iva-Frankivsk, 100 kilometers (60 miles) away, and capital of Kyiv.

Thousands of Ukrainians who h temporary jobs in Europe have returned home amid pandemic and some brought virus back with m.

As COVID-19 patients flood into struggling hospitals, some doctors and nurses must buy ir own protective gear or use improvised equipment. Many of m are getting sick: medical workers account for about a fifth of all coronavirus cases in Ukraine.

“My soul is crying!” said Mykola Sharakhlitsky, an anessiologist at Chernivtsi’s main hospital as he cleaned a protective suit. “We are experiencing a short of medical equipment and protective gear, and we all get infected as a result.”

re is t a hospital-gre ventilator for 250 patients in facility in Chernivtsi, a city of 266,000 people.

“I don’t believe that a single hospital in Ukraine has all it needs,” said ICU chief Kostyantyn Dronev. “We are short of everything.”

crisis could t have struck at a worse time for Ukraine.

country’s corruption-ridden ecomy has been drained by six years of war with Russia-backed separatists in east, and year-old ministration of President Volodymyr Zelenskiy inherited health care reforms begun by his predecessor that are still rolling out. reforms have slashed government subsidies, leaving hospital workers underpaid and poorly equipped.

“ coronavirus has shown what kind of medical reform it was — hospitals aren’t rey, re aren’t eugh beds for infected patients, salaries are very low, medical infrastructure is missing,” Zelenskiy said. “We didn’t even have 1,000 ventilators in working condition in a country of over 40 million. It’s just a shame.”

health care reforms also sought to replace old rules that allowed patients to choose ir own doctors and consult with specialists with a system empowering family doctors to direct patients to or experts. But new system has failed to work properly amid outbreak.

“Family doctors have refrained from dealing with problems,” said Ivan Venzhyvych, a 51-year-old rapist in Pochaiv, a town in western Ukraine. “Doctors don’t visit patients, y give consultations over phone. Everyone is afraid of getting virus.”

Pochaiv’s hospital doesn’t have an infectious disease specialist: One left and ar one has been diagsed with COVID-19.

“All people have run away, and those who are left are working at ir limit because of that reform,” Venzhyvych said.

Aware of health care problems, authorities began a strict coronavirus lockdown on March 12, complete with police patrols and tight restrictions on using public transportation. Farmers, businessmen and ors have been pushing authorities to ease rules, and government said it would do so starting Monday.

Yet doctors fear it will le to a new wave of contagion.

“You can see this s picture of our reiness, and it happens in fourth month of epidemic,” said Dr. Oleh Stetsiuk, a pathologist in western city of Terpil who wears a yellow protective suit that his friend, a shoemaker, me for him.

“y don’t give us a penny to improve sanitary conditions,” Stetsiuk said. He conducts autopsies on patients killed by virus outdoors behind his hospital because its morgue lacks proper air and water filtration system.

“Ukraine was completely unprepared for epidemic, and it’s a big question if it’s rey w,” he said, ding that authorities rejected his plea to provide a tent for autopsies, citing a lack of funds.

government used to subsidize things like ws for medical workers and hospital utility bills, but under a second st of reforms that began last month, re will be furr cuts to alrey-limited state funding.

Under new rules, state doesn’t fully cover cost of treatment. It only pays equivalent of $780 for treating a stroke patient, while experts estimate cost at $2,000-$3,200.

Limited state funds have resulted in low ws. ICU doctors have monthly salaries ranging from $148 to $174, while nurses get $111.

“It’s s and scary that I have to think t about my patients, but how t to die of hunger, how to pay for my apartment and feed my family,” said Dr. Ihor Feldman, a 38-year-old lung specialist in Chernivtsi with 15 years of experience who makes $174 a month.

new system also redistributes subsidies among hospitals, with most money going to those with more patients, putting many smaller and specialized clinics on verge of closure.

Zelenskiy has vowed to revise reforms, saying that it orwise could le to closure of more than 300 hospitals, leaving 50,000 medical workers jobless.

“Except for medics — excellent professionals who are among best in world — we have thing else,” he said. president hasn’t specified how he could increase subsidies to ailing health care sector in a cash-strapped country that bly depends on loans from International Monetary Fund and or global lenders.

Medical workers across Ukraine have held rallies to protest reforms and some hospital chiefs std hunger strikes.

“We haven’t fled from front line,” doctors in southwestern city of Vynnytsia said in a statement. “We have abandoned our children, husbands and parents and have been practically living at hospital to save lives. government must decide whom it is fighting against — medics or coronavirus.”