Report from EURACT -a visit to Ukraine
Dr Jo Buchanan, president of EURACT reports - a visit to Ukraine
The European Academy of Teachers in General Practice and Family Medicine (EURACT) is a WONCA Europe network. For more information on their activities see website
Following the council meeting in Budapest meeting I travelled to Uzghorod in the Ukraine with Pavlo Kolesnyk, at the invitation of Professor Ivan Chopey where I spoke at a national Conference of Family Doctors on the development of Family medicine in Europe. I was able to spend a day prior to the conference visiting locally family practices with Pavlo and I attended a CME course, which Pavlo was delivering on the management of chronic pain. I spoke to the 60 Gps at this course about General Practice in the UK. At the end of my talk one of the participants said ‘I wish we could swap our problems for yours’. As I found out more about the Ukraine I completely understood this comment.
Ukraine is a country with serious economic problems and a limited health service and no health insurance. Visits to GPs are free but medication and investigations have to be paid for. Provision of secondary care is patchy and care for a limited range of conditions such as Diabetes, TB and HIV are provided free of charge through vertical programmes, with the inevitable problems that that causes.
There is a problem with vaccine supply throughout the country and the clinics I visited had had no vaccinations for several months. Last year there were two cases of polio in Ukraine and multiple drug resistant TB is common.
GPs in the Ukraine are paid 60 Euros per month, this forces GPs to take other work to survive. Understandably medical migration is a significant problem.
Pavlo has formed a charity with friends in the USA and Netherlands to help develop GP centres in Uzghorod and his well equipped and attractive clinic had clearly benefitted from this, he was being creative in the way he delivered care to patients and was able to offer point of care lab tests for a range of investigations at much lower cost to the patient than going to the laboratory.
I was made extremely welcome in Uzghorod and was humbled by the way in which people were endeavouring to improve the care offered to patients in very difficult circumstances.