The war against Russia is fought by economic, informational, diplomatic means, but the power phase can begin at any time. The army and navy are actively re-equipping themselves with new VVST, conducting exercises. The Supreme Commander personally supervised the training of the SNF with ballistic missile launches. And are military medicine and civilian healthcare ready for mass reception of the wounded and sick?
During the Great Patriotic War, millions of people were hospitalized with injuries and sickness in excess of 22 - soldiers and officers of the Red Army. Of this huge number of 17 millions returned to the line, continued to fight on the fronts.
Not only the military medical service participated in the treatment of the wounded and sick, but also civilian health facilities throughout the country.
Marshal of the Soviet Union Konstantin Rokossovsky recalled: “... in preparation for the battle of Kursk, replenishment of parts of the front was mainly due to the returning wounded. It was the former wounded, who received complete cure in evacuation hospitals, found themselves in the parts by those veterans who taught the art of combat to newcomers, taught them not to be afraid of the enemy bullet, led to the attacks and formed the backbone of our front-line units. ”
Three new motorized rifle divisions equipped with modern weapons and military equipment are deployed along the western border of Russia. tank army. The revival of the defense industry is proceeding at an accelerated pace. Regularly conducted sudden checks of combat readiness of the armed forces, large-scale comprehensive exercises throughout the country, on adjacent naval theater, in the airspace, civil defense events. But military-medical units and civilian medical institutions do not appear in reports about this.
But in the event of the emergence and development of an armed conflict between military units of NATO and the Armed Forces of the Russian Federation, there will be a need to mobilize large hospitals, which must be located in a secure rear. It is unlikely that hospital complexes next to Ukraine can be considered as such in regional centers such as Bryansk (100 kilometers from the border), Orel (160), Kursk (100), Belgorod (40). All these cities will immediately be in the shelling zone and will be obliged to take in the first place the affected population.
According to some calculations, with the start of large-scale hostilities among the wounded, injured, patients may be up to 100 thousands of soldiers. It will be necessary to quickly deploy a bed network in the amount of at least 10 percent of this number, that is, at least 10 thousands of places. Moreover, patients will go mostly surgical. They should be engaged in military field medical units near the front line. And what do we have in stock, if we focus on the Western theater of military operations?
This is primarily the 1586-th District Clinical Hospital in Podolsk. But with all its branches there will be two thousand beds at most. And the central military clinical hospitals of the Krasnogorsk Central Culture and Clinical Hospital located in Moscow and the Moscow region are intended primarily for senior officers.
Secondly, in peacetime, military hospitals do not have such a diverse and varied surgical experience as in civilian hospitals. Thirdly, and this is probably the most important thing - in military medicine, no more than 15 percent of surgeons of all profiles will be recruited. The rest are therapists. So without civilian health care is not enough.
As for mobile military field medical units, their first task will be to provide emergency assistance to the wounded, their sorting and sending to the rear medical facilities, which may include regional and district-level civilian hospitals. Are they ready to accept so many patients?
Each of us knows about the sores of our health, personally confronted with the system. There are numerous glaring cases of rendering poor-quality (to put it mildly) assistance, lack of qualified doctors. Everything suggests that the expected growth in efficiency and availability in recent years has not happened. This is known at the top. 13 May 2017 of the Year issued a Decree of the President of the Russian Federation No. 208, approving the “Strategy of the Economic Security of the Russian Federation for the period up to 2030 of the year”, where in the section “II. Challenges and threats to economic security ”in paragraph 21 openly acknowledges the fact that“ the quality and accessibility of education and medical care is declining and, as a result, the quality of human potential is declining. ”
How does the patient usually communicate with the doctor today?
1-th stage - a medical examination, which is designed to identify the disease, including serious, in the early stages. But it was and remains formal. It is not by chance that the well-known commandment says: "He who is well diagnosed can heal well." How many people (mostly men) have died due to acute heart failure, stroke in 40 – 60 years? This is the level of our clinical examination.
The reasons? Weak material interest of doctors, lack of qualifications, limited time to communicate with the patient, the lack of modern diagnostic equipment. But even equipping hospitals and clinics with modern equipment does not mean that your ailment will be timely installed with the appointment of adequate treatment. The best tool is effective only in capable hands.
2-th stage - access to a doctor. Begin to go on a pain. The procedure of making an appointment has become much easier - modern information technologies allow doing it from home. But in reality, even the therapist can now be reached at best in two or three days. Moreover, in many clinics there was a reduction in medical staff, there is an acute shortage. Recently this was discussed at the Plenum of the Union of Veterans of the Air Defense Forces. In the suburban village of Zarya, for example, where mostly the military and their families live, only one of the nine therapists is left, according to the chairman of the local veteran organization Alexey Dedov. Colonel-General Anatoly Hyupenen called the situation with the medical care of veterans a complete disgrace. In the Zvenigorod military sanatorium, the general and his wife could not even take a blood test. From hospitals, according to him, patients are exposed to under-treatment. Sometimes doctors push this FMS: no complaints - write out.
In Soviet times, the reception could be reached immediately, on the day when the need arose. Now, if you want to contact a specialist, the wait can last up to a month. It is far from a fact that they will accept without a coupon even with acute pain - there are enough of those suffering. Time to receive the patient is now strictly regulated. For 10 minutes you need to listen to complaints, ask questions, study the results of tests and examinations, make a diagnosis, prescribe treatment. The doctor sometimes does not even raise his head to the patient and writes, writes ...
The 3 stage is to go to a medical institution with a serious illness when high-tech medical care (VMP) is indicated. Such a procedure, the very request for a quota is demeaning - such as asking for the right to life. And then - a few more stages: operation, nursing, rehabilitation.
In specialized medical centers, you can still find local House doctors - knowledgeable, able, thinking and willing to help. And in the district hospitals and clinics? In addition, many medical institutions were overwhelmed by the plague of our time - hidden and frank extortion.
14 August Muscovite died in emergency ward in the famous Botkin hospital after four hours of waiting for help. He was taken to an ambulance with a diagnosis of bilateral pneumonia. Tragic accident or pattern? It happens that they are brought with a diagnosis of "stroke", but the patient does not receive the prescribed care during the day. But in such cases it is extremely important to render it in the first hours, otherwise irreversible changes begin in the brain.
Alcohol, scalpel, wallet
What happens far from the capital if something like this happens under the walls of the Kremlin?
District settlement No. 5 (RB No. 5), former medical unit No. 48 of the Third Main Directorate of the USSR Ministry of Public Health, which served the employees of sensitive enterprises (mailboxes) that were part of the USSR Ministry of the Economy, is located in the village of Selyatino, Naro-Fominsky district. At one time, such institutions were created according to a single principle - the entire infrastructure (medical and sanitary and auxiliary) was located compactly, as a rule, in well-constructed buildings, equipped with first-class medical equipment. In Soviet times, the NFM-48 was the pearl of the Naro-Fominsky district in providing highly professional medical care to the population of the village and employees of enterprises located in it.
Today, the former level in the past, with doctors sparsely. Over the 2015 – 2016 years, mortality in the village exceeded the birth rate. The trend persists in 2017. And all those who need to consult a narrow profile of doctors, sent to institutions of the regional or republican level.
What prevents, on the basis of the medical unit, to make a modern medical center of the district level? Next door, behind the fence is a military hospital - a branch of the 1586 district. On the fenced areas there are free areas that can be used for construction. In addition, 55 kilometers military airfield Yermolino, capable of taking helicopters of all types and military transport aircraft. And to the western border with Ukraine (Chernihiv, Sumy and Kharkiv regions) - 350 – 400 kilometers.
On the basis of such a hospital-hospital complex, it is feasible to organize a medical center of constant mobilization readiness with a modern diagnostic and treatment base. In peacetime, he could receive civilians and people in uniform, and in the wartime he could provide medical care to officers, sergeants and junior officers who received injuries of varying degrees of severity.
In the past, the profession of a doctor was considered prestigious, was revered by the people. Now its attractiveness has fallen sharply: only 30 percent of medical institute graduates get a job in their specialty. Doctors in hospitals and clinics are forced to work at several rates. Salaries of teachers in medical schools do not exceed 15 thousand rubles, candidates and doctors of medical sciences - 25 – 40 thousand. Get someone as you can.
But the specialists of the higher school, research institutes, institutes for the improvement of doctors often provide advice to military doctors in hospitals in the treatment of the wounded, who need specialized types of care. The need for such close cooperation was also mentioned by the Chief of the Main Military Sanitary Administration of the Red Army, Yefim Smirnov, analyzing and summarizing the work of the medical service during the years of the Great Patriotic War. Alas, there is no prophet in his homeland.
In Crimea, polyclinics and hospitals miss about nine hundred specialists of different profiles - for a peninsula with a population of 2,3 million people, the figure is threatening. Urgently required district physicians and pediatricians, neurologists, cardiologists, oncologists, diagnosticians, infectiologists, gastroenterologists ... Deficiency in all medical areas.
Something is being done. In 2016, 116 young professionals arrived in Crimea. However, many of them preferred private clinics or left health care altogether, “unable to bear the burden of responsibility for the lives and health of patients.”
Many complaints have been received, for example, from Alupka. About two years ago, in a single complex with the Yalta (Livadia) city hospital number 1, the regional Ministry of Health united all medical institutions of Alupka. More precisely, what is left of them is a polyclinic and a hospital, in which the number of beds has been reduced from the round-the-clock to the daytime. The necessary materials are obtained here on a residual basis. X-ray has been out of order for several months. Since mid-summer, the salary has almost fallen by half. Nurses receive on hands 10-11 thousand rubles. Why? The answer can not achieve. Moreover, doctors are liable to fines for taking more patients per shift than is required by the regulations.
But the Crimea is the unsinkable aircraft carrier of Russia. Attitude must be appropriate.
A year ago, an increase in the average life expectancy of Russians to 71,5 was reported, and now to 72,2. But at the same time there is information about the excess of population loss over the birth rate. According to a study commissioned by the World Bank, the Russian Federation is the European leader in the death rate of men up to 65 years - 43 percent. But these are all potential and real defenders of the Fatherland. In Switzerland, Japan, Israel (a constantly fighting country), the average life expectancy for men is 81 a year.
In our country, public health expenditures amount to only 3,5 percent of GDP and have been declining in recent years. We will not compare them with similar expenditures of the USA and European countries - they exceed Russian ones by several times. The minimum level recommended by the World Health Organization for underdeveloped countries is five percent.
“Military-Industrial Courier” found out from the specialists what to do besides what the leaders of the national health care are talking about. It is necessary:
change attitudes towards admission of students to medical specialties of higher and secondary educational institutions - only by vocation, after a preliminary interview proving that a person is suitable for medical practice, if approved, the candidate is allowed to take entrance examinations;
to train only at the state expense (if the toll is prohibited!) with the provision of a worthy scholarship (no less than the subsistence minimum) and housing;
to recreate the system of postgraduate state distribution of graduates;
establish salaries for faculty members not lower than 8 – 10 MROT with additional payments for academic degrees, titles and teaching experience (respectively, also for personnel providing the educational process);
to introduce a similar wage system in hospital and medical institutions;
to transform the management of medical institutions, to separate administrative and medical management, life support infrastructure and medical and preventive work; the chief physician should manage the healing and rehabilitation process, and the director, in cooperation with administrations at all levels, should provide the necessary conditions, including financial and economic ones;
abandon insurance companies as inefficient and burdensome intermediaries between hospitals and budget financing.
Finally, the main question is about the material sources of such large-scale transformations. The time has come to take advantage of Alexander Livshits' covenant “We must share!”. First of all, land the defiant salaries of the State Duma deputies. To bring to reasonable values a fantastic salary of top managers of companies with state participation. Yes, and our oligarchs could share the example of American billionaires, transferring significant amounts to charity. Vladimir Putin set a good example - he extended the term of his decree by 2018, according to which the salary of the head of state and the prime minister, vice-premiers and ministers, as well as the prosecutor general, the head of the Investigation Committee and the head of the Central Election Commission is paid at a “discount "In 10 percent.
It would be good to form an extra-budgetary fund for health development, to which money confiscated in court from corrupt officials would also be deducted. External debts are not forgiven, but returned, as many Western countries pragmatically do, and at least partially sent to such a fund. With the world on a thread - our health care will be a good shirt. In a word, finances can be found, there would be political will and desire.
In the meantime, very often it is necessary in despair to scoop up all the available funds, collect them by friends and acquaintances in order to go to a good clinic, where there is an opportunity to receive highly professional or at least just qualified help.
There are positive examples in the development of medicine, including military. The elite military hospital (A.Vishnevsky Central Military Clinical Hospital) in Krasnogorsk became a multidisciplinary center with a high level of services, which we are primarily obliged to by the former head - Major General of the Medical Service, Doctor of Medical Sciences, Professor Yuri Nemytin, during the Afghan campaign - Head of the Medical Service of the 40 Army. But this only confirms the conclusion: it all depends on specific people, their attitude to work.
There is an episode in the film of Alexander Row's wonderful film director and storyteller Vasilisa the Beautiful: Ivan, a peasant son, approaches the place where the magic sword is stored, which can do away with Serpent Gorynych. But then a huge spider appears and declares that Ivan will receive a treasure trove if he guesses at least one riddle. And no matter what the insect asks, everything is irrelevant to Ivan. Without waiting for the answer to his last riddle “what is sweeter than anything in the world?”, The spider is already going to swallow Ivan, as it came to the conclusion that “life is nicer and more precious than anything in the world.”
And its basis is human health, which the state and each of us should attend to. It is time for our power and each of its representatives to realize a simple truth: a healthy nation is a strong state, and health care is a component of defense capability.