'I Saw Doctors Crying'

• 6.11.2023, 21:10

A film that shows the real state of Belarusian medicine has appeared.

How the young doctors are trained in Belarus, why the work in the polyclinic is hell, and district therapists do not diagnose the flu? This is discussed in the documentary film about the realities of Belarusian medicine, the health care system and repression of doctors in Belarus.

The film "Main Department of Health Care" debunks myths about the availability and quality of medical services in Belarus and analyses systemic errors - that's how the film's creators write about it. It consists of interviews with Belarusian doctors, excerpts from official documents and statistics and searches for answers to difficult questions: what is wrong with our medicine and why doctors are leaving.

The film is directed by human rights activist Tatsiana Hatsura-Yavorskaya. Her interlocutors are world-class Belarusian professionals who went to work abroad or were forced to leave Belarus for political reasons, as well as the former chief physician of the 3rd City Clinical Hospital in Minsk, Maksim Acharetny, who refused to repress his subordinates in 2020.

The full film is available on YouTube. "Euroradio" watched it and selected the most interesting quotes from it.

About Burnout and Stress

Stanislau Salavey, gynaecologist, trade union activist, works in Ukraine:

- I remember two cases when I fell asleep in the operating theatre during surgery. Once we were standing, I fell asleep and almost fell into the wound. It was the third shift in a row. And I was so tired that I don't remember it, it was just on autopilot. And this, unfortunately, is fraught, shall we say.

And this system has long been formed and works not only according to the law, but on the principle "Everybody works like this - we work like this". No one even reads the laws. When you ask the question "Why so?", the answer is "Because. Why aren't you like everyone else? And this is the way we always work".

Maya Terekulava, a district paediatrician, is preparing to become a doctor in Poland:

- I have seen doctors crying in polyclinics more than once. Patients fight in the corridors because of the queues, because there are so many of them, because of the low quality, and then they call you home and after 15 years of study, you just walk between flats for 4 hours a day, like some kind of courier, a pizza delivery man. And you also get some rudeness in response, they say, this is your job, to come to me to bring me sick leave to my house. And it all leads to a lot of fatigue.

And I've seen doctors crying. They go to meal rooms, which are always empty, because we don't have time to drink tea at work, but doctors used to cry there. From fatigue, hopelessness, from the fact that they want to leave and abandon their profession, to which they have devoted many years.

The thing is that everything is organised in such a way that there are too many requirements and they are absolutely inadequate and meaningless.

>What It Means to Be an Intern in Belarus

Vasily, a neurosurgeon, is now working in Germany:

- When there was a surgical internship in Minsk... we were scattered around different clinics, but nobody really needed you as an intern. So I came and made arrangements at other hospitals.

And then it starts: go and work - without much understanding of what and how. If you are not interested, do not read books, do not try to understand something, no one will explain it to you personally.

Neurosurgery and surgery are organised in such a way that there are operations 'through good connections' and common ones. 'Through good connections' - where people may bring you money, 'common ones' - where they won't bring you money.

Nobody was interested in craniocerebral traumas at all, young people went and did them, although it is a complicated subject, you need to have understanding and experience. And here we have - oh, go and do it, can't you make a hole in the head?

Stanislau Salavey, a gynaecologist, trade union activist, works in Ukraine:

- In the understanding of the countries of the European Union, America or the rest of the world, we have a very fast preparation. A year or a little less postgraduate training. To make you understand: a surgeon in France is 5 years of training, in America it will be close to 10. Now even neighbouring countries - Ukraine and Russia - have increased postgraduate training.

A person with a doctor's diploma does not automatically become a doctor, it does not work like that. There must be a certain experience, a certain development of skills.

A doctor's mistake is not always a patient who dies and that's the end of it. It can have distant consequences. He will have a heart attack not in 20 years, but in 5.

Missed oncological disease - diagnosis at the second stage, not the third. There are many little things that can have a big impact on both the quality and length of a person's life. The "Figure It Out For Yourself" approach.... You will learn, if you are a person with brains, you will learn from mistakes, but mistakes are people.

About Polyclinic Overloads, "Reports" and Flu

Ihar Belatserkouski, Head of the Head and Neck Pathology Department of the Republican Scientific and Research Centre of Oncology in Barauliany in 1997-2016, now Head of the Head and Neck Pathology Centre "Theophany", Kyiv:

- 90 per cent of the problems that patients come to us with are pre-hospital problems. A fever due to a cold, a cough. A qualified doctor is involved, and this should be handled by a doctor's assistant, a nurse who gives recommendations, sometimes even over the phone.

A doctor-neurologist, worked in the Republican Scientific and Practical Centre:

- When I worked in a polyclinic, I wanted to leave medicine at all. I had an appointment with about 50 people. There were rare days when they were 30, but on average - from 50 to 70 people, there were days of 90. Children in their first year of life are often seen by a neurologist, so I had a super full house on Tuesdays. And little kids need more attention. It was my least favourite day.

Maya Tserekulava, a district paediatrician, is preparing to become a doctor in Poland:

- All the papers that are in the health system - they are just template reports. All the reports are often written at the end of the month, when they have to be handed in, in 15 minutes, out of fantasy, just out of your head. And they are written so that to write as little as possible.

Nobody registers infectious diseases - you have to write a lot about them, suspicions of oncology, any suspicion of something serious will not be registered, because they require a huge amount of time to complete the paperwork.

We treat mononucleosis according to the protocols, but we always write it down as a respiratory infection, as if it were snot. Therefore, when it comes to any statistics in the health care of Belarus, it is always doubtful. It is false from the very bottom.

If something in the reports you submit is not as it should be from the point of view of the Ministry of Health, for example, if not 60% of those vaccinated against influenza, but 40%, you will be deprived of your bonus for this. And nobody wants to lose their income! And everyone writes: 60% vaccinated.

And then, the next year, the same amount of vaccines is purchased. And the same 20% get vaccinated, and the rest is poured into the sink. And it's a vicious cycle.

Every year, millions of vaccines are purchased, every year they are poured into the sink, every year we write that 60% of the population is vaccinated, every year we can't diagnose "influenza," because according to statistics, people are vaccinated - as a result, there is no flu in Belarus.

Lidziya Tarasenka, endoscopist, coordinator of the Medical Solidarity Fund:

- Society doesn't understand, doesn't see these problems. I don't want to throw a stone at anyone, I don't know where the tail of this vicious circle is. Because the problems are silenced, there is no political and public will to discuss any important problems - it's as if they don't exist.

Year after year they say: you knew where you were going, on whom you will leave patients - most people at best guess that there is something wrong behind these phrases, but it is even difficult to formulate in their heads what it is, because everybody lives like that.