Former Soviet Union Sites
Minsk, Belarus
A day as a JHI Minsk Mission Participant
Observations from Dr. Leonid Kalichman,
PT, PhD - Physical therapist
October 2010. "Monday morning we had a tour of Hessed, we learned about its activities, and the people that use Hesed services. We also conducted a home visit, the 80+ year-old woman that we visited had not left her bed for 10 years..."
The seminars that we taught were exactly as planned on the schedule. From Monday through Friday, we met three groups of home care workers and we presented lectures and hands-on practice. Many questions were raised by homecare workers that showed the need for more comprehensive practical training of basic rehabilitation techniques: mobility of patient in bed, transfer from bed to chair and back, positioning in bed etc. Workers also need the better understanding of body mechanics (how to use their bodies during transfer of patients).
One of the particular qualities that we found in Minsk is that patients are very passive and homecare workers do all the position changes and transfers for them. One of the aims of our seminar, therefore, was to teach approach that is more active.
Chisinau (Kishinev) Moldova
The first site JHI sent medical professionals to was Chisinau, in May 1999. What we found when we visited was a Moldovan society in a state of major change, and one of the poorest countries in Eastern Europe. It was our first choice as a community in need of medical infrastructure reconstruction. JHI’s first team of physicians and medical providers were a group of cardiologists and supporting personnel. Since that time, we have sent 30 missions to the city covering virtually every specialty. One major success has been working with Elena Stempovscaia, PhD; Chief Nurse, Ministry of Health, Republic of Moldova and President of the Nursing Association, Republic of Moldova as we brought nursing instructors to Chisinau to lead seminars for Nursing Instructors that is helping bring nursing in Moldova into the twenty-first century.
First, a little history on Chisinau also known as Kishinev: It is the capital city and industrial and commercial center of Moldova. It is also the largest city of Moldova and is located in the center of the country, on the river Bîc. Economically, the city is the most prosperous in Moldova and is one of the main industrial centers and transportation hubs of the region. As the most important city in Moldova, Chisinau has a broad range of educational facilities and has among the highest proportion of green spaces of any major city in Europe. A devastating earthquake occurred in November, 1940 which led to substantial destruction in the city. Scarcely one year later, the assault on the newly created Moldovan SSR by the German and Romanian armies began. In July 1941 the city suffered from large-scale shooting and heavy bombardments by Nazi air raids and the city had lost about 70% of its buildings. The Red Army resistance held until Chisinau finally fell on 17 July 1941. Following the occupation, the city suffered from the characteristic mass murder of predominantly Jewish inhabitants. As had been seen elsewhere in Europe, the Jews were transported on trucks to the outskirts of the city and then shot in partially dug pits. The number of Jews murdered during the occupation of the city is estimated at approximately 10,000 people.
In the years 1947 to 1949 plans were developed for the gradual reconstruction of the city. The 1950s saw a rapid population growth, to which the Soviet administration responded by constructing large-scale housing and palaces in the style of Stalinist architecture. This process continued under Nikita Khrushchev, who called for construction under the slogan "good, cheaper and built faster". The new architectural style brought large blocks of flats arranged in considerable settlements. The period of the most significant redevelopment of the city extended from 1971 until 1991 when Moldova gained independence, after a series of Moldovan nationalistic riots against the Russian-speaking population (Russians, Ukranians, Jews, Gagauz and others). Many streets of Chisinau are named after historic persons, places or events.
After the overthrow of the former Soviet Union the country is beginning to re-organize itself. Without much regard for how well any part of the former Soviet society functioned, all aspects of this culture were discarded. Unfortunately shortly after the downfall of communism there was also a major economic crash which left Moldova as the poorest country in Europe. Physicians are currently trained in the local medical school in Chisinau. It is difficult to asses the quality of this education but many of the practices and techniques are still from the former Soviet era. Family medicine is a new concept and the average primary care physician does not use an otoscope or ophthalmoscope. Also rectal and pelvic examinations are not part of the routine care that the primary physician offers. There is a shortage of much equipment and supplies including simple examination gloves.
Patients have few tests as it is often too expensive. Thus such basic tests are not done frequently. Often the patient cannot afford the medication that has been ordered. There is only 1 MRI unit for the entire country and the table for this unit has a weight limit of 212 lbs. Many patients live on a very poor diet of mainly starches. Thanks to food packages from the Hesed nutritional help is being offered.
Many of the doctors who graduate from the medical school do not go on to practice medicine as the average physician is paid only $35 per month as compared to 3 to 4 times that for a store clerk! This fact also speaks to the dedication of many of the physicians who continue to work while at the same time having to accept a small amount of money from many of the patients. Many of the patients carry diagnosis which we do not commonly see in the US. It is not unusual to be told that a child is suffering from Increased Intracranial Pressure although no tests have been done to confirm this condition. Also one of the pediatric neurologists from their medical community stated that 1/3 of all children suffered from a seizure disorder during the 1st 2 years of life. Obviously there is a need to be very careful in accepting the accuracy of the past history from a patient.
The JHI goal in Chisinau has been focused on the education and training of professional medical personnel. Because JHI is intent on improving care to the general population, we work with the Institute of Communal and Welfare Workers; International Independent University, Department of Medicine; The Republican Hospital; Dental School of Medical State University; Military Hospital and Emanuel Christian Medical Center and the Moldova School of Nursing; as well as other organizations. The training and activities we do result in an exchange of expertise between our team members from the USA and Israel and local medical professionals. The result is a consolidation of the network between Jewish and non-Jewish institutions and collaboration with international organizations. The general community, the Jewish community and Hesed clients all benefit from this group effort.
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Minsk, Belarus
It was in 2000 that JHI started working in Minsk, in connection with the Jewish Federation of Greater Atlanta, who began partnering with the city of Minsk that year. In December of 2000, our first mission included lectures on Urology, Neurology and Oncology. In the twenty plus missions since then, we have continued to emphasize these three specialty areas in our on-going missions, including leading a very prestigious oncology seminar, and adding programs in Cardiology, Palliative Care and Healthy Lifestyles along the way.
First, a little history of Minsk. It is the capital and largest city in Belarus, situated on two rivers and headquarters of the Commonwealth of Independent States (CIS). It has a population of 1,830,000 inhabitants (2008). The earliest references of Minsk date back to the 11th century (1067), then a provincial city within the principality of Polotsk. In 1242, Minsk became a part of the Grand Duchy of Lithuania. From 1569, it was capital of the Polish-Lithuanian Commonwealth. It was annexed by Russia in 1793. Minsk was annexed by Russia in 1793 as a consequence of the Second Partition of Poland. In 1796 all of the Polish street names were replaced by Russian, though the spelling of the city's name remained unchanged.
Throughout the 19th century, the city continued to grow and significantly improve. In the 1830s, major streets and squares of Minsk were cobbled and paved. A first public library was opened in 1836, and a fire brigade was put into operation in 1837. In 1838, the first local newspaper, Minskiye gubernskiye vedomosti (“Minsk province news”) went into circulation. The first theatre was established in 1844. By 1860, Minsk was an important trading city with a population of 27,000. There was a construction boom that led to the building of 2 and 3-story brick and stone houses in Upper Town.
Minsk became an important rail junction and a manufacturing hub. According to the 1897 Russian census, the city had 91,494 inhabitants, with some 47,561 Jews constituting more than half of the city population and it grew until just before World War II, to a population of 300,000 people. When Germany invaded the Soviet Union on June 22, 1941, Minsk immediately came under attack. The city was bombed on the first day of the invasion and was occupied four days later. The Germans designated Minsk their administrative centre and treated the local population harshly. Communists and sympathizers were killed or imprisoned. Thousands starved as food was seized by the German Army and paid work was scarce. Some residents supported the Germans occupation, but by 1942, Minsk became a major centre of the Soviet partisan resistance against the occupation and was the site of one of the largest Nazi-run ghettos in World War II, housing over 100,000 Jews. Minsk was liberated by Soviet troops on 3 July, 1944. The city was the centre of German resistance to the Soviet advance and saw heavy fighting during the first half of 1944 for which Minsk was awarded the title Hero City in 1974. Factories, municipal buildings, power stations, bridges, most roads and 80% of houses were reduced to rubble and by 1944; Minsk's population was reduced to 50,000.
Throughout the 1990s, after the fall of Communism, Minsk continued to change. As the capital of a newly-independent country, it quickly acquired the attributes of a major city. Embassies were opened, and Soviet administrative buildings became government centers. During the 1990s, Minsk was hit by an economic crisis halting many development projects, resulting in high unemployment and underemployment. Since the late 1990s, there have been many improvements in transport and infrastructure, and a housing boom has been underway since 2002. On the outskirts of Minsk, new residential developments have been built and the road system (including the Minsk ring road) has been improved. Owing to the small size of the private sector, most development has been financed by the government. In January 2008, the city government announced several projects on its official web-site. Among them are the refurbishment of some streets and main avenues, the constructions of more up-to-date hotels, the demolition of the out-of-date Belarus hotel and the erection in the same premises of a complex consisting of sport facilities, swimming pool, 2 hotel towers and one business center building with the help of potential foreign investors and the construction of a modern aquatic park in the outskirts of the city. On September 8, 2007, the city of Minsk celebrated 940 years since its founding.
JHI works closely with hospitals, universities and medical schools including the Academy of Postgraduate Training of Physicians, the Medical Institute; City hospital #1; Hospital of Urology; Belarusian State University and Minsk Linguistic University bringing lecturers on diverse topics from Aging to Oncology and from Cardiology to Children with special needs and everything in between. Dr Lenny Lesser said it best one night- “It is all about connecting with one person at a time” I believe that this is the essential spirit of all of the missions of JHI. After a recent mission including cardiologists, our site coordinator Irina Batsenko told us: “I have just received information from Dr. Dmitry Goncharic (Minsk Cardiologist) that thanks to JHI participant Dr. Michael Lipsitt’s lectures and the techniques he suggested; our local doctors have saved the lives of three people at the cardiology department this May. This really makes the commitment of the JHI doctors priceless.
Odessa Ukraine
Odessa was the city JHI initially visited to test the theory of bringing modern medicine to the FSU countries. In 1998, during a visit with Dr. Nelli Nunuparova and several other dignitaries from the Jewish community and the Hesed, the relative complications and values of embarking on what would become known as Jewish Healthcare International were discussed.
First, a little history on Odessa. It is simply enchanting with its marvelous architecture. The name Odessos means "great trade way", a fitting name for the city as Odessa's history as a thriving enterprise has left the city with some splendid architecture from the 18th and 19th centuries and a multifaceted, irrepressible spirit. Odessa has many nicknames, including "Riviera of Russia". Some buildings display a curious mixture of different styles, such as distinct French architecture with a distinct Russian flavor, and some are built in the Art Nouveau Style which was in vogue at the turn of the century. Its stately 19th century classical architecture is set on orderly planned streets that are surrounded with green space, giving the city an air of elegance.
Strikingly ornate buildings of the late 19th and early 20th century are reminiscent of Right Bank Paris. Most buildings in Odessa were built with white stone consisting of calcareous materials imbedded with seashells, which appears to be saturated with hot sunshine. This gives many of the city's buildings a whitewashed appearance. The extracted limestone resulted in the formation of an entire labyrinth of underground galleries.
One of the few planned cities in Ukraine, Odessa's central core is laid out in a grid. The first city plan designed in the late 18th century was executed by the generations of Odessa architects that followed. As early as the first half of the 19th century, the numerous landowners who had moved to Odessa attracted by the profitable grain trade; started constructing their private residences.
In 1915, Odessa was the fourth largest city in the Russian Empire with a Jewish population of approximately 138,000, or 33%, in a city with 403,000 inhabitants. During the war and under Soviet domination, the Jewish population dwindled and is now less than 30,000 in all of Ukraine. The years under Soviet jurisdiction were particularly hard for the all Ukrainians but in the late Twentieth century, changes began to occur. When Soviet leader Mikhail Gorbachev introduced reforms to national policy from 1985 to 1989, it caused a domino effect that no Soviet leader could stop. Suppressed Ukrainian nationalist feelings gradually awoke. The newly democratically elected Ukrainian parliament declared the republics sovereignty in 1990. The Ukrainian parliament declared independence on August 24th, 1991, an act that was approved by the 90.3% of the Ukrainian people who voted in a general referendum on December 1st, 1991. Currently, there are more than 120 nationalities living in Odessa.
In May, 2008 JHI completed the 31st mission to Odessa and we are making a significant impact on both the general community and the underprivileged Jewish community. Recently, JHI’s Odessa coordinator Dr. Nelli reported “We have been partners for nine years. During this time 165 specialists, highly qualified professionals have visited us.” JHI has sent American and Israeli doctors including Cardiologists, Ophthalmologists, Proctologists, Dentists, Nurses, Urologists, Orthopedists, Family Practice, Gerontologists, Palliative Care, Occupational and Physical Therapists along with Pediatric Physicians and nurses and Healthy Lifestyles educators. The seminars and lectures are provided to physicians from the general community, in an effort to help improve medical services to elderly Jewish people and children of Jewish community in the region. Among the many successes of JHI in Odessa, hundreds of elderly Hesed clients have their vision screened resulting in improved vision for more than 75% of those tested.
The evaluation forms the doctors and home workers complete, tell us they find the lectures very informative and encouraging. They help the local healthcare providers improve and update their methods. The friendliness and camaraderie of JHI medical practioners helps create a wonderful atmosphere of mutual understanding, while propagating an opportunity for self-improvement.
TopRiga, Latvia
JHI decided early to concentrate on improving Bikur Holim the only Jewish Hospital in eastern Europe. To accomplish this goal, the first group we sent to Riga was composed of professional hospital administrators as well as several medical specialists who worked with the Bikur Holim administrators and specialists to develop a long range plan for growth and development at the hospital. That first mission consisted primarily of the evaluation of specific departments in the hospital and an overall assessment of the long-term goals for the future of the hospital. Since that time, 20 additional missions have been sent to Riga, pursuing the goal of Excellence in healthcare.
First a little history of Riga. It is the capital of Latvia, situated on the Baltic Sea coast on the mouth of the river Daugava. Riga is the largest city in the Baltic states. The Historic Centre of Riga has been declared a UNESCO World Heritage Site, and the city is particularly notable for its extensive Art Nouveau architecture, which UNESCO considers to be unparalleled anywhere in the world.
Between World War I and World War II (1918-1940), Riga and Latvia shifted their focus from Russia to the countries of Western Europe. The United Kingdom and Germany replaced Russia as Latvia's major trade partners. During the World War II, Latvia was occupied first by the Soviet Union in 1941 and then by Nazi Germany in 1941-1944. The Baltic Germans were forcibly repatriated to Germany. The city's Jewish community was forced into a ghetto in the Maskavas neighborhood and then destroyed. Concentration camps were constructed in Kaiserwald and at the Salaspils city. In 1945 Latvia was again occupied by the Red Army. As a result of the war Latvia lost approximately one-third of its population. Forced industrialization and planned large-scale immigration of large numbers of non-Latvians from other Soviet republics into Riga, changed the demographic composition of Riga. The policy of economic reform, introduced in 1986 as Perestroika, led to dissolution of the Soviet Union and restoration of independent Latvia in 1991. Latvia formally joined the United Nations as an independent country on September 17, 1991. To ensure an economic stability, Latvia and the other Baltic States wanted desperately to join NATO and the European Union (EU) but this race towards Europe was not easy to achieve in the early 1990's because of Russian pressure. However, in January 1998 the US-Baltic Charter of Partnership was signed, which gave support to the Baltic integration into western institutions, including NATO. In 1999 Latvia began accession talks with the EU and joined the World Trade Organization, along with Estonia. In the meantime, the Baltic countries have started harmonizing their laws with those of Europe including the abolition of the death penalty. In 2004; the Baltic states and the people of Latvia achieved membership in the European Union.
Riga is a unique site for JHI because of “Bikur Holim” Jewish Hospital. JHI felt the need to develop a unique model for our missions to Riga. In 2001 the agenda for the first mission to Riga was developed to concentrate determining what was necessary to help this hospital become all it could become.
One of the primary goals that JHI hoped to accomplish in Riga was to strengthen the hospital and help it become more competitive with other hospitals in the city. To that end, Centers of Excellence were decided upon as the most productive method. The Centers of Excellence at Bikur Holim are focused on Dental, Gastroenterology, Hospice, Endoscopy and Ophthalmology. Currently, other than the Ophthalmology department, all centers are making tremendous strides in the quest for excellence. Numerous “eye hospitals” and clinic make this area a very competitive field, which is compounded by the fact that young doctors tend to leave the area for more lucrative environs.
Today the Dental Center of Excellence is a leading provider of advanced dental care in Latvia. In 2005, we suggested changes to the physical facility to make it more “patient friendly”. Many changes have been effected and the clinic has a brighter appearance. We recommended that they seek advice from an architect, versed in contemporary hospital dental clinic design. The dental equipment is adequate; however the ambiance is less than conducive to attracting patients who are willing and financially able to seek the type of care BH is striving to provide. The proposed “VIP” facility at BH will serve as a model for a dental clinic with a modern appearance and efficient internal design.
The Bikur Holim Endoscopy Department is superior to many in Eastern Europe. In 2001, JHI was the driving force in the development of Bikur Holim’s endoscopy unit, pulling together the donation of state of the art equipment and matching funds to get the equipment delivered and installed and providing the medical professionals to train end users. We helped develop the Gastroenterology network in Riga for academics as well as practice management issues and the strategy to implement Telemedicine for case discussion and 2nd opinions. We lead seminars in Gastroenterology and Hepatology treatments an average of three times each year.
TopKiev, Ukraine
Jewish Healthcare International began working in Kiev at the request of the Jewish Federation of Chicago in 2006. The Project submitted to the Harry and Jeanette Weinberg Foundation by the Jewish Federation\Jewish United Fund of Metropolitan Chicago (JUF) was for funding over a three-year period with objective of implementing a vision program in Kiev that would benefit the Jewish community.
First, a little history on Kiev. It is the capital and the largest city of Ukraine, located in the north central part of the country on the Dnieper River. As of April 2007, official municipal estimates placed the population of Kiev at about 2.7 million inhabitants, although some much higher unofficial estimates are often published.
Kiev is an important industrial, scientific, educational and cultural centre of Eastern Europe. It is home to many high-tech industries, higher education institutions and world-famous historical landmarks. The city has an extensive infrastructure and highly developed system of public transport, including the Kiev Metro.
The name Kiev is said to derive from the name of Kyi, one of four legendary founders of the city. During its history, Kiev, one of the oldest cities in Eastern Europe, passed through several stages of great prominence and relative obscurity. The city may have been founded in the 5th century as a trading post, and then was completely destroyed during the Mongol invasion in 1240. It was a provincial capital of marginal importance in the outskirts of the territories controlled by its powerful neighbors: first the Grand Duchy of Lithuania, followed by Poland and Russia. The city prospered again during the Russian industrial revolution in the late 19th century. After the turbulent period following the Russian Revolution of 1917, from 1921 onwards Kiev was an important city of the Ukrainian Soviet Socialist Republic, and, from 1934, its capital. During World War II, the city again suffered significant damage, but quickly recovered in the post-war years remaining the third largest city of the Soviet Union. Following the collapse of the Soviet Union and the Ukrainian independence of 1991, Kiev remained the capital of Ukraine.
The city of Kiev has the largest Jewish population in Ukraine (the 2001 census identified 18,000 Jews in Kiev. The actual number is thought to be much higher. ) The elderly make up over 30% of the cities’ population and have limited access to the medical system. JHI and the Jewish Federation of Chicago, have developed a tri-city project in Ophthalmology, that includes Chicago, Kiev (Chicago’s "twin city"), and Kiriyat Gat (Chicago’s twin city in Israel). Through "Hesed Avot" (Jewish Social Welfare Center in Kiev), we have established collaborations local hospitals to enhance the medical infrastructure in the field of ophthalmology, thus providing easier access, improved care and quality of life for the entire population of the city. JHI is providing Ophthalmologic consultations in Kiev for the Chicago Federation.