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Doctors Stage Warning Strikes as Medical System Decays

April 23, 1992

MOSCOW (AP) _ Doctors and ambulance medics staged warning strikes across Russia on Thursday and were threatening a full-scale protest against low wages, decrepit equipment and a shortage of medicine.

The strikes stem from a general collapse of the medical system as Russia struggles to move from a centrally planned to a market economy.

Russians, who for decades have been given free medical care, may now be forced to pay, and few have the money to spare. Government authorities are unable or unwilling to cope with the crisis, doctors say.

Strikes began Monday in eastern Russia, and on Friday, doctors from Moscow, St. Petersburg, Smolensk and Kaluga plan to picket the legislature in the capital, according to organizers and reports.

Ambulance workers in Moscow also plan to strike starting next Monday, said Mikhail Kuzmenko, chairman of the Union of Medical Workers.

Dr. Leon M. Akopov, an organizer of the Moscow doctors’ protest, said the city government had refused to negotiate doctors’ demands to reorganize medical services in order to provide better care.

″I think it’s the petty clerks,″ Akopov said. ″The old apparatus is still there under a different name, and they are incapable of really working.″

City ambulances are falling to pieces and the telephone system to summon emergency medical help ″may break down any day,″ Akopov said.

″Then, strike or no strike, there will be no medical care.″

Doctors staged warning strikes last January, but postponed a general shut- down in order to negotiate, union leader Kuzmenko said in a telephone interview. ″But nothing was decided,″ he said. ″We got 42 percent of what we require to survive. We have had no pay increase.″

Kuzmenko said that doctors, among the lowest paid professionals in Russia, receive 920 rubles a month, about average for skilled and unskilled Russian workers in general. The doctors are demanding 3,500 rubles a month, he said. A ruble is worth slightly less than a penny.

A full shutdown of medical services began a week ago in the eastern city of Magadan, and on Monday in Udmurtiya in the western Ural Mountains, the ITAR- Tass news agency reported.

Emergency room physicians will go on strike Saturday in the west Siberian city of Omsk, the report said. Doctors from St. Petersburg, Smolensk and Kaluga are expected to join Moscow physicians planning a demonstration on Friday at the Supreme Soviet building, the report said.

Doctors in the Far Eastern port of Vladivostok staged a 40-minute warning strike on Thursday, the Russian Information Agency reported. City officials, faced with a budget crisis, were providing only 38 percent of the money needed to pay for medical services, the report quoted Dr. Alfred Gartman as saying.

If doctors charge patients enough money to cover the expenses of medical care, Gartman said, ″the simplest surgical operation will cost 7,000 rubles and a more complex one 30,000 rubles.″

Medical insurance does not exist in Russia, where health care was free for most of the seven decades of Soviet rule.

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