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ILO: East Europe Economy Triggers Healthcare Crisis - 2001-12-26

The International Labor Organization (ILO) says the grim economic situation in Eastern Europe and countries of the former Soviet Union has created a severe crisis in healthcare, with some systems near collapse. The findings are a result of surveys of thousands of households, industrial facilities and health care workers.

The International Labor Organization says there is a crisis affecting both the people in need of health care and those who provide those services in East European countries.

The ILO report notes the deteriorating health care situation is making people more vulnerable to chronic illnesses and other diseases. At the same time, it says health care workers are afflicted with high stress because of poor working conditions, long hours and low pay.

The survey finds 88 percent of families in Ukraine and 82 percent in Hungary are unable to afford basic health care. The ILO says the situation is even worse in Moldova and Armenia where health services are close to collapse.

"It is a very serious phenomenon," said Guy Standing, coordinator of the ILO study. He says wages for East European health care workers, in many cases, are low and often are not even paid. "And of course, it has led to impoverishment and considerable stress on workers concerned and their families. It has also contributed to the phenomenon that we know about and we hear a great deal about, which is the petty corruption of people having to take under the table payments for services in order to merely survive," said Mr. Standing.

The ILO report finds these so-called "under the table arrangements," or bribes, represent an estimated 40 percent of all expenditures by people seeking medical care.

It notes poor pay and job insecurity has led to an increase in work related stress. Many health care workers have to take second jobs to supplement their wages. Many migrate to other countries for work. The ILO notes in Moldova, for instance, doctors earn $12 a month.

Mr. Standing says the impact from failing health services on patients is very serious.

"If you look at all the life expectancy rates across Eastern Europe, in most cases they have fallen. Some very dramatically indeed," he said. "For men in Russia now, life expectancy is 58 years. That means they have dropped 10 years in the last 10 years. And, a number of diseases which were thought to have disappeared - diphtheria, cholera, to some extent [tuberculosis] - are all on the increase, particularly in countries of the former Soviet Union."

Mr. Standing says rates of union membership have plummeted in the region. He says health care workers have little bargaining power with the state authorities, so they are unable to improve their work conditions.