During its years in its so called “native harbor”, Russia has turned Ukrainian Crimea into a military base isolated from the rest of the civilized world. Ordinary Crimean citizens, citizens of Ukraine who have become accustomed to living and working quietly and developing and relaxing, have suffered the most from this. Today, almost everything has been taken away from them: the right to a native language and culture, the opportunity to use land and resources, hope for a European future and prosperity.

Russia has brought total corruption to the Ukrainian peninsula, which has penetrated into all spheres of society, and has become incomparable in scale with all the similar negative phenomena that existed in Crimea before 2014 and, unfortunately, exists in mainland Ukraine and in other European countries now. The field of health care is no exception, which is almost fundamental for every developed country, as it is related to the human right to life.

In fact, it becomes scary for Crimean residents when you see the news that “director of the state unitary enterprise of the Republic of Crimea” “Crimea-Pharmacy” Irina Bakhlina was detained for “receiving a bribe of 400 thousand rubles from two pharmaceutical companies for lobbying their interests” [1]. In fact, the scale of the problem is much larger, but Victor Filatov, Candidate of Law, will try to understand it.

Complaints about poor quality Russian-style medicine began to come from the Crimea in 2014, immediately after the attempted annexation the peninsula. Most of them were low quality medical services, lack of qualified doctors, inadequate organization of patient reception and lack of modern equipment. Ukrainians were shocked by the news tapes of the time, because they told very scary stories, for example, when a person died banally without waiting in line for an MRI [2]. Similar complaints about the health care of the occupied Crimea are received systematically. Imagine how critical the situation is if ordinary Crimean residents try not to go to the hospital, but treat themselves, because they are afraid of falling victim to unqualified doctors, most of whom are on the peninsula today. The fact is that a significant number of professionals left Crimea after the beginning of its occupation by Russia [3]. This is rather sad, as such practices can lead to an increase in mortality, which is already recorded by international and Ukrainian experts. Even the so-called “Krymstat” last year recorded a double increase in mortality compared to 2020, and all this against the background of a significant decline in birth rates [4].

The inhuman treatment of doctors by the Russia-controlled “authorities”, total violations of their labor rights, contempt and disregard for appeals were also highlighted. For example, even in the context of a coronavirus pandemic, doctors are not fully provided with personal protective equipment. Cases of underpaid wages are also common. Thus, in 2015 in Simferopol, doctors of the “sixth city hospital” accused the “management” of reducing payments and inflating the staff of the “administration” by the relatives of the “chief doctor” [5].

It should be noted that even the Russian invaders’ “authorities” are forced to acknowledge the numerous problems in the field of health care. In particular, Mr. Aksonov acknowledged “the need to strengthen social support for health workers, provide them with housing and adequate wages”. At the same time, the same Russia-controlled “authorities” announced the reduction of doctors, and the Kremlin in general offered the Crimean residents to create “volunteer detachments” from among the “medical students” [6].

We will add that according to “official data” of the same Russia-controlled “Krymstat” from 2014 to 2020 in Crimea the number of medical institutions decreased from 117 to 68, of separate polyclinics – from 58 to 19, of children’s hospitals – from 6 to 4, of medical and obstetric points – from 504 to 493, of hospital 24/7 available beds – from 16.3 thousand to 15.8 thousand, places in maternity hospitals and departments – from 938 to 558; the number of employed pediatricians fell in the Crimea from 740 to 705, hygienists – from 447 to 307, midwives – from 902 to 710. The result was sad and expected; for example, if in 2014 in Sevastopol 353 children had developmental defects among all the new born, in 2020 – already 1629 [4].

The main factor in such destruction of medicine in the occupied Crimea was corruption, which is confirmed by the available facts. Thus, already in 2014, the “rector” of the “medical academy” of Crimea, controlled by the occupiers allowed “subordinates” to provide paid medical services, which earned him about two million rubles [7]. Corruption in the “purchase of medicines” is also systematically reflected. For example, in 2015, the Russia-controlled “Crimean Research and Practice Center of Narcology”, purchased drugs at the expense of “budget funds” for more than four million rubles. To avoid “public bidding”, the subject of the procurement was divided into several parts between two “private firms”, such as “KMS-Krym” and “Krym-Laborreactiv”. As a result, patients received vitamins, antibiotics and hormonal drugs of very poor quality [8].

Corrupt schemes involving the salaries of doctors, who are sorely lacking on the occupied peninsula, are more widespread.

These are deals with so-called “incentive payments to doctors”, which are mentioned in the “Russian legislation”. Since 2016, hospitals in Crimean cities have become a practice where these surcharges to physicians “flowed” into the salaries of “chief doctors” and “accountants” of these hospitals in the amount of 400-500 thousand rubles per month, given the average salary of a surgeon of the same qualification hospitals amounted to “as much as” 21 thousand rubles [9]. However, the “fruitful usage of budgets” for the construction of health care infrastructure facilities has become more appealing to the Russia-controlled “authorities” in the Crimea. Probably the most striking example was the construction of the “Semashko Medical Center” in Simferopol, which the “administration” began to build in 2017. Currently, the facility is “commissioned” after delays in the supply of equipment [10]. Even the representatives of the so-called “Crimean Anti-Corruption Committee” are forced to state that the regime of “long-term construction” was a consequence of corruption, because the “contractor’s workers” did not receive wages and the pace of construction did not correspond to “official reports” [11].

By the way, if we talk about the “new medical center”, then corruption in construction is only part of the iceberg. The Russia-controlled “authorities” and unscrupulous businessmen have established a systemic corruption scheme to supply medical equipment from world-famous manufacturers “General Electric” and “Siemens” to the “Semashko Hospital” and other medical institutions in Crimea. These are tomographs that have been available on the peninsula since 2018. Surprisingly (actually – not very much), but multimillion-dollar tenders for the supply of such equipment won “Medtekhnika-Service” LLC, registered in the Rostov region with an initial capital of 10 thousand rubles. The facts indicate that after such deliveries, the company’s profit is more than 100 million per year [12].

It is clear that there were “kickbacks”, paid to local “medical officials” by this society. However, there are questions to universal manufacturers who not only have to take into account the status of the occupied territory, but apparently gladly became a chain of corruption, because the high-tech equipment needs to be evaluated and “certified” by the manufacturer. And in this case, we are talking about well-known global companies with a fairly high reputation.

The case of Vladislav Nusinov, the former “deputy director of the health department” in Sevastopol, is another example of systemic corruption in medicine in the occupied Crimea. As part of the “cleansing” of the city from the “team of the previous governor” in July 2021, the invaders’ “security forces” accused Mr. Nusinov of “receiving a bribe in a particularly large amount”. Because of this, it was easy for the “officials” to join a group that was engaged in corruption and systematic embezzlement of “budget funds”. For example, the mentioned Sevastopol “department” issued an “order” by which it “delegated the right to conduct tenders for the supply of medical equipment and its maintenance” to a kind of “medical information and analytical center”. The key seats in the “institution” were given to members of Nusinov’s family, and the “commission” that was supposed to “monitor its activities”, was headed by Nusinov’s “ex-wife”. It is obvious that she had to be “especially picky” about the commercial adventures of the “ex-husband” [13].

Such “control” could not help but inspire the corrupt, and they signed almost 50 “contracts”, being the only “bidders”, which was “earned” more than 600 million rubles [13]. This happened at a time when cancer patients from the AR of Crimea and Sevastopol were being sent to “Russia’s regions” for medical treatment, as the number of neoplasms detected in Crimea increased since 2014 (even according to “official statistics”), but relevant equipment, conducting radiation therapy, has “disappeared” on the peninsula. Due to the mentioned “clan wars” for control over Sevastopol’s medicine, the new apparatus cannot be “put into operation” since 2017, and it still has dust in the warehouse [14].

Looking at such an “example”, doctors in Crimean cities also manage to make money en masse on their patients, contrary to the Russian invaders’ claims about the alleged “eradication of corruption in medicine”. Thus, only in the framework of “testing indicators”, 23 “criminal cases” were initiated on corruption of Crimean doctors by the occupiers’ “security forces” in 2015-2017, who for bribes issued “certificates” of medical examination, and demanded from some Crimean residents 20 thousand rubles for “providing a disability group” [15].

By the way, if we talk about the disabled persons, this is another category of citizens who gives benefits for “officials” from the invaders’ “administration”. In particular, due to the collapse of the health care system, the number of people with disabilities in the Crimea has increased rapidly during the years of occupation. Today there are more than 120,000 of them on the peninsula, and this despite the fact that the collapse of Crimean reproductive medicine, described above, is constantly increased the number of children with disabilities, because today in the occupied Crimea there are about 7,000 of them [16].

And even children with disabilities have not escaped the corruption of the occupiers. Currently in the occupied Crimea there is no solution to the problem of rehabilitation of children with disabilities, including providing them with wheelchairs. But the invaders’ “officials” have already worked out a scheme that is very beneficial for them: “specialists of the medical and social examination bureau” include such parameters of the wheelchair as “necessary” for the child in the “individual program of the disabled”, which meet the requirements of only one factory which paid bribe to “officials”. Therefore, even in an open “tender”, this plant a priori becomes the “winner” and supplies to the Crimea wheelchairs not only with a significant overpayment [17], but also completely unusable. As a result, parents of children with disabilities buy wheelchairs for their children at their own expense, or ask for help from volunteers.

Such inhuman arbitrariness essentially takes place with the tacit consent of the invaders’ “security forces” and their Kremlin curators. After all, how else to explain the fact that in 2021 the “case” of the above-mentioned corrupted “officials” who headed the Sevastopol “department of health” and “earned” billions of rubles, the “prosecutor’s office” of the Russian invaders “brought” purely “disciplinary action” for “concealment of bank accounts, real estate and money” [18]. Such a “slight fear” of corruption means a total hierarchy of bribes and the corresponding impunity, which in the context of the coronavirus pandemic has only gained momentum in the Crimea.

In particular, the corrupt have set their sights on the “coronavirus-payments” that Putin “solemnly guaranteed” to Crimean doctors, working with coronavirus-patients. Every month, Crimean doctors did not receive about 10 thousand rubles, and in the second half of 2021, “COVID money” stopped to be paying at all. The main argument was for allegedly “non-fulfillment of the plan for the treatment of patients”, as a result of which the “republican budget” allegedly did not receive almost 90 million rubles [19]. Although at the same time of “non-payment” the Kremlin has allocated from the “federal budget” more than one hundred million rubles in Sevastopol alone for the “fight against coronavirus and additional payments to doctors”. One could ask where exactly this money went – if the doctors did not receive it, but it is so rhetorical question that even the “ex-wife” of the above-mentioned Vladislav Nusinov probably knows the correct answer.

There are also strange excuses of local “officials” who simply stole “surcharges” from doctors. For example, Igor Chemodanov, the so-called “minister of health” of the occupied Crimea, said that allegedly “the observer is not a medical institution” and therefore “its staff could not count on surcharges”. The “minister” apparently “forgot” that in “order to be employed by the observer”, it is necessary to “have a doctor’s degree of the appropriate qualification”, and “forgot” about the work of exactly and only medical workers there.

It is necessary to mention the housing schemes for doctors, which Russia-controlled “power” began to “scroll” actively almost immediately after the occupation of the peninsula started. In this sense, the most striking example was the forces eviction of five medical families in Sudak in 2015. The families of the medics moved to the Crimea in 2007 and received service apartments. But a year after the occupation of the peninsula started, Sudak “administration”, controlled by the Russian invaders, refused to “extend the social rental agreement”, and later doctors received a written “request to vacate the housing within 10 days” from the head of the “administration” Volodymyr Serov.

Sudak “officials” referred to the fact that the housing provided by the Ukrainian authorities is allegedly “no longer subordinated to the hospital”; the Russian invaders’ “administration” even “sued” because doctors refused to vacate the apartments. To the direct doctors’ question – to whom will their real estate be transferred – the “administration” answered that “respectable persons will receive those apartments” [22]. It is not difficult to assume that these apartments, which are located in the resort town, went to either local Kremlin collaborators or to the “officials” from Russia who are involved in corruption schemes on the peninsula.

At the same time, since 2014, Russian propaganda has been constantly promising to “provide Crimean doctors’ housing with one hundred percent”. Today, the Kremlin-controlled “administration” promises to “provide Crimean doctors with apartments in new buildings”, in particular in 2020 doctors were promised to get as many as 300 apartments [23], and last year Crimean “officials” promised to provide doctors “15 thousand square meters of housing in new neighborhood in Yevpatoria” [24]. However, this did not happen “for some reason” and there is still a total shortage of medical staff throughout the peninsula, which is direct evidence of the “truthfulness” of the promises of the invaders’ “government” of the Crimea. Probably Crimean “officials” decided to “keep up with their Russian counterparts” who, according to the head of the Accounting Chamber of Russia Alexei Kudrin, steal 5 million rubles from the federal budget every 10 minutes, and, according to Russian officials, “it is impossible to count at all” the amount of stolen funds from regional and local budgets [25].

Summing up the sad results, we can only wish the Crimean residents a good health, as they have to rely for it solely on their own immunity and finances. Occupying the peninsula, Russia did not even think to establish there socially significant areas of life, including medicine. Local Russia-controlled “officials” immediately began looking for ways to enrich themselves, and Crimea’s health care sector became just a cog in the imperial corruption machine.

Of course, the cynicism of robbers, stealing billions on children’s wheelchairs, is impressive, but this is the reality of the “Russian world”. The complexity and hopelessness of the situation is that Ukraine can only develop medical infrastructure in areas adjacent to the Crimea, document numerous human rights violations on the peninsula and demand for international courts and negotiating platforms to Russia stop bullying Crimean residents. However, the prospects for the Crimean medicine’s developmen are likely to be bleak, the situation will only become less difficult after the de-occupation, and the lives of Crimean citizens of Ukraine cost less than a bribe to win the next “tender” now.

Sources:

1. https://www.rbc.ru/society/07/06/2018/5b1868099a79471e1367d24a

2. https://censor.net/video_news/392717/z_pomynok_ya_yiomu_mrt_pryznachyly_a_tam_cherga_velyka_vin_pomer_meshkantsi_okupovanogo_krymu_skarjatsya

3. https://ukrainenews.fakty.ua/389110-medicina-v-krymu-umerla-zhiteli-pol uostrova-stolknulis-s-sereznymi-problemami

4. https://crimea.suspilne.media/ua/news/6191

5. https://ua.krymr.com/a/27204270.html

6. https://arc.construction/4943?lang=uk

7. https://www.vademec.ru/news/2015/05/27/v_krymu_vozbudili_23_ugolovnykh_dela_iz_za_korruptsii_v_zdravookhranenii/

8. https://vademec.ru/news/2015/04/09/krymskiy_tsentr_narkologii_zakupil_lekarstva_bez_konkursa_na_4_mln_rubley/

9. https://regnum.ru/news/2190315.html

10. https://ru.krymr.com/a/simferopol-medcentr-semashko-sryv-srokov/3033 6083.html

11. https://ru.krymr.com/a/perenos-sroka-otkrytiya-bolnicy-semashko/30369 919.html

12. http://argumentua.com/stati/sanktsionnyi-skandal-kak-general-electric-i-siemens-snova-popadayut-v-krym

13. https://meridian.in.ua/news/66694.html

14. https://rg.ru/2017/06/29/reg-ufo/pochemu-onkobolnye-kryma-vynuzhden y-ehat-na-lechenie-v-drugie-regiony.html

15. https://vademec.ru/news/2015/05/27/v_krymu_vozbudili_23_ugolovnykh_dela_iz_za_korruptsii_v_zdravookhranenii/

16. https://ru.krymr.com/a/bez-dostupnoy-sredy-i-mediciny-v-krymu-rastet-invalidnost-naseleniya/30982510.html

17. https://rg.ru/2017/04/27/reg-ufo/pochemu-v-krymu-deti-invalidy-ne-polu chili-speckoliaski.html

18. https://www.crimea.kp.ru/online/news/4612596/

19. https://ru.krymr.com/a/kak-krymskie-mediki-vybivayut-kovidnye-doplat y/30928494.html

20. https://crimea-news.com/society/2021/12/02/865970.html

21. https://www.svoboda.org/a/30657589.html

22. https://lenta.ru/articles/2017/04/17/mediki/

23. https://tass.ru/nedvizhimost/8379793

24. https://crimea24.tv/content/v-evpatorii-postroyat-noviy-mikrorayo/

25. https://www.mk.ru/economics/2020/01/14/rossiyskie-chinovniki-kazhdy e-10 -minut-voruyut-5-millionov.html