Демография России (сайт посвящён проф. Д. И. Валентею)
мужская консультация

Lives Lost: Russia

'TB is not a medical problem. It is one of economics and organization.'

(Boston Globe, 28 February 2003)
By David Filipov, Globe Staff
VLADIMIR, Russia -- Nikolai Bogdanov hobbled painfully down the dark, moldy corridor of the tuberculosis ward, through the thick clouds of cigarette smoke, past dozens of men in flannel shirts, jeans, and slippers, many of them with faces as gaunt and sallow as his own.

Once in his doctor's office on that chill November day, Bogdanov sat deferentially on the edge of the couch and spoke in a frail voice about his worst mistake, one that has made him a symbol of how Russia's TB epidemic has become so intractable and so dangerous. It was a mistake that cost him his life.

Bogdanov recalled how in April the nightly fevers had returned -- a sign that he had suffered a relapse of the tuberculosis he contracted in 1997 while hospitalized with a pancreatic infection. The doctors in Vladimir, an industrial city about 100 miles east of Moscow, wanted to hospitalize him right away, but the 38-year-old electrician refused to go.

Bogdanov had been making ends meet however he could since the end of communism brought economic uncertainty along with more personal freedoms in this country. The old system promised ordinary workers little, but it did guarantee a job, a place to live, and cradle-to-grave medical care. Now, he had a family to take care of. And he had to pay $15 a month -- half of his unemployment and health benefits -- for the private school that his pride and joy, his gifted 11-year-old daughter, Nastya, attended.

"I decided to take on work to put clothes on my kids," Bogdanov said in his low, quavering voice. "You see, I have no close relatives, no one else to take care of them if something happens to me."

His voice tailed off. Bogdanov turned away and coughed discreetly into his cupped fists to avoid passing on his personal death sentence -- multi-drug-resistant tuberculosis, all but incurable for someone in such a weakened state -- to his visitor, who wore a protective mask, and his doctor, who did not. The doctors rarely wear them, even though Grigori Volchenkov, the clinic's chief physician, said "quite a few" medical workers had become ill, including an anesthesiologist who died last year.

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