[state health system] in the russia of the late 90s and the noughties

A polyclinic might be found on the first floor [ground floor] of any large housing block

South African Steve Hayes, of the fine blog Notes from Underground, writes:

My only experience of the NHS was over 40 years ago when I went to a dentist in London. It seemed to work OK then. Like anything worked by humans beings, no doubt it leaves room for improvement.

What was the Russian health service like when you were there? When I was there in 1995, it seemed pretty putrid, and everyone I spoke to seemed to think that it had deteriorated rapidly in the early 1990s.

Steve, on the British system, I'm no expert. These folk say it's bad but this chap, Rick, says it's good [don't mind my feistiness in comments].

My girlfriend's mother was a doctor in the state system and I'd occasionally go to the polyclinic to see her although she was a paediatrician and by all accounts, a good one. I saw people with appointments sitting around and as far as I could see, it operated as it does in the west. People went in, were treated and came out of that room. Different rooms had different purposes.

It was prescriptive in the early days but there was a major move to catch up with the west and a lot of in-service studying was going on with the doctors. Our university [and in fact all institutions] had compulsory fluorographs and near the end of my stay, compulsory biennial check-ups, which had to be seen to be believed.

The fluorographs were OK - a van came near, we were informed and had a couple of days in which to queue up [not too many in the queue]. I was in that van with women mainly and not all were particular about changing out of dress so I thought why should I be any different? The radiologists were perfunctory and Soviet but not unpleasant.

Coming back to the biennial checkup, it was like circuit training in a gym or jabs in the army. One floor of the university was given over to the doctors and it was a case of go to Table A to have your reflexes checked, then to give our sample which we'd brought, into a room for a bloodcheck then onto a bench to wait.

Next into another room where the interview came with a doctor with a quite pleasant bedside manner and he did the blood pressure, next room for the eyesight and so on until the thing was through. Sounds horrible but actually it was all done in an hour and a bit and I didn't mind it. The Russians were used to it.

It did appear to become better as the post-Soviet years went by. Russians adore their children and overindulge them whenever possible - the stern attitude almost always relaxes with children.

The only time I was sick was at the beginning of my stay, 12 years earlier and that was pure Soviet. I had flu and apparently, it was close-to-death stuff - I was diagnosed as having been likely to snuff it if the medicos hadn't rushed to the flat where I was staying. A doctor dressed in dusky military green came and sat down on a chair and directed junior doctors to do the jabs etc.

A special doc arrived and inserted this tar compound down the back of the nose and I tell you what - it cleared everything for weeks. My friends arrived with fruit [and it was damned expensive at that time, mid winter] but that's what people did there - friends and family, de rigeur, stepped in and helped anyone in such a situation.

Look, it was rough and ready but it was mighty effective. The bedside manner no doubt came in later years, when private clinics sprang up.

I can speak of the dentist better and after a brush with the state variety, on referral by my gf's mum [very NHS in its documentation and referrrals], one had to give a box of chocolates to the woman doctor for deigning to see us ahead of the queue and the service was OK. Later, when I had my first filling in the private clinic, the doc asked who had put in the filling which had fallen out and I told him the state doc. He raised his eyes to the ceiling and put it straight.

All that work is still in place, I always had the anaesthetic ... really it was no different to here I imagine except that everyone had disposable plastic galoshes to put over our shoes and these were binned on the way out. There was dispute over payment and my gf had a standing row at the front desk [she was a little lioness] over free treatment in an emergency [some law] and they argued it was not an emergency but the papers were signed anyway and I got a heavy discount.

Plus tea and sympathy later, which was more than nice. Russians don't suffer malingerers or hypochondriacs in their tough life but if someone is genuinely sick, all hands chip in to get the person up and about again.

It was still whom you knew and which clinic you went to but there was, at the end, private choice, at a cost - no health insurance - one paid cash. Or else it was the local polyclinic for your area, long queues, brusque reception and no beg pardons. The Russians went to the pay clinics in droves.

Doctors did too because a state doctor's salary was about $250 p.m. in 2008 but in a private clinic, was half western doctors' salaries - big difference.

Medicine itself - western, drug based. Have a problem? Get prescribed a pill although herbal remedies were still used a lot and I had some of those after dental work. Getting the right herbs was a big deal over there, grandmothers knowing exactly which ones and how. They worked too.

They were humans, the Russians, as we are and much of it was probably a bit as it is with us. I'd appreciate knowing how the South African system works, by the way, if you could do an article on it, Steve. My best treatment ever was in Finland and in an American forces hospital in NW Australia. My worst [and it wasn't too bad, to be fair] was in a British clinic in North Yorkshire.

That's about all I can think of, really.

This picture seems close to what I recall - newer technology coming in, in still old buildings - you can see the ladies are not ogres, as appeared to be de rigeur in early post-Soviet days