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A Disease that Kills in Russia

This week the Financial Times is running its global health outlook section, and the journalist Miriam Elder (whom you may know from Moscow Times and PostGlobal) has probably the most unique and hard-hitting report:  a first person account from a Moscow doctor who contracts tuberculosis, one of Russia’s deadliest pandemics. 

According to USAID, Russia ranks 12th on the list of 22 high-burden tuberculosis countries in the world, claiming the lives of 288,250 people between 1998-2007.  In late August, the Washington Post reported on the increased spread of new strains of drug-resistant TB in Russia, sped along by government missteps and causing infection levels in the Far East of the country to rise above three times the epidemic classification from the United Nations.

This FT report hits close to home for us, following the state’s treatment of the former Yukos general counsel Vasily Alexanyan.  

While serving hard time in pre-trial detention, though he had broken nolaw, Vasily contracted both tuberculosis and HIV AIDS.  The prosecutorssaw an opportunity for extortion,and withheld life-saving medical treatments from the prisoner in orderto medically blackmail him into providing false testimony againstMikhail Khodorkovsky.  That must be some strong case that thegovernment has against him if this is what they need to do.  Alexanyanhas been released now, but far too late to make any difference in hisrapidly expiring life.

At any rate, Elder’s piece makes forgripping reading, giving us just a glimpse of the kind of terror hemust have gone through, along with tens of thousands of other Russiancitizens dealing with TB:

When I look back, I can see I had symptoms for a while. I started tohave sweats and to cough, and I was losing weight. But I just thought Iwas tired or eating badly.

One night, I lay down to sleep and I started to cough. I went to thebathroom and started coughing up blood. A lot. That’s when I really gotscared. I didn’t sleep the whole night. I stayed up thinking what couldbe wrong. (…)

I didn’t go to the doctor because, at the time, I was working in aprivate clinic and they didn’t offer us insurance. A doctor withoutinsurance – that’s Russia.

When I discovered my treatment was not working, I changed the pills, and started giving myself injections.

Throughout,I kept working, which was really hard. These medicines are very hard tohandle. Some made me really drowsy; some made me really nauseous. Twicea day I was giving myself injections in my legs, which meant theyreally hurt. But I still hid everything and told no one.

Then,when it got really tough, I quit my job, telling my employer I hadfound another that paid more. And I told my family I’d taken asabbatical. I tricked everyone.