And Now We Have to Prove We Got Sick on the Job

pni-no 10Psychoneurological Resident Treatment Facility (PRTF) No. 10 in Petersburg. Photo courtesy of City Walls

And Now We Have to Prove We Got Sick on the Job
Galina Artemenko
MR7.ru (Moy Rayon)
May 18, 2020

The first case of COVID-19 at Psychoneurological Resident Treatment Facility (PRTF) No. 10 in Petersburg was at the very beginning of April. All efforts were made to hush up the story, but they failed. MR7.ru reported that the Ministry of Labor and Social Protection and three other relevant agencies had recommended that the regions remove the most severely disabled people from PRTFs. The ministry had also recommended that  social welfare facilities switch their employees to long live-in rotations while raising their salaries. Finally, the chief public health physician in the Petersburg office of Rospotrebnadzor had issued an order permitting volunteers to work at PRTFs.

The virus spreads most quickly in closed places such as hospitals, barracks, and residential treatment facilities. And we have heard the sad stories of infection at the nursing home in Vyazma, and the deaths of elderly people in nursing homes in Italy and Sweden. I hope that, after the pandemic, the conclusions will be clear. PRTFs are factories of misery, and facilities housing over a thousand patients should not exist.

On condition of anonymity, Nastya (her name has been changed), a young attendant at PTRF No. 10 told us about her experiences during this time. PTRF No. 10 houses more than a thousand people living with severe disabilities, who are cared for by approximately 400 staff members. According to official reports, more than 400 people at the facility have been infected, and two disabled girls who lived there have died.

At the beginning of April, we all got phone calls: they were asking people whether they were willing to volunteer for long rotations. We were told everyone would be under observation to make sure covid did not get into the residential treatment facility and to keep the patients from getting ill. But the director said there would be no long rotations, because there was no money, and we were supposed to get extra pay for that. But he was unable to pay bonuses to the staff. So we were not shut down and kept working as normal. As during an ordinary quarantine, access to the residents was closed to their parents. But we kept coming in for our shifts as usual—until April 8, when our residents started going off to hospital with pneumonia, while the first case of covid was confirmed on April 10. The same day, the tenth, people from the district office of Rospotrebnadzor came to the facility. There was a meeting, where we were told the decision had been made to shut us down. So we began working on long rotations. Right now, while I’m in hospital, only two wards [at the PRTF] are on watch. They’re under quarantine, while all the rest are clean.

So when they had called and assembled all us volunteers, all of us were locked up in the facility. Hermetically sealed.

We had been promised the ward would be divided into a red zone and a clean zone, but that had not been done. We made the zones ourselves. Well, what I mean is that we assigned the residents to one of two stations so, at least, they wouldn’t be going back and forth. We had two stations on the ward, connected by corridors.

Yes, we have one doctor on duty on the ward, but he or she is a psychiatrist, not an infectious disease specialist.

We did not have any PPE, only gloves, which have always been issued in the residential treatment facility, and the cotton-gauze bandages that we sewed ourselves. The first week was more or less okay. We worked. And then everyone began to get sick—both residents and staff. Everyone’s temperature started to rise. At first, everyone on the ward tried to treat themselves with Antigrippine. We had smears taken on April 13. There were still smears that came back negative, but on April 22, everyone’s smears came back positive, so I think that of the sixty people or so whose smears had come back negative [on April 13], they were false negatives, meaning that the entire facility was sick. Staff who had mild cases went home, while those with more severe cases went to hospital. And the residents also went to hospital.

I was also taken to hospital. When I got there, we were heavily fed malaria pills. I had almost no fever, but I had a cough and was gasping for breath. I have been in hospital since April 20.

The money? I don’t know whether they will pay us—they didn’t even pay all the wages they had promised. We didn’t sign anything about agreeing to work with covid. We took our management’s word for it. Now we have to prove that we worked with covid and got sick at work.

I know that [Petersburg Governor Alexander Beglov] came to the facility, and he and the director agreed that not only the doctors would get paid, but also the nurses, and the attendants, and the cafeteria workers, because everyone had worked directly with covid.

The residents didn’t understand what was happening. And we didn’t understand at first either, we didn’t know what the condition was until we got sick ourselves.

No, I wasn’t scared, I just wanted to go home. Well, it was scary when the young male residents on the ward started having disorders, and the psychiatric hospital wouldn’t accept them because our facility was under quarantine.

Residents who were ill with covid were taken to regular hospitals without being given psychiatric medication. That’s rough. I ended up at the same hospital as an old woman from our facility. I saw how the hospital nurses could not cope with her—they simply could not put her diapers on. Until she was transferred to the psychosomatic ward, I took care of her. Ordinary nurses and attendants don’t have the skills to interact with such people. They don’t know how to dress them, how to feed them, how to give them medicine. I think it was very wrong on the part of the municipal health committee or whoever was involved in this, that such people were sent to ordinary hospitals. This is intolerable. They pissed and shat themselves, and they yelled, and some of them smashed everything up and behaved badly. The staff at ordinary hospitals do not encounter this [ordinarily]. And they were without psychiatric medication. Later, they learned how to tie them down.

What will happen next? As long as we all sit on our asses waiting for something to happen, there is no hope that everyone who was cheated will be paid properly. But we are afraid that if we start this commotion, it will bounce back on us quite hard. So far I have started alone, but one soldier does not make a battle. They will take it out on me and my family. I will be fired and fired with cause, and then I will not be able to get a job anywhere.

PRTF No. 10 in Petersburg had previously been closed for quarantine due to the coronavirus. A patient at the facility had recently returned from treatment for other ailments at another facility, where he contracted the coronavirus. Ivan Veryovkin, the head of PRTF No. 10, then suddenly removed his facility’s intensive care unit from infection surveillance and suggested that volunteers come in the morning and leave in the evening.

As MR7.ru has argued recently, the epidemic has shown that PRTFs are “factories of misery,” and it is time to shut them down.

Translated by the Russian Reader. In case you were wondering who, exactly, was housed in Psychoneurological Residential Treatment Facility No. 10 in Petersburg, the Russian version of Wikipedia has the depressing answer. (The only other language in which there is an article on the subject is French, but the French article merely explains what PRTFs are in Russia.)

By the end of the twentieth century, there were 442 official PRTFs in the Russian Federation, but by the end of the first decade of the twenty-first century, their number was 505. According to data for 2019, there are about 650 PRTFS in the Russian Federation, housing 155,157 patients. Most of these patients (112,157) are officially incapacitated.

According to the data for 2003, more than half of all patients in PRTFS (68.9%) were people with reduced intelligence: people who had been diagnosed with mental retardation and various types of dementia. At the same time, intellectual disabilities in persons transferred from orphanages are often associated not so much with a real decrease in intellectual capabilities, as with pedagogical neglect [sic], lack of proper training and education, insufficient rehabilitation programs, and lack of rehabilitation centers for post-orphanage training.

According to information for 2013, during the year, about a thousand people were admitted to PRTFs in Moscow; in total, 10,500 patients lived in PRTFs in the city (of which 8,245 were men aged 18-58 years). About 5,000 were admitted to PRTFs from orphanages without undergoing psychiatric re-examination.

Sorry, We Have No Medicine

Unlike life-saving prescription drugs, hashish and other narcotics are easy to come by in Russia. Photo by the Russian Reader
Unlike life-saving prescription drugs, hashish and other narcotics are easy to come by in Russia. Photo by the Russian Reader

Sorry, We Have No Medicine
Alfia Maksutova
Takie Dela
November 24, 2016

What doctors and officials do to avoid giving patients the free drugs they have coming to them

“You’re not ill.”

“You don’t have that.”

“You don’t need that drug.”

“You need that drug, but a cheaper substitute will also do.”

“You need the drug, but we’re out of it, so you’ll have to wait.”

This is how doctors and officials respond to thousands of people who, by law, are supposed to receive subsidized medicines. They trick them. They know these people are ill, and they know what drugs they need. According to rough estimates, however, the state now lacks 45 billion rubles for providing drugs to the populace. In certain regions, only 10% of applicants can be supplied with subsidized medicines. Officials and doctors turn down patients in such a way that it is as difficult as possible to prove they have broken the law. The Health Ministry and the health care regulator Rosdravnadzor regularly report that things are stable when it comes to preferential drug provision in Russia. The figures underpinning the reports bear no relation to reality. The true scale and brutality of the war between patients and the state is striking.

***

“Every time, they say, ‘Sorry, we have no medicine. There is nothing we can do about it.’ But by law I am supposed to get them. If they are out of them today, the state should purchase them tomorrow. Isn’t that right?”

Veronika has repeated the question over and over, but her voice still sounds surprised. When she speaks, her hands, with their long, elegant fingers, tremble slightly, as if they too are incapable of coping with the surprise. She has used hormonal inhalers for fifteen years. Without them, she cannot breathe. She has asthma, a host of related ailments, and official status as a disabled person. She is entitled to get the necessary dose at the pharmacy for free, but the medicine has not been issued for a year and a half now.

“It was always given out intermittently,” says Veronika. “You had to find out ahead of time the day when the drug would show up and run to the clinic when it opened to be in time to get it. If you were late, they would tell you they had run out, and it was your problem. But it was only last year I had to deal with the medicine not being available for months at a time.”

Then, after waiting six months, Veronika first turned to the Moscow Health Department for help. It was enough to file an application and the inhaler, which the pharmacy did not have in stock in the morning, turned up in the evening. But the magical effect of phoning the health department did not last long. A couple of months later, the drug was once again no longer available. When Veronika called the health department this time, she was told the situation was complicated. She could file an application, but no one knew when the drugs would arrive. The same day, the pharmacy called her and said her request was pointless: the drugs would not be available. Currently, relatives have been paying for her inhalers to the tune of several thousand rubles a month. According to Veronika, many of the people queued up to see the pulmonologist could not afford to pay this amount. The phrase “we are out of drugs” is tantamount a death sentence to them.

Veronika’s case is one of thousands. It suffices to peruse the regional press for the past month to read a dozen such stories. In Mordovia, the pharmacies not only have no prednisolone for patients entitled to the free drugs benefits, but no iodine or bandages, either. In Oryol Region, a woman suffering from lymphoma managed to get medicine only after local media wrote about her case. In Khakassia, the Audit Chamber will be investigating the problems with subsidized medicines due to the large numbers of complaints by patients. Organizations involved in protecting patients’ rights talk constantly about the growing number of pleas for help. The Movement against Cancer, for example, has noted an uptick. In September of this year, there had been so many cases of cancer patients turned down for subsidized drugs that the Prosecutor General’s Office investigated legal violations in a number of regions. According to online monitoring data for September 2016, done by Alexander Saversky, head of the League of Patients, over 80% of those surveyed had trouble obtaining subsidized drugs. Only 35% of those people had managed to get a prescription for the drugs in question without problems. Similar figures were adduced in a survey done last year by the Russian People’s Front: half of the patients surveyed were not issued the medicines they requested on time.

A 2016 government report stated the subsidized drugs provision program was suffering a shortfall of 45 billion rubles [approx. 660 million euros]. This was no surprise. The standard cost per person receiving free drugs has dropped from 849 rubles a month, in 2011, to 758 rubles, in 2016. According to Rosstat, however, the price of drugs has increased this year by 24%. In 2015, the government allocated an additional 16 billion rubles to alleviate the situation, but, unexpectedly, they were not used. The Health Ministry has said that all necessary drugs have been purchased. Roszdravnadzor regularly monitors the supply of drugs nationwide and has remained satisfied with its results. According to the reports issued by these agencies, around 98% of beneficiaries in Moscow Region, for example, receive their drugs, and the situation in other regions is stable. The Health Ministry’s ability to force public health officials to bend reality for reporting purposes has amazed even the president. Continue reading “Sorry, We Have No Medicine”

Ministry of Funny Walks

motyl-lightsoutforputin_hockey
Russian President Vladimir Putin skates during a training session of participants of the Night Ice Hockey League in Krasnaya Polyana, Sochi, Russia, January 6, 2016. Photo: Aleksey Nikolskiy/Reuters

Disabled Man Not Admitted to Ice Hockey World Championship Match Because He “Walked Funny”
Rosbalt
May 17, 2016

Roman Mironov, a Category I disabled man, was unable to attend a Ice Hockey World Championship match, despite the fact he had a complimentary ticket. He told his story to Rosbalt.

“I was given a complimentary ticket, because I am a volunteer and help people with disabilities. I decided to go to a hockey match at Yubileiny Arena [in Petersburg], but the police turned me away, saying I ‘walked funny.’ I asked them to substantiate their actions, but they refused to give me an explanation. I showed them my ticket, but they did not even want to look at it.”

According to Mironov, this was not the first time he had not been admitted to public events.

“There have been cases when I have not been admitted to public celebrations and football matches,” he said.

Mironov has childhood cerebral palsy, because of which, he admits, he has been the target of discrimination on more than one occasion.

The Russian Federal Interior Ministry officially announced that police do not exercise checkpoint and admission functions at sporting events.

“It should be noted the police’s job at sporting events, including the hockey championships, is solely to ensure public order,” the Interior Ministry said.

The Ice Hockey World Championship kicked off in Petersburg on May 6 and winds up on May 22.

Translated by the Russian Reader. Thanks to Mediazona for the heads-up. Photo, above, courtesy of Foreign Affairs