Experts Predict the Closure of All Rural Hospitals by 2023
Ilya Nemchenko RBC
December 9, 2016
If the number of social welfare institutions continues to decrease at the same pace, there will be no hospitals in rural areas within seven years. Experts argue that all rural schools and medical clinics could be closed within seventeen to twenty years.
Based on Rosstat’s data, the CEPR has calculated that, over the past fifteen to twenty years, the number of rural schools had shrunk by nearly 1.7 times (from 45,100 in 2000 to 25,900 in 2014), the number of rural hospitals by four times (from 4,300 to 1,060), and the number of rural clinics by 2.7 times (from 8,400 to 3,060).
The upshot is that all rural hospitals could close in seven years, while all rural schools and clinics could close in seventeen to twenty years, claims the report.
“It is clear that this is not possible and that all ‘optimizations’ have their limits. However, there are fears that social welfare institutions will continue to close in the countryside in the coming years, albeit at a much less impressive pace,” write the report’s authors.
The optimization of schools and hospitals is often justified by decreases in population, although it is socio-economic problems that facilitate flight to the cities. The experts argue the government has deliberately pursued a policy of depopulating rural areas and has deprived the countryside of its “last hope for the future.” They call the current circumstances a vicious circle. Optimization of social welfare facilities has proceeded at a much faster rate than rural depopulation and the abandonment of villages.
According to the report, the rural population has been in constant decline over the past twenty years. This has happened due both to migration outflows and the fact that the death rate has exceeded the birth rate. The number of deserted villages increased by more than six thousand from 2002 to 2010, to 19,500. Moreover, less than one hundred people live in more than half of all rural settlements.
The experts note that while the number of depopulated villages has continued to grow in Central Russia and the north, rural areas have been developing vigorously in the south. In 2016, the North Caucasus Federal District had the largest population in terms of percentages (50.9%), while the Northwest Federal District had the lowest (15.8%).
The study underscores that the main causes of depopulation in the countryside are social and economic problems. The standard of living is low in rural areas, while unemployment is relatively high, and this has spurred a growth in the crime rate. The experts note that prices in rural areas are high, so country dwellers spend more money on food than city dwellers do.
Population outflow has also been due to the poor quality of utilities and housing. According to the CEPR, only 57% of rural housing stock is supplied with running water, while only 33% of houses have hot water. The condition of the water mains in the countrsyide has constantly grown worse: only 54.7% of residents are supplied with safe drinking water. The experts note that only 5% of villagers have sewers. (This figure has not changed since 1995.) However, the provision of natural gas is relatively better. According to Rosstat, approximately 75% of the rural housing stock is supplied with pipeline or liquefied gas.
The CEPR’s researchers write that the government policy has concentrated capital, jobs, and people in the large cities, while attempts to maintain the rural population have failed, because there are no conditions for developing the villages. The experts believe that comprehensive socio-economic reforms are needed to solve the problem. Otherwise, the number of deserted villages will have increased by the time of the next census.
Translation and photo by the Russian Reader
See some of my previous posts on life in the Russian countryside:
You Have the Oyat at Your Back, Young Arseny
Viktor Smirnov 47news
November 23, 2015
Arseny, a third-grader from the Podporozhye District, crosses a river in a boat on his way to school. On the weekends, he serves as an altar boy at a church. His father abandoned Arseny and his mother, a real estate agent conned them, but the authorities know the score. At school, he got two zeroes for conduct when he had no pencils or shoes on September 1, the first day of school. 47news journeyed to the backwoods of the Leningrad Region and spent a day with Arseny’s family.
Every weekday at 7:40 a.m., 9-year-old Arseny Prokhorov and his mom Irina Prokhorova ford the Oyat River in a rubber boat. They are hurrying to school.
The Oyat River, which has its source in the Vologda Region, is 266 kilometers long and flows into the Svir River. It has a strong current and contains rapids. Its course has not changed for at least a thousand years.
“It is especially frightening in the mid season, when the ice sets and the current pulls along whole sheets of it. We make a point of carrying the boat higher upstream. And in the spring, the current carries the slush produced by the ice, and the water rises a lot,” Irina Prokhorova told me.
Last spring, she was crossing the river alone when the boat capsized and she fell into the water. But she swam ashore pulling the boat out with her. Arseny stood on his side of the river and cried.
Believe me, he is quite grown up. Incidentally, the only two zero marks for conduct he has had this year were on September 1 and September 2. He had no notebooks, pencils or shoes. Children’s protective services came after that and inspected the house, but nothing has been heard on this shore from social services since then.
The boy and his mother have lived in the village of Gribanovskaya in the Vinnitsy Rural Settlement of Podporozhye District for four years. The village is situated on the right bank, but seven houses have stood on the left bank for a long time. No one lives in six of them during the winter: they belong to summertime cottagers.
The school bus picks Arseny up at 7:50 a.m. The school itself is four kilometers away, in the village of Vinnitsy. On the weekends, the only way to get there from Gribanovskaya is on foot. Irina uses an old bike to get there or she and Arseny walk there together. The commuter bus runs three times a week: Mondays, Wednesdays, and Fridays.
The village of Gribanovskaya is 350 kilometers from Petersburg and 76 kilometers from the district center, the town of Podporozhye. The village contains around ten households and three dozen inhabitants. The first census of Gribanovskaya was taken in 1873.
That House There
After our phone call, the mistress dashes out of the house, climbs down a steep bluff, unties the boat, and drags it to the water. Plying the oars in a masculine fashion, she sails towards us.
A petite woman jumps nimbly from the craft. She is dressed neatly, but is nervous. We clamber aboard the boat. The first to go aboard is Father Vladimir, rector of the local church. He helps the family any way he can. I, the correspondent from afar, get on the boat second. We have to step from the sloping ice into the boat’s soft bottom. The black water, the tiny oars, and the air temperature do not inspire me with optimism. I begin to doubt whether the boat will bear our weight. The priest is not having such a smooth time of it on the oars. We begin to drift.
The backyard is depressing. Irina gets right down to business. They will soon run out of firewood. Father Vladimir frowns.
I am given a brief, simple tour of the local way of life. Irina and Arseny once had rabbits and a couple of pigs. They slaughtered them out of necessity. The garden and the potatoes they grow there are their salvation.
Arseny’s diet is as basic as that of a postwar child: oatmeal in the morning, soup for lunch, and buckwheat kasha or macaroni for supper. The family lives on 2,500 rubles a month [approx. 35 euros], which Arseny’s grandmother sends them. Irina’s oldest daughter from her first marriage helps them out by sending produce.
“Once every two weeks we sail to the mobile shop,” says Irina.
She would be glad to work, but jobs are nowhere to be found, neither in Vinnitsy nor, especially, in Gribanovskaya.
Irina is from Petersburg. She has two daughters from her first marriage, aged 17 and 27. She and her new husband moved to Vinnitsy. They had decided to get away from the noise of the city. Arseny was born there. In 2012, their house burned down. Since Irina was officially registered as a resident of Petersburg, she was refused assistance by the local authorities. With this incident in the back of her mind, she does not ask the authorities for anything nowadays. She had to sell her share in an apartment in Petersburg and buy the house in Gribanovskaya. Moreover, the real estate agent, who showed them the house in winter, did not mention there was no bridge or ferry. Nor did Irina ask. Then her husband hit the bottle and left the family. In parting, he gave Arseny a lifejacket.
We go into the house. Only of one of the three floors is inhabited. It contains a kitchen with a brick oven and a double room. It is warm and cozy inside, not at all like it is outside. Arseny comes out. He shows us his desk, books, and drawings. He gets Bs and As at school, although he recently got a D in shop. He did not bring glue and cardboard to class. His mother did not have the money to buy them. On the other hand, he is a champion at reading contests.
Arseny takes weekly lessons with a painting teacher in Vinnitsy. Once again, Father Vladimir has helped him out with this. Arseny says his dream is to be an artist and see the Coliseum and the Louvre one day.
Arseny’s hobbies included books and chess, which he has played since the age of six. He also likes the SpongeBob SquarePants cartoons.
When asked whether he knows who Bobby Fischer was, he confidently replies, “I saw a book about him, but I haven’t read it yet.”
Right at this moment, a film about the life of the brilliant American chess player is showing in Petersburg theaters. I doubt that most young people would have responded to my question as Arseny has.
There is a computer in the house with Internet access. Although his mom does not encourage it, Arseny has his own page on the VKontakte social network and is interested in the news. Among the latest news, he remembers the crash of the Malaysian Boeing the most. Arseny has the sense the world is ruled by God, and that Vladimir Putin reigns on earth. True, at first the lad misspoke himself, calling the president “Alexander.” He also knows about important people “somewhere out there.” But the ticks and vipers in the backyard are more real to him. He makes no bones about the fact he is afraid of them.
A tick bit him this past spring. It turned out to be carrying encephalitis. The doctors kept Arseny in hospital five days and then sent him back home with his mother. Since then, Arseny has periodically had a temperature.
This is bad, because earlier the boy had suffered from barely noticeable disabilities that had almost disappeared through the efforts of his mom. The boy has been exempted from attending physical education classes. Which is just as well, since every day he does chores at home like an athlete. Now Irina worries whether the encephalitis will affect his nervous system.
“The school requires a written waiver exempting Arseny from transfer to boarding school. But how can I give him up?” wonders Irina.
Father Vladimir supports her. He booms that it would be wrong to send the boy from his child’s bed, with his mom nearby, to a state-sponsored cot.
And There is a Church Nearby
We get ready to go to the local church. Arseny serves there as an altar boy, helping with the mass. As we get ready to go, it transpires that the most burning question will soon be the question of winter boots. Arseny simply does not have any. The boots donated to him two years ago have fallen apart. Despite their problems, mother and son look neat and self-possessed. We have to cross the river again.
We take Father Vladimir’s Zhiguli to Our Lady of Smolensk Church in Vinnitsy. We go into the church, which smells of oven, wood, and incense. There is a stand-up piano in the corner. After the icy snow, drizzle, and darkness, I immediately feel sleepy. Arseny assists the priest for two hours.
It is getting on towards nine in the evening. There is neither a single soul nor a single car on the streets of Vinnitsy and, especially, Gribanovskaya. We have returned to the ford. The road was utterly muddy, and snow mixed with rain is coming down. In the darkness, descending the steep bank to the boat is completely unpleasant. We bid farewell to the squeaking oars. We cannot see the boat all. Just in case, we say goodbye again. We hear a reply. It is like a film about the war, as if they are going off on a recon mission.
I finished my work in Gribanovskaya around nine in the evening. Father Vladimir gave me a lift to Vinnitsy and set off to administer extreme unction to a local woman. In her youth she is said to have practiced witchcraft.
There was no sign of cars on the street, so my logistics hit a dead end. The local police saved the day. A call to Podporozhye District Deputy Police Chief Dmitry Vladimirov asking to facilitate my not kicking the bucket was understood loud and clear. His guys saved the day. Police officer Andrei (who, incidentally, was supposed to be finishing his shift) drove me 75 kilometers through a blizzard and over potholes to Podporozhye. Along the way, his wife called, worried.
Suddenly, in a place where the thicket had almost overgrown the road, a healthy white wolf with gray markings crossed the road in front of us. The beast stopped, flashed its eyes, and vanished. Perhaps it was surprised to see people at such a time in such a place.
P.S. Of course we talked with Arseny and his mother. You can soon read about Arseny’s dream on 47news. In the meantime, think about this article.
Translated by the Russian Reader. Videos and photos courtesy of 47news
This is the school in the tiny village of Nikolskoye. You can get to the village by bus from Tula: the trip takes an hour and a half. There is no public transportation between Nikolskoye and the nearest large village, Krapivna, and the district center of Shchyokino. The locals rarely leave the village.
Zoya Nikolayevna: “In four years, we’ve turned it into a normal school.” Sergei Alexandrovich: “The parents now see their children as human beings.”
This is the school’s director Zoya Nikolayevna and her husband Sergei Alexandrovich, a teacher and the school caretaker. They live in Krapivna, and until 2008 they worked at the Krapivna boarding school for orphans and sick children. When the boarding school closed, Zoya Nikolayevna, Sergei Alexandrovich, and a team of Krapivna teachers transferred to the Nikolskoye School.
Around eight in the morning, the couple leaves for work by car. The trip takes them through hills, a forest, and fields.
“It’s been flooded for a month.”
The road from Krapivna to Nikolskoye crosses the river Upa. In the spring, the Upa floods, completely covering the bridge. During the floods, the Emergency Situations Ministry organizes passage across the river. Previously people were ferried on a military amphibious vehicle, which resembles a tank without a gun. Now they are ferried in a small motorboat. The motor constantly stalls, and an ESM guy has to row all day from shore to shore, battling the strong current.
“There is no spare motor, mooring or field kitchen,” the ESM guy complained as he plied the oars, “but the brass flies in an expensive helicopter and shoots everything on an expensive screen.”
The teachers from Krapivna make the crossing twice a day.
Teacher: “Children calculate on their telephones. They have no use for mathematics.”
There are twenty-three pupils and ten teachers at the Nikolskoye School. There are four pupils in the biggest class, and one in the smallest.
Several pupils commute from the neighboring villages, where there are no schools. In summer, they come on bicycles; in winter, they go on foot. When the roads are drifted over with snow, and the local authorities have not had time to clear them, they stay at home.
The school in the neighboring village of Kuzmino remained open for a long time with five pupils. There were more teachers than pupils.
If there is no school, a village is doomed, the teachers say.
By comparison, there are no fewer than twenty pupils in each grade at the Krapivna village school, and a total of 226 pupils in all.
There are classes in which half the pupils are children of migrants. Families from Dagestan are moving to Krapivna in large numbers and buying homes. Migrants from Central Asia settle in hostels on the outskirts of Krapivna. They work in gardens and storage facilities.
In the class depicted in the drawing, above, there were two pupils who were Uzbeks, a Tajik, a Lezghin, and an Azerbaijani.
The children get along with each other.
“They’re all local kids to me. We have a friendship of peoples here,” said the teacher smiling.
But there are problems, too. Not all the children of migrants speak Russian passably. Not all the children are sent to school on time. For example, the Tajik boy was three heads taller than the other pupils. It turned out he had been enrolled in the first grade at the age of ten.
Teacher: “Is ‘Moscow’ a person’s name or a place name?” First-grader Sasha: “It’s a street.”
For now, there are only ethnic Russian children at the Nikolskoye School—no migrants.
The village has a single employer, Nikolai Kurkov, former chairman of the Lenin Komsomol State Farm and now the owner of two farms, a grove, and a dairy.
The parents of the pupils at the Nikolskoye School either work for Kurkov or have moved to Shchyokino or Tula, leaving their kids with their grandmothers.
The kindergarten closed back in the 1990s and, unless their grandmothers raise them, the children turn into rural Mowglis.
There are two pupils in the first grade, but the teacher has a hard time coping with them.
“At the beginning of the school year, they ran around the classroom during lessons and screamed,” she recounts.
It would be unprofitable to open a private kindergarten in the village: Nikolskoye residents would not be able to pay more than a thousand rubles a month (approx. twenty euros) per head to send their kids there.
The village school lacks a gym and a cafeteria. A kitchen has been set up behind the bookshelf in the most spacious classroom. The tables there are laid when the children have lunch.
They are fed buckwheat kasha, macaroni, and rice with gravy, sausages or hamburger patties, and a delicious compote. The grandmother of one of the students, a former employee of Kurkov’s dairy, works as the cook.
A chauffeur drives the village’s “gilded youth,” Kurkov’s numerous grandchildren, to a more comfortable school in the district center.
Chorus on stage: “These are the victims who have come to life from the ashes and risen once again, and risen once again!”
On May 9 (Victory Day), the pupils at the Nikolskoye School put on a holiday concert under the direction of the music and physical education teacher. Guests arrived: two war veterans, who had got tipsy for the occasion; two female graduates of the school; three old women; and an elderly former teacher who cried throughout the concert.
The upperclassmen have been touched by the events of the Great Patriotic War (World War Two). Many of their grandparents had told them how the fascists marched through Nikolskoye when they were children. But other events of Russian history are dry, boring texts in textbooks to the kids.
The first-graders do not know the name of our country’s capital.
“Well, and what of it?” winces their teacher, who believes Moscow is a big dump.
Indeed, what of it? Moscow residents are also uninterested in the life and death of lost villages like Nikolskoye.
Recent publications in English by and about Victoria Lomasko: