Valentin Urusov: A Worker’s Struggle (August 2012)

One of the most egregious frame-ups on drug charges in Russia in recent memory was the case of Yakutia trade union activist Valentin Urusov.

The weekly magazine Russian Reporter told Urusov’s story in August 2012, after he had been in police custody and then prison for over three years.

The article was, in fact, part of a second international campaign, led by Russia’s independent trade unions, to persuade the Russian authorities to release Urusov from prison.

This time around, their efforts paid off, and after his release, Urusov was awarded the Arthur Svensson Prize, the “Nobel Prize” of international trade unionism.

When I posted the following translation of the Russian Reporter article on January 25, 2013, Urusov was still in prison, doing time for crimes everyone who knew anything about the case knew he had not committed.

It is silly to compare these things, but I think Urusov’s story is much more horrifying than the much more recent story of Meduza reporter Ivan Golunov. First, it happened at the end of the earth, geographically speaking. Second, Urusov’s supporters had neither the social capital or the numbers to instantly launch a widespread moral panic to secure his immediate release.

Powerful men, including the men who run Alrosa, Russia’s state-owned diamond mining company (whose board at the time included Alexei Kudrin, laughably regarded as a “liberal” by people who do not want to know any better), wanted Urusov to go down, and so he went down, despite the absurdity of the charges against him, despite the fact that the police officer who engineered his frame-up was later found guilty of fraud and abuse of authority, and despite the fact that the Yakutia Supreme Court overturned his conviction in May 2009. (It was reinstated by the original, lower court a little over a month later.)

In fact, although Urusov’s story is a central episode in the recent history of independent trade union activism in Russia, I would wager a large amount of money that the vast majority of Russians have never heard of Urusov and his horrifying ordeal at the hands of Russian “law enforcement.” || TRR

__________________________

A Worker’s Struggle
How an attempt to create a real labor union lands you in a penal colony
By Andrei Veselov
Russian Reporter
August 23, 2012

It is now acceptable to talk about political prisoners in Russia—it has become good form. But for some reason, bankers and financiers now and again end up on lists of “prisoners of conscience.” Their troubles are discussed in great detail, and there is sincere sympathy for them. Little is said about the fact that for the last four years Valentin Urusov, a rank-and-file worker, has been doing time at the penal colony in Verkhny Vestyak, Yakutia, for attempting to establish an independent labor union. Russian Reporter has decided to rectify this.

“When they drove off the road into the taiga, I hear, ‘Take out the plastic sheet so nothing gets splattered.’ That, as they say, is when I bid farewell to life, calmed down and resigned myself. I lay on the floor of the car and waited. Hands cuffed behind my back. They pulled me out, put me on my knees and fired three shots over my head. But they didn’t kill me.”

Valentin Urusov. Photo by Aleskey Maishev for Russian Reporter

The senior officer for education at the colony listens attentively to my conversation with Valentin Urusov, a prisoner at Penal Colony No. 3 in the Sakha Republic (Yakutia) and former leader of the independent labor union local in the town of Udachny. After the interview, the officer comes up to me and says, “You know, maybe he is really innocent. But if five percent are wrongly convicted in America, what can you expect from us?”

“What a terrific job!”

The idea that a full-fledged rather than puppet labor union could emerge in Udachny occurred to Valentin, a rank-and-file employee at Almazenergoremont, a subsidiary of the local mining and processing plant, after the scandalous “affair of the sandblasters.” Urusov himself is a local man, although he was born in Karachay-Cherkessia: he has lived in Yakutia since he was two years old and worked here since he was sixteen, mostly at facilities run by the state-owned diamond mining company Alrosa. There are few other options here.

Udachny is a town fourteen kilometers from the Arctic Circle, and one of the three main sites, along with Mirny and Aikhal, where diamonds are mined. Among the workers involved in the mining process are the so-called abrasive blasters or, more simply, sandblasters, whose job is to work solid surfaces with an abrasive, high-pressure stream of air pumped through a hose. It is not a job that is good for the health of the worker, to say the least: pulmonary silicosis is the occupational illness. Neither a safety helmet nor a [hazmat] suit, like cosmonauts wear, helps.

In 2007, a team of these sandblasters demanded overtime pay, which at that time went chronically unpaid. The workers filed a lawsuit and even managed to win their case: the Labor Code was clearly on their side.

“A special commission arrived in Udachny to arbitrate the dispute directly,” explains Andrei Polyakov, an Alrosa spokesman. “The company agreed with the validity of the claims, an agreement settling all grievances was signed, and compensation was paid out. The managers who were in direct dereliction of their duties were punished.”

This happened, it is true, but later. The main scandal occurred when the dispute was still being settled: the semi-official labor union at Alrosa, Profalmaz, negotiated not on the side of the workers, but on behalf of . . . management. This provoked astonishment and outrage in Udachny.

So, on the one hand, Profalmaz’s authority was undermined. On the other, the feeling arose that one’s labor rights could be protected—moreover, in a civilized manner, through the courts and arbitration, the European way, so to speak.

“I just found it interesting. I’m a generally curious person, and that is probably why I’m in prison,” jokes Valentin. “I went online and came across Sotsprof, a trade union association that is an alternative to the FNPR (the Federation of Independent Trade Unions of Russia). I wrote an email to its leader, who was then Sergei Khramov. He replied by sending me documents on how to create a new union.”

“But why a new one?” I ask. “Was it really impossible to make things work within the existing union?”

“All [organizations] belonging to Mikhail Shmakov’s FNPR, including Profalmaz, are not labor unions but appendages of personnel departments. All they do is allocate vacation vouchers. They will never oppose management.”

“Was the only problem overtime and the fact it wasn’t being paid then?”

“Of course not. There were a lot of problems! And then, you understand, this is very difficult work: you have to work night and day, and on holidays, and take someone else’s shift, whatever management says. But you get paid for an eight-hour day. And then there are the working conditions and safety. In the department where I worked, the equipment should have been scrapped twenty years ago, at best. There are a lot of accidents as a result. The ones that were made public were like a speck in a big heap of sand. I got a big piece of flesh taken out of my hand, and that was nothing. Of course, it’s hard to hush up fatal incidents. But fractures and injuries are different. There are thousands of them and nobody cares. It was a shame that the company was so wealthy, that it built five-star hotels and all kinds of business centers, but scrimped on us.”

In Moscow, I met with Sergei Khramov, to whom Valentin had sent the email and who had instructed him on creating a union local.

The open pit of the Udachnaya Diamond Mine, Russia, from a helicopter, July 17, 2004. Photo by Alexander Stepanov

“Add to this the aggressive water in the gully where they mine diamonds.” Khramov hands me a complaint from Udachny miners addressed to Vladimir Putin. “It’s nearly acid and it penetrates their rubber suits. Here they write, ‘We don’t know what it is we are breathing when the ventilation equipment is lubricated with used oil.’ Or there’s this one: ‘Cold, unheated air is pumped into the mine, even in winter.’ And it’s minus forty-fifty in winter there. What a terrific job!”

How to frighten a republic’s leadership

Right at this time, in August 2008, the so-called Siberian Social Forum was held in Irkutsk. “Free” trade unions were among the forum’s founders. Urusov’s new acquaintances invited him there, too. In fact, it was a small event, attended by no more than two hundred people, but it made a strong impression on Valentin.

“[Civil rights lawyer] Stanislav Markelov, who was later murdered in Moscow, lectured on legal issues. He was a very competent, energetic, lively man—it’s a shame [what happened] to him. He talked about how to act in this or that situation so as not to set oneself up and achieve [your goals] at the same time. And then the call came. Problems with pay had begun at the second motor depot, and the guys had decided to organize a strike.”

Events unfolded rapidly. In a small suburban home outside of Udachny, Urusov met with motor depot drivers and mechanics in an almost conspiratorial atmosphere and began persuading them to join the union. Armed with new knowledge, Urusov tried to prove to his comrades that if a strike began they would immediately be fired for trumped-up excuses, and there would be no one left to work on getting them reinstated. During the second “conspiratorial” meeting, sixty-two people joined Urusov’s union local.

There were two options as to how to proceed. First, a classic strike. But the Udachny miners had no experience with strikes, and therefore they could easily have been fired for “absenteeism.” And even if they had managed to get fired workers reinstated, they would have lost the initiative, and the remaining workers would have been demoralized. The second option was a hunger strike. Everyone goes to work; there is no downtime and, therefore, nothing for management to complain about. But demands are loudly declared and, basically, a scandal erupts. They chose the second option.

“At first, [management] demonstratively paid no attention to us. Then they see we aren’t going to back down. That is when they began dropping by,” Urusov laughs. “People came from the police, from plant security, from the company itself, trying to talk us out of it. In exchange for setting up a conciliation commission, we suspended the hunger strike.”

However, the commission was unable to achieve a compromise. Management made no concessions.

“We decided to hold an open union meeting right on the town’s central square. It wasn’t a [protest] rally, and by law, we weren’t required to notify anyone. On the first day, all the motor depot workers came, plus another two hundred people. The director of the plant came and tried to say something. But he couldn’t answer a single question and left. And right there on the square, people began joining the union. By the end of the day, something like three hundred people had joined. We decided to repeat the meeting. The second time, more than eight hundred people gathered. There was no rioting and no laws were broken. We didn’t even have a loudspeaker. By evening, I remember it even now, 1,012 people had joined the union.”

We have to remember that Udachny is a very small town with a population of slightly over ten thousand, and such developments outright scared both the local authorities and certain people in high places. The situation was headed towards a citywide strike and a potential stoppage of diamond mining in the Udachnaya kimberlite pipe—the largest in the world, by the way.

“We have enormous enterprises in our country. Often [they] monopolize their regions, and so a strike or simply a large [industrial] action could freeze an entire industry,” explains Alexander Zakharin, Urusov’s friend and colleague, and chair of the Sotsprof local in Surgut. “And if you organize such an action, you risk running into a brutal response. From the owners and from the authorities. But it happens that milder measures don’t work. Then you need to choose: take a risk or keep your mouth shut.”

At Alrosa itself, the union’s activities in Udachny are seen primarily as an attempt at self-promotion.

“A media effect—promoting awareness of Sotsprof and the number of times it got mentioned in the press—was probably the main objective for some of its executives,” argues company spokesman Polyakov.

As during the [dispute in 2007], Profalmaz adopted a peculiar position in the new confrontation. Its leader, Il Tumen (Sakha Republic State Assembly) deputy Pavel Tretyakov, not only failed to help the workers but also asked the republic’s leaders to reason with the “rebels.” Profalmaz’s executive committee sent an appeal to the President of Yakutia, Vyacheslav Shtyrov, and FNPR head [Mikhail] Shmakov asking them to prevent “incitement of a conflict.”

Tretyakov later, in a similar vein, told Vasily Gabyshev, the Mirny town prosecutor, “It’s surprising that law enforcement authorities didn’t respond to attempts by various persons to artificially incite conflicts, to calls for illegal hunger strikes and [labor] strikes.”

The Yakutia presidential administration composed a panicked memo on the basis of Tretyakov’s appeals. The President instructed law enforcement agencies to figure out what was happening. (Russian Reporter has all these documents in its possession.) What exactly Shtyrov wanted from the security services is still unclear, but the local office of the FSKN (the Federal Drug Control Service) reacted to the situation, let’s say, in an extremely original way.

Udachny—Aikhal—Mirny

“Then what happened? Then the third of September came. I was leaving my place. I heard a car door open. I instinctively turned around. It was a simple UAZ[-452], a “Pill” [i.e., a van] with tinted windows. Out came three guys in leather jackets and jeans with shaved heads. I didn’t know them. I immediately knew something was wrong and ran. They caught up to me and knocked me down.”

“Did they show you any identification?”

“Absolutely nothing. They restrained me and brought me to the van. First, they handcuffed me with my hands in front. Later, in the van, they tried to cuff me with my hands behind my back. I clasped my hands and held on. They pulled and pulled, broke my finger, and finally handcuffed my hands behind my back. They threw me to the floor and one of them sat on top of me. We drove for a long time.”

It subsequently emerged that Lieutenant Colonel Sergei Rudov, the head of drug control in the Mirny District, had personally led this “operation.” In order to apprehend Urusov, he and his subordinates had driven six hundred kilometers [to Udachny]: [his] “Hunter” [i.e., jeep] was waiting for the “Pill” on the outskirts of the town. In court, Rudov claimed to have had “operational information” that Urusov was involved in selling drugs.

“We asked the court to confirm or refute Rudov’s testimony, and requested written confirmation that the ‘operational information’ had been registered in the police operational ledger,” says Urusov’s attorney Yevgeny Chernousov, a former police colonel who specializes in narcotics cases. “We didn’t demand that this information itself or its source be revealed. We just wanted to confirm that the information had existed. The court did not fulfill our request. There is thus no evidence of its existence. In light of this, Rudov’s unwarranted trip to Udachny and back seems more than suspicious.”

Valentin says that Rudov was on the phone with a certain Alexei Yurevich or Yuri Alexeyevich the whole time, reporting to him that they had “taken” Urusov and wanting to know what to do next. After one of these conversations, the van pulled off into the taiga. There the narcotics officers spread out plastic sheeting and fired a few shots over Urusov’s head, recounts Urusov.

“They were shooting the whole time,” says Valentin. “They shot at birds, and at trees. Apparently, they wanted to frighten me. We had already driven far from town, and basically, they could have done whatever they wanted with me.”

At a fork in the Udachny-Aikhal-Mirny road, the car of Grigory Pustovetov, head of security at the Aikhal mining and processing plant, drove up to Rudov’s group “entirely by accident.” Only then did the police decide to search Urusov for drugs. Pustovetov and his driver acted as official witnesses. The search was a complete success: sixty-six grams of hashish oil were found in the union activist’s pocket.

“A number of questions arise,” says an outraged Chernousov. “First, when the arrest happens in one place, but the [official] search with witnesses happens dozens of kilometers away, it’s a clear sign that the drugs could have been planted. Second, if the head of one of a company’s security units serves as a witness when an employee in a labor dispute with that company is being searched, it also gives rise to the most unpleasant thoughts.”

Urusov himself claims the hashish was planted on him in the car after the fake execution. He says that hash oil was specially applied to his hands so that traces of the drug would later be detected when his hands were swabbed.

“When we were organizing the miners’ union in Neryungri (a major industrial center in Yakutia), I was reminded of this story,” says Valery Sobol, first secretary of the Neryungri Communist Party City Committee. “I won’t name the names [of the persons involved] because I live there. Employees of the so-called organs [i.e., the security services] invited me to a pub. We hung out there for a while. Then at another place, and then another. I myself didn’t drink, [but] they drank a lot. And, as if it was an afterthought, though they had summoned me there [to deliver just this message], one of them says, ‘You remember that thing with Urusov? You also better not be naughty. If anything happens, we’ll plant a gun [on you] or whatever.’ And then he laughed. Like it was a joke.”

Several months ago, Sobol nearly won the election for the head of the Neryungri District. He came in second by only a small margin. And if a potential district head can be threatened almost openly, then the kidnapping of a simple working stiff like Urusov, who has no political backing at all, does not seem farfetched.

Sobol and I sat in the kitchen of Sergei Yurkov, an engineer, businessman, and leader of [an organization called] the Russian Community of Yakutia. He met Urusov in a pre-trial detention facility. I ask him how he had ended up there.

“My story is simple. Transneft was building a pipeline here. They didn’t want to pay normal wages to the locals. So when the locals balked, they brought in rural Chinese willing to work for peanuts and live in barracks. When we organized a rally and put up flyers saying this wasn’t how things were done, I was arrested under Article 282 of the Criminal Code for ‘incitement of interethnic hatred.’ What does ‘incitement’ have to do with it? I was sentenced to two years in prison.”

Drugs via the Special Courier Service?

It must be said that the theme of drugs, with which they decided to shut Urusov up, did not arise by accident. Drug use is a local scourge. And this makes sense. There are few other ways to have fun in small towns and villages in the North. That is why on the surface Urusov’s prosecution under a drug statute was meant to have appeared more or less plausible.

“It’s a big problem here, as is drinking,” says Maxim Mestnikov, a Sotsprof spokesman in Yakutia. “When Friday comes, hang onto your head: there is a deluge of knife wounds [and] head injuries.”

But Urusov, in fact, never had the reputation of a mischievous drug addict. In his youth, at the beginning of the 2000s, he and a few friends created an organization called Youth for an Athletic Movement-North, whose activists patrolled the city monitoring places where drugs were sold. Eventually, the mayor of Udachny even suggested that they create a branch of City Without Drugs on the line of [Yevgeny] Roizman’s [controversial anti-drugs organization].

The relationship between certain local [Alrosa] subcontractors and drug dealers, however, may require a separate investigation. Russian Reporter has in its possession an official memo written by Sergei Denisov, the predecessor of [Grigory] Pustovetov (the man who acted as a witness during the police search of Urusov) as head of security at the Aikhal mining and processing plant.

The memo is addressed to Yuri Ionov, former vice-president for security at Alrosa, and it deals with the overall crime situation in the area. Among many others, the memo contains the following passage: “It is impossible to ignore the fact that a drug trafficking network has developed in the village. According to operational information from the Mirny office of the FSB, the delivery of drugs is carried out by the [Federal] Special Courier Service, with which Alrosa has a contractual relationship for the transportation of diamonds.” Moreover, the memo shows that confidential and friendly relations exist between certain high-ranking Alrosa executives, law enforcement officers, and outright criminals.

“I’ll say this: the criminal world is generally in first place here,” [Sotsprof’s] Mestnikov says with conviction. “In this respect, it is still the nineties here. Something needs to be done so you go to them and they handle it. And this could also have happened with Valentin. Perhaps it was better that they sicked the cops on him and not the wise guys.”

After he presented the memo to Ionov, Denisov was forced to resign and move to Novosibirsk.

“No decision was taken on my report. Ionov showed me the door and said he didn’t need any unnecessary problems. As for Urusov, I can say that it’s a pure frame-up,” [Denisov says].

In May 2010, Lieutenant Colonel Rudov was sentenced to three years of probation for fraud and abuse of authority. According to [Urusov’s other] lawyer Inga Reitenbakh, “He was charged with receiving 2.5 million rubles from Alrosa for the purchase of an apartment in Mirny.” The investigators and Rudov himself categorically denied any connection between this case and the Urusov case. Nevertheless, the funds were allocated to Rudov shortly after Urusov’s arrest. According to Russian Reporter’s source, Rudov now works as a procurements specialist in the repair and construction office at the Mirny mining and processing plant.

“He shoots before he thinks”

Urusov was also unlucky in that he had set about creating a Sotsprof local in Udachny exactly when the union’s leadership had entered the complex process of building relations with the Kremlin.

“Beginning in 2007, people from the Russian Presidential Administration began to pressure us very actively,” says Sergei Khramov. “We were strongly recommended to name Sergei Vostretsov from the United Russia party as [our] new leader. I had good reason to believe that if we didn’t, we would simply be destroyed. And I figured, the heck with him, let Vostretsov be the leader and do public relations, while I, as Sotsprof’s general labor inspector, will do the day-to-day work.”

The first outcome of this “castling” move was that the formerly oppositional Sotsprof supported Dmitry Medvedev in the 2008 presidential elections.

”And when they began pressuring Valentin, Vostretsov told me not to make any unnecessary noise, because he would fix everything anyway. I knew that the Vostretsov family—his younger brother was the youngest FSB colonel in the country—was very close to General Alexander Mikhailov, the then-director of the Federal Drug Control Service. I thought that Valentin’s case would be decided with a single phone call.”

For the sake of fairness, we should note that complicated events were underway at the Federal Drug Control Service at the time. Viktor Ivanov had replaced Viktor Cherkesov, who had famously publicized the existence of a war within the security services in an article [entitled “We Can’t Let Warriors Turn into Traders”]. In October, General Mikhailov left the FSKN as well. There was simply no one left to make that “single phone call.”

Subsequently, Vostretsov pushed Khramov out of Sotsprof altogether, and the organization became completely loyal to the Kremlin.

In December 2008, the Mirny District Court sentenced Valentin Urusov to six years in prison for drug possession. Vostretsov tried to fight it, but more from behind the scenes: he met with officials from the Yakutia administration and officials of the security services, and even, allegedly, raised the issue of Urusov with Medvedev. It was no use.

Khramov, in contrast, acted publicly. It was he who got the famous lawyer Chernousov to take the case. Chernousov convinced the Yakutia Supreme Court to overturn the verdict (on procedural grounds: the judge had not retired to chambers while considering a motion to dismiss), after which the case was retried.

“I had absolutely no illusions,” Valentin smiles. “After the Supreme Court decision, many people thought I would be exonerated. I was certain of the opposite, that now I would be ‘shut down’ for sure. This was evident from the faces of those in the courtroom at the second trial. After the first hearing, I gathered my belongings, put on the track suit I’d been wearing while traveling between pre-trial detention facilities and prisons, and from then on I went to hearings in this outfit.”

In Udachny, there is a small newspaper with the humorous name of Gorodok [“The Burg”], edited by a local journalist named Alla Demidova. After Urusov was released, she published a short article. Immediately, the very same day, she got a call from Maxim Dobarkin, one of the police investigators who had participated in Urusov’s “arrest.”

“Dobarkin called me at home,” says Demidova. “Drunk. He told me how many bullets he would put in me, said that ‘he shoots before he thinks,’ that he knows where I live, and that he would ‘get’ me ‘whether in Udachny or in Sochi.’”

“What did you do?”

“I filed a complaint with the FSB.”

“Did they respond?”

“They responded by sending me a one-line answer: ‘There is no threat.’”

Dobarkin, however, was promoted to the rank of lieutenant colonel and together with Rudov took command of the Federal Drug Control Service’s interdistrict department in Mirny.

Another Yakutia journalist, Aitalina Nikiforova, was also threatened for covering Urusov’s case.

“I reported on every hearing during the trial from the courtroom. Rudov called me over during one of the hearings and said word for word, ‘Your oldest daughter is fifteen. It would be interesting to see how you’ll defend Urusov after some old drug dealers drug her up and pass her around.’ This definitely sounded like a threat. At the time I was working as editor-in-chief at the only independent newspaper in Mirny, Moya Gazeta. The only printing plant in town refused to print us. Local Federal Drug Control Service agents began coming to my house, allegedly because of anonymous tips that I also used and dealt drugs. Some of [the agents] were insolent and rude; others were ashamed because the last visits took place when I was six to seven months pregnant with my third child.”

After that Nikiforova decided it would be safer to leave her hometown and move to Yakutsk.

In June 2009, the Mirny District Court delivered a new verdict in the Urusov case that completely upheld the previous verdict, but in September the Yakutia Supreme Court lightened Urusov’s prison sentence by one year. The Sotsprof local in Udachny had been crushed. The second motor depot has been completely shut down. The company has had no more problems with the workforce in this town.

“Valentin, who do you tend to blame for what happened to you?” I finally asked.

“Alrosa is a state-run company. It is owned by the government, by the state, so . . . you understand.”

Valentin Urusov. Photo by Aleskey Maishev for Russian Reporter

***

“Our government is fascist,” Yurkov, the leader of the Russian Community of Yakutia, suddenly declares, and it sounds quite equivocal.

Sobol, the man who missed becoming head of the Neryungri District by a heartbeat, turns and stops smoking next to the window.

“We have to be precise with our terms: neither Nazi nor nationalist, but precisely fascist as it is understood in Mussolini’s theory of the corporate state, as Franco, Salazar, and even Pinochet understood it. In our country, the authorities and big business are intertwined in a ball. And anyone who gets in their way is crushed. Here in Yakutia, in the provinces, it’s just more clearly felt. But it’s the same thing all over the country.”

Translated by Sean Guillory and Chtodelat News. Slightly different versions of the same translation were published by n+1 and Sean’s Russian Blog.

Dr. Yekaterina Chatskaya: “Doctors Are Pushed to the Limit”

Dr. Yekaterina Chatskaya: “A Year Ago There Were Three of Us. Now There Are Six Times as Many”
Confederation of Labor of Russia (KTR)
May 20, 2016

Dr. Yekaterina Chatskaya, a gynecologist at Moscow Municipal Clinic No. 180 and a leader of the Moscow local of trade union Action told Novaya Gazeta what it is like to be a trade unionist when Russia health care has entered an area of turbulence.

Yekaterina Chatskaya is a gynecologist at Moscow Municipal Clinic No. 180. In April 2015, she was involved in a work-to-rule strike by Moscow physicians, meaning that doctors spent as much time with each incoming patient as was necessary and ignored newly introduced, stringent patient-intake standards. Novaya Gazeta found out what happened with the strike and personally with Dr. Chatskaya over the past year.

How did last year’s work-to-rule strike end?

I kept a diary of my patient intakes. We analyzed the standards that took shape during the course of the strike and sent them to the head physician. It turned out our figures were similar to those issued by the Health Ministry. But the problem is that the Health Ministry’s standards are recommendations. They are not obligatory, meaning that they virtually don’t function in practice.

For example, in Moscow, a gynecologist’s standard intake time varies from twelve to fifteen minutes at different hospitals, but the federally recommended initial appointment time is twenty-two minutes. That is a fundamental difference.

In the blogs and appeals written by physicians, they say they are fighting to increase appointment times by three minutes. Do these minutes add up to something in actual practice?

Of course, they do. I have a fifteen-minute limit for seeing a single patient, and I see patients for six hours in a row without a break, meaning this limit does not include a lunch break or even a simple trip to the toilet. Over this six-hour period, according to the standards, I should be able to see twenty-four patients, who have registered in the electronic data base. But it is virtually impossible to keep up with this pace. There are complicated patients, and there are urgent cases. Old women dress slowly. They require a special approach. And you must not hurry pregnant women at all, whether someone is pregnant for the first time or has had a miscarriage in the past. But when the intake period lasts longer than six hours, it is inevitable that doctors make mistakes. Your concentration is reduced, and your eyes are tired.

You really feel by the end of the intake period that you are losing concentration and can make a mistake?

That is exactly why I started thinking about how long it takes to examine a patient in reality. Before the strike, my official intake period lasted seven hours, but in fact it came to eight hours without stopping. After the strike, we succeeded in getting six-hour schedules, while everything is still the same at other clinics.

Has what happened last year changed anything about your team?

At first, a lot of people wanted to support me, but when a group letter was drafted and we took it to other doctors for them to sign it, people got scared. The head physician called me into his office and said it was extremism, that I was going against the regime, although there were no political demands at all in the letter. Certain colleagues stopped speaking to me altogether.

But the turning point came. A year ago, we organized a local of the independent trade union Action (Deistvie). Initially, there were three of us. Now there are six times as many. We managed to stop the introduction of so-called effective contracts. One of the points in the contracts was that incentive pay would be based only on the decision of the clinic or hospital director. My pay consists of 20,000 rubles base salary and roughly the same amount in incentive pay. Under the so-called effective contracts, incentive pay would have included work assignments that are not part of my job description. Theoretically, if I had refused to mop the floors on the orders of the department head, I could have been stripped of my incentive pay. We wrote to the head physician and the prosecutor’s office. The prosecutor’s office acknowledged the decree facilitated corruption and ordered it abolished. This was a victory. But many clinics have switched to the so-called effective contracts.

Your latest protest campaign has targeted the Moscow Health Clinics Standard. What don’t you like about it?

The standard has led to a collapse at work, and not only at our clinic. During the flu epidemic, GPs were working over twelve hours a day. One doctor made a house call to a patient at one-thirty in the morning, and before that she had been seeing patients since eight in the morning, and then went out on house calls. Another colleague of mine worked three weeks without a single day off.

They have begun to drive away specialists. How? For example, a GP has to refer a patient to an endocrinologist. But to do this, he or she has to write up a full justification for the referral, get the chart and referral signed by the department head, and manage all this within the twelve-minute limit for the appointment. Management have been strongly advising GPs not to refer patients to specialists but to threat them themselves. Naturally, the endocrinologist sits there without any work. After some time has passed, management decides that since such a small number of patients come to see him, the clinic has no need of his services. Our clinic fired a mammalogist, a dentist, and an endocrinologist in this way. There is very big queue to see the gastroenterologist. But our clinic immediately set up paid appointments to see him. If you have the money, you will be served right way.

Getting an ultrasound appointment has become a disaster. In late 2014, one ultrasound specialist went on maternity leave, a second was cut, and a third resigned of her own accord. For several months, a single specialist examined pregnant women in the entire district of Mitino. It even came to blows at the terminal when two women fought over an ultrasound appointment voucher. Another big minus of the reforms has been the virtual abolition of the principle of neighborhood health care.

Now you can make an appointment with any primary care physician at a clinic. Is that a bad thing?

In our conditions, it is a bad thing, because it leads to the unavailability of medical care. For example, my primary care neighborhood covers six thousand people, although according to the standards I should be serving two thousand two hundred people. When my appointment bookings for fourteen days in advance open up at 7:30 on a Monday morning, the appointment vouchers are already gone by eight in the morning. Patients can now choose a doctor themselves, and naturally they choose doctors with good reputations. Inevitably, these doctors will be overbooked. Patients assigned to these doctors as their neighborhood doctors are simply unable to get an appointment to see them, although they will be seeing many patients from other neighborhoods.

An absurd situation has developed. The municipal health department monitors the availability of specialists. On our clinic’s overall chart, there is constantly a red light next to my name, meaning that I violate the norm, because patients sign up to see me two weeks in advance. A good doctor is not profitable to a clinic because she or he skews the statistics.

How much do you earn?

My take-home pay is between twenty-five and thirty thousand rubles a month. My last paycheck was 35,000 rubles [approx. 465 euros a month per the current exchange rate—TRR]. I have been working at this salary since April of last years. I am not paid a kopeck more, only the mandatory minimum.

Does the Moscow health department know about this situation?

Yes. We regularly appeal to them. The last appeal by primary care physicians was sent to them on March 31. After that, we got paid a little more.

Doctors are pushed to the limit. Seeing the shiny pictures on the TV, our patients imagine that everything is alright with medical care, and if something is wrong, it is the doctor’s fault. A patient can come and sit outside a doctor’s door for an hour: that means he is a bad doctor. It was that way at first, though now, it is true, patients have begun to realize that if there is a queue, it means the doctor is good. I was reprimanded when an urgent care patient got wedged into my schedule, and I was unable to see another patient before my lunch break. I asked her to wait, but when I came back fifteen minutes later, she was filling out a complaint in the department head’s office. I was reprimanded, even though the patient was seen the very same day after my break.

Would it be easier if the Health Ministry issued strict regulations rather than recommendations?

It would be ideal. We have written several times to the Moscow health department asking them to establish regulations in keeping with the Labor Code and the Russian federal government decree stipulating that a doctor should see patients for no more than thirty-three hours a week. The reply we received was meaningless, as always.

Meanwhile, our head physician issues orders that violate the recommended norms. These two realities do not intersect at all.

For example, hardship pay has been abolished throughout Moscow. Even our radiologists lost additional holidays and pay. But the federal decree clearly stipulates that medical workers who come into contact with HIV and tuberculosis should receive both additional pay and additional holidays.

Source: Novaya Gazeta

Translated by the Russian Reader. Thanks to Valentin Urusov for the heads-up

Moscow Doctors Go on Work-to-Rule Strike

Work-to-Rule Strike: What Moscow Doctors Are Fighting
Julia Dudkina
March 25, 2015
snob.ru

Moscow doctors have declared a work-to-rule strike. Disgruntled by personnel cuts and the introduction of time limits for seeing patients, they said they would now work strictly by the rules, without overtime. We found out how the strike has been going in the capital’s clinics.

“Our working day is not set,” explains Dmitry Polyakov, a neighborhood general practitioner at Diagnostic Center No. 5. “When forty-five people pass before your eyes in a single day, you feel awful. And there have been staff cuts, many specialists have left, and their patients are referred to us. People are unhappy, of course, and they take it out on us. By the end of the day it is often difficult even to focus one’s eyes, let alone concentrate. Salaries have fallen, incentives to work have decreased, but the workloads have grown.”

In addition to seeing patients in clinic, a neighborhood GP has many other duties, such as visiting ten to fifteen patients at home. Plus, there is paperwork: outpatient charts, registration stubs, and discharge sheets. Much of the paperwork has to be filled out during the doctor’s free time. And yet salaries have been rapidly shrinking. Whereas before they had been as much eighty and even one hundred thousand rubles per month, neighborhood GPs are now paid around forty thousand rubles a month [approx. 640 euros at current exchange rates].

“We have a very large flow of patients,” complains Yekaterina Chatskaya, an OG/GYN at City Clinic No. 180. “There is no one to see all the patients; the workload is colossal. It happens that you work nine and ten hours a day. I basically don’t see my husband and child, and I make only forty thousand rubles a month. If we were at least provided with stationery supplies. Yesterday, I was issued paper for my printer for the first time in five years. Usually, though, I have to buy supplies out of my own money. But the main disaster is the lack of time for examining patients properly. The Health Ministry allots ten to twelve minutes for each patient, but it is impossible to meet this standard.”

Elena Konte, a GP at the first branch of City Clinic No. 220, had hoped that the start of the work-to-rule strike would simplify things. If she didn’t have to work overtime, she would manage to go home on time, and fill out outpatient charts that had piled up from last week. But a nurse who was supposed to help with patients took ill; a conference was scheduled for the middle of the day; and a mysterious “inspector,” a doctor from an outpatient center, suddenly showed up as well.

“This never happened before. I am sure she came because of today’s strike,” says Elena. “She didn’t say anything about the strike, but she asked about how much we have to work and inquired about the UMIAS (Unified Medical Information Analysis System). I think she was horrified by how much unnecessary scribbling falls on us and how much running around the entire clinic we do searching for patients’ test results: after all, they’re not even recorded in the computer at our clinic. Of course, it’s uncomfortable working when you’re being observed all day. But at least they paid attention to us.”

Elena Konte managed to see all her patients that day, but she was unable to complete all the outpatient charts. The first day of the work-to-rule strike failed to solve the problems that have accrued over the past months for staff at the first branch of City Clinic No. 220.

“At first, there were six doctors working eight neighborhoods in our second general practice department,” says Elena. “Then, one of the neighborhood GPs was sent to retrain as a family doctor, and there were five of us left. In February, yet another doctor was transferred to a neighboring branch. But this is winter, the peak time for upper respiratory infections. And the workload is such that it is like we’re working two positions. The strain is very hard, both physically and mentally. Yesterday, I got to the clinic at 8 a.m., and went home at nine in the evening. But I will continue to participate in the strike. They have already promised to reduce consultation hours from five to four hours, and have added another position in reception.”

Downstairs, on the ground floor, two old women were vigorously discussing the news from the world of medicine.

“They all got laid off. Who is there to do the work now?”

“Exactly! And in a couple months, they say, there will be further layoffs. They have to go on strike.”

If the strike has gone unnoticed for both patients and physicians at this clinic, things are quite different at Diagnostic Center No. 5.

“Today, I managed to see everyone who came by appointment, and even finally filled out all my paperwork in normal handwriting and finished working with the outpatient charts that had piled up,” says neighborhood GP Irina Kutuzova. “Maybe the bigwigs won’t notice the strike at first, but when an emergency occurs, everyone will get it. Generally, it is hard to work in the present circumstances. You cannot examine a patient who has come by appointment longer than ten minutes, but some patients require much more time. And it often takes twenty minutes to fill out a sick leave form. I get forty to forty-five patients a day; it is a constant blitz. And there is another whole crowd of patients who come ‘just to ask a question.’ As a result, people get disgruntled: they literally kick open the door and voice their complaints. By the end of the day, it all becomes a blur, and I don’t have the strength to write out prescriptions. But today I had thirty-seven patients. Also a lot, of course, but better nevertheless.”

In the hallway, an elderly woman catches my hand. She is waiting in the queue for the next room.

“Young woman, you’re not a patient? Maybe you know whether they’ll see me today or not?” she asks hopefully.

Her name is Galina Bordo, and she has been waiting her turn for nearly two hours. A few weeks ago, she had a tumor removed, and now she must have regular checkups. The doctor’s visiting hours ended twenty minutes ago, but the last patient still has not come out.

“I heard they started a strike today. Good for them, it’s the right thing to do. Otherwise, in today’s environment, with the queues and unnecessary paperwork, they don’t cure anyone,” Bordo says.

According to the healthcare workers union Action (Deistvie), twenty employees at six clinics have been taking part in the work-to-rule strike by Moscow doctors. In the near future, twenty-two other health care providers may join them.

“Our goal is not to cause a collapse, but to show how and under what conditions doctors work,” explains Andrei Konoval, Action’s organizational secretary. “To demonstrate that under normal, unhurried service, the number of patients who can be seen in a day is reduced by one and a half to two times. This means that it is necessary to increase the number of doctors and medical facilities. Even if there were only one brave doctor willing to participate in the strike, we would still go through with it.”

Andrei Khripun, head of the city’s health department, has already dubbed the strike a “political provocation,” and claimed that it had failed, because “Moscow clinics are operating in normal mode.” Although that had been the point of the strike: to work according to the rules.

________________

Valentin Urusov
March 25, 2015
Facebook

Today, a comrade and I went to a medical facility to hand out leaflets (the appeal by striking doctors to patients). Fortunately, people have been reacting quite positively to the doctors’ strike and have gladly agreed to support them. Many people took leaflets to hand out at home.

I called one of the strikers and asked whether she has felt pressure from management. She said she had, but since they are determined and have really enjoyed working according to the law, the strike could continue for quite a long time. But now they are able to spend exactly as much time as they need on a patient, and not what officials want them to spend.

What is interesting is that if women have taken something on, they’ll definitely see it through to the end, unlike most of us men. I think it would be better if officials started listening to what they’re saying and stopped destroying healthcare while it’s still not too late.

One shady type drove up in a car and asked for a couple of leaflets. Then he pulled away and photographed us. Apparently, he was a spy. Security behaved properly, and at first they even tried not to notice us. Later, though, they asked us not to make trouble for them and go outside. That was even more convenient for us, and we handed out more leaflets.

Tomorrow, we will go to the other strike sites and notify patients. I think it would be great if everyone who was going to a hospital or clinic would take several such leaflets along and hand them out there. So, friends, don’t stand on the sidelines so that you’ll regret it later. Make your contribution to the common cause. The text of the leaflet is below. Anyone can print it out.

Dear Patients,

On March 24, a “work according to instructions” action, which journalists often call an “Italian” strike, was launched at several Moscow clinics. Its gist is that doctors who have decided to draw the attention of authorities to the disgraceful state of medical care have started to work in complete accordance with the Labor Code and the standards of care.

We have worked in inhuman conditions for years. Our workday often lasts nine, ten, and even twelve hours. However, rather than increasing staff and creating normal working conditions, health officials have begun laying off physicians and reducing the time patients can be seen to mere minutes. But the workload and amount of paperwork have only grown. In our view, such excesses only serve as cover for bureaucrats pursuing a policy of commercializing healthcare: the longer the artificially generated queues in clinics are, the easier it will be to make patients pay.

From March 24, we have decided to hold consultations based on established standards. Moreover, if a patient’s condition requires more time than is laid down in the regulations, we are not going to speed up examinations, because haste poses a threat to the person’s life and health.

We ask for your understanding and support. We are in the same boat, on the same side of the barricade erected by “optimizing” officials. We will do everything we can to ensure that no problems with the provision of medical care arise. Eight days ago, we warned our chief physicians, as well the Moscow Department of Health and even the Russian Federal Prosecutor’s Office, of the need to ensure that patients whom we do not have time to examine during our shifts are seen.

If you are, nevertheless, unable to get an appointment through the negligence of management, we suggest you send a complaint to the Department of Health. (Believe us, it helps!) In the complaint, you should write that the physician you wanted to see had warned management of possible problems in connection with “work to rule,” but management failed to take the necessary organizational and personnel measures. You can do this on the site mosgorzdrav.ru in the section marked “For the public” > “Petitions from the public” > “Receipt of petitions from the public.”

We would be grateful if you would sign the online appeal in support of the issues we have raised. To do this, simply type in the address goo.gl/nxJ8C5.

Together we will make the system work for the benefit of patients, not bureaucrats.

Your Doctors