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Michael Siggs, Chairman of the St. Petersburg Healthcare Trust, visited some hospices in St. Petersburg February 8th -13th 2004. These are some of his observations:
The beautiful people.. a visit to St. Petersburg, Russia in the month of February has its peculiar joys - minus 15 degrees centigrade, the magnificent façade of the historic buildings freshly gilded for the 300th anniversary celebrations (2003) against a background of snow and blue skies. For the writer warmth comes from meeting the doctors and care staff working selflessly in the hospices and outreach centres providing palliative care to the five million people living in the City. The development of the hospice and palliative care movement, from one hospice at Lachta in 1989 to the seven that now exist across the City, has relied on the efforts of these dedicated professionals.
Lachta Hospice was opened in 1989 thanks to the support of Mayor Anatoli Shobchak and an initiative of the British Journalist Victor Zorza and the Russian pioneer Dr. Andrei Gnezdelov. The hospice now provides hospice and palliative care to the 500,000 people living in the Primorski District of the City. There are thirty beds plus an outreach service. The inspirational part of the work is that it is fully holistic in the true sense of the modern universal concept of "hospice". Out of the work has come the establishment of a religious order of the Sisters of Mercy who have taken upon themselves the care of bereaved children whose mothers may have died in the hospice.
This work coordinates support to the bereaved from the extended families preventing them from being institutionalised and fuelling the numbers of street children in the City.
The City administrative authorities support the work of the Hospices paying the wages of the doctors and care staff ($US180 per month for doctors and $US90 per month for carers) and the provision of some medicines and food for patients. All hospice care is provided free of charge. There are great issues relating to the provision of medication. The cost of MST has been reduced by half; and it is hoped that increased pressure on Moscow will see the provision of MST also become free. The provision of morphine is a huge political issue with great concern that availability to patients will lead to a growth of the drug culture within the country.
Lachta Hospice has undergone a large renovation programme, its first in 100 years.
Supporters of the Hospice movement are recommended to visit Lachta and also Kolpino Hospice as "Mecca's" of what can be achieved with minimal resources in providing true "hospice" care.
Kolpino Hospice is on the southwest side of the City and serves four regions with a catchment of 1.5 million souls. It opened in 1991 and has emerged from what was a derelict shack to what today is a remarkable facility providing both bed care and a large outreach service.
Resources are hard won, but again the City and regional government are supportive recognising the extraordinary work of the hospice staff.
So many "western" hospices rely on "volunteers". The concept is understood in Russia, but people have to have two or three jobs to earn sufficient money to live. Care staff become cleaners for their second eight hour shift! Some doctors become priests!
The exceptions to this rule are the Sisters of Mercy who are mainly grandmothers. The growth of the influence of the Church and religious orders is a miracle to behold. Where there were eight "parishes" in Bolshevik Leningrad, there are now over 300 where volunteers are the key to development and restoration. Mother Russia is reclaiming her spirituality and sense of charity.
The involvement of the "State" in the Hospice movement is now most clearly seen in the construction of the Kalininski Hospice. Kalininski is another vast new region to the east of the City. After eight years, the new facility is nearing completion. It is vast! Hopefully it will be resourced. There will be 40 beds, a children's 10 bed ward; it will be a resource and outreach centre for the Region. The St. Petersburg Healthcare Trust hopes that it will become a centre for its education and training programme. 2004 will be a time of great decision-making that will determine the next stage of hospice and palliative care in Russia.
The great spectre that overhangs the City and indeed the Russian Federation is the horrendous spread of the HIV/Aids infection. The challenge to the hospice and palliative care movement to help deal with the pandemic is profound. The St. Petersburg Healthcare Trust is hoping to coordinate education and training with the help of the Global Fund and other international aid foundations.
The winter sunshine lights up the beauty of the silver birch and pine forests of the City especially in the region where the hospices work. What is most encouraging behind the façade is the enthusiasm and dedication of the Russian doctors and care staff to meet the incredible challenge facing them. It is a challenge to the world community to support their Russian colleagues in meeting this major health security risk to us all.
The Trust is a British Charity. To learn more please visit their website at URL:
www.stpetersburg-healthcare-trust.org
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