When I read this first story in the NY Times I felt as if I was reading an account of the 1918 Spanish flu…the description of the blood-filled lungs and the patients in acute respiratory distress were amazing and frankly horrifying to read.


When patients began arriving in Vyacheslav Bonder’s intensive care unit two weeks ago, their lungs so saturated with blood that they could barely gasp, the only thing he could compare it to was a field hospital in wartime. As soon as he hooked one patient up to a ventilator, a second and third would appear in the doorway.

Ukraine Nov
By that time, hospitals were clearing wards to make room for a wave of pneumonia cases, and people were crowding into drugstores to buy whatever they could get their hands on. Rumors were circulating that the government had ordered the city aerially sprayed with chemicals, to cure Lviv (pronounced luh-VEEVE) of disease or, in a grimmer version, to exterminate its carriers.

The panic lifted almost as quickly as it had arrived, and WHO announced Friday that the H1N1 illnesses and deaths so far in Ukraine — 265 fatalities nationwide, with 87 in the Lviv region — were statistically no worse than those in other countries. But what happened here has drawn rapt attention from experts bracing for the epidemic to hit Europe, and especially the fragile health care systems of countries of the former Soviet Union.

Early findings are that serious cases mounted because the sick avoided hospitalization until their illness was dangerously advanced, stockpiles of Tamiflu were locked in centralized locations and the supply of ventilators fell short, said David Mercer, of the WHOs European regional office. “It’s not like this caught us by surprise; we’ve known for months that this was coming,” said Dr. Mercer, who heads the office’s communicable disease unit. “We’ve been working very hard on plans, but sometimes the battle plan doesn’t survive the first contact with the enemy. We’ve had to change a lot of things on the fly.”

With the worst of the health care crisis here past, many in Ukraine’s western provinces are trying to puzzle out what led to it. Doctors blame the news media and politicians for spreading fear and misinformation. The mayors of Ternopyl and Lviv, which reported their first deaths from atypical pneumonia on Oct. 12 and 19, have complained that the federal epidemiological service refused to act without laboratory confirmation that the virus was present, delaying serious measures by nearly two weeks.

Others point to more remote causes, among them the desperate poverty of Ukraine’s health care system 20 years after the Soviet Union collapsed. In Lviv, senior doctors earn a monthly salary of 1,500 hryvnas, approximately $184, pay so low that many physicians leave their practices to work as home health aides in Western Europe.

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Though health care is officially free, patients typically pay a stream of cash bribes for services as large as X-rays and as small as blood tests or linen changes.

Ukrainians rely heavily on home remedies, and that is what they did for the third and fourth weeks of October, resorting to garlic and lemons and waiting so long to check into hospitals that by the time they did, many were beyond treatment. “Medicine is underdeveloped in Ukraine, and people don’t believe in it — it’s a vicious circle,” said Oleh Berezuk, a physician who heads the mayor’s administration in Lviv. “In a mature country, if you get sick you will not say, ‘Nobody can help me.’ ”



The Health Ministry confirmed 282 deaths of flu and acute respiratory viral infections in 23 regions, the city of Kyiv and Crimea as of 14 Nov 2009. Ukrainian News learned this from a statement by the Health Ministry. Of 282 lethal cases, 17 cases were registered over the past 24 hours.

Since 29 Oct 2009, a total of 1,347,538 people have contracted flu and acute respiratory viral infections in Ukraine, according to the statement. A total of 73,373 people have been hospitalized with flu and acute respiratory viral infections and 39,380 patients have been discharged. The epidemic threshold has been [exceeded everywhere] except in Crimea, Dnipropetrovsk region, Odesa region, Kharkiv region, Kherson region, and the city of Sevastopol.

As Ukrainian News earlier reported, the Health Ministry confirmed 265 deaths of flu and acute respiratory viral infections in 21 regions, the city of Kyiv and Crimea as of 13 Nov 2009.



Interview with Dr. Victor Bachinsky: [Professor Victor Bachinsky, M.D. is a coroner in the Chernivtsi region of Ukraine. He also teaches at the Department of Anatomical Pathology and Forensic Medicine of Bukovynian State Medical Academy.]