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. Last Updated: 07/27/2016

An Aid Dilemma: Medicine Needed, Food Is Sent

Last of a three-part series

UFA, Russia -- Western nations are flooding Russia with donated food the country does not need, while at the same time failing to provide enough drugs which the country sorely needs, officials across the Ural Mountain region say.

"The sick are dying and the West is sending us canned food and other food products", said an impassioned Alfiya Ismagilova, assistant director at City Hospital No. 6 here. "We don't need this; the main thing we need is medicine".

The recent death of the welder Minigali Almirov, 50, is typical of the tragedy caused by insufficient medical supplies, Ismagilova said.

After an operation to treat his clotted blood vessels, Almirov did not receive routine follow-up medication to prevent clotting, doctors say. He died of a stroke several days later.

"There are medicines that could have helped him", said attending doctor Tatyana Galeyeva. "We feel guilty in our souls because we could not give him everything he needed".

Such tragedies might be prevented, some hospital administrators say, if the West, prompted by Russia's leaders, would redirect more of its international aid from food to medicine.

Statistics on food and medical aid to Russia are hard to come by because of the multiplicity of agencies administering the assistance and because the aid is often lumped together.

One indication of the dominance of food aid is the 1992 total in the two fields from the United States, the largest food donor, Germany, the largest drug donor, and the European Community: $574 million was donated in food aid, more than twice the $236 million in medicine.

The Western emphasis on food aid is a classic case of the aid community reacting to last year's perceived problem, rather than getting ahead of the curve. The drive to send food took root in late 1991 when there were fears that Russians would starve as the country switched to market economic policies in the dead of the winter. The fears were never realized.

Two women receiving handouts of American powdered milk in Polevskoi, a northern Ural Mountains town of 80, 000, illustrated the misdirected assistance.

Neither Natasha Shakhmina, 24, nor Lidia Salodina, 30, told aid officials that they already had a pretty good source of milk: Both families own cows.

"If we didn't get this aid, of course we would survive anyway", said Salodina, who thought the aid was a gift of the former East Germany. In some instances, residents who did not need the food are even selling it off to buy alcohol, according to Polevskoi's social welfare director Anatoly Kirpishchikov.

Over the past year, however, the medical situation has grown ever worse, health officials say, because Russia was forced to pay world prices for medicines it once received cheaply from Eastern Europe and the former Soviet republics.

Hospitals say they do not receive sufficient government subsidies to afford the drugs they need to continue their tradition of providing free medical service. Regional health officials, in turn, say they are waiting for Moscow to help, and they accuse bureaucrats in the capital of not understanding their problems.

"We think our leaders don't understand", said Ismagilova. "I don't think Yeltsin has a problem with antibiotics".

In Moscow, Georgy Maltsin, the official overseeing Russia's aid distribution to the provinces, blamed regional hospitals for failing to supply themselves. He also contradicted several hospital officials by asserting that no one is dying from the lack of medicines.

Hospital No. 6's assistant administrator Ismagilova and others calling for more medical aid said ultimately they must do more than just ask for international handouts. Several aid officials cited the maxim that giving a person a fish will feed him for a day, while teaching him to fish will help for life.

"We are increasingly understanding that only we can help ourselves", said Zufar Murtazin, deputy minister of health for the semi-autonomous Republic of Bashkortostan around Ufa. "We need technology to make our own medicine here".

The West has been gradually increasing its medical aid, and medical donations are expected to increase tenfold year this year, Maltsin said. Yet food remains the dominant humanitarian contribution to Russia, and donors will quadruple shipments to 1. 8 million tons this year, he said.

Benedicte Berner, a spokeswoman for the Red Cross, blamed the United States -- which already provides a third of all food aid to Russia -- for the overemphasis on food aid. Taiwan, the European Commission, and Britain also contributed large quantities of food last year, according to the Russian Agency of Cooperation and Development.

"I'm sorry to say, but I think it's mainly the United States that hasn't got the message", Berner said.

Both Russian and American officials and experts have said that President Bill Clinton's $1. 6-billion aid package put forward at his summit with President Boris Yeltsin, more than half of which is in food, is motivated largely by domestic politics, not by what Russia needs.

"The Americans are proposing to send more food, not medicine, in order to support American farmers", said Russian aid official Maltsin. "America is helping itself first and foremost".

Officials at CARE USA, the agency distributing much of the American aid, say that food aid provides help to people suffering from high prices and falling nutritional standards. It also provides a visible symbol of the West's desire to help Russia and earns political goodwill, they say.

"We understand we're not feeding starving people", said Jeff Jacobs, who heads CARE'S operations in the Urals. "It's just a nutritional supplement to their diets".

Daniel Puzon, an official in the office that coordinates American aid policy toward the former Soviet Union in Washington, D. C. , said the United States was trying to provide Russia with a balance between food, medicine and other needs.

"We may be moving into an area where that will be a bigger need now", he said, referring to medicines. "But when we did the studies, food was the highest priority".

"These are going to be changing targets", he said.

When medical aid does get to Russia, it is often concentrated in the largest regional hospitals, while smaller neighborhood institutions are not supplied.

In Yekaterinburg, the administrative center of the Urals, District Hospital No. 1 had its basement bomb shelter filled with $600, 000 worth of American medical aid in November.

A small fraction of this assistance seems misdirected, such as the special vitamin pills for pregnant women, since the hospital does not have a maternity ward. But hospital director Sergei Sibirtsev said the other supplies -- including single-use syringes, antacids, aspirin, insulin, antibiotics and many other drugs -- are a great help.

At Ufa's City Hospital No. 6, however, the medicine chest is practically bare. A Dutch aid shipment two years ago to the hospital has nearly run out, and nurses are reusing needles and other items commonly disposed after a single use in the West.

Skeptics say the food-aid programs are not only unnecessary, they also squander the West's limited finances.

"I think doing food aid is counterproductive", said Serge Duss, Moscow field director for World Vision, a Christian humanitarian aid organization which delivered some food aid a year ago. "This country can feed itself 10 times over; if you keep bringing food though, they'll keep their hands out".