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. Last Updated: 07/27/2016

No Coconuts but It's Home

When Dr. Fran?ois Gourraud talks to his colleagues from the south of France, trying to persuade them to join him at the European Medical Center, where he works in Moscow, they usually have a few questions.


Can they windsurf in Moscow? No, he answers. Can they sail? Again, the answer is no. Well, can they at least ski? Yes, if they are willing to travel to Kazakhstan, as he and his wife have done, is his inevitable answer. They why, they ask, is he still here?


For Gourraud, 31, who has traveled extensively in Asia and the South Pacific and worked in the French islands of New Caledonia, his interest in Russia encompasses more than just a love of new places. "It's not an island, there are no coconuts, but the work is somewhat similar," he said. "You have to do many more things here than you would be doing in Europe."


In his two years in Moscow, Gourraud has covered a broad spectrum of general medical practice. As the only full-time physician at the European Medical Center, he monitors pregnancies, follows up with pediatric patients, administers vaccines, and consults on emergency cases for the center's primarily foreign clientele of diplomats, journalists, business people and students.


Although they still make up a minority of his patients, Gourraud said that he is also seeing more Russians as western companies begin to extend medical coverage to their local staff. He was reluctant to criticize the health care system of his host country, but he did observe that the collapse of state funding and the growth of private options has led to an increasing sense of the confusion. "There's no real policy about health care," he said. "Many people are out of the system -- either they don't know where to go or they can't pay."


Lack of information is a particularly serious problem, Gourraud said, and one evident in Russians who have come to him for consultation. "When I see people here, they often come with an awful diagnosis when they often have simple conditions," he said, adding that misperceptions and differences in the way illnesses are diagnosed lead to fears such as those that prevent many of his younger patients from being vaccinated. "If a baby is waving its arms in anger over the vaccine, a Russian doctor will not vaccinate it, saying that it is nerves," he said.


"The cultural perception of disease is very different in the West from here," he added, explaining that his Russian patients often see their current illnesses as part of a chain beginning with childhood ailments and including their entire medical history.


It is this basic lack of information, he said, that leads many Russian patients to come to see him. As a result, he said, patients are often grateful when he takes the time to calm their fears. "I think people need to be a little more secure with their doctors," he said. "Maybe if Russian doctors would take time" with patients, he added, "then it would be different. This is my hope."


Gourraud, who was raised in Aix-en-Provence, studied medicine in Marseilles and worked in hospitals in the south of France before taking up his island post. After leaving New Caledonia, he sailed to New Zealand and traveled to Australia, Indonesia, Japan and Nepal over the course of several months. En route to France from New Delhi, he said, he wound up in Sheremetyevo without a Russian visa and called a friend for help. With the help of a 15 day transit visa, he found a job and met his wife. He returned to Russia a month later to begin work.


He now has a Russian doctor working with him part time and helping with hospitalizations and other complicated cases which, he said, is extremely useful as he does not speak Russian and his assistant speaks strong French. He said that he hopes to attract another full-time physician to the center, perhaps expanding its services by next autumn.


Gourraud compared Moscow favorably to his previous island residence in many respects, with the exception of the weather. He said that he spends much of his free time visiting museums, relaxing in the convivial atmosphere of the banya or traveling around the country.


In addition, he added that he values his friendships with Russians who, he noted, are often more enigmatic than their Western counterparts. "It takes a long time to discover them, but when you discover them they are very interesting people," he said. "Maybe because of these people, it is easier to stay here."