Terrible situation in Semashko

Mosquitoes flying through the windows in a ward without a grid, some lamps in the ceilings absent, crowds of relatives some to each patient during the day, some are sitting on the hospital wards, not a single visitor has a robe. Doctors are forced to squeeze through relatives who have surrounded the patient in order to examine the patient. Nurses expel visitors into the corridor so that patients can go to toilet and healing procedures, but the "guests" quickly return back, as if the patient will recover faster from their constant presence in the wards. Toilets are in poor state, device do not work, water flows through the broken taps to the floor, there is no soap or towels. The patients, whom no one visits, eat state food. When asked by a journalist, the patients said that the quality of food was normal.

Nurses loudly discuss in the presence of patients a colleague who took five manats from patient and did not transfer this money to "legal addressee". For medicines, medical syringes and other necessary things, relatives go to the pharmacy recommended by the doctor and buy with their own money. For clean bedding and the work of nurses, nurses and doctors, the staff asks for payment in cash. Less than 100 manats per day, if the patient accepts the procedures, his stay in one of the departments of the 1st Baku hospital (in common "Semashko") is not enough for the family. Such are the observations of a journalist who spent three days in the department of the oldest Baku hospital of the Ministry of Health of Azerbaijan.

On the first day, he was placed in a ward with men for receiving the procedure. On the second day, he was transferred to the ward with six women, as there were no empty places, and one double room was "bought" by the patient for himself and his relative.

We do not indicate the address and names because the personnel of the medical institution did not know about the patient"s profession, did not know with whom to be frank, and in case of disclosure of accurate data, these people could lose their jobs. In fact, when reading the article it will become clear they are not the perpetrators, but victims of circumstances created at a level even higher than the Minister of Health.

City Clinical Hospital № 1, previously called a hospital named after Semashko, was built in 1912 and initially was called the hospital named after Musa Nagiyev. In the Soviet years, many others were added to the central buildings of the hospital. During the years of Azerbaijani independence, the first Clinical Hospital was repaired: whitewashing of the walls, the replacement of the internal partitions with glass ones and the installation of spot-lamps on the ceilings. However, tiled plates in the bathrooms "walk" under their feet, and the outer doors of the department resemble the doors of prisons.

"The nightmare begins in the evening, when drunken and drug addicts, victims of street fights and homeless people are brought to us, sick, unable to explain their misfortune, behaving inadequately, beaten and drowning in the mud," said the doctor of the department who passed the difficult professional way of the Baku doctor.

He regrets that he entered the Medical Institute, and pities the students of the Medical University, who are eager to become doctors. Now graduates of this university seek to leave for Turkey in order to obtain the status of "Uzman" there, but in Turkey, they receive purely practical guidelines for the treatment of specific diseases. The theory of medicine is not taught there, the Uzmans have not heard about the elementary theory of the dominant of Ukhtomsky (the dominant of the nerve center and the inhibition of neighboring centers). "Unprepared doctor come to hospitals. There will be no one to cure the sick after the Soviet generation," said the doctor.

He recalled a well-known saying "Fish begins to stink at the head." The doctor considers Minister Oktay Shiraliyev incapable of directing and modernizing the entire system of Azerbaijani health care. He remembered how the minister asked the physicians who had returned from training in Europe about their impressions, and asked them to compare what they had seen in Germany with our hospitals. Those young physicians who expressed their claims to our hospitals were fired.

The journalist asked the hospital medical staff about salaries. The nurse receives 180 manat per month, a qualified experienced doctor - 540 manat. The hospital does not issue funds for medicines and other medical preparations free of charge, except for the simplest ones - bandages, syringes, a short list of cheap medicines and painkillers. Without the acquisition of necessary goods by patients in pharmacies, treatment is impossible. Without the money, that the staff receives "available" from the sick, doctors, and nurses will not be able to live, given the need for night duty with forced trips home by taxi.

In 2020, the health care system of Azerbaijan will switch to compulsory insurance medicine. A source in the department of the First city hospital believes that almost nothing will change with this innovation for the sick and medical staff. Minimum insurance will cover a limited list of medical procedures and drugs in accordance with the established protocol.

The reform will not affect the salary of staff and financing of the hospital. This means that in Azerbaijan bribes will continue from the side of sick employees of medical institutions and the purchase of medicines, etc., in pharmacies at their own expense, the doctor explained. He told how on the day of reception by President I.Aliyev of the renovated medical building of the "Semashko hospital" two palm trees appeared on the territory. The President examined the renovated facility proposed by the Minister of Health, did not visit the others, and in the coming days after his visit two palm trees disappeared.

The journalist compared this hospital with the Baku market; the only difference is that there are no hospital beds in the market. Dirt, noise and crush the same. "Do you think we like asking for money from patients?" We have to pay for repairs to the building and medical equipment from our salaries, we are constantly stripped of money for some internal obscure expenses, condemning us to extortion. The head of our department cannot improve something in this system, it is beyond his competence," the doctor shared with the journalist.

He lowered his hands when talking; the doctor does not see a way out of the plight of Russian "free medicine". The best specialists go to work in paid clinics, where there are more visitors and patients despite the high cost of treatment there. But in "free" you also have to part with money, and people choose a hospital where conditions are better - clean, high level of equipment and treatment, high-quality food, and you have to pay once and only to the cashier.

Coming out of the hospital, the journalist was waiting for a bus on a city street. A bus N 83 arrived - an old and smoking one; on the front step a young cashier, spitting on the asphalt was calling passengers in a hoarse voice, as if at a fair.

Immediately after that, a bus N 6 arrived, similar to a spacecraft, with an air-conditioned cabin and payment via plastic cards. The electronic voice calls the following stops; passengers enter through the front door and exit through the others.

The passenger at the bus stop spoke to the author of the article, pointing out two such different buses and explained that the first one will remain old because the city of Baku needs routes that collect uncounted cash payments from passengers. Comparison of the passenger in an amazing way corresponded to two levels of medicine existing in Azerbaijan - private "paid", and public "free". In the latter, they take money from the sick, but they do not report to the state, as if this is an old and dirty bus.