Overview – JCRC Working Trip to Dnepropetrovsk, November 2011

JCRC’s delegation to Dnepropetrovsk was a seasoned and well-connected group. This trip was Beth Moskowitz’s fifth as chair and my seventh as Director of International Partnerships; it was very smooth and remarkably productive. The highlight was a post-graduate course called “Issues in Geriatric Psychiatry,” but every meeting was useful and our time was extremely well spent. Yan Sidelkovsky was at the top of his game and the logistics were nearly flawless—the only issue was that Yan’s work with the Psychiatric Course made it impossible for him to be with us on our program visits. In most cases his absence was not a problem, but at the Day School it was a real loss given the challenges facing Havayah in this year of transition. We will need to think even more carefully about how to schedule our meetings during the medical courses to make sure we have the necessary people around each table. In sum, I applaud Yan and Noga Nevel’s careful and thorough preparation of the schedule and the materials necessary to make the trip maximally fruitful.

The psychiatrists formed a fabulous team, collegial and mutually supportive. Their respect for one another and for the professionals in Dnepropetrovsk, as exemplified by the course head, Dr. Eran Metzger, was palpable and set a very positive tone for the entire visit. The Dnepropetrovsk psychiatrists and family doctors found the course extremely helpful and our delegation made a great connection with the head of the city’s geriatric psychiatry unit. In the interest of full disclosure, I should say that one of the other Boston doctors, Michele Baker, is also my wife; the other, Tanya Bolbot Taranovsky, also has a family tie to Dnepropetrovsk, as she is the daughter of Dr. Yuri Bolbot, vice-rector of the Dnepropetrovsk State Medical Academy and a long-time partner of JCRC’s Medical Services Committee. In addition, Marsha Frankel, a social worker with JF&CS, was making her third trip to Dnepropetrovsk and continued her remarkable work with Beit Baruch. The trip was also Eran’s second. These deep connections (to which I can add that Eran was among Michele’s mentors in residency) made the trip especially heimish and fun. It’s a truism that relationships based on continuity and trust make fertile soil for productive work and change, but I can’t stress sufficiently the importance of our repeated visits to Dnepropetrovsk. We will need to continue our work to bring new people to Dnepropetrovsk and to encourage, as much as possible given constraints of time and money, repeat visits and, if the economic situation improves, visits to Boston from Dnepropetrovsk.

I should also mention that the economic and political atmosphere in Ukraine is ominous. The regime of Viktor Yanukovich, who is more aligned with Russia than Ukraine’s previous leaders, Viktor Yushchenko and Julia Tymoshchenko, has begun to show signs of political repression, assigning Soviet style functionaries in regional governments, jailing political opponents (most notably Tymoshchenko herself), and making mysterious and apparently unmotivated statements about plots for armed insurrection. People complain that corruption, which had begun to level off, is again on the rise, and that young people aspire not to careers in business but to government service, since that’s where the real money is! (Not that we met any young people who expressed such an aspiration!) There is a persistent rumor, at least in Dnepropetrovsk—I saw nothing in the newspapers I read, but my reading was very limited—that the government is plotting to devalue the grivna. Such a move would further erode the purchasing power of pensioners and, we heard from Natasha Riyer, who runs our Microenterprise program in Dnepr, the rumor itself has spooked potential borrowers: some 50% of our loan fund is currently unused. We will continue to monitor the situation in Ukraine, especially since political oppression and economic adversity can coincide with a resurgence of antisemitism. As in previous, we noticed no overt antisemitism in Dnepropetrovsk and, what is more, we heard encouraging news about the place of Jews in Ukraine in general from Igor Shupak of the T’kuma Holocaust Research Institute (more about that in another post). However, we will remain vigilant.

JCRC Celebrates 85 years of Hospital #9

On Friday, November 11, Beth Moskowitz and I delivered this speech at the 85th Anniversary of the Founding of State Hospital # 9, one of the main partners in our medical services project in Dnepropetrovsk. The first half I delivered in Russian; the second half Beth read in English with Russian translation. After we spoke, Yan Sidelkovsky (to the left) recited a poem based on the number 85. (The woman to Beth's right is Irina, our translator.) It was great fun to join in this celebration—we immediately preceded the dance troupe!

(Jim) More than ten years ago, with funding from Combined Jewish Philanthropies and private donors, Boston and Dnepropetrovsk doctors collaborated on ambulatory public health facilities for women and children. Under the auspices of the Boston and Dnepropetrovsk Jewish communities and with the leadership of Rabbi Shmuel Kaminezki and Nancy Kaufman of the JCRC, we established the Corky Ribakoff Women’s Clinic here at Hospital #9 and the pediatric clinic at Hospital #6. Boston provided medical equipment and supplies, including new ultrasound machines for these clinics, purchased in 2009. More importantly, we arranged for Boston doctors, including David Link, Benjamin Sachs, Lew Lipsitz, and Eran Metzger, to come to Dnepropetrovsk to work with Ukrainian colleagues, including the chief of Hospital #9 Elena Finkova, Yuri Bolbot, and Georgii Dzyak, Rector of the Dnepropetrovsk State Medical Academy. In addition, we brought Dnepropetrovsk physicians to Boston to train at Harvard hospitals. The response from our Dnepro partners has been overwhelming—you have taken every investment we’ve provided and multiplied it many many times. Together, we have transformed healthcare for both doctors and their patients in women’s and pediatric health.

Today, on the 85th anniversary of this great hospital, we reaffirm our commitment to healthcare in Dnepropetrovsk for Jews and non-Jews alike. We are committed to doing our small part to make this city a model for health care reform throughout Ukraine. To this end, we are bringing two of your doctors, Ludmilla Garish and Valeria Sidelkovskaya, back to Boston for additional training in ob/gyn and radiology. This week, we have brought three Harvard psychiatrists to Beit Baruch, the Jewish community’s assisted living facility for the elderly, to collaborate with Ukrainian colleagues on an intensive course in geriatric psychiatry. We will continue to share expertise, to provide training, and to build relationships in these and other specialties.

(Beth) As we celebrate 85 years of Hospital #9 and 20 years of Ukrainian independence, we are optimistic that the new model of health care funding here in Ukraine will further improve the quality and access to healthcare for all your citizens. You, the government and people of Ukraine, are taking responsibility for supporting this great hospital with the resources necessary for a world-class healthcare system. We are so proud of our partnership with Hospital #9, which has become a leader in preventive care, diagnosis, and treatment in women’s health. After 15 years of partnership, we look forward to many more years of transformational work. As our sages said, if you save one person’s life, you save an entire world—let’s continue saving lives

Haircuts and Poverty

Michele (my wife, here in Dnepropetrovsk for the first time as part of our delegation of psychiatrists) wanted a manicure and a haircut, so we arranged with Natasha Riyer, the director of our Microenterprise Loan Program for women (overseen by JVS in collaboration with MATI-Haifa), to point us in the right direction. We ended up at a small salon on Karl Marx Prospekt, “Very Well Salon.” Asya did a beautiful French manicure for Michele and Afina gave me a haircut (Michele went to another salon, this one a microloan recipient, for her cut--“she did a great job with my hair—I’d go back to her if I could”). Afina’s parents moved from Georgia when she was very young, but the family’s heritage is Greek (thus her name). Like many Ukrainians, she’s been abroad, including to Greece, but prefers to live in her native city.

This is my seventh time in Dnepropetrovsk, but the first time I’ve had a haircut. The experience pointed to some of the economic realities in Ukraine: the haircut cost me 50 grivna, about $6.25 (including two trips to the hair washing sink and, somewhat pathetically, a blow dry of my peach fuzz), but inflation on consumer goods, including staple food items, continues to rise. After my haircut, I visited a supermarket to buy some snacks, and spent a similar 50 grivnas on 2 chocolate bars and some nuts (almonds are nearly $30 a kilo). This mismatch between wages and prices affects the whole country, especially the elderly, who unlike Afina, cannot stay on their feet from 9 a.m. until 7 p.m. cutting hair.

Before our haircuts, we visited Oksana, a woman—born in 1947, so she’s younger than my parents, but seems much, much older—who lives with her son, Sasha, in a half a house in the outskirts of the city. She welcomed us into her kitchen, hoping we could speak Yiddish with her. She told us that the other rooms in her apartment were under construction, so we couldn’t go there. Yan (our Dnepro staff person) later told us that in fact those rooms are so full of stuff that it’s almost impossible to find a place to stand—she was embarrassed for us to see them. When we asked her about herself, she said that she loves cooking Jewish food and is essentially confined to the house. She is obese and suffers significant pain in her feet. She has sought medical treatment, but rejected the recommendation to amputate her feet—not that she could have afforded such a major surgery. She started crying when she told us about her family, most of whom perished in the Holocaust—her father managed to get out of the city before the Germans came, but his parents and siblings were all killed. She then related Sasha’s story: when he was in school (at a regular government school, she said, because the Jewish school hadn’t opened yet), he was walking home when some bigger boys beat him up, leaving him with severe head trauma and headaches that persist to this day. The hint that antisemitism motivated the attack was hard to miss. He cannot work and spends most of his time with his dog.

Oksana’s economic situation is dire: every month she receives a pension of 800 grivnas ($100), half of which immediately goes to pay for utilities. That leaves 50 dollars a month for medicine, food, and other supplies. (When Michele went to use the bathroom, there were only a few scraps of paper there and she felt guilty using even one of them.) Therefore, the assistance Oksana receives from the community is invaluable. This assistance includes food packages at Jewish holidays and occasional visits from foreign visitors, who bring a small stipend to supplement her income. It’s not clear how she can survive, especially supporting her son (who also receives a pension, even smaller than hers), but as with so many Ukrainians, she finds a way not only to survive, but to continue to live independently.

The juxtaposition of the young women working long hours in the beauty salon (who mostly continue to live with their parents) and this poor elderly woman with a disabled son captures so much of the reality here—the challenges that this resourceful population faces every day.

Greetings from Dnepropetrovsk -- It's Cold!

I'm writing from Dnepropetrovsk, where Beth Moskowitz (chair of our Committee for Post-Soviet Jewry) and I are having an amazing trip. It's truly amazing how much work is going on here in the context of our Dnepropetrovsk Kehillah Project, not to mention how much more is happening outside that context. We are endlessly impressed with our partners here, so I hope to post notes from the trip as I accumulate them. The only problem is that we keep on having incredible meetings, so I can't keep up with everything! It's a nice problem to have!

The main goal of this trip is the success of our intensive post-graduate course in psychiatry, titled "Issues in Geriatric Psychiatry," which is taking place at Beit Baruch, the community's assisted living facility. Led by Dr. Eran Metzger, chief of psychiatry at Hebrew Rehabilitation Center of Boston, the faculty also includes Dr. Tanya Bolbot Tarnavsky, who is a native of Dnepropetrovsk and a psychiatrist south of Boston, and Dr. Michele Baker, a psychiatrist in private practice. Reviews from today (Sunday, the first day of the conference) have been positive, but I'll offer you updates. In preparation for the conference, the psychiatrists learned about our ongoing medical partnerships with hospitals in Dnepropetrovsk as well as a few of our other projects. They then spent a day with local psychiatrists, learning about the state of psychiatric treatment in Dnepropetrovsk.

The other member of our delegation is Marsha Frankel, a social worker for Jewish Family and Children's Services, who is making her third trip to Dnperopetrovsk and has been instrumental in making mental health a priority for this community and for the DKP. Here, she works primarily at Beit Baruch on issues relating to staff burnout, but has been extremely helpful on several of our other projects.

I will be posting as often as I can over the course of our trip--feel free to follow me on twitter @RabbiJimM--there you will find links to photos from our trip.