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Volume 4, issue 08 August 2010 Kharkiv was not originally included among Ukraine`s four first choice Euro 2012 host cities, but the East Ukrainian capital forced itself into contention by pushing ahead impressively with a variety of infrastructure projects. This determination was finally rewarded when Kharkiv replaced Dnipropetrovsk as a UEFA host city in 2009.
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Metalist maracles win UEFA respect
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Kharkiv airport: ready for take off
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23:37 Saturday, September 4, 2010 |
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Industry Staying sane in Ukraine
Mental health issues remain taboo in modern Ukraine but the emotional and economic cost is huge
Dr. Richard Styles, American Medical Centre Volume 4, issue 6 June 2010
Psychological illness is often seen as the black beast of Slavic health care: it remains stigmatised, underdiagnosed and poorly treated and perhaps most damagingly, it has historically been politically abused. It is little wonder that the issue of mental health presents many challenges which Ukraine must face in coming decade. However, it is also worth noting that Western attitudes to mental health in Ukraine and the former Soviet Union in general may also be in need of updating. Western physicians reared on Cold War propaganda images of depressed and depressing Soviet citizens lined up in eternal bread queues would be forgiven for assuming that Ukrainians would be particularly prone to depression. However, over the years I have come to feel that depressive illness is perhaps less common in Ukraine than in some northern European countries where its incidence is said to be as high as 1 in 7 women and 1 in 14 men. Ukrainians less prone to depression than European neighbours? There are reasons why Ukrainians may be less susceptible to depression and those include in part genetics, although interestingly their neighbours in eastern Hungary have one of the world’s highest suicide rates. We do understand that depression has a hereditary tendency and so relatively low rates of depression may simply be due to the genetic ability to handle brain chemicals in much the same way that some families handle cholesterol better than others. Ukrainian society has maintained strong family links that often involve extended families and this undoubtedly provides strong support in times of emotional crisis. Until recently debt was a fairly uncommon concept and although marital breakdown is not uncommon in Ukraine it seems to have fewer protracted problems and people seem to be more able to rebuild their lives without excess baggage. Talking to many Ukrainians, especially women, you will hear the argument that mental illness and depression are remain alien concepts and that the day-to-day burden of getting enough money, feeding the family and keeping everybody happy fail to allow for enough free time to consider the emotional niceties of life. Whilst such commonly held attitudes reflect a certain healthy realism they also sadly deny the existence of psychological illness in society. Regional inertia taking its toll on rural mental health The relative emotional bouyancy of Kyiv is not reflected regionally and the truism that Kyiv is not Ukraine is immediately evident when you travel beyond the city limits to areas where unemployment and depopulation have taken their toll of emotions. Whilst in Kyiv the media and some enlightened doctors openly recognise the effect of psychological illness on the country’s health, in most of Ukraine the idea of suffering from clinical depression remains stigmatised and regarded as a shameful personal failing. I have met country doctors who have refused to diagnose depression because they say their patients would no longer trust them or are afraid that the diagnosis would be indelibly entered on their work records. General medical education in Ukraine does not recognise the importance of psychological illness and many polyclinic doctors feel a lack of confidence and basic skills in making diagnoses of emotional illness, further compounding the problem. Prescription problems add to social stigma The difficulties in overcoming medical ignorance, reticence and stigma are added to by further problems surrounding the prescription of psychotropic drugs for emotional illness. Like many things Ukrainian this is difficult to unravel and seems to reflect more historical and administrative practice than legal regulation. It is generally perceived and practiced that only psychiatrists can prescribe psychotropic drugs. This barrier leads to further stigmatization of psychological illness. However there are some enlightened oblasts where such diagnoses, treatment and prescriptions can be made by family doctors or polyclinic doctors and where postgraduate training in psychological illness is accorded the necessary importance. In some areas incentive schemes have been successful in raising the salaries of family doctors who can demonstrate, amongst other activities, that they are actively exploring psychological illness in their patients. In development work it has been found useful to encourage doctors to develop their normal communication skills - and Ukrainians are normally cheerful and good interpersonal communicators - and to abandon the hierarchical skills that they have seen in centres of excellence where they were medical students. Depression is essentially an extremely treatable disease and does not require very expensive drugs to make the adjustments to the brain chemistry that can bring happiness and the ability to cope with life’s difficulties. Whilst it is always difficult to treat unhappiness caused by social circumstance, the current failure to diagnose, treat, and help those with psychological illness in today’s Ukraine comes at a huge economic and emotion cost to the country. Much work has still to be done in medical schools, in the press, by individual doctors and by society itself to recognise, de-stigmatise and treat psychological illness and to recognise its place in the spectrum of healthcare. Such changes in attitude can only further enhance the freedom of individuals within Ukraine and to continue to build a society that is caring and tolerant of individual health issues. Dr. Richard Styles ( This e-mail address is being protected from spambots. You need JavaScript enabled to view it ) is a British family physician at American Medical Centres in Kyiv. He has 32 years experience of practicing family medicine in the UK, Ukraine and elsewhere, and for three years worked for the EU in cooperation with the Ukrainian Ministry of Health in developing family medicine in Ukraine.
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