Institute for War and Peace Reporting | Giving Voice, Driving Change

South Ossetians Stay Clear of Hospital

People prefer to go to Russia or Georgia for treatment than rely on their capital’s crumbling medical centre.
By Alan Tskhurbayev
South Ossetia’s main hospital in Tskhinval, the capital, is almost deserted. Above the main entrance, bullet holes are still visible from the fighting in 1992 when the territory won de facto independence from Georgia.



Inside, the scene is much more shocking. The plaster is peeling off the walls, and there are holes in the ceiling. Rats dart about the corridors.



Under the windows in the surgery department, there are sacks of sand. In the summer of 2004, there was an upsurge of fighting and the sacks defended the doctors and patients from bullets. They have not been removed.



The only patient in the urology department bears the same name as the unrecognised republic’s recently re-elected president, Eduard Kokoity. Fyodor Kokoity, a World War II veteran, is 83 years old and his condition, second degree prostate adenoma, could be cured with an operation - only the hospital does not have the necessary equipment.



The department is intended for 60 patients, but everyone who can seeks treatment outside South Ossetia - either in Russian North Ossetia or Georgia. Kokoity’s family does not have the money to fund his treatment elsewhere and so he is a prisoner of this ward in Tskhinval.



“My son lives in Vladikavkaz,” Fyodor Kokoity manages to say through his pain. “He sends me money from there, but he has his own family to look after.”



“Every time I have to apologise to the patients on behalf of the rulers of South Ossetia, who force their citizens to get treatment in conditions unfit for normal people,” said Sarmat Parastayev, head of the urology department and co-chairman of the association of doctors of South Ossetia. “It’s become a professional habit to apologise.”





Parastayev said that in the previous month, 11 people with urological problems had come to him but ten of them, seeing the conditions of the hospital, had chosen to be treated elsewhere. Most go to North Ossetia, although some opt for Georgia.



“Whole branches of medicine have stopped functioning in South Ossetia,” said Parastayev. “For example, I can’t say that we have urology here, if we don’t have the basic essential equipment. And I’m not even mentioning more advanced fields of medicine.”



Local people said they heard promises that there would be a “complete re-fit” of the hospital during the recent election campaign, but say nothing has been done here since 1989.



South Ossetian leader Eduard Kokoity recently threatened to dismiss health minister Jemal Jigkayev, but locals say the problems go beyond one individual.



The international medical organisation Medecins sans Frontieres used to provide aid to South Ossetia, but stopped working here in 1997. Now, the health sector, like much else in the republic, mostly gets its funding from Russia.



On October 30, truckloads of humanitarian aid arrived in South Ossetia sent by the government of Moscow and personally by the mayor of Moscow, Yury Luzhkov. A public relations campaign organised around the event emphasised that the cargoes contained hi-tech medical equipment.



Alla, who works at the Tskhinval hospital, tells a different story. “There were just operating tables, lamps, sterilizers - useful things, but nothing really important and that we don’t have already,” she said. “What we need is diagnostic and operating equipment.”



“The basic approach to these problems in Moscow has not changed,” said Parastayev. “South Ossetia is regarded as a humanitarian disaster zone and supplies are limited to humanitarian aid. So they do not send equipment and supplies here which raises the standard of living or might bring jobs. And local politicians support this situation.”



Well-known local non-governmental activist Alan Parastayev, the brother of Sarmat, says that Russia uses these aid deliveries to make South Ossetia dependent.



“Luzhkov’s aid…no way allows the social rehabilitation of a conflict zone, as not a single person is provided with work,” he said. “Moscow is creating the ideal conditions for the further transformation of the country into a real conflict zone.”



Despite the unresolved Georgian-Ossetian conflict, sophisticated medical equipment does come from Tbilisi. The Professor Todua centre there has supplied a tomography computer to the Tskhinval hospital and the urology department is negotiating to be supplied with new modern equipment.



“Medicine is outside politics,” said Sarmat Parastayev. “I am in constant touch with doctors from Tbilisi and it is only through this kind of personal agreements, with good will on both sides, that you can solve a crisis.”



A Tbilisi doctor, Levan Nachkebia, studied at university with Sarmat Parastayev. Though divided by the conflict, the two men have kept up a friendship. Nachkebia is now studying to gain extra qualifications in Australia - something his South Ossetian colleague can only dream of.



“One of the biggest problems for medicine in South Ossetia is a lack of qualified personnel,” said Lev Gagiev, a surgeon in the Tskhinval hospital. “But how can there be any specialists here if I a surgeon have a monthly salary of 1,800 roubles (68 US dollars)? Naturally people just leave this place.”



The head of a department in the health ministry, who asked not to be identified by name, was frank about the problems of South Ossetia’s health system.



“I have an idea of what sums are needed to bring medicine here up to a modern level,” the official told IWPR. “The sums which reach us and which pass across my desk are tiny.”



“I agree that the clinical hospital has basically turned into a big reception centre, where people can receive first aid but they are sent for clinic analysis or treatment to North Ossetia or Georgia. That is the reality here. Unfortunately.”



Alan Tskhurbayev is a reporter for www.gazeta.ru in North Ossetia