Financially Strapped Russian Red Cross Struggles to Help Siberia's Homebound

Written by Stephanie Kriner, Staff Writer, RedCross.org

The Russian Red Cross does not have enough walkers to help all patients of its Visiting Nurses program.

The petite, young Red Cross nurse eases Anna Zubkova up from her lumpy cot. The old woman's frail body relaxes under the nurse's sturdy support. Together, the two women walk in circles around Anna's tiny bedroom, the only room in the house besides the kitchen. Anna leans on a wooden chair while Tanya Timofeeva, the nurse, supports her from behind, helping Anna avoid the coffee table, chairs and other hazards that clutter the room.

"I'm afraid of falling down and breaking my arms," says Anna, who is recovering from a stroke that left her unable to walk. Her husband, Fyodor, sits on another cot, a wooden cane leaning against his leg. In poor health himself, he is Anna's primary caregiver, except during the two hours each week when Timofeeva visits the house.

"I suffered a hernia once when I tried to pick her up. I don't want to go to the hospital to get an operation, because I can't leave her," he says. The love the couple shares is palpable. Anna points to a worn doll, sitting on a table in the room. "Fyodor gave that to me when I retired," she says, her husband grinning beside her.

The American Red Cross is helping to develop the Russian program.

After 45 years of marriage and shared responsibilities, Fyodor now has to run the errands, do the housework and prepare the meals himself. "My husband has a difficult time because he never cooked before and now he has to," says Anna, who also has diabetes.

Anna is among thousands of patients served by the Russian Red Cross Visiting Nurses Program. The Red Cross program targets Russia's poor, elderly, handicapped, sick and homebound, assisting patients who are unable to care for themselves by providing both health care and help with daily chores. Timofeeva visits Anna each week to check her blood pressure, deliver medications, bathe her and cook meals.

"Normally, it's lonely, sick and poor people who need assistance," says Lubuf Balkanova, director of the Visiting Nurses program in Irkutsk, Siberia.

Since the 1998 economic crisis hit Russia, the Visiting Nurses program has struggled to survive. Irkutsk's meager program has only one walker to offer its patients. Nurses take turns bringing it to homes of those who need it. Between 1997 and 1998, the number of nurses throughout the Russian Red Cross system dropped from 2,087 to 1,876 due to lack of funds. The number of regional Red Cross committees able to keep the program running dropped from 81 to 76.

The program is suffering just when people need it most. Nurses, who visit about 322,000 patients each year, cannot meet the demands of some 1.5 million people in need of home-care assistance.

Red Cross nurses help thousands of homebounds patients, but many still need assistance.

Russia continues to struggle through its financial difficulties and social unrest that has hindered people's access to healthcare. Funding cuts have disrupted hospitals, and the medical system is virtually nonexistent in some areas, according to an International Federation of Red Cross and Red Crescent Societies appeal. A decline in public health resources has led to a resurgence of deadly illnesses such as tuberculosis, diphtheria and sexually transmitted diseases

"There are more people who need help, but the Red Cross has less means to provide nursing care," says Ramsey Rayyis, Russia's head of delegation for the American Red Cross in Moscow.

Fyodor and Anna lost almost their entire savings when the ruble crashed nearly three years ago. Their savings account plummeted from 4,000 ($143) rubles to 40 ($1.42) rubles. At the same time, their pensions dropped by more than half. The couple, whose pensions now bring in about 2,000 rubles ($71) per month, is slowly recovering. Still, it is difficult to afford food and all the medications Anna needs for her diabetes and high blood pressure.

When the Red Cross brings the Zubkovas an unexpected delivery of food to help during the difficult times, the couple is moved to tears. "When I was healthy, I used to help people," says Anna, dabbing her weary eyes.

"It was a very sudden decrease. We used to have money in the bank. Now our pensions are going back up, but inflation keeps rising too. We're still trying to save money for our funerals. It is a very difficult time," Fyodor says. "Prices are high, and they vary all over the place. During Soviet times, it wasn't like this."

The American Red Cross, which has similar programs in the United States, created a comprehensive training manual called "Foundations of Caregiving" for Russia's visiting nurses. The manual, intended to improve the level of home care provided by Red Cross nurses, is used as a training device and resource.

The American Red Cross is currently developing a $200,000 program to assist the Russian Red Cross in their efforts to address the spread of tuberculosis, which already has infected an estimated 111,000 Russians. The program includes training Red Cross nurses to help homebound tuberculosis patients.

Through the program, nurses would monitor patients' progress in combating the disease, ensure that they follow a healthy diet and remind them to take their medicine properly and on schedule. The program also includes an information campaign for both tuberculosis and HIV/AIDS.