2008 Is Year of Family: Two Villages Die Out in Russia Each Day."

 

Russia is rapidly dying out. As of 1 January 2008, according to Rosstat (Federal State Statistics Service), the country's population stood at 142,008,838. As of late July 2008, it was 141,888,000. Over a period of seven months, more than 120,000 Russians died. By 2050, Russia's population could fall to 100 million (according to a UN estimate). The Russian Academy of Sciences' Institute for Sociopolitical Research predicts it will fall to 83 million. Nikolay Gerasimenko, first deputy chairman of the State Duma Committee for Health Care, believes that if no action is taken, Russia will become a country of widows by 2010. Indeed, mortality rates in Russia have risen by 20% over the last several years. Low birth rates give little cause for joy. Average life expectancy offers no solace: Russian men now live to an average of 58 years and 8 months, while women live to 72. Over the past 13 years, 290 cities and 11,000 towns have completely disappeared from the map of Russia. Another 13,000 Russian villages have been left by inhabitants. What is to blame for this? Alcoholism, drugs, road accidents, stress, abortions, genetic disorders, and counterfeit medicines. It seems the country is on the verge of a humanitarian catastrophe. What is to be done?

 

Unreliable screening

 

"Russia's mortality rate is currently outpacing its birth rate. With every passing year there are 700,000-800,000 fewer of us," Academic Aleksandr Baranov, Russia's chief pediatrician and director of the Russian Academy of Medical Sciences' Scientific Center for Children's Health, lamented in a conversation with Argumenty Nedeli. "Each year more than 17,000 children under the age of one die in Russia. As do approximately the same number of children between the ages of 1-18. That is around 35,000 in total. The reason for infant deaths is poor prenatal preventive care. This particularly applies to developmental defects, premature births, and maternal illnesses. We need mass diagnosis of fetal infections. But this does not currently exist in Russia. When we screen newborns for genetic diseases, we only identify four diseases, compared to 30 in the United States."

 

The most powerful factor in children's poor health, according to Academic Baranov, is poor diet and a lack of calcium, which leads to osteoporosis. Defects in the formation of bone tissue occur in 40% of children. Some 70% of girls and almost 50% of boys under the age of 18 have reproductive abnormalities. The solution is to create specialized reproductive health centers and adopt a special federal program. Creating such centers would obviously be expensive. But it seems there is no other solution.

 

Fake drugs: how not to kick the bucket

 

"It is important for children to be born healthy. And this is where doctors can and should make a contribution," believes Professor Leyla Adamyan, M.D., a member of the Russian Academy of Medical Sciences.

 

"Russian has everything for this: both the staff and the high technology. As part of the National Health Program, international conferences on reproductive medicine are held on a regular basis. These conferences focus on complex problems related not only to female reproduction, but male reproduction as well. From birth to old age. And this is due to a number of factors. First of all, the overall aging of the population. Second, the specific nature of modern illnesses among women of child-bearing age and children. Genetic illnesses have appeared."

 

In Leyla Adamyan's opinion, Russian specialists are among the best in the world. They are also among the best at treating one of the most complicated illnesses of the century: endometriosis. But the main trouble is that our women do not look after their own health. Smoking, alcohol, and abortions do a great deal of harm. But even that is not all.

 

"I would also highlight poor diet, stress, bad environmental conditions, and infections," Leyla Vagoyevna (Adamyan) continues. "This is especially true of women in the major metropolitan areas ."

 

Modern reproductive medicine makes it possible for women to give birth even if they have a history of oncological illness, thyroid disorders, diabetes, or cardiovascular disease. But there is another serious problem here: Russian pharmacies have been stocked with fake medicines that cause illness and even death.

 

There are 5 million infertile families in Russia. With proper treatment, 3 million of them could have children. There is just one small problem: providing such treatment. As well as providing non-fake drugs. But what will it take? Government interest and support. But the Ministry of Health and Social Development is planning to split into two halves in the near future. There are persistent rumor to this effect. During this reorganization, the focus will hardly be on patients.

 

Russia is world champion in abortions

 

Russia is the world's leader in terms of the number of abortions performed. Seven out of ten pregnancies end in abortion. In the first nine months of 2008, more than 1.5 million abortions were carried out in Russia. According to unofficial estimates, abortions kill up to 6 million children a year in Russia (the (official) statistics do not include underground abortions). Out of 3.5 million pregnancies in Russia, only 1.5 million children are born.

 

The Birth Certificate Program, implemented as part of the National Health Project, was supposed to change things for the better. As it turns out, things have yet to improve.

 

New studies show that the mortality rate among women who have abortions is unusually high. Around 10-15% of abortions result in various complications. The number of infertile women in Russia increases by 200,000-250,000 each year.

 

And the number of infertile women is only going to increase, since one in ten abortions in Russia occurs among adolescent girls. Some women have more than 30 abortions throughout their lifetime.

 

Catastrophic arithmetic : Male supermortality

 

Male mortality has always been high in Russia, but today it has become one of the highest in the world. 30% of those who die are men of working age.

 

In the late 1990s, another problem emerged: aging. In 1998, the number of pensioners in Russia surpassed the number children and adolescents under the age of 16 for the first time, by 110,000. In Russia today there 2.5 times more pensioners than children under the age of 14 (27.2 million and 10.6 million respectively). The average Russian today is four years older than the average Soviet citizen was. According to the projections, pensioners will make up more than a quarter of Russia's entire population by 2016.

 

Over the last five years, heart disease has also become a far more common cause of death among young men, increasing from 29% to 36.6% among men aged 20-39. At the same time, a large proportion of deaths from heart disease are caused by alcoholic cardiomyopathy.

 

Back in the 1970s, the World Health Organization passed a special resolution equating alcohol with narcotic substances that undermine the health of a nation. There are two ways to fight alcoholism: prohibition and raising prices for alcoholic beverages. The anti-alcohol campaign that was launched in the Soviet Union in 1985 led to a sharp drop in mortality rates. In 1998, however, mortality once again started to rise, reaching a peak in 1994. The next peak of this sort came in 2002.

 

In 2006, 185,800 people suffered heart attacks, 64,722 of whom died. That is 35%. In developed countries, the mortality rate from this pathology does not exceed 6-8%. What should be done to bring these numbers down?

 

"Perhaps funds should be used to improve the social safety net and provide job training in order to reduce the stress associated with unemployment," Professor Sergey Maksimov, M.D., believes, "and to restore the ruined healthcare system. In the United States, they perform around half a million aortocoronary bypass operations a year, compared to just several hundred in Russia. One c annot rule out the possibility that investing in mass sports and routine physicals would be more effective than increasing the number of such medical operations."

 

54% of boys will only reach retirement age

 

In the 1990s, Russians consumed 250 billion cigarettes a year; today, that figure has risen to 375 billion. Who smokes? People between the ages of 20 and 40-49. After that, the figures begin to taper off, but not because smokers suddenly start leading a healthy way of life. They simply die out.

 

"Every day we lose two villages, and over the course of a year we lose a small oblast," Nikolay Gerasimenko, first deputy chairman of the State Duma Committee for Health Care, insists. "We have the highest mortality rates in Europe, comparable to the figures for African countries. Just 54% of today's 16-year-old boys will reach retirement age.

 

And the number of births has fallen by half. It is well known that it takes 2.15 children per family just to maintain the replacement rate, but in Russia this figure is a mere 1.2.

 

The number of congenital deformities has doubled.

 

Medical services are now fee-based almost everywhere. Even the federal medical centers charge money. This is despite the fact that the Constitution guarantees free medical service.

 

For 1,000 marriages - 800 divorces

 

Russia has been hit by a tsunami of divorces, so to speak. Prior to 1917, incidentally, divorce was only recognized in Russia if it was carried out by an ecclesiastic court. Under the laws of that time, only the Holy Synod could allow a divorce.

 

In pre-Petrine Russia (prior to the reign of Peter the Great, which began in 1682), the following were recognized as grounds for divorce: infertility, adultery, cruelty, drunkenness, shameful behavior, a wife's abduction... Ecclesiastic statistician I. Preobrazhenskiy provides the following data on the number of divorces in the Russian Empire: 198 in 1840, 920 in 1880, and 942 in 1890. According to the 1897 census, there was just one divorce per 1,000 men!

 

And today? The numbers are shocking: 800 divorces per 1,000 marriages!

 

Alcoholism and drug addiction are the main causes of divorce in Russia. Other factors that cause families to break apart include: lack of home ownership (41%), inability to feed a family due to low income (29%), and interference by relatives (18%). Less common reasons given by Russians include inability to have children (10%), prolonged separation (8%), imprisonment (3%), or the illness of one spouse (2%).

 

What is interesting here? The lowest divorce rates are found in Kabardino-Balkaria and Ingushetia. The leader in divorces (and marriages) is the Khanty-Mansi Autonomous Okrug: 7 divorces and 11 new families per 1,000 residents.

 

"Test-tube babies" are cheaper in the Urals

 

Of the 17 countries that practice IVF (artificial fertilization), Russia is the only one that does not provide public funding for this procedure. In Spain, the state pays for any number of attempts by a woman to get pregnant; in Germany, a woman only starts paying from the fifth attempt; and in the Netherlands from the fourth.

 

Russia has two state IVF centers and more than 30 private ones. One procedure costs over R100,000. Incidentally, over 1,000 babies have already been born in the Urals with the help of artificial fertilization. In Novosibirsk, 580 babies have been born with the help of assisted reproductive technology. And the first "test tube baby" already started school this year.

 

Incidentally, attempts to get pregnant are hardly ever successful the first time round. Some women undergo IVF treatment 8-10 times. The question arises: Why is the state so reluctant to provide this kind of assistance to childless couples?

 

Heroin - enemy of the young

 

Alcohol-related deaths, which have turned into a kind of humanitarian catastrophe, coexist in Russia with another threat: hard drugs. Although all drugs destroy the body and increase the likelihood of early death, in Russia there is a particularly high rate of death from injecting drugs.

 

People become addicted to these kinds of drugs very quickly -- after just 3-5 injections. The most terrifying thing is that the majority of injecting drug users in Russia are HIV-positive.

 

As a result, the average life expectancy of a drug addict is less than seven years from the start of drug dependency, and mortality rates among injecting drug users exceed 90%. The overwhelming majority of them are essentially condemned to an early death.

 

And while Russia may lag behind Western countries in terms of "ordinary" drug use, when it comes to using the most fatal injecting drugs, we are the leaders: 13.9% of young people aged 11-14 use drugs. Five percent of Russian drug users die young.

 

Clearly we are still waging a very weak campaign against drug addiction.

 

Handouts for single parents

 

Labor and housing laws provide for social benefits for single mothers raising children without their husbands. These women are given priority in the allocation of free housing if they are registered as people who need better housing conditions. Single mothers may be permitted to work reduced hours. They are given higher welfare payments. And yet our editorial office received a letter from Yelena N. in Chelyabinsk: "I am a future single mother. How much welfare am I entitled to receive?" It turns out that under Article 5 of Chelyabinsk Oblast's Law on Monthly Child Benefits, "173.90 RUR in child benefits is payable until the child reaches the age of 16. The sum of monthly child benefits increases by 100% for single mothers." Frankly speaking, this is quite modest.

 

Deputies of the Legislative Assembly of Maritime Kray voted in early September to amend the Law on the Protection of Children's Rights in Maritime Kray. The amount of child benefits paid in the kray is set to increase by 100%. It will now comprise a total of R240 (per month) (compared to the current rate of R120). The sum of monthly payments for single mothers will increase by 200%, from R240 a month to R780. The amount of child benefits in Maritime Kray will be increased effective 1 January 2009. This is better than in Chelyabinsk Oblast, but still not very much. This is part of the path to extinction.

 

Minister T. Golikova's argument

 

Minister of Health and Social Development Tatyana Golikova opposes the break-up of her ministry: "It would be more effective to retain the unified structure of the ministry. In light of the priorities that have been set by the state, it would not be advisable to divide the ministry once again into a ministry of health and a ministry of labor and social development, since in this case we would have to divide responsibility as well. At issue here is the plan for Russia's demographic policy up to 2025. Along with social measures to raise birth rates and reduce mortality, this plan calls for ensuring Russians' access to health care."

 

Who is to blame and what is to be done?

 

In order to correct the situation, the state has of course taken measures to stimulate birth rates by allocating subsidies for multiple-child families and increasing child benefits. But here, too, there is a paradox: Yevgeniy Gontmakher, head of the Social Policy Center at the Russian Academy of Sciences' Economics Institute, is certain that this kind of policy will produce a large number of disadvantaged and "rejected" children.

 

It appears that is precisely the way things are going. Russia continues to die out.

 

Six million children become aborted material each year, and 5 million infertile families do not know how to have babies. Drug addicts continue to die by the hundreds. Hordes of alcoholics perish from the demon drink.

 

Another part of our human "material" is taken by road accidents, cancer, AIDS... "Rejected" children stay in the hospital for years. It seems the national projects are not yet working as they were supposed to. Bu t why? The healthcare base has not received serious investment for 15-18 years. Medical equipment is aging, and buildings are becoming dilapidated. The average doctor is 56 years old, and staffing levels are at 54%.

 

So what needs to be done? In Nikolay Gerasimenko's opinion, we need routine physicals and a return to forgotten preventive care for a variety of illnesses. As well as vaccine prophylaxis of controllable infections: measles, rubella, hepatitis, polio, and flu; then the diagnosis and treatment of HIV/AIDS and better equipping of medical institutions. Not to mention the further development of high-tech medical care... It seems that it would not take all that much to create a healthier situation and save the nation. What do you, our readers, think?

 

From Argumenty Nedeli 's files

 

• Today 40% of first marriages, 60% of second marriages, and 74% of third marriages end in divorce. There are more than 11 million divorced people living in Russia.

 

• The ten leading causes of death in Russia are: high blood pressure (35.5%), high cholesterol (23%), smoking (17.1%), unhealthy diet (12.9%), obesity (12.5%), alcohol (11.9%), lack of physical exercise (9%), poor environmental conditions (7%), lead poisoning (1.2%), and drugs (0.9%).

 

• In 2006, according to data from the Russian Federal Court Bailiff Service, there were more than 10 million children living in single-parent families. In the first half of 2007, only around 400,000 of the 12 million people who were supposed to pay alimony did so voluntarily.

 

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Source: "Argumenty Nedeli"