In Jeopardy: Minimal Healthcare Relief for FSU Elderly Jews

The rampant, inconceivable poverty facing elderly Jews in the FSU has prompted JDC to mount the Jewish world's largest hunger-relief effort in over half a century. With only meager means of their own, some 250,000 people depend on us for life's most basic necessities—food and healthcare.

The decay of the Soviet healthcare system, once the pride of its empire, has resulted in more than 100,000 Jews turning to JDC's Hesed welfare centers for vital medical care. And their numbers are growing.

Since welfare services were non-existent under Communism, the Soviet successor states are ill-prepared to help today's destitute elderly Jews. In contrast to the socialized system which provided basic medical services free of charge, healthcare in the FSU has proven expensive, inefficient, and unsustainable.

The High Price of Poor Care

Medical treatment today comes at a price, even at public clinics and hospitals on which all but the wealthiest rely.

Patients can wait a year for operations by surgeons who depend on outdated, ill-repaired equipment. Hospital patients may be asked to provide their own bed linens, meals, and to pay for mundane necessities like doctors' gowns. Conditions are so poor that as many as one Russian hospital in five has no running water.

With services under-funded and over-taxed, pulling strings has become a routine part of securing a timely doctor's appointment. Antibiotics, insulin, and other common drugs are often unavailable from a system unable to pay suppliers.

As governments slash subsidies, increasing co-payments place treatment beyond reach; 12-15 percent of patients cannot afford even the cheapest medicines.

Males, for example, can now expect to live only to age 60, some 15 years less than in the West. Today in the FSU, only the fittest survive – those fit enough not to require healthcare, and those fit enough to work and afford treatment.

Most elderly Jews are neither. Many are also without children to provide them lifesaving help. With monthly pensions averaging $58 in Russia and $14 in Moldova, and health costs rising–generic antibiotics can cost $10 or more–elderly Jews increasingly find even basic medical care a dispensable "luxury". With worsening conditions, needs requiring response by JDC's Hesed welfare centers have multiplied.

JDC: Preserving Quality of Life, and Life Itself

Before the precipitous decline in public healthcare, JDC focused on rehabilitative equipment. The Hesed network provided loans of tens of thousands of wheelchairs, walkers and other aids to its hunger-relief programs, to relieve elderly Jews of a homebound or totally bedridden existence. The program helped over 17,000 seniors in 2002 alone, easing indignity and immeasurably enriching quality of life by restoring to them a measure of mobility and independence.

In the mid-'90s, though, public healthcare deteriorated and costs to patients rose so rapidly that even with the food relief Hesed centers provide to 250,000 elderly Jews, increasing numbers could no longer afford basic medical care. With lives at stake–literally–JDC expanded services to bring them at least minimal care.

Vital Care for Desperate Elderly

The Hesed network provides the essential framework for this vital relief. Using volunteer doctors–general practitioners and specialists–Hesed centers provide free in-office and at-home consultations to their clients.

JDC helped ensure that 52,600 Jewish elderly received medical care in 2002, and provided over 100,000 clients free or highly-subsidized prescription medicines. JDC also helps raise care standards by bringing health professionals from Israel, the United States and other countries to give medical seminars for colleagues in Hesed centers and the FSU's public healthcare system.

Hesed staff and volunteers visit hospitalized clients, bring them bed linens, meals, medicines, and arrange for appropriate care.

Nonetheless, Hesed medical relief has yet to fully help those who require extensive treatment. The S.O.S. program provides funds for 15,000 people a year to undergo major surgery or extended treatments such as chemotherapy. Yet need far outstrips capacity, leaving S.O.S. able to help only the most critical cases.

Impossible Choices

That means making tough decisions. Despite support from various foundations, organizations and Federations, resources for JDC medical relief have not kept pace with the growing life-or-death needs brought on by the FSU's crumbling public healthcare system.

So despite cutting costs through competitive drug purchases and tightened criteria, JDC's tough decisions could soon become impossible choices. Without our help, destitute elderly Jews would be forced to choose: food or medicine. Nobody should have to make that choice. We shouldn't have to make it for them.