Dr. Alexandra Kriminetskaya

“When did that spot appear?”

It’s nearly noon in the sterile ward of the Hematology and Intensive Care Department, part of Russia’s National Center for Hematology. Dr. Alexandra Kriminetskaya, head of the Hematology Department, looks worried. With a dozen young doctors and medical students peering over her shoulder, Dr. Kriminetskaya gently presses on the abdomen of her patient, a paper-thin teenage girl wearing a kerchief over her shorn head. After some discussion, she orders a change in medication. Then she and her flock move on.

The sterile ward houses the most serious cases under Dr. Kriminetskaya’s care: hepatitis, acute leukemia, lymphoma, Hodgkin’s disease. Several of the patients, all in their teens and early twenties, come from parts of Russia exposed to radioactive fallout from the Chernobyl nuclear accident.

The National Center for Hematology is one of Russia’s leading medical centers, but you might not think so from a visit to Dr. Kriminetskaya’s ward. While most of the Center’s facilities are housed in a newer, better-equipped building, Dr. Kriminetskaya’s Hematology and Intensive Care Department has surely seen better days. Cracked and worn linoleum covers the uneven flooring. Ancient iron bedsteads support layers of thin, faded mattresses. As many as five patients share a single room. One scrupulously clean bathroom serves 50 patients.

That the Hematology and Intensive Care Department exists at all is a minor miracle. When Dr. Kriminetskaya was asked to create the department in 1990, the empty space offered to her was in even worse condition. Trying to save money, she negotiated for used hospital furniture and equipment with acquaintances at other Moscow hospitals. When a wall needed demolishing, she took up a hammer and chisel herself.

55-year old Dr. Kriminetskaya leaves home each morning at 7:20 for the hour-and-ten-minute commute to work; usually returning home between 8 and 9 at night. At the end of the day, she is often hoarse from endless phone conversations and medical consultations with patients, their relatives, and especially with her staff of 50.

“Russia’s wonderful medical tradition of compassion and empathy for the patient is passed from hand to hand,” she explains. “Ever since I opened the department and could choose my own staff, I’ve tried hard to carry on the tradition taught to me.”

At the end of the Soviet period, approximately two-thirds of all Soviet doctors were women; in 1989, some six million women worked in medicine at all levels (midwives, nurses, paramedics, and physicians). The average salary for both male and female doctors in 1990 was only about 80% of the salary paid to an industrial worker.

In the post-Soviet world, even prestigious state-owned institutions like the National Center for Hematology — which receives referrals of complex cases from hospitals throughout the former Soviet Union — must watch every ruble. Extra money goes directly into medicine and equipment.

Despite tight budgets and her department’s inability to provide truly sterile conditions, Dr. Kriminetskaya is able to treat patients according to internationally recognized methods. Her own monthly income of approximately $315, while roughly twice that of a manual laborer who shovels snow off Moscow streets, permits only a Spartan existence in one of the world’s most expensive cities.

Soon after the Hematology department opened, a grateful patient offered a sizable donation. Dr. Kriminetskaya promptly established a charitable foundation. Through the foundation, she has been able to provide a few extras, such as refrigerators in every patient’s room. The foundation also funds a small, non-profit store in the hospital where patients and staff can purchase food and other necessities. Dr. Kriminetskaya calls the foundation “a crutch that helps the clinic to walk.”

Dr. Kriminetskaya estimates that it will take nearly $10 mn to complete repairs to the hospital wards under her care. She openly expresses her disappointment in Russia’s failure to support quality medical care.

“They can find millions of dollars to rebuild the Christ the Savior Cathedral — which is as it should be, loss of faith is terrible for a country — but we also ought to be able to find the funds to care for our patients.” She longs for the day when she will be able to stop asking for charity and be in a position to offer it herself.