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Foreign Correspondence

Oct. 26
Diagnosis: Critical
In the Remnants Of the USSR, Health Care Is In a Deadly State Of Shambles

Oct. 26
The Most Vulnerable?
Region's Children

Oct. 27
'Like a Genocide'
Underfunded ex-Soviets losing battle against soaring TB rates

Oct. 28
A Bacterial Breeding Ground

Oct. 28
Czechs devise a Stringent, Scientific System

Oct. 28
Coney Island, an Entry Into Western Medicine

Oct. 29
Shots in the Dark
Stunningly low vaccination rates behind surge in diseases

Oct. 29
The Dr. Spock of Russia

Oct. 30
Region's Culture of Abortion

Nov. 2
The Drug Explosion
An epidemic of abuse, disease is devastating region's youth

Nov. 3
Plague of Alcohol
Russians are drinking more than ever, with deadly results

Nov. 3
A Region's 'Lost Generation'

Nov. 4
'Elista' Incident Fosters Distrust in the System

Nov. 4
A Hotbed of HIV

Nov. 11
Fallout of Fear and Uncertainty

Nov. 18
Resuscitating Science

Nov. 18
A region in psychological turmoil

Nov. 18
An Oasis of Medical Privilege


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7. Foreign Correspondence

Laurie Garrett

NEWSDAY
Laurie Garrett

Crumbled Empire,
Shattered Health
published October 26-29 and November 2, 4, 11, 18, 1997

"The travel for this story, which spanned eight time zones, six countries and three seasons, was grueling. Old Aeroflot jets were the least of it: weeks of rendered pork fat washed down with water of dubious quality and nights 'slept' in Soviet-style hotels took their tolls."

--Laurie Garrett

While writing her book, The Coming Plague: Newly Emerging Diseases in a World Out of Balance, Newsday science and medical writer Laurie Garrett came across disturbing news of epidemics erupting all across the former Soviet Union. The region was experiencing chaos, deprivation, despair and disease.

In 1993-95, UNICEF released reports calling attention to plummeting life expectancies, rising infant mortality and astonishing abortion rates in most of the former Soviet states and Eastern bloc nations.

Garrett said one line in the 1994 UNICEF report haunted her for years: "The largest peacetime decline in life expectancy seen anywhere in the world over the last 500 years."

"That sounded like a damned big story to me," she said.

Newsday's project involved a year's work, and the answers to the region's troubles were more complex than the typical explanation for a health crisis--systemic and individual stress caused by economic collapse.

Garrett said it is true that economics played a role; finances for medical supplies, health-care personnel salaries, patient hospitalizations, research support and basic public health have suffered.

And, from 1991-97, protein and caloric consumption declined precipitously, and unemployment rose.

"Such stressers alone cannot explain the tragedy that has befallen the people of the former communist nations," Garrett said. "Many of the flaws in the Soviet system--dating back to the days of Stalin's rule--were massive enough to prove systemically fatal, causing the entire health infrastructure to crumble under pressure like a house of cards. Among those flaws were definitions of illness so broad that even common colds routinely prompted days of hospitalization at government expense."

Garrett said concepts of basic biology and evolution were easily three decades behind the West. All Western medical journals and texts were banned, and the basic scientific method was not taught in school. "Diseases of shame," as they were called--drug addiction, alcoholism, sexually transmitted diseases, and tuberculosis--were treated with punishment rather than rehabilitation. As a result, Garrett said, when antibiotic resistance emerged in every pathogenic bacterial population in the region, physicians with no training in evolution had no idea how to stop the evolving microbes.

For Garrett, the most difficult aspect of this story was "the sheer scale of despair and hopelessness in the people.

"While travel has certainly proven more arduous and dangerous in other parts of the world, I have never before encountered such a mass level of cynicism -- better, fatalism," she said. "Few of the hundreds of people interviewed for this series seemed to hold out the tiniest modicum of hope that their personal lives, or the status of their nations, will improve in years to come."

In September 1997, Garrett gave a 90-minute speech to an audience of health leaders from the former Soviet states. She outlined the key findings of the series. Some significant changes occurred. The Soros Foundation put $20 million into tuberculosis control in Russia. The U.S. Agency for International Development shifted funds away from "democracy building" toward general public health support. Garrett delivered a lecture to the U.S. Centers for Disease Control and Prevention and to the National Academy of Sciences. She also gave briefings to national security personnel from the departments of Defense and State, the National Security Council, and the White House.

"The list could go on, but the overall point is this: The series appears to have awakened influential corners of U.S. government, philanthropic community, and governments in newly independent states," Garrett said. "Policies have shifted, funds have been provided and, for the moment, there is hope."

Garrett is grateful for the help she received from Romanian-born photographer Viorel Florescu, who was with her for half the journey across the former Soviet Union. "Raised under the Soviet-influenced Ceaucescu government, Florescu understood subtext and behaviors that I, an American, simply could not have grasped on my own," Garrett said. "Through Florescu's eyes, I gained a deep and painful sense of what life under Soviet rule was like."

She also was grateful for the educational backgrounds of her translators, most of whom had medical degrees. "The economics of health in the region are so poor that I was able to pay a neonatal cardiac surgeon, a cardiologist, a psychologist and a scientist far more for a day's work translating than they could ever hope to earn in a month's time toiling in their given professions," she said.

Judges said Garrett "proved in this series that she is not only an expert on public health issues, she also is an excellent reporter. She chronicled the serious nature of the spread of diseases in Russia triggered by both environmental factors and lifestyle choice and dramatized these problems with vivid human examples….She undoubtedly overcame enormous reporting roadblocks…even medical reporters in America can have trouble gaining the type of access she managed to operating rooms, hospital wards and sanitariums." The judges commended Newsday for its commitment of space, time and money.

The series
October 26, 1997
Diagnosis: Critical
In the Remnants Of the USSR, Health Care Is In a Deadly State Of Shambles
November 3, 1997
Plague of Alcohol
Russians are drinking more than ever, with deadly results
October 26, 1997
The Most Vulnerable?
Region's Children
November 3, 1997
A Region's 'Lost Generation'
October 27, 1997
'Like a Genocide'
Underfunded ex-Soviets losing battle against soaring TB rates
November 4, 1997
'Elista' Incident Fosters Distrust in the System
October 28, 1997
A Bacterial Breeding Ground
November 4, 1997
A Hotbed of HIV
October 28, 1997
Czechs Devise a Stringent,
Scientific System
November 11, 1997
Fallout of Fear and Uncertainty
October 28, 1997
Coney Island, an Entry Into Western Medicine
November 18, 1997
Resuscitating Science
October 29, 1997
Shots in the Dark
Stunningly low vaccination rates behind surge in diseases
November 18, 1997
A Region in Psychological Turmoil
October 29, 1997
The Dr. Spock of Russia
November 18, 1997
An Oasis of Medical Privilege
October 30, 1997
Region's Culture of Abortion
 
November 2, 1997
The Drug Explosion
An epidemic of abuse, disease is devastating region's youth
 

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