We were asked repeatedly offline and in the comments for our views on what was or was not going on in the Ukraine, but we steadfastly declined to post on it. We didn’t know any more than you can find out from news sources, so we had nothing to add in the way of hard information, We did know there was a WHO team on the ground and we thought it best to wait to find out more. We still don’t know much, except that news reports are suggesting that the health care system in the Ukraine is a shambles and its likely the chaos and panic were self-inflicted more than virally inflicted. Mike Coston over at Avian Flu Diary has a great run down and we agree with the way he approached it — gingerly, cautiously but with the right amount of anxiety that something could be happening but it was best to wait for information before hitting the alarm button (I didn’t say panic button because it’s never appropriate to hit the panic button).
Meanwhile, multiple stories out of the Ukraine were detailing disorganization, incompetence, politicization of the outbreak during a presidential campaign and much else. Few citizens believed what their leaders or government were saying, which is probably just as well because the messages were often contradictory and confused. The most recent version of this is from the New York Times :
Early findings are that serious cases mounted because the sick avoided hospitalization until their illness was dangerously advanced, stockpiles of Tamiflu were locked in centralized locations and the supply of ventilators fell short, said David Mercer, of the World Health Organization’s European regional office.“It’s not like this caught us by surprise ; we’ve known for months that this was coming,” said Dr. Mercer, who heads the office’s communicable disease unit. “We’ve been working very hard on plans, but sometimes the battle plan doesn’t survive the first contact with the enemy. We’ve had to change a lot of things on the fly.” (Ellen Barry, New York Times)
Here’s an earlier report from Ukraine’s English language Kyiv Post :
Public officials have known for many months that it was a matter of when, not if, the swine flu would arrive in Ukraine. Nevertheless, they provided little advance notice and took few precautionary measures. The Cabinet of Ministers in April 2009 provided the Health Ministry with only $6 million (Hr 50 million) to prepare for a swine flu epidemic. But not even that modest amount was well-spent, it appears.“The money was allocated for . . . drugs, laboratories, artificial respirators, test systems . . . everything necessary to get the patient out of the critical condition,” Prime Minister Yulia Tymoshenko told lawmakers on Nov. 3. A day earlier, the General Prosecutor’s Office opened a criminal investigation into how the funds were allegedly misallocated.
Time and money- half a year and Hr 50 million- were not used wisely to prepare the nation for the approaching epidemics.
“There are no test systems or antibiotics. Hospitals are not equipped with artificial respirators. All the drugs and equipment are either in transit or storage,” Tetyana Bakhteeva, chairwoman of parliament’s health committee, said on Nov. 3.
Victor Ovrachuk, deputy head of the Ternopil Oblast administration health directorate, agreed.
“We have not received laboratories, artificial respirators or antibiotics. We have received a two-day supply of the antiviral medication Tamiflu. That’s about it,” Ovrachuk told the Kyiv Post on Nov. 4.
It was the same story in Luhansk. “We paid for test systems from our regular budget. We did not get the equipment we needed the most,” Anatoly Dokashenko, Luhansk’s chief sanitary doctor said.
He criticized the centralized state purchases, insisting regional government is more aware of their needs. “We know locally what exactly we lack and what exactly we need,” Dokashenko added
Piet Spijkers of Dutch Humanitarian Aid described the situation at Lviv Oblast hospitals his organization supports as “appalling.” He said on Nov. 4 that there is a lack of basic medical supplies, barely any flu tests, vaccines or antiviral drugs, such as Tamiflu. (Kyiv Post, "Pandemic politics")
WHO’s regional office in Europe did send a team there and the above notwithstanding, here is what it reported on November 12, 2009 :
Health facilities in Ukraine well prepared for pandemic (H1N1) 2009 influenza
12 November 2009
On Wednesday, 11 November, the last WHO regional investigation team returned to Kyiv. While the teams have yet to finish drawing conclusions, they found health facilities in Ukraine well prepared and highly motivated to deal with the influx of cases.
In separate meetings with the Prime Minister and the President of Ukraine on Monday, 9 November (also attended by the ministers of Foreign Affairs and Health), the WHO mission thanked the Government for its openness and providing unrestricted access to facilities and data. The discussion focused on further action needed to combat the disease, particularly vaccinating the main risk groups in the population. WHO once more offered its full support in all necessary activities.
On 11 November, the Ministry of Health arranged and led a teleconference in Kyiv, connecting 486 hospitals and nearly 10 000 doctors in all 27 regions of Ukraine to facilitate sharing of clinical experience and lessons learned in fighting the pandemic (H1N1) 2009 virus. Clinicians in the worst affected areas had detailed discussions on what therapies they had used and how these could be adapted for the future. The participants discussed a wide range of issues and developments, including primary, obstetrical and intensive care and the essential supplies and equipment that were currently available and being mobilized. (Statement by WHO’s Regional Office for Europe)
So while we waited for WHO’s team to report about reports that were at the least, worrying, they were concocting crap like this. Anything in this statement that isn’t completely vacuous is just plain bullshit. WHO is an intergovernmental organization that is subservient to its member nations. We’ve explained that often here, often in sympathetic terms. But there comes a time when the niceties of diplospeak conflict with telling the truth. When that time comes, it’s better to shut up rather than mouth utter tripe.
Sometimes it’s the opposite of what our mother’s taught us about polite discourse : if you can’t say something bad about someone, you shouldn’t say anything at all. Because once you start telling the world what a nice beard Osama bin Laden has, they will stop listening to you, no matter what else you say.
