08 October 2003 03:25
New NGO to Target Russia`s Health Problems
The statistics are grim. On average, Russians older than 15 drink half a bottle of vodka a day. Seventy percent of
Russian men and about 35 percent of women smoke. The country has one of the fastest-growing rates of HIV infection in
the world. Life expectancy for men has dipped below 60 years of age.
Faced with these and other equally troubling numbers, a new NGO recently launched a major campaign to improve
Russia's national health.
Backed by a $25 million grant from the U.S. Agency for International Development, or USAID, the Healthy Russia
campaign will appeal directly to the Russian people to change their behavior. The specific aims are to improve mother
and infant health, to convince teenagers to make healthier lifestyle choices, and to curb the spread of tuberculosis and
HIV/AIDS.
USAID awarded the money to the Center for Communication Programs at Johns Hopkins University, a group that oversees
public health programs in more than 65 countries. The center has worked on smaller-scale health projects in several
Russian regions for almost a decade. With the grant in hand, the center launched Healthy Russia, a membership
organization uniting groups all over the country.
In addition to leading a nationwide public-advocacy campaign, Healthy Russia will serve as a clearinghouse for
information and resources on public health. A cornerstone of this work is the group's web portal at www.fzr.ru.
"Campaigns to change behavior are extraordinarily effective," said Michele Berdy, who heads the Center for
Communication Programs in Russia. "That's the good news. The bad news is that campaigns to, say, stop smoking
cost a lot of money, they take 15 to 20 years to be effective and you have to continue running them forever."
The USAID grant will fund Healthy Russia through September 2007. Meanwhile, the foundation is attracting companies,
private and state funding, and looking into commercial marketing ventures to be able to continue the work nonstop.
Few people dispute that Russia's health has been in dangerous decline for more than a decade. The average life
expectancy for Russian men has dropped to 58 years. The HIV infection rate is growing faster here than almost anywhere
in the world. Tuberculosis, a problem largely solved in the West, killed almost three times more people in 2000 than it
did in 1990. Abortion is still widely used as a form of birth control.
Russians often cite the declining birth rate -- there were 2.5 million births in 1987 compared to 1.2 million in 2002
-- and the overall population decline as signs that the nation's health is worsening. Healthy Russia charges that
many of the country's woes are not directly the fault of a deficient healthcare system, but more often result from
unhealthy choices made by citizens.
The new program will reach out directly to the population via television, educational pamphlets, as well as community
events like dances and contests to raise awareness of risky behaviors.
In practice, this could mean lobbying the television industry to ban interviewees from smoking on camera or to
regularly shoot a box of condoms on the nightstand during sex scenes in soap operas. It will likely also include
printing brochures about prevention of tuberculosis and hosting social gatherings in small cities to promote family
planning.
A previous campaign run by the Center for Communication Programs in Yekaterinburg from 1996 to 1998 helped increase
the percentage of women using modern contraceptive methods from 46 percent to 58 percent, according to the center's
surveys. Healthy Russia hopes to replicate such statistics throughout the country, but leaders of the group acknowledge
that they face big obstacles. "It will be very difficult for us to introduce these new technologies of health
communication in Russia," said Yelena Dmitriyeva, director of Healthy Russia. "People are used to thinking
that health is the responsibility of doctors, not a result of their behavior. Another challenge is to move the project
from a group working with a grant toward a sustainable organization."
The scale of Russia's health crisis is the group's biggest challenge. Officially, the number of registered
HIV cases jumped from 11,039 in 1998 to 248,005 cases as of this August. Experts say in reality there are somewhere
between 700,000 and 1.2 million people in Russia infected with HIV.
Russia has one of the highest abortion rates in the world -- as many as 13 abortions for every 10 live births -- and
roughly 40 percent of abortions result in complications, according to Healthy Russia. One in five couples cannot have
children. Poor health among the male population also contributes to this figure, with harmful environmental factors and
untreated or mistreated sexually transmitted diseases preventing pregnancy.
"We are trying to get the message out that the best way to make sure you can have babies is to use birth control
properly," Berdy said. The group is focusing on adolescents and young couples because they are more likely to be
influenced, she added.
This, Berdy and Dmitriyeva concede, means that much of their work will not show up in the statistics and affect the
lives of people for another 15 to 20 years. While they expect to see a drop in the number of abortions and a slowdown in
the HIV infection rate in the next five years, problems like cardiovascular disease will not see a major impact until
about 2020.
They hope Healthy Russia is still around to witness the changes.
"It's not going to be easy. But being skeptical is part of being Russian," Dmitriyeva said. "With
the new technologies, I think we can influence people toward living healthy lifestyles."
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