Strategy:

Support health and clinical officials as well as leaders in both government and education in their efforts to improve the health and environment for the people of Tula and, especially, the children.

We do this by:

1. Sponsoring and promoting exchanges of health and scientific students, faculty and professionals in the areas of medicine, public health and environmental science and engineering to advance the health and well-being for both regions.
    
2. Developing joint research and health intervention projects.
    
3. Continued involvement in the managed care demonstration project in Tula which was initiated by collaboration with the Alliance.

 

Health and Environmental Activities

In the healthcare field the Alliance shipped, with the assistance of the Fund for Democracy, a container load of good quality used hospital beds and equipment to Tula. Over $8,000 worth of medicines was hand carried to Tula in 1992 alone. Other contributions of medicines have been hand carried to Tula on several occasions.

The Alliance assisted Tula to obtain a USAID grant to develop a managed health care demonstration project. The level of confidence throughout Tula in what the Alliance does is so strong that the organizers have named the HMO the Tula-Albany Health Insurance Company, feeling that the name will have good market potential. The technical assistance grant was provided to the Alliance, the Albany Medical College and Community Health Plan. Several thousand people in Tula have purchased the health insurance, and the supporting clinic opened in the Spring of 1997. While the present state of the Russian economy poses problems for the fiscal health of the clinic, it is none-the-less a model of a facility providing primary care to Russian citizens.

Under Alliance sponsorship, medical professionals and others associated with the health care industry in Tula have visited organizations in the Capital Region to learn about insurance organization, capitation, and health care management.

In the Soviet era, all physicians were educated in Moscow or St. Petersburg. The Russian government has decided that regional medical schools should be established. The Tula State University started its medical training in 1994. Physicians from the Albany Medical Center have assisted in the development of their curriculum, both for general family practice and for endocrinology. There is at present little expertise in public health in Tula. At present there are only nine live births for every fifteen deaths in the Tula Oblast. Faculty of the School of Public Health of the University at Albany and the Albany Medical College are working closely with medical and environmental engineering professionals at the Tula State University to develop joint programs which will promote the health of the general public.

Environmental issues, and related health problems, loom heavily on Tula. The city air is polluted with industrial emissions in quantities that have long been prohibited in the US. There have been a few exploratory contacts on the issues of pollution and industrial waste disposal. Many people in the southern part of the oblast suffered from the nuclear fallout created by the Chernobyl power plant disaster in Ukraine. There is substantial evidence of elevated incidences of diseases related to the radiation pollution. Joint research activities are being developed to promote the use of geographic information systems in order to organize data concerning environmental contamination and human health.