Medical disaster

The tragedy in Perm demonstrates a terrifying state of healthcare

The tragedy in the Perm club "Lame Horse" claimed 148 lives, 81 people remain in hospitals. The governor of the region, the government, mayor of the city are ready to resign, but not to return people with resignations and landings. Fires, including in entertainment institutions, were, are and will be, and by no means not only in Russia. But the tragedy in Perm once again demonstrated in what monstrous state the country's infrastructure is, medicine in the first place. How they saved and why many were not saved - I tried to figure out The New Times

The tormented doctor fled to the corridor of the Perm City Hospital No. 21. He has been on duty for more than a day, the very days when the burned and suffocated people from the Lame Horse club were carried. The doctor did not have time to bandage several dozen victims, although to do this right now, the second time in a day, subjecting patients with a painful procedure, it was not necessary. It was just that the doctor was told that the visit of the chief combustiologist of Russia is planned and it would be necessary to change the bandages.

* * Combustiology - a branch of medicine that studies severe burn lesions and related pathological conditions, in particular, burn shock. Patients, you know, have already begun to smell, and the "big man" is not used to this ...

People on Earth
Following the commander, Prime Minister Vladimir Putin flew to the city, who announced the disorder in the healthcare system of the Perm Territory. Referring to the reports of the experts of the Ministry of Health and Social Development, Putin said that the objects of healthcare in the region are “in a deplorable state” and there was no “even necessary funds”. The head of the Ministry of Health and Social Development Tatyana Golikova, having visited the burn center of the 21st Perm City Hospital, "was horrified by what she saw."

Numerous witnesses and experts from blogs added oils into the fire. They said that the burnt and choking people almost for hours lying at the steps of the “lame horse”, and no one approached them, there were not enough doctors, private traders delivered, including guests of the same “lame horse” who managed to jump out one of the first. They wrote that there weren’t enough reanimobiles, there were no doctors, there were no equipment, in general, there was nothing!

“Black smoke fell from the windows, there was no fire, no one ran out of the building. It seemed that everything was not so scary, ”one of the eyewitnesses described what happened on his blog. - It became scary five minutes later. Firefighters began to pull out people ... They carried the first two women, put on the asphalt right at the porch, someone began to do artificial respiration, but then they began to take out more people and put it right here. Firefighters could no longer walk, jumping through people ... two ambulances drove up, the doctors began to tear apart, showing them the victims and demanding help. It was probably the most difficult moment. " The ambulance was not enough, although the cars arrived constantly. Doctors and volunteers rushed around the victims, took away, of course, primarily the living, those who were able to get to the hospital. Someone took away someone: eyewitnesses talked about the prestigious cars, where healthy businessmen, who had recently seemed self-good, were sitting at the wheel. Guys, despite the wild chaos, groans and screams around, made three or four trips, taking away the crippled, but still alive people. “After I got out of the street, there were no firefighters or the Ministry of Emergencies for about twenty minutes. It’s dark on the street, the lanterns did not burn, ”the other victim recalls in his Internet diary. - Firefighters arrived the first. Some knocked out the butterfly windows and began to fill the interior of the club with water. At this time, a strongly charred girl jumped out. "How is the face?" She asks me. And I look at her and do not know what to answer. There was practically no skin. Neither face nor eyebrows - nothing. Continuous bloody mask. She held her hands in front of herself. And from them the skin hung with shreds. She was conscious, albeit in shock. “I'm cold, cold,” she repeated. I threw my jacket on her. ”

According to the 72 -unconfirmed data, 72 victims were taken away by ambulance carriages, 26 - rescuers of the Ministry of Emergencies, 15 - police, 7 - vehicles of "disaster medicine". Total - 120 people, the remaining volunteers delivered. The evacuation of the victims ended up for more than an hour. “People lay on the ground for about an hour and a half. Maybe many died because of this, from hypothermia. There was minus 16 outside, ”says one of the eyewitnesses of the tragedy. “These were the most terrible impressions: people who lie in the snow without help without help.” In total, after the tragedy, 142 people were hospitalized. However, not everyone showed heroism, according to the victims. According to the 21-year-old Maxim Shikhov (he survived), the marauders were faster than rescuers at the site of the tragedy. “The bodies of the dead were still smoking, and the looters were already operating with might and main,” the young man recalled in an interview with one of the Internet media. “They got everything that could be stolen from their pockets and bags: money, phones, values ​​... The police barely managed to drive them away from the bodies.”

Slocked rule
A doctor with 15 years of experience, Yuri states that "everything was as it should be." Reanimobiles for immediate sending one and a half hundred victims to hospitals will not be enough in any city. Additional reanimobiles arrived from Bashkortostan and the Sverdlovsk region to Perm the next day. The victims were sent to other regions (Moscow, St. Petersburg, Chelyabinsk): in the Perm Territory there simply are no so many specialized medical institutions. High mortality is explained, because burns are terrible injuries in which it is almost impossible to predict the development of the disease. “There is an unspoken rule: by age, add the percentage of body damage. If you are 50 years old and 50%affected, the chances of dying are 100%. If the respiratory tract is burned in a mild degree - plus 10%, in a heavy one - plus 30%, ”says the doctor. The average age of the victims of about 30 years, the degree of burn is 45-50%, in almost all the burns of the respiratory tract. Doctors are powerless in such a situation.

Medoptimization
Perm medicine lives under the slogan "Optimization and the most strict reporting!" In the same Perm hospital No. 21 in recent years, surgery, endoscopy, traumatology, pulmonology and therapy have been “optimized” in recent years - reduced staff, hospital expenses, and took the premises. In the burn center of this hospital (the only one on the whole edge), about 10% of beds were reduced. Now there are exactly 50 of them (for comparison: the same 50 people fit into the burn department of the Sklifosophist Hospital Hospital, another 10 can be placed in the anesthesiology department and resuscitation of the burn center.) But the number of deputies with the chief physician of the Perm hospital No. 21 has doubled.

For burn centers you need special beds. They are purchased according to the competition, the documentation for which officials are prepared. For them, the main criterion is the purchase price. Therefore, they prefer not expensive Dutch equipment, but domestic or at best Polish. Let it be worse, but cheaper. The same situation with medicines: they buy cheap and ineffective drugs. But according to the documents, everything is. Money is allocated, purchases made, no questions. By the way, there is also not enough money. Therefore, doctors surveyed by The New Times willingly believe that "there were no doctors." If you call the doctor to the hospital in the middle of the night, then you need to pay him overtime, and the deputy head of finances will be able to: there is no money. Therefore, that doctor ran and bandaged alone - they did not cause others. The crown of the bureaucratization of Perm medicine, when everything needs to be written for everything, reports, reports, and better than 2-3, the newly established form, which is filled out ... when the relatives of those who suffered during the fire in the Lame Horse club, are being addressed. There we must indicate who, when, with what complaint he addressed and was sent to a psychologist after that. “This is a system, a huge system, exactly the same as in the police, army, education. The main thing is to fill out forms, forms, report, master the means. Then you will be ahead of the planet, ”the interlocutor states. The salvation of people in this list of priorities is not listed.

Internal diagnosis

Not a single Perm doctor undergoes serious treatment and does not fall on the operation in the Perm Territory. “Once I went to my native hospital from the main entrance and without a robe, like an ordinary patient. I will never repeat this more - I really want to live, ”one of the doctors of the same hospital No. 21 bites bitterly. The former head of the mountain health department Perm Andrei Ronzin described the state of Perm Medicine best of all, saying that“ we used to have complete devastation, but now incomplete. ” Therefore, the “horror” of Minister Golikova does not cause anything but smiles, the practitioners of Perm doctors do not. Yes, there are no medicines, doctors, places in the wards, equipment - there is not all, but the Perm Territory is hardly an exception to the general rule. “Yes, they know everything, even know how to fix it. There are no people who want to fix anything. Nobody needs it. No doctors, they have reconciled for a long time, nor managers from medicine - this is already good, ”says the doctor Yura. “So the collision of Tatyana Golikova on Perm medicine is a collision with the minister himself.”
... And the victims in the Lame Horse club continue to die. Perm has been buried already a day. And those who are buried, and those who bury, do not matter who are right in these intra-Medicine showdowns-the Minister Golikova or the dared doctor Yura from the 21st hospital. The horror is that, as the crying old women say, it was so twenty years ago, and thirty - "But we make rockets." Those who are responsible for medicine in the country and the region are treated in special lines or abroad, everyone else can only put a candle to God ...