For rural folks (including physicians), things are tough all over (including in Russia)

The New York Times reported out of Russia a few days ago that physicians in rural areas (even those in the western part of the country; we're not talking Siberia) are striking for better wages.  The dateline is Okulovka, in the Novgorod region between St. Petersburg and Moscow, and the story is headlined "In Russia's Provinces, the Doctor Is In (the Streets)."  Andrew Kramer's story, however, is not only about health care professionals, it is about the enormous divide between the haves and have nots in Russia, the latter often languishing in the "the provinces."  As Kramer expresses it, Okulovka "might just as well come from a different century," and the photos certainly give that impression.  About a third of the residences have no indoor plumbing, and the life expectancy there is among the very lowest in Russia.  (A prior post out of this region is here).   

Here's an excerpt from Kramer's story that focuses on state of health care, in particular doctors' salaries. It discusses the situation of Dr. Korovin, a general and colorectal surgeon: 

One issue gaining traction in particular is the impoverishment of doctors in rural Russia. After a medical procedure, it is more often the doctor than the patient who winds up with sticker shock — not because the payments are so outrageous, but because they are so small. 

Dr. Korovin, who is paid about $8,670 a year and extra for after-hours operations, recently treated a man with a stab wound to his lower abdomen.

* * * 

For that hour-and-a-half, after-hours operation, the hospital, which is funded by Russia’s state-run insurance program, paid Dr. Korovin 500 rubles, or $7.70.

It's thus not surprising that physicians and nurses are pressing for "local authorities fulfill a decree signed by Mr. Putin that doctors be paid twice the average salary of the region where they work."  In the Novgorod area, that would be about $11,448, about a third more than Korovin now earns.  Compare that to the average salary for a physician in the U.S., which is $313,000.  Indeed, where hospitals are able to keep their doors open, jobs in healthcare are critical to sustaining rural economies. 

Interestingly, Dr. Korovin says he voted for Putin, "we all voted for Putin."  That brings me to this terrific line from Kramer's story:

But the brush fires of provincial discontent highlight the disconnect between Russia’s chest-thumping rise abroad and its stagnating economy at home.

As in the earlier Russia story about which I posted nearly six years ago, there seems to be a big disconnect between the local and the national in Russian politics.  Putin is attractive as a strongman on the national stage, which may help him escape backlash over failures of lower scales of government.