Morte a Vilnius, in stile sovietico



La morte di un intellettuale all’aeroporto della capitale lituana è il tipico, lugubre prodotto dei “Villaggi di Potemkin” al tempo degli zar e poi dell’Urss: costose apparecchiature mediche comprate per “far scena” e giustificare i posti degli uomini d’apparato, anziché rivolte ad assicurare la salute e la vita dei cittadini

End the Potemkin Villages!

Early in the morning on September 21, my friend and colleague Leonidas Donskis stepped out of the Vilnius airport hotel for a short walk to the airport building in order to catch a plane to Saint Petersburg. His wife went ahead of him, because he had to finish a few e-mails before flying off. When he did not appear after some time, she went back looking for him and saw a group of people huddled over a person who evidently had collapsed in the airport building. The person on the ground turned out to be her husband, who had a heart attack and was dying. The people around were in shock, paralyzed, and basically watched him die. By the time the ambulance came, eight minutes later, Leonidas could no longer be saved. He died right there, 54 years old, on the airport floor.

His death came as a shock: not only to his wife, mother and other relatives, but also to his friends and colleagues. The reaction in Lithuanian society was overwhelming; people who never knew the man lamented his passing away as a huge loss to the country. His funeral was a solemn and impressive ceremony, lasting two days and attended by two former Lithuanian presidents and the Prime Minister, while the current President Dalia Grybauskaite sent flowers. It ended at the Kaunas cemetery of Petrasiunai, where between the graves and towering pine trees hundreds of grieving people gathered, cried, and listened to speeches, ending with a speech by a Roman Catholic priest followed by the kaddish sung at his graveside by the well-known Lithuanian-Jewish opera singer Rafailas Karpis. The funeral not only showed how important Donskis had been, but also how many people he inspired and empowered. I saw that I was actually only one out of many people, from all walks of life, for whom he had always been there, helping out, stimulating, pushing to do more and better. And all of us had felt important, not knowing how many of us were really out there.

The tragedy of Leonidas’ death is the fact that he did not have to die. The fact is that Vilnius airport has three defibrillators and none of them was touched. None of the airport staff tried to resuscitate him, and instead just waited until the ambulance arrived – too late to save his life. In all major airports and public buildings in the civilized world is not only adequate equipment around, but staff is also carefully and repeatedly trained to act in time of crisis and save a person’s life. One cannot really blame the Vilnius Airport staff that was present and did not act, as no one apparently taught them to do so. However, one can blame the authorities that like in so many other cases created a Potemkin Village by buying equipment and put it up on the wall, without any procedure in place to use it in time of need and without teaching all personnel to do what they were supposed to do.

Alas, the image that appears is such a common one. Ten years ago, Lithuania had a young and progressive health minister, Zilvinas Padaiga, who decided to prioritize mental health as one of the four priorities for EU structural funds. A unique step, that could have led to tens of millions of EU financial support going into the development of community mental health care services.
Soon everything was ready, and detailed plans had been drawn up. Alas, Padaiga was sacked after less than two years in power, on basis of a ridiculous pretext, and succeeded by a former Soviet-style hospital director who changed the allocations and instead carried out reconstructions of buildings and bought a lot of often totally unnecessary equipment. Money that was supposed to go into consumer-oriented modern mental health care went into maintaining old Soviet-style services, and probably into something else as well. We all know why authorities love buildings and equipment, no need to go into further detail.

For Ukraine, the Lithuanian experience should be an important lesson. If all goes well, the country will finally embark on a health reform program, catching up with the rest of the world and trying to fill the gap of many decades with international health care standards. Many health care managers and civil servants will oppose the reforms, because it upsets their lives, positions and in particular their way of making money. Yet some will be more clever and go along, understanding that it is better to join the movement when it becomes hopeless to resist. Yet I can assure you, the push will be for buildings and equipment, rather than health care services that serve the clients, that are community-based, that focus on keeping people in society, rather than ostracizing them and marking them for life.

It is time to end these Potemkin Villages of reconstructed buildings with nice equipment and no trained staff. It is time to focus on real reforms, where the patient is central and everything is focused on helping persons to return to normal life. It is time professionals are empowered and adequately trained and paid for work on which lives depend – your lives, as well as mine.

True, changing attitudes and systems will not bring Leonidas back. Alas, he died because of a typical aspect of post-Sovietism, about we so often talked and debated. However, if his case can be a lesson, and a trigger to do different, to do better, then his death will at least serve a purpose and maybe save the lives of others in the end.

di Robert van Voren

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