Τετάρτη 30 Δεκεμβρίου 2009

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Health care system in Azerbaijan


by Arzu Keybulla

Following dissolution of the Soviet Union, Azerbaijan's health care system was devastated. What was used to be centrally planned, free and general health care system, became vague institution run on "small" bribes (hormet) paid in form of everything and anything (depending on that person's status) with worsened quality and poor access (especially in remote areas of the country).

Those who can afford it, head to private hospitals for treatments and check- ups that could cost more than an average salary (which is approximately 250 Azeri Manat according to state statistics).

Those who can't, head to state hospitals (worse nightmare) where quality is so low that you feel like going back home and basically dying (perhaps you might think I am exaggerating, but trust me its the last place you want be if you are sick).

The law “About Protection of Health of the Population” stipulates state’s responsibility in financing health services. According to the law, the state takes on the full responsibility to pay for all aspects of the health system, however, so far (since transition) the state failed to fulfill its obligations within this realm and thus people must pay informally for health care and while the state constitution exempts certain groups- veterans, servicemen, pensioners, refugees, IDPs, medical professionals, education professionals- from medical payment, no such regulation is valid within the current system (Health care systems in transition: Azerbaijan, John Holley, Oktay Akhundov, Ellen Nolte, WHO, 2004, pp. 20, 23).

So on one hand we have a law that stipulates free health care and on the other hand, hospitals where one can spend around 200 EUR for a simple visit (blood test, brain scan and other needs, one might need when coming to a hospital).

This brings me to a conclusion that stipulates one thing but proves to be a completely different thing in practice. So, if lets say in theory, I am a pensioner, getting minimum pension, which is 75 manat and need to get a brain scan which costs approximately 50 manat, how the hell I am supposed to live for the rest of the month (and this is only if I just gotten my pension which leaves the bills, the medicine, and rest of expenses unpaid)? Do I then, in this case, stay home and not see a doctor, do I see a doctor and spend my last money on the visit and then starve (which basically makes my visit a doctor completely useless) or do I complain- but to whom and where and will that even matter?

So, bearing this mind, I wish everyone a healthy New Year (and especially for those living in Azerbaijan, without insurance and on minimum salary and pension)!

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