“They don’t ask me for help, so I help them myself”

After helping a woman give birth to her baby in a village home lit only by an oil lamp, with the other children watching from the stove-bench (and this is in the comparatively well-to-do Lutsk raion), one of Yelyzaveta Chaikovska’s colleagues underwent a six-month treatment for stress and then solemnly swore that she would never work at a rural paramedical station. Yelyzaveta has been in charge of the paramedical-midwife station in the small village of Umantsi for 48 years; she is the only medical worker for several neighboring villages.

In Chaikovska’s opinion, if the end of the world happened anywhere last winter, it was in Umantsi. This small village is located far from any highway, so if an ambulance is called, it arrives in an hour. Last winter the snow was so deep, she began to be afraid of nighttime. She would toss and turn in bed, afraid that someone in the village needed her help, God forbid!

The village’s telephone lines were out of service again and the roads were impassable. Beyond Umantsi were the villages of Vatyn, Vatynets, Skirche, and Zhukivets, all buried under a thick blanket of snow, and all its residents know the way to Chaikovska. One man from Vatynets refers to her as ‘godmother.’

“He was taking his pregnant wife to Horokhiv, when she went into labor in the car. He drove up to the pine tree and tried to see if the door of the paramedic-midwife station was open. ‘If it had been closed, I would probably have died right there in the car!’ There were only the two of them in the car. His wife delivered her baby right here on this couch,” Chaikovska points to the piece of furniture, adding, “She and I were alone, there was one else to help.”

Chaikovska is a child of WWII. She was five years old when her father was killed in action, leaving a pregnant wife. Her mother died last August, and her brother lives in his native village of Pirvanche, a five-minute ambulance ride from the raion center. In a good-natured way Chaikovska envies her brother’s wife, who is also a village paramedic.

“If I hadn’t gotten married in Umantsi, I would have had to work for just three years, as required by law, and then I could have kissed Umantsi goodbye,” she says.

Young physicians do not want to work in such villages, even if they are located closer to the raion center. “They don’t want to work here, none of them! They say it’s too hard for them. They are right. The job is hard and the pay is meager, perhaps the lowest there is. I started out with 40 rubles a month, and now I’m not even paid 400 hryvnias.”

That’s practically the same as the former 40 rubles...

Ye.Ch.: It’s hard, but it was even harder when we started.

Yelyzaveta Chaikovska found herself in Umantsi after graduating from Lutsk Medical College in 1958 and three months of practice in the village of Korytnytsia, Lokachi raion. The road to the village was built only in 1982. There was no motor transport, no telephone lines, and the paramedic station was located in three village homes. The comfortable office in which Mrs. Chaikovska received me was built by her.

There is a small carpet, and the snow-white sheets are crisply clean. The midwife is proud of the fact that her station has two examining rooms, one of which is for expectant mothers. The stove is heated only when women are waiting to be examined. There is a small glass cabinet with an assortment of drugs that differ little from those found in Horokhiv’s drugstores; sometimes a private car is rented to bring other drugs.

There is a taxi van from Lutsk, but it comes only when its owner feels like it, so people who need to reach the raion hospital hire private cars. A ride costs 40 hryvnias. Needless to say, the village paramedic is the only guardian of public health in the area. During almost half a century of working in the front ranks of public health, in the absence of trained physicians, Chaikovska has experienced a number of truly stressful situations.

“On this couch I once delivered a Vatyntsi woman of twins. Another time a man had a stomach hemorrhage and his blood pressure was down to 50, so I had to fix a drip and keep his pressure up before the ambulance came. I thought he would never make it to the hospital. And all those sick children and bleeding women! After treating them, you can’t sleep or eat for a month! It’s a horrible experience — well, I mean it’s a hard job,” Chaikovska corrects herself. When I asked if she had been in any situations that simply could not be resolved, she waved her hand. There have been, of course, and she’s not the only one.

“This incident happened in Umantsi, after I had just started my maternity leave. A local woman — she had something to do with medicine, by the way — got pregnant but concealed her condition for some reason, and kept it secret for as long as she absolutely could. I guess her husband wanted a son and she knew she would give birth to another daughter. Then she went into labor and her husband took her to Horokhiv. But the road was awful; there was too much snow and their car got stuck on the way. Her father was worried sick and went after them. They only got as far as a house on the outskirts of Yarivka.

“The woman started giving birth in the car. The driver ran to the nearest house to see if there was a woman who could help. There was, and she knew enough to come with a towel and some hot water. Then the child was born. The baby wasn’t making a sound, and the mother was in such a state of shock that she wrapped the infant in her coat and tossed it on the floor of the car. She said the baby was stillborn and that they should drive back home.

“At home she went to bed, but felt sick because she hadn’t expelled all of the afterbirth. The medical woman, who was my replacement, was called. The baby was left lying in the cold corridor. She saved the woman and the baby (a girl, who was still breathing). Now the girl is a married woman and her family left Umantsi a long time ago. Do you think that young people would want to work here and be responsible for everything and suffer? I think they would refuse to work here even if they were paid a thousand hryvnias a month.”

You were young, but you didn’t run away from the village.

Ye. Ch.: People have different characters. Mine is hard to live with. You’re supposed to work six hours a day, but I have been known to work sixteen hours. I had patients today, a lot of them. I also made entries in their medical histories. After that I will go to the village. There is a baby that needs to be inoculated and another one I have to visit to make sure it is OK. I visit village homes until eight in the evening. This winter the roads were so slippery that the paramedical-midwife station in Umantsi (at the crossroads of two villages, Umantsi and Zelena Luzha, now just a street — Auth.) was practically unreachable. I had to give shots to a baby suffering from pneumonia. I was struggling on my way to their house. There was no light in the windows, no one to help me get there. I had to knock on the door and asked to be let inside, so my daughter accompanied me there and back.

Your daughters didn’t want to follow into your footsteps and become medics?

Ye. Ch.: I didn’t want them to go into medicine.

After living and experiencing so much over the years, saving hundreds of lives, Chaikovska was accused of unprofessionalism in a formal complaint filed in her 48 th year of service. She was accused of insisting that the parents bring their child to a hospital when they did not want to. If she lived in a city, she could have avoided meeting these people. Even in the countryside, she could have avoided walking past their house.

Ye. Ch.: There are two families that are very difficult. The mother has three sons. Two of them have served prison terms, one of them for manslaughter. The middle-aged one married the wife of another man with whom she bore five children, and then had another one by this man. His older brother made her 13-year-old daughter pregnant. By the way, you may have seen him. He came to get his shots because his mother-in-law hit him in the head badly. He is 30 and his wife is 13 years old; he took her away from his mother-in-law to his mother’s house. The baby is better off there, too. His mother apparently cares for the child, but the girl’s mother didn’t like that, so she took her daughter back, even though they have nowhere to live. So they are living in someone else’s house. When the son-in-law came to take his wife and child, the mother-in-law hit him in the head with a heavy object; he was unconscious and people had to rub him with snow to revive him.

You have passions boiling here like on a Brazilian soap opera. /B>

Ye. Ch.: They never show such things on any soap operas. The child, the one that was born to that family’s mother, has pneumonia for the third time in one year. The baby is dying before my eyes, but the mother says no hospital!

Chaikovska says that the people have become used to her. They never question her prescriptions. Incidentally, Umantsi does not have a high rate of cancer and tuberculosis. One woman was operated in 1977, another one earlier, in 1962; both are alive because of a timely diagnosis. The paramedic has taught her patients to undergo regular medical checkups. The district hospital’s gynecologist has a busy day every time he visits Umantsi. Not all villagers can afford a car trip to the district hospital, but very few pass up an opportunity to visit Chaikovska to have their blood pressure measured and their health checked, because this paramedic is known and respected.

Ye. Ch.: We actually have to check on children younger than one-year-old once a week, but I visit them every day. It was during the New Year celebrations, Jan. 1-2, our days off, but I visited that family on Jan. 3, and the baby was in a very bad way, blue in the face and gasping for breath. I could hardly hear its heartbeat, but the parents were adamant: no hospitalization in Horokhiv!

Yelyzaveta Chaikovska got through to the district pediatrician.

Ye. Ch.: We promised the mother the best possible conditions: free treatment and food, just so she would agree to take her child to Horokhiv or Lutsk, even Kyiv. She said they could afford to take the baby to Lutsk. They never did, and I had give the child shots for 10 days and nights, and then the child started coughing again. It got so bad, the chief physician sent a 10-man team. The family had official visitors from the district education department and the village council because the older children were not attending school. They pleaded with the parents the whole day, and then the officials started drawing up documents to start court proceedings to deprive them of their parental rights.

“Finally, she took her sick child to a hospital, but vanished the next day! She must have realized that she would lose her childcare stipend. A man told her, “You got 1,500 hryvnias, but Yelyzaveta Chaikovska gets only 300 hryvnias a month.” Well, they don’t ask me for help, so I help them myself. It’s not the child’s fault!

We rode to Umantsi through high tunnels of snow. Vatyn and Myrne still have powerful farm businesses with snow-plowing equipment. When I called Chaikovska the next day, she said the snow was so deep, she didn’t believe the road would be passable any time soon.

Her village looks pretty in the summer. The homes look well built, there is water supply, and one of the streets has gas pipes. There are trenches around the paramedical-midwife station in Umantsi. Hopes for a gas connection serve to compensate for the loss of the beautiful flower beds that used to decorate the station from spring to autumn. When Chaikovska started working, there were several dozen babies under one year of age. Then there was a noticeable decrease in the birth rate; now it looks as though a baby boom is coming.

However, increasing numbers of people are getting sick and an even greater number of men are dying. The attractive school building stands hulking at the entrance to the village, a reminder of a better life. People now say that the school is too large, with a gym and daycare center. There were carpets everywhere, but the heating season took eight or even ten truckloads of briquette. The school was closed, so now almost three dozen children make their way to school through marshes or snowdrifts.

“There seem to be more young people; some years there are between five and ten children under one year of age. But the impression is that the village is dying. Men get lifts to work in Vatyn. There is one farm left in Umantsi. Once it had 16-18 dairymaids, now there are only four,” says Chaikovska.

After the unjustified complaint was filed against her, Chaikovska submitted her resignation papers. She has been on pension for a long time and now has health problems. Last year she was on several months’ sick leave after fracturing her hand. But people started visiting her at home, seeking her professional help. The fact that they haven’t stopped coming persuaded her to continue working for a while longer.

“A lot of local people have graduated from medical colleges, but not a single one has come to work in the village. This is hard work. A paramedic may work here for 10 years and feel that it’s not enough experience. I only started feeling that I could help people like a doctor only after 20 years.”

This is the high standard set by a woman who is the “golden treasury” of rural medicine in Volyn. “They say that a girl will soon graduate from a medical college and take my place, but somehow I don’t believe it.”