New studies into health services in the former Soviet republic of Ukraine paint an alarming picture of dropping life expectancy and a rise in infectious diseases, including TB and Aids. Universal health care for all workers is no longer an option with an economy in transition and high unemployment. The International Labour Organization and the union federation, Public Services International, found that health workers are struggling to survive on their wages and - with the SARS virus - there’s a new fear, as ILO TV now reports from Kiev.

Yet hospitals are so underfunded, they are unable to provide basic comfort and even food for patients. For staff, too, conditions are becoming unbearable. The new study found that health workers earn around forty dollars a month – below the minimum subsistence level.

They have other worries, too – of succumbing to the diseases they are supposed to be treating.

Head nurse

There was a case, six years ago, of a colleague, a nurse, who got TB – For us it was a shock… I believe in our team. We have good people, very sympathetic with our patients. What keeps us working is not money, because the wages are so low.

Health workers are on the frontline, but with increasingly scarce resources, they feel vulnerable.

Alan Leather, Deputy General Secretary, Public Services International

The conditions that workers are facing means they are likely to get communicable diseases because of the lack of protection for them in the health service. If there was a SARS outbreak it’d be difficult for the Ukrainian health service to be able to contain it. They need better protection and they need a voice in the way the health service is being managed, in the way the health service is being reformed.

Many hospitals rely on elderly workers, trying to survive on little or no pension.

Some doctors set aside private facilities for patients who can afford to pay more. But the ILO report says the economic situation is corroding the existing health care system.

Dr Ellen Rosskam, Senior Specialist, ILO

When you see it for yourself visually, the conditions that health workers are working under, unsanitary conditions and deplorable conditions, you don’t even provide basic comfort for the patients, it’s shocking.

Throughout Eastern Europe, conditions are as bad now as in many poverty-stricken, developing countries.

Ellen Rosskam

Access to health services and provision of decent health services is a fundamental element of any democratic society.

In Ukraine the government has promised health workers pay increases and reform of the system. But it will be a long time before the health sector makes a complete recovery.