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Russia - Health Service
Vaccinations Required For Travel To Russia
It doesn’t matter if you are staying in Russia for a holiday or for the next two years, whether you’re living in Moscow or the Arctic, working in an office or caring for relatives – you must review your vaccination history before you travel.
Every country poses a risk of infection through its environment or population. Russia’s complicated political and economic history means that a sizeable number of adults living there today did not receive vaccinations during their childhood. The risk of death and disability posed by communicable disease therefore cannot be underestimated, although vaccinations will significantly reduce that risk.
Whilst outbreaks of poliomyelitis, dysentery, hepatitis A, diphtheria, tuberculosis, leishmaniasis, meningitis and rabies have been reported in Russia in recent years, migrants are rarely affected as they are likely to have vaccine protection.
The majority of vaccinations last a lifetime, but tetanus requires a number of boosters. The flu jab – which is often ignored by people who don’t understand the damage flu does to lungs – should be received by a wide range of vulnerable groups once a year.
At least eight weeks before you set off for Russia, check the National Travel Health Network and Centre (NaTHNaC) on the TravelHealthPro website.
Work with your GP or practice nurse to check you have had all vaccinations required and arrange a booster if required.
If you intend to head out to a forested area, be aware of the presence of tick-borne typhus, encephalitis and Lyme disease. Ticks will bite without you being aware of them, and the resulting symptoms can be vague enough to cause delays in diagnosis. Wearing a good pair of boots and thick socks will help protect your ankles from these tiny forest insects and the diseases they carry.
Private Healthcare Insurance For Russia Is Required
You are required to have adequate healthcare insurance in place for entering Russia. This is a requirement of your visa.
Migrants are not permitted to be a burden on the Russian state, either by asking for benefits or healthcare treatment. In reality, very few expats would want to rely on the Russian healthcare system due to its limitations.
Why Russian State Healthcare Systems Struggle
Russia has many natural resources. The country produces more than a tenth of the annual global oil supply and is the second largest producer of natural gas in the world. More than half of Russia’s economic output now relates to banking, insurance, property and other high value service sector industries.
This mean that you might expect the provision of a decent healthcare system in the country to be achievable. However, inequality and politics mean that in reality, the system is starved of funds. This has left many sick people across the nation in a desperate situation.
Unfortunately, Russia is a country of financial extremes. Power and wealth sit in the hands of a few, who enjoy luxury homes, travel in their private jets and yachts, and buy up companies and organisations which increase their wealth and standing. About a quarter of the population, meanwhile, struggle to make enough money to fund even a modest lifestyle. Regional government areas away from Moscow have few wealthy taxpayers and many households requiring support.
The situation is exacerbated by corruption. It is thought that more than a third of the Russian population works in the black economy to some degree, accepting cash-in-hand payments which are never declared to the tax authorities. Organised gangs operate all sorts of schemes to generate and launder crime money, and petty crime is rampant.
Meanwhile, official systems are slow, bureaucratic and lack the investment required for drastic change. The tax and legal systems aren’t up to bringing in a population-wide culture of tax compliance.
All of this means that crumbling healthcare buildings continue to be used, with underpaid staff using ancient equipment and limited supplies of medication.
Finding The Right Health Insurance For Russia
It can be tempting to just focus on the price of your healthcare policy when you feel fit and healthy. However, at the time you actually need help, your capacity to think options through and pay for extras can be limited.
You could need treatment abroad for a sudden illness or want to be seen by a specialist for a minor condition, and only then discover that these options aren’t covered by your policy because you opted for a slightly cheaper policy. Therefore, take care to avoid high excess charges and ensure that you read the terms and conditions carefully.
English Language Medical Facilities
The majority of people in Russia don’t speak English very well, if at all, although in large cities such as Moscow and St Petersburg, you are more likely to come across highly skilled medical professionals who also speak English proficiently.
Private health facilities catering to the expat market are likely to employ doctors and nurses who can speak to you fluently in English. Such facilities actively recruit staff who have trained or worked in Western countries.
The UK’s Foreign and Commonwealth Office (FCO) maintains lists of medical practitioners in Moscow, St Petersburg and Ekaterinburg which is a good source to start your search.
Jasilyn, an American expat living in Ufa, told to ExpatFocus: “Be aware that bureaucracy is different and their way of thinking is different. It was really hard when I first came here because it felt like everything was disorganized, but if you just accept it as the way things are you’ll be a lot less stressed out.”
When you’re living in Russia, you are required to carry your passport and visa with you at all times. Additionally, keep a note of your healthcare insurer’s reference and contact number. Add the phone number to your mobile contacts.
Administrative systems for private healthcare facilities should be straightforward as long as you have the correct policy in place and can prove it. Entering a state facility will normally involve filling out the paperwork in Russian.
Depression And Seasonal Affective Disorder In Russia
The majority of expats in Russia have a positive experience overall, but the country consistently comes about 20th on the HSBC Expat survey for expat satisfaction.
For those living in big cities, joining the expat community can help enormously, plus salaries in these locations are usually good. However, pollution, crime, bureaucracy, overcrowded public transport and the cost of living can all take their toll, even before the winter climate makes everyday life difficult. Depression is a risk for any expat trying to build a new life in an unfamiliar environment, and Russia’s environment doesn’t always make the task easy.
Depression is recognised in Russia as a mental illness which can be treated. Outside of the major cities it quickly becomes difficult to get appropriate help, but in Moscow and St Petersburg, there are many psychiatrists and psychologists working in both the state and private sectors.
The long months of grey skies and bitter cold can take their toll on Russian residents, including expats. Seasonal Affective Disorder (SAD) is a form of depression which is at its worst during the darkest months and gets better during summer. It’s a well-recognised condition in Russia. Cognitive behavioural therapy, anti-depressants and light therapy are some of the common treatments for SAD.
Food And Drink In Russia
Do not drink the tap water in Russia as you may suffer a gastrointestinal infection. Instead, make sure water from the tap for food preparation is boiled. For drinking, buy bottled water from reliable sources.
Meat and fish should be thoroughly cooked before serving, which is the same advice given in most countries.
Smoking Rates In Russia
Up to a third of Russia’s adult population smoke cigarettes, and the practice is particularly high amongst men. Many start smoking as young teenagers.
In 2013, smoking was banned in public places in Russia. That includes workplaces, shops, offices, schools, hospitals, bars and entrance ways. Further anti-smoking measures have been brought in and smoking rates are slowly beginning to fall.
Alcohol Consumption In Russia
Russian people drink a lot of alcohol compared to many other nationalities. However, recent analysis suggests a slow overall decline in consumption. Death rates connected to alcohol have fallen dramatically in the country.
Vodka is the most popular drink in Russia, along with other spirits, beer, wine and champagne. Avoid moonshine if you are offered it. Whilst it will be strong and cheap, the wide range of chemicals used will be a disaster for your health.
Recreational Drugs In Russia
Drug use is rife in Russia. Everything from marijuana, cocaine, speed, heroin and spice (also known as synthetic marijuana) has a big market, especially amongst the young.
However, this is a conservative country which disapproves of illegal drug taking. Moreover, much of the population knows someone killed by their nicotine or alcohol addiction, so want to protect their young people from the many harmful effects of drug use.
Drug smuggling and drug networks are controlled by violent gangs. You will not be safe if you become involved with these criminal groups, especially as some officials working for the state are open to corruption.
Should you be found carrying a small personal quantity of marijuana, you will probably get away with a fine, although this may affect your ability to stay in the country when your visa needs to be renewed. For all other drugs offences, expect a prison sentence in harsh conditions. You are, therefore, advised to avoid all contact with recreational drugs in Russia.
Risk Of Being Kidnapped In Russia
Whilst this topic isn’t directly related to the healthcare system in Russia, it is a reminder to be careful about your own safety. If you make the wrong choices, there is no guarantee that someone else can make everything right again.
The UK’s Foreign and Commonwealth Office (FCO) warns that a number of Western nationals, including British people, have been kidnapped. This has happened in the North Caucasus, where some victims have been killed.
Working in these areas as a humanitarian, journalist or business manager has been no protection for previous victims. It may be extremely difficult to pay the kidnappers, especially with international law such as the UK’s Terrorism Act (2000) making ransom payments to terrorists illegal.
Examine the FCO’s map closely and avoid going into areas highlighted there, especially the North Caucasus.
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