The standard of healthcare in Ukraine is extremely neglected with a severe lack of medical facilities and medicines. Some of the medical staff are highly trained, but some have only completed half of the training required. The healthcare is in an extremely poor state. Healthcare in Ukraine is supposedly free and available to all citizens and registered long-term residents. Private healthcare is also available in the country. All employed citizens contribute to the healthcare system. The Government of Ukraine oversees the health service and all citizens are entitled by law to equal access to healthcare
I __________________________ Healthcare in Ukraine is funded almost entirely by general government revenues; this fund makes up 7.4 percent of the fund. 3.2 percent of the fund is made up by social insurance contributions from the wages of the employed and 3.3 percent is funded by private clinics and their private patients. Dependant family members are covered by the contributions paid by employed family members. The unemployed, old age pensioners and people on long-term sickness benefit or maternity leave have to pay healthcare contributions but not as much as an employed citizen. Foreigners immigrating to Ukraine without jobs must produce proof of private health insurance in order to obtain their residence permit.
If you are self-employed, you need to get additional insurance to cover members of your family and you must pay the full contribution to cover yourself.
The state fund covers most medical services including treatment by specialists, hospitalisation, prescriptions, pregnancy and childbirth and rehabilitation.
The state, in theory provides free healthcare for its citizens and long term residents who become ill; however this is a serious problem for many parts of the country. Doctors’ wages are extremely low and often ask for a fee. This makes healthcare difficult, as many citizens are on a low income.
Doctors are known as a likar and are the first point of contact with the Ukrainian health system. Citizens can register with the doctor of their choice, however, people seeking state medical care must make sure that their doctor is contracted into the health scheme. If you are treated by a doctor whether or not the doctor is covered by the state you will have to pay a fee.
GPs prescribe drugs, treat acute and chronic illnesses, and provide preventive care and health education.
Waiting times to see doctors vary and it is advised that you make an appointment in advance. If you need urgent help, you may go to the doctors surgery on speculation, but be prepared for a long wait.
Health centres in Ukraine are in an extremely poor state. The medical facilities are of a poor standard compared to Western standards; the medical equipment and facilities are in short supply compared to the high demand. All services, including doctors and nurses cost a lot of money which makes health care in health centres not always a feasible option for the ordinary citizen. The doctors and nurses who work in the health centres are not always fully trained in the health system.
IV ___________________________ Consultants are senior doctors who have completed a higher level of specialised training. GPs refer patients to a Consultant if he believes that a patient may need specialist help and diagnosis. There are very few consultants in Ukraine, which therefore makes a high waiting list to see the Consultant doctors. The consultants are no different to a doctor in terms of them still asking for a fee, normally higher than a normal doctor due to their higher level medical skills.
V _____________________________ Hospitals and clinics exist in all major towns and cities of Ukraine, but are nowhere near the standard which is required in Ukraine. Hospitals are dirty and the level of care in extremely low due to staff shortages. Patients are admitted to hospital either through the emergency department or through a referral by their doctor. Once a patient is admitted treatment is controlled by one of the hospital doctors. All hospital doctors require a fee which makes hospitalisation difficult for its citizens. Doctors and nurses are in short supply due to low wages which is resulting in doctors and nurses going abroad and offering their services. There may be a waiting list for some non-emergency treatments and services.
VI _____________________________ Emergency care is supposedly to be free for everyone including those without state health insurance. However, once your condition is stabilised the doctor will probably ask for a fee for their services due to the low wages that the state provides. Emergency departments are open non-stop all year. You may use their services if you need immediate attention, or if your GP refers you to them, or if there is no GP service available.
VII ____________________________ There are a few private practices in Ukraine which are provided by independent office-based doctors and specialists. The premises are funded largely by private insurance contributions, but it is used only by a small minority of people, often as a top up to the basic state healthcare and to cover them for the services deemed non-essential. The private hospitals are cleaner and the comfort factor is a lot higher than a state hospital, there are no waiting lists, but then there is a higher fee, which is not always a feasible option for the ordinary citizen.
VIII ___________________________ Dental care in Ukraine is expensive and not very many citizens can afford the dental care that is necessary, all dentist services are private in Ukraine. Dentists are known as a zubnyy likar. Dentists can be found in major cities of Ukraine normally where the income of the citizens are of the amount where they can afford dental care.
IX _____________________________ Dispensing chemists known as an apteka sell medicines in Ukraine. Prescriptions known as prypysannia are generally not needed to buy medicines, which are normally tightly monitored in Western countries. There are many pharmacies throughout Ukraine and the cost of medicine from a pharmacy can be expensive as there is no monitoring of drug prices. Many pharmacies in the major cities are open 24 hours, so there is always access to pharmacy medicines.
Exercise 70. Make up questions to the text covering its main points. Work in pairs. Ask your partner the questions and answer his.
Exercise 71. Read the text on the History of Medicine and choose the best option to fill in the gaps.
1.Medicine/Healthcare is the science or art of preventing and treating diseases. It was natural for man to develop the 2.practice/practise of medicine because it is natural for man to protect himself. 3.Skeletons/Skulls of men who lived before the time of written history seem to show that men tried to treat wounds and broken bones. What they thought about the disease and its treatment is not certain. Probably they thought that disease was the 4.result/cause of witchcraft. It was something they did not understand, and therefore it frightened them. The main treatment 5.for/of it was magic and superstition. These magicians and witch doctors were the 6.ancestors/descendents of modern physicians, surgeons, and psychiatrists.
The ancient 7.Egyptians'/Egyptian’s system of medicine made disease and its treatment more sensible. They were 8.good/bad observers and recorded what they saw. Medical schools were established and surgery, particularly eye surgery, was advanced. However, disease and its treatment were part of the ancient Egyptian 9.religion/revenge. Prayers, charms, and sacrifices to the gods were part of the treatment. The doctor was a doctor- 10.witch/priest.
Medicine in India, especially 11.dentistry/surgery, was highly developed. Plastic surgeons did certain operations 1000 years before other surgeons tried them. Here too, magic and religion were a part of medical practice.
Scientific medicine had its beginnings in Greece. Doctor-priests ran 12.churches/temples where the sick could be treated and nursed. In Greece these priests were called Asclepiads; that is servants of the god of 13.medicine/doctors, Asclepius.
The Romans called the god of medicine Aesculapius. Hippocrates (460 ?–?377 B.C.) is called the 14.son/father of medicine. His approach to 15.medicine/the medicine was scientific. He put aside all superstition, magic, and charms as having no part in understanding the cause and treatment of disease. He and his 16.relatives/pupils made careful records of their cases.
Some of their observations are considered to be true even today: e.g. Weariness without cause indicates disease. When sleep puts an end to delirium, it is a 17.good/bad sign. Hippocrates' moral idea of what a doctor should be has had a 18.slight/great influence on physicians ever since. It is as important as his scientific contributions.
Medical schools today have graduating students have the Hippocratic 19.Oath/Prayer. The best of Hippocratic medicine was continued in the great medical school of Alexandria, Egypt, which was 20.founded/found about 300 B.C. By dissecting human bodies Greek physicians learned a great deal about how the organs work and the diseases that affect them. They were greatly interested 21.in/about the nervous system and described the brain with fair accuracy.
With the 22.flourish/breakdown of the Roman Empire around A.D. 400 there was little encouragement of medicine in Europe. After the 8th century the Arabs spread their empire from Persia to Spain. Under them medical schools and hospitals flourished. Greek and Roman medical books were translated into Arabic. Ibn Sina (Avicenna) and Rhazes were two of the most famous Mohammedan physicians. Mohammedan physicians however were forbidden to perform autopsies. Thus they did not add to the knowledge of anatomy (structure of the body) and the effects of disease on the body.
A few centuries later a new desire to study and inquire into the nature of things gradually started in Europe. This is called the 23.Romanticism/Renaissance. By the 15th century this movement was at its height in Italy. Artists such as Leonardo da Vinci began to learn the structure of the human body. But it was not until the 18th century that medical knowledge was used widely to safeguard the health of people. Many hospitals were 24.built/closed, sanitation for cities and towns became more important. 25.The sewers/Sewers were covered and streets were paved and lighted.
The first «pulse watch» was introduced in 1707. Around this time thermometers were also tried out. The most important name among many excellent 18th century physicians was Edward Jenner, an Englishman, who successfully produced a vaccination 26.against/for smallpox. Experimental medicine and surgery 7.were/was greatly advanced by John Hunter, 28.an/the English surgeon and physiologist. It is said that he 29.took/had taken surgery away from the barbers and made it a scientific profession.
Modern medicine, as we know it now, 30.has begun/began in the 19th century. An important way of testing for diseases of the chest was developed by French physicians. They 31.found/founded that different parts of the body give their own sounds when thumped. The story is told that the French physician Rene Hyacinthe Laennec could not thump the chest and heart of a patient because her chest was too stout. She was young and so he hesitated to put his ear on her chest. He finally rolled a heavy piece of paper into a cylinder and put one end to the 32.patient's/patients’ chest and the other to his ear. The beat of the heart could be 33.clear/clearly heard. In this way a very important tool for diagnosis of diseases, 34.the/a stethoscope, was invented.
On March 30,1842, Crawford Williamson Long, a US physician, anesthetized a patient with 35.gin/ether. Painless operations were possible from that time on. This event was the beginning of modern surgery.
A Scottish surgeon, Joseph Lister tried to prevent 36.bacteria/bacterium from entering a wound by boiling instruments and using antiseptic solutions. Modern aseptic (germ-free) surgery grew out of his work. In the early 20th century, Wilhelm Roentgen 37.successfully/successful developed X-ray pictures for medical use.
The history of antibiotics began in 1928 with Sir Alexander Fleming, an English bacteriologist, who noticed that bacteria did not 38.grew/grow around the Penicillium mold. In 1939 Howard Florey and Ernst Chain, English scientists, had 39.studied/studied the observations of Fleming and developed penicillin, the most widely 40.used/using antibiotic.
Exercise 72. Discuss the following quotations.
1. A sad soul can kill you quicker than a germ. John Steinbeck
2. The only way to keep your health is to eat what you don't want, drink what you don't like, and do what you'd rather not. Mark Twain
3. He who has health has hope; and he who has hope has everything. Arabian Proverb
4. Our mental and emotional diets determine our overall energy levels, health and well-being more than we realize. Every thought and feeling, no matter how big or small, impacts our inner energy reserves.
5. "If taking vitamins doesn't keep you healthy enough, try more laughter:" Nicolas-Sebastien Chamfort
6. "A good laugh and a long sleep are the best cures in the doctor's book." Irish Proverb
7. "Health is worth more than learning." Thomas Jefferson
8. "Health is not valued till sickness comes."
9. There’re lots of people in this world who spend so much time watching their health that they haven't the time to enjoy it. Josh Billings
10. The greatest wealth is health. Virgil
11. Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. World Health Organization, 1948
12. Eat right, exercise regularly, die anyway. Author Unknown
13. When it comes to eating right and exercising, there is no "I'll start tomorrow." Tomorrow is disease.
14. My own prescription for health is less paperwork and more running barefoot through the grass.
15. If man thinks about his physical or moral state he usually discovers that he is ill. Johann Wolfgang von Goethe
16. The part can never be well unless the whole is well. Plato
17. Doctors are always working to preserve our health and cooks to destroy it, but the latter are the more often successful. Denis Diderot
18. Nothing is more fatal to Health, than an over Care of it. Benjamin Franklin
Exercise 73. Imagine you are an exchange student in the UK now. Your counterpart from the UK has fallen ill while staying in Ukraine. You, being in the UK, have to write him an e-mail letter explaining the differences between health care systems of Ukraine and the UK.
Exercise 74.Match the parts of the body with the definitions
a. organ in the head which controls thought and feeling
b. long pipe leading from the stomach which takes waste
c. two small, fleshy organs in the throat
d. baglike organ in which food is broken down for use of the body
e. one of 24 bones protecting the chest
f. one of a pair of organs which separate waste liquid from the blood
g. one of two bony parts of the face in which teeth are set
h. large organ which clears the blood
i. one of a pair of breathing organs in the chest
j. passage from the back of the mouth down inside the neck
k. short organ in the chest which controls the flow of blood by
organ in the chest which controls the flow of blood by pushing it round the body
Exercise 75. Choose the correct answer.
1. The doctor asked me to …………. to the waist.
a. bare b. strip c. take off d. undress
2. The nurse put a ....... round Jane's bleeding knee.
a. bandage b. belt c. ribbon d. scarf
3. He had injured his arm badly and had to keep it in a ……… for several weeks.
a. cradle b. litter c. sling d. stretcher
4. The doctor told her that her temperature was ……….. .
a. current b. familiar с. habitual d. normal
5. Although the patient's condition is serious, she seems to be out of a ………… .
a. bedstead b. cot c. couch d. stretcher
6. My sister works in a house for the deaf and ....... .
a. dumb b. mute c. speechless d. voiceless
7. Make sure you ....... your food properly before you swallow it.
a. bite b. chew c. crunch d. eat
8. The doctor took his temperature and felt his ....... .
a, blood b. muscle с. pulse d. vein
9. The man who was taken to hospital had been ....... for three hours.
a. indifferent b. insensitive c. unconscious d. unfeeling
10. The injured man was taken to hospital on a(n) ....... .
a. ambulance b. bed c. sling d. stretcher
Exercise 76. Fill in the blanks with the words below.
bacteria body break dangerous delicate disease eyes germs line skin liquids membrane moisture mouth nose parts prick sneeze stomach
HOW THE BODY FIGHTS DISEASE
The 1 ....... is often called "the body's first 2 ....... of defence." It acts as armour, resisting many germs that might harm the more 3 ....... parts of the 4 ....... . Any 5 ....... in the skin, even a pin 6 ....... , provides an opening for 7 ....... germs. Some 8 ....... enter the body through the 9 ....... and 10 ....... and other natural openings. These areas provide warmth and 11 ....... , in which germs thrive. When the 12 ....... of the nose and throat becomes irritated, we cough or 13 ....... , blowing out the unwanted substances.
Other body 14 ....... also provide a defence against 15 ....... . Tears, for example, wash 16 ....... from the 17 ....... . Tears also contain substances that fight bacteria. Acid in the 18 ....... kills many germs before they can reach other 19 ....... of the body.
Exercise 77. Match the questions and the answers.
1. Why are you sneezing?
2. Why are you crying?
3. Why are you yawing?
4. Why are you coughing?
5. Why are you bleeding?
6. Why are you sweating?
7. Why are you shivering?
8. Why are you shaking?
9. Why are you vomiting?
a. I'm terrified by this story.
b. I've cut myself with a bread-knife.
c. I'm bored with the lecture.
d. Cigarette smoke irritates my throat.
e. You are hurting me.
f. I have a bad cold.
g. I'm very cold.
h. I must have eaten some bad food.
i. It's too warm in here.
Exercise 78. Match the problem and the piece of advice.
1. I keep getting the headaches.
2. I can't get into my clothes.
3. I can't sleep at night.
4. My eyes are often sore and I sneeze a lot.
5. I'm going to Kenya on business.
6. I've got a bad stomach.
7. I feel much better now, doctor.
8. I've got a terrible cough.
a. ....... Good, you needn't come back for a month.
b. ....... You really must stop smoking.
с. …… Perhaps you should have an eye test.
d. ....... You ought to do more exercises. It's very relaxing.
e. ....... You'll have to have a few injections.
f. ....... You shouldn't eat so much fried food.
g. ....... You really must lose some weight.
h. ….. You should have some allergy tests.
Exercise 79. Match the two parts of the sentences.
1. I feel much healthier since ...
2. Both women played well and ...
3. I'm so unfit, ...
4. Citrus fruits such as oranges and lemons ...
5. Brown bread is ...
6. The discovery of penicillin ...
7. Doctors are trying out ...
8. My mother's having an operation tomorrow - ...
9. Before undergoing surgery, ...
10. The side effects of this drug may ...
11. He was examined by the doctors, ...
12. We had to take Bob to casualty after ...
a. ... she's having her appendix removed.
b. ... revolutionised Western medicine.
c. ... he fell downstairs.
d. ... a new treatment for depression.
e. ... looked in good shape.
f. ... include fever and dizziness.
g. ... but none of them could find anything physically wrong.
h. ... more nutritious than white.
i. ... I can't even run to the top of the stairs.
j. ... patients can discuss their operation with a doctor.
k. ... I stopped smoking.
1. ... are very good for you.
Exercise 80. Complete the sentences below with a preposition.
My wife complained that something was wrong … her. She said she had a pain … her back and that she suffered … bad headaches. As she was getting worse and worse I sent … a doctor. Immediately afterwards she was taken … hospital. Yesterday she was operated … . Now she feels much better.
Exercise 81. Your friend has a few marks on his body. Match the name of the mark with the explanation of its origin.
1. This bite on my leg
2. These blisters on my feet
3. This bruise on my eyelid
4. This cut on my thumb
5. This graze on my knee
6. This scar on my belly
7. this scratch on my arm
8. These spots on my cheeks
9. This sting on my chin
a. I got when I was operated on for appendicitis.
b. I got when I went on a walking tour in too tight shoes.
c. I got when I was hit by my friend during our quarrel.
d. I got when I fell down while running.
e. I got when I suffered from measles.
f. I got when I was cutting onions with a sharp knife.
g. I got when I was attacked by a fierce dog.
h. I got when I was playing with my cat.
i. I got when I went to take some honey from the beehive.
Exercise 82. Match the following symptoms of disease with their definitions.
a. difficult or infrequent emptying of the bowels
b. weariness from bodily or mental exertion
c. to become senseless and motionless
d. feeling as if everything were turning round
e. act of sending out gas from the stomach noisily through the mouth
f. a burning sensation in the stomach from indigestion
g. pain in a nerve
h. feeling of sickness as caused by bad food
i. yellowness of the skin and the whites of the eyes
j. inability to sleep
k. a sensation in the skin causing a desire to scratch
l. the soft yellowish substance formed in and coming out from a poisoned place in the body
m. patch of tiny red spots on the skin
n. severe pain in the stomach and bowels
o. too frequent and too watery emptying of the bowels
p. sudden and painful tightening of the muscles
q. condition of the body with temperature higher than usual
r. a spasm of the respiratory muscles
s. a redness and swelling attended with heat, pain
t. difficulty in digesting food