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spending money on our health care” since health serv ices used to be free-of-charge to all citizens of Ukraine. Due to inadequate state financing of the health care system, governmental polyclinics and hospitals are extremely short of medications, medical supplies, syringes, linens, and equipment. As a result, patients must buy all necessary materials and medicines for their operations and pay for all diagnostic tests. It is also an accepted practice for many doctors and medi cal personnel to accept gifts and money for services rendered, especially for surgical procedures, births, and hospitalizations. Doctors continue to be severely underpaid, earning the equivalent of US$40-$50 per month. Private medical facilities are available to citi zens but services are provided for a fee. Health care in Ukraine has become very expensive and inaccessible for most people and has made preventive health care almost non-existent. Another women’s health problem raised by respondents and in the literature is the issue of infertil ity. Several of the interviewees indicated that they know women who have difficulty getting pregnant. When asked what they thought were the reasons be hind infertility, some claimed that it was ecological problems in the area (poor air quality, water, remnants of Chornobyl) while others believed it may be the re sult of increased stress. None of the women mentioned that the difficulty in conceiving might also be the re sult of untreated sexually transmitted infections, pelvic inflammatory disease, prior abortions, or even prob lems associated with male infertility. This issue of in fertility was also reported in the 1999 Ukraine Repro ductive Health Survey which indicated that 15% of women surveyed reported having a problem becoming pregnant in the previous ten years. A final set of health problems discussed by the women centered around mental health concerns. Sev eral of the women interviewed indicated that because of the economic and social situation in Ukraine and feelings of uncertainty for the future, women are suf fering from mental health problems, including depres sion and nervousness. However, there are very few places women can go for counseling and there is still a negative connotation and distrust associated with psy chologists and psychiatrists, most probably a remnant from the Soviet times. In addition, domestic violence is coming to be realized as a major problem being faced by women in Ukraine. In its Women 2000 publi cation, the International Helsinki Federation for Hu man Rights reports that until recently, domestic vio lence was not recognized as a problem in Ukraine. Because it is so widespread in both private and social environments, there is an impression that a “non violent existence” is impossible. In many cases, women do not consider themselves to be victims of violence because they are “used to” this lifestyle. It is interesting to note that none of the women interviewed listed domestic violence or physical or psychological abuse as women’s health problems. It is encouraging to note that most of the women surveyed indicated that they had participated in health education classes both in school and at the uni versity. Almost all the women indicated that topics such as human growth and development, male/female anatomy and reproduction were covered during biol ogy or anatomy lessons. The women also noted that there were discussions during certain classes about contraception, pregnancy prevention, sexually-trans mitted infections, and HIV/AIDS, particularly during World AIDS Day (December 1st) commemorations. However, topics with a more psychological focus, such as understanding sexuality, relationships with mem bers of the opposite sex, communication and negotia tion with partners, self-esteem, self-respect, decision making, domestic violence, and sexual abuse, were, for the most part, not covered in sessions. In summary, all these health problems impact not only the individual woman, but also the health and well-being of her children, her family, and her com munity. Information and education programs, begin ning in childhood with school health curricula and continuing throughout the life span, must be age and culture-specific to make women aware of health issues affecting them. Health education programs and inter vention programs need to be created, not just to in form, but to change the attitudes of women towards their health and well-being and bring about behavior changes which will allow women to take control of their health and protect themselves from a variety of illnesses. Preventive health care must be emphasized and changes must be made in the healthcare structure to provide women, and all persons, access to low or no-cost quality health care. It is not only the health of women that is being jeopardized by today’s economic, political and social changes occurring in Ukraine, but also the health of future generations of Ukrainians. * R esearch f o r this article w as su pported in p a rt by a gran t fro m the International R esearch & Exchanges B oard (IREX) with fu n ds p ro v id e d by the N ational En dow m ent f o r the H um anities, the U nited States D epart m ent o f State, and the IR E X S cholar Support Fund and by a F ulbright G raduate Student A ward. N one o f these or ganizations is responsible f o r the view s expressed. Martha Kolinsky Bojko is a d octoral student in m edical anthropology a t the U niversity o f C onnecticut and is cur rently living in Uzhhorod, Ukraine, w here she is conduct 10 “НАШ Е Ж ИТТЯ”, ЧЕРВЕНЬ 2003 Видання C оюзу Українок A мерики - перевидано в електронному форматі в 2012 році . A рхів C У A - Ню Йорк , Н . Й . C Ш A.
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