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What Bulgakov can tell us about reforming nursing in the former USSR

By Blog Admin, on 13 November 2012

Re-reading Bulgakov leads health researcher and guest contributor Erica Richardson to some sharp realisations about primary healthcare in the former Soviet Union

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Photo: Vladmir Menkov via Wikicommons

I have now reached an age when I can go back to novels I read twenty years ago, reread them with fresh eyes and experience the joy of new discoveries.  Most recently, this has involved revisiting A Country Doctor’s Notebook by Mikhail Bulgakov, a collection of short stories based on his experience as a newly qualified doctor sent to a remote region for his first job practicing medicine.  I sincerely believe it is essential reading for all new doctors and cannot recommend it highly enough.  In the 1990s, I was struck by how little had changed in the rural Russian landscape despite the electrification and mechanisation drives under Stalin.  In 2012, I was struck by the way in which different members of the clinical team were presented.

Maybe this is because I’ve recently returned from Minsk, Belarus where I was representing the European Observatory on Health Systems and Policies at a sub-regional policy dialogue on human resources in countries of the former Soviet Union.  As an aside to discussions about skill-mix and task shifting, a fascinating discussion developed around the concept of a ‘nurse’ and in the post-Soviet context, and where ‘feldshers’ fit into the picture. Nurses have their distinct heritage and philosophy which is focused on ‘care’, while the doctors are more focused on providing ‘treatment’.  So what’s a feldsher? (more…)

Letters in Russian literature: A top ten

By Blog Admin, on 26 October 2012

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Image via Wikicommons. Public domain


Letters, ranging from the absurd to the tragic play an important role in Russian literature, notes Sarah Young

Letters play a significant role in some of my favourite works of Russian literature, and a couple in particular have been very much on my mind lately.  Here is my top ten, which manages to encompass everything from the absurd to the tragic. Apologies for the plot spoilers (especially in entries 10, 7 and 4), which were unavoidable. I adhere to my usual rule that no writer may appear more than once.

10. Lermontov, A Hero of Our Time. The letter Vera writes to Pechorin in ‘Princess Mary’, in which she informs him she is leaving and will never see him again, is remarkable not so much in itself as for the reaction it causes. Pechorin, so cool and calculated in his actions elsewhere, rides after her in such a frenzy that he kills his horse. The image of his anguish outlasts his own acid comment, ‘anyone who saw me at that moment would have turned away in contempt’. Russian text | English text

9. Olesha, Envy. Two letters feature prominently in part one the novel as important expressions of their authors’ personalities. Kavalerov’s outburst of hatred for the man who saved him, in chapter 11, fixes the dominant characteristics we have already defined, but Volodya’s letter, in chapter 13, is downright sinister, admitting his jealousy of Kavalerov, and hinting at a viciousness we might otherwise not suspect in his character. Meanwhile his paean to the machine has become a key passage in the formation of the New Soviet Man. Russian text

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