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Field notes from Moscow
Dr Matthew Reid, from New Zealand, is a medical co-ordinator for MSF based in Moscow. He has been there since December 2005. He was previously in Monrovia, Liberia in a similar role. Before this he was a Field Coordinator in Moyamba, Sierra Leone and a medical doctor in Panjshir, Afghanistan. When we arrived in Russia, in December last year, we were prepared for the cold. Before my wife and I left for Moscow we went to a camping store and bought the thickest, heaviest cold weather clothing we could find. It was a substantially different kind of pre-departure shopping compared to those I have done before leaving for Sudan, Liberia and Sierra Leone. We definitely needed warm things: it was the coldest winter for a few decades, with temperatures down to below minus thirty degrees. Despite the Everest-expedition thickness of our jackets if you were outside for any length of time you could still feel your nipples starting to freeze. Moscow city authorities had to close factories and ration electricity to maintain heating. But others in Moscow were not so lucky. In the middle of the worst of the winter in January I went out with one of the teams of workers from the Street Children and Teenagers project that MSF runs in Moscow. These teams help the kids on the street and identify ways to help them there and in a daycentre where MSF runs medical, social and psychological activities. I met some kids who were living under a railway platform. To get into the little space they had found they crawled through a tiny hole in the side of a railway building. Through the hole you could smell that they were sniffing glue. They get glue and other volatile substances and put it in plastic bags and inhale the fumes, which keeps out the sensation of cold. It was in the minus twenties that night and I was losing the sensation in my feet despite the fur-lined boots. The kids had many layers of dirty clothes, but a couple of them had no shoes. Some of them had chattering teeth and a bluish tinge to their lips. The glue also helps them escape for a while from the harsh reality of their lives and perhaps whatever it was that drove them to run away from their home or an orphanage – often violence and abuse or plain neglect. The kids suffer from side effects of the glue (which might also explain the blue lips), respiratory problems like pneumonia and bronchitis, and skin problems from living rough. Some of them use intravenous drugs – they buy an injectable opiate painkiller called butaphanol – and have nasty skin infections where they inject. They are at high risk of transmitting HIV both from sharing needles and unprotected sex (along with other sexually transmitted infections). In February I thought I would escape the cold when I visited the North Caucasus, the other part of the Russian Federation where MSF is working. It was a bit warmer there but it was still covered in waist-high piles of snow. I wasn't wearing my thick down jacket (for security reasons it’s preferable to blend in a little with the locals) but I did have several layers under a woollen coat. Again I saw people living there in desperate conditions where the cold is an ever-present discomfort in winter. In Ingushetia MSF have mobile medical teams bringing health care to people displaced from Chechnya by conflict. Some live in abandoned factories where they construct box-like rooms from plywood to separate some private space or even in tents out in the extreme weather. Any assistance they get is being reduced as the authorities would like them to go back to Chechnya, where the situation has "normalised". I also visited Grozny in the snow. It is a city under reconstruction from obvious and devastating destruction during the previous decade. From talking to people you get a clear idea that for them the situation has not "normalised" at all. They live under a constant feeling of fear and threat. The team in Chechnya (in Grozny, and in a new project started in June in Kargalinskiya, a town in the north of Chechnya) work relatively independently in the positions normally taken by international staff. Because of the extreme security risks (of violence or abduction) for foreigners in Chechnya we can make only very fleeting visits, unannounced to the team in the field. Even though I have only been in Grozny for a few hours I have felt directly and intensely the insecurity the team lives with every day. Now it is summer in Russia and Moscow is a completely different city. It is plus thirty degrees today, there are leaves on the trees and people out in the street in shorts and t-shirts. At least for a few months it must be a less unpleasant time to be living on the street or in a tent. But there is another winter coming. Dr Reid will be working with MSF in Moscow until December. » Read more articles from Russian Federation
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