wait, don't switch, how the war is changing ukrainian medicine and whether there will be anyone to treat ukrainians, now and after the war, let's try to understand in today's edition of bbc ukraine, in the studio olga palomaryuk. tens of thousands of ukrainian doctors went abroad after russia's invasion of ukraine. who will replace them and whether ukrainian medicine is threatened by a shortage of personnel. tens of thousands of doctors have already left ukraine since the beginning of the war, according to statistics. medics are leaving from the occupied and front-line regions and even from the western regions on. conditional security, most of the medics

who left are women, although there are also men, how and where they are leaving, and the most important thing is how many, it is impossible to name the exact number, because there is no such record, but if you compare how many medics worked before and how many now, then according to the data center of public health, in the medical system of ukraine during the first year of the war, there were 41,000 fewer doctors, these are doctors, more than 6,000, the rest are nurses, nurses, paramedics and paramedics, in a word: junior and middle medical personnel, does this mean that 41,000 ukrainian doctors and nurses went abroad, no, they could be freed or go to the front, it is also impossible to say the exact number, but it is thousands of doctors, and in almost two years of the great war , more than 150 ukrainian doctors died, and shelling damaged more than 1,500 medical facilities where ukrainian doctors go , most often to poland.

according to official data, more than 4,000 doctors and thousands of nurses have already been employed there. in europe, ukrainian doctors are happy because they have a shortage of their own, but they have to literally start from scratch. it is necessary to take exams, get a permit for work what is it like to build a medical career in a foreign country? my colleague, diana kuryshko , talked to a lorli worker from lviv. maryana cherkes, in the spring of 2022 she left for austria, where she has already managed to resume her profession, although i am from western ukraine, but unfortunately, there is no safe place in ukraine now, where you can work calmly and not worry when the air alarm, that your children are safe, because anything can happen anyway, and that's why we made the decision, considering that we have three young children, that's why i went abroad, for them,

was it easy to get a job as a doctor, no, not easy, but when you have a complete resume, i personally had a lot of internships abroad, publications, both scientific and clinical, career, then, accordingly, when you come to the interview, because everywhere, both in austria and in poland, talking with my colleagues who went to... poland, america, or france, they encourage high-ranking, highly qualified specialists to work here. at the moment we live in austria, we are planning some, at least the next year or two of our lives, here in austria, in the future, of course, if it will be safe in ukraine, and if, and even more so with the new...

acquired knowledge and skills, we, my family, and i, including myself, will never swear that we will never return to ukraine, because ukraine also has a lot of good doctors, a lot of good hospitals, the hospital where i worked is now very, very developing, and if you compare, for example, i was on an internship in austria in 2008 and now it is 2023 , i wouldn't say that anything has changed so significantly, despite the new equipment, some new methods of treatment, of course, if you compare ukraine, 2008 and 2023, then in ukraine everything has changed very, just globally, a lot of new equipment, health care reform, only for the better, and i believe that now the main thing is that this war ends. and ukraine, will be

a beautiful, prosperous country, and maybe one day specialists from other countries will want to come to us to work. with such an outflow of personnel, will there be anyone to treat ukrainians? the ministry of health says yes, because despite the crisis, there are no personnel. according to the ministry of health, no more than 8% of medical workers left ukraine. another study by the humanitarian agency zdorovye notes that 14% of medical institutions, on the contrary, have an insignificant influx of personnel. basically, this is the west of ukraine. however, the shortage of doctors is particularly acute in the de-occupied territories. 40% of hospitals. they feel a lack of personnel. so, how to be in such conditions, who should replace doctors? in some regions, those doctors who left were replaced by medical workers who became internally displaced persons due to hostilities, because promptly it is impossible to train doctors. training is

a long process, even in peacetime, listen to what the medical director of a clinic in odesa, a place that has suffered from regular russian shelling since the beginning of the great war, tells about it. initially, after a full-scale invasion , about 60 medics left the hospital from us, and 50 medics joined the armed forces of ukraine, and this was a very large outflow of personnel, which we had not encountered before, it was very difficult for us, and it was a matter of their safety , safety of their families, safety of their relatives, safety their children we could not influence it, it was very fast, chaotic, and it was not discussed, they just said we are leaving, or we are already abroad, and when the nurses tell us this, it is not so scary, but when we

started receiving such calls , this or even a notification from our doctors, from our leaders who worked with us here, it was very difficult. because we understood what we have in front of us, the problem becomes how to provide assistance to our patients, the situation is such that, for example, senior nurses, they are educated for years, they are not taught in universities, they are not teach in colleges, and these, this staff, they are very important to us, and when they made the decision to leave, several seniors. nurses went abroad, it was a very difficult situation for us, it was very, very difficult to replace them, and when people arrived, temporarily displaced persons, they appeared somewhere in

charity centers, we provided a lot of help to such people, people, and we talked with them about if there are medics among you, if there are nurses, if there are doctors, we are ready to... employ you and work with you, and so gradually we found everyone who we needed, well, at the moment the authorities cannot do anything in particular, because it is a very gradual process, students must learn, become doctors, they cannot be replaced there, there is no way there quickly, but we know that everyone unites, everyone supports each other and does everything so that... our patients are helped, and how the situation is commented in the relevant ministry, how they plan to close the deficit, and in general, whether there will be anyone to treat ukrainians. minister of health viktor lyashko assures that the departure of doctors is not a crisis, because no more than 8% of medical workers left, the crisis

is created by constant shelling, and the problem is most often with specialists of a narrow profile, especially in villages and small towns. even if now there are no... traumatic figures regarding the departure of doctors, they are not inevitable in the future, experts say, because even before the war , doctors went abroad. this is a global trend, when some countries attract specialists from other countries. how to achieve this, to raise salaries, to overcome corruption in medicine, to do everything that doctors want return and stay, so believes the british neurosurgeon henry marsh. he has been regularly coming to ukraine for more than 30 years, where he trains doctors and advocates. health care reform. as journalists, we receive reports that, in fact, now ukrainian doctors are in despair, and some of them want to leave the country if they can. this is partly due to globalization. it is the same in many other countries,

and the war made the situation even worse. there is a shortage of doctors in many european countries. germany is very eager to absorb. doctors from other countries, and this a tragedy, but it is difficult to stop it, well, you should introduce some obligations according to which medical students promise, agree that they will not leave. they will work in ukraine for a certain number of years, but this also means that the government should make it more attractive to work as a doctor in ukraine, and you mean the money? yes, money, and the problem is that it's different in the public sector, doctors are largely dependent on unofficial extra payments or money in an envelope. senior doctors can earn big money and they don't want to

the system was changing. i know for a fact that a surgeon here operating on a brain tumor in the public sector will earn more off the books than i would operating in a private hospital in london. you were in favor of reform, yes, but we understand that war and its urgency are almost antithetical to reform, right, when? not if, but when, ukraine wins the war, people ask why we suffered so much, why so many people died, if nothing has changed. a classic example, the end of world war ii in britain, when churchill, who was a great military leader, was immediately expelled after the election because he was an old right imperialist and the people wanted change and so they created the national health service and the welfare state. created thanks to people. who said: we fought, we want to see real benefits as a result. therefore, i hope

that in ukraine after the war, this will become a catalyst for changes in the health care system. when i listen to this, i think about the news from october 5 about the civilian hospital in beryslav, kherson region. of course, it is near the front line, but the russian army fired at it from the air, and half of the hospital simply not. so in light of that, how would you imagine the ukrainian system would accelerate after the war, and this is just one of many hospitals. it will depend on what kind of financial support the rest of the world will provide if you have the equivalent of a marshall plan, but rebuilding ukraine will be very difficult and very expensive. however, this is a huge opportunity, but there is a fear that ukraine will come out of the war as a wasteland and everyone... will want to leave, and it will be a terrible mess, but judging by what i have read, the western

countries accept the fact that after the war there will be a lot of money was involved for the restoration of ukraine. most ukrainian hospitals are terrible, so i think it's a good thing that they are destroyed. like, for example, that terrible hotel in odessa down by the potemkin stairs. and what do you think depends on ukrainians and ukrainian doctors in this situation. you should bring up the problem of corruption, you know, in the west there are critics who say that ukraine is hopelessly corrupt, we should not support it, to which i say: no, no, no, this war is a war against corruption, the war is against influence of russia, because russia absolutely corrupt, and i consider the war against russia, at the same time, a war against corruption in ukraine, and this is what you are trying to get rid of. and obviously it is very difficult, but really, if you are going

to get money from the eu, it will be very important for ukraine to show that you are really fighting corruption. what threatens ukraine is a lack of doctors, while officials assure that there is no personnel crisis. experts predict that ukraine is in for another wave of doctor migration. that at first they left for security reasons and simply fleeing the war, then the next waves of migration will have other motivations, primarily economic. if you want to read more about it, my colleague diana kuryshko wrote an interesting article, it is already on our website bbc.ua, i highly recommend reading it. and that's all for today, we're back on the air tomorrow at 9 p.m., good luck and take care.

greetings friends, the live broadcast of the espresso tv channel continues with the verdict program, my name is serhiy rudenko, i congratulate everyone once again and wish everyone good health, today in the program. elections only after the war. all political forces parliament signed a memorandum. can this be considered the key to unity? from avdiivka to volyn, ukraine is significantly strengthening its fortifications, what does this mean and what to expect? mobilization in ukraine, how many more people the armed forces need and what changes are being prepared in the council. during today's broadcast, we are conducting a survey, friends, today we are asking you about the following: do you see attempts

to usurp power in ukraine, yes, no, please vote on youtube using the buttons yes, no, everything is quite simple. or write your comments under this video, if you are sitting in front of the tv, pick up the phone and vote on 0.800 2001-381, if you see signs of attempted usurpation of power, if you do not see attempted usurpation of power, vote on 0800, 211 382, ​​all calls to these the numbers are free, at the end of the program we will sum up the results of this vote, what are we asking anyway... why did we start asking you about this, dear tv viewers, in the magazine spygen there was an article about the situation in ukraine, the german weekly took comments from the mayor of kyiv, vitaliy klitschka, and the mayor the capital of ukraine says that there are signs

that an autocracy is forming in ukraine , that is, the power of one... one person or some group of people who are trying to take all the power into their hands, although we understand that after 2019, the year presidential and parliamentary elections, when it was formed by a monomajority in the verkhovna rada, this monomajority appointed its government, in fact there is a monomajority in ukraine, with the beginning of the great war, from february 24, 22, when martial law was introduced, it is clear that all the concentration of power was concentrated in the hands of the supreme commander -in-chief of the armed forces of ukraine volodymyr zelenskyi, but now , when a certain time has passed and questions have arisen from representatives of local self-government bodies to volodymyr zelenskyi and

volodymyr zelenskyi, or to the commander-in-chief of volodymyr zelenskyi's team. armed forces of ukraine valery zaluzhny, conversations began about the fact that the current government is trying to take on a little more than it needs, and that in what conditions, in the current situation, it is very important to preserve unity, because our unity is the key to victory over russia, only in unity we can defeat putin and the russian occupiers. people's deputies of ukraine volodymyr vyatrovych from european solidarity are visiting the verdict today. mr. volodymyr, i congratulate you and am glad to see and hear you. good evening, vitaly bezgin, people's deputy of ukraine from the servant of the people. mr. vitaly, i'm glad to see you and thank you for joining our

broadcast. and we are waiting for the inclusion of solomiya bobrovska, people's deputy of ukraine from the voice party. well, since gentlemen, we are already here began to ask our tv viewers whether they see signs or attempts to usurp power, i will also ask you, since you are people 's deputies of ukraine, and you know for sure, or have more information about us than our viewers, but i repeat once again, we are asking this question solely due to the fact that it has now begun to be publicly discussed in the world and european press. in particular, vitaliy klitschko stated in spiegel that there is a threat of autocracy in ukraine. let's start with mr. volodymyr, mr. volodymyr, i have the floor. well, unfortunately, such threats are in the current government were even before the start of a full-scale war, and it is impossible to say that a full-scale war completely eliminated them. moreover, we see that

even sometimes the circumstances of a full-scale war, during these one and a half years, give some, probably for some. authorities an additional temptation to take advantage of this in order to concentrate power even more tightly in their hands, we are talking about the situation in the media in particular, we are talking about a single marathon, we are talking about the same foreign business trips, which are usually quite alarming bells, regarding , that with democracy in unfortunately, everything is not so good for ukraine. mr. vitaly, what do you say about this, you are a representative of the monopoly power and it is probably more difficult for you to talk about whether there is an autocracy or... usurpation of power in ukraine or not, but still, i think, mr. serhiy, that what is now we are on your channel live, we have an opportunity. in fact, discussing this with you and with the channel, which behaves absolutely democratically and has democratic rhetoric, and with mr. volodymyr, whom i respect, with whom we

are absolute ideological allies in some issues, opponents in some, is a sign that ukraine is a democratic and not an autocratic country, that's why i think that such accusations by mr. kyiv city mayor are unfounded political accusations, i don't think that he acted wisely. voicing such things , especially at the international level, because we must understand that ukraine, yes, winning this war, must not lose itself internally, and yet, when we defend democracy, the european way of life, probably the most important thing for us to preserve democratic institutions within, although it is clear that any martial law, some processes are being centralized , this is not inevitable, it is great that we are discussing this on the air of the tv channel, it is a pity, it is true that we are not in t2, from where we were thrown out in the spring of 22, but, as they say, in galicia there is less with that, solomiya bobrovska joins our broadcast, people's deputy of ukraine from the voice, ms. solomiya, i congratulate you and

i am glad that you are with us today. glory to ukraine, congratulations to the heroes. glory, with vitaly bezgin and volodymyr vyatrovych we have already discussed the survey, or rather the answers, i received on our survey, which we are conducting today, among our tv viewers, we ask them about that. do they see attempts to usurp power in ukraine, do you see such attempts? i see very bad trends, which can lead to such unpleasant things for ukraine, and after usually after such already red beacons, things are really happening in ukraine that are beyond the control of either the president or those who are trying to build a vertical , but in fact, what i don't like the most is political interference. higher command, here i am absolutely categorical about this and i understand absolutely clearly that if you can silence the military, you can silence certain people's deputies, you can

silence the armies, the families of prisoners of war or the families of the dead, it can all be done with everyone, but there are for example, it is very strange that there are people, or members of parliament, whose mouths cannot be closed, and perhaps it seems to me that this is such a nature, which is not explained by anything, it is currently more threatening to me, threatening and incomprehensible and absolutely strange behavior, which is impossible to explain, and of course, i cannot touch on the subject of graduation abroad and how the police can go abroad for meetings, in particular with pro-government orban deputies and be absent 207 days out of 365 in ukraine, i want to remind you, i want to remind you, that the government cannot control the supreme council and the parliament regarding travel abroad. the occasion will be a business trip or a personal trip, respectively, such things, this, too, is a scenario of certain good trends that can actually lead to usurpation. thank you, mrs. solomia, ot

klitschko in this interview, he said that at the beginning of the great war, since february 24 , 2022, he never once spoke to president zelensky and did not have any contacts, mr. vitaly, i know that you you communicate quite actively, with representatives of different regions, and local self-government is basically your topic, and you clearly understand what is happening locally, why in your opinion, the same klitschko complains that representatives of local self-government do not contact, or the president is not in contact with them, and i am like now this contact takes place, why, in principle , does the central government remain central, and the local self-government itself remains with its own problems and with what it has at its level? well, here the first thing must be said, after all, it is normal that local self-government somewhere solves the problems of the basic

level, the central government should focus on its problems, regarding the communication of individual representatives of self-government with the president, well , let's say, the president during a full-scale war is supreme commander-in-chief, if we are talking about the president's team, we have, because we have monopolies, we have a profile pair that embraces local self-government, we have a profile ministry with an entire vice prime minister, and we directly have a deputy head of the president's office who is responsible for regional policy, i think that if we are talking directly about the office of the president as an institution, then with the arrival of oleksiy kulebo, there are no problems in communication between local self-government and this branch of government, as for vitaliy klitschko's theses, i think that separate political positions. kyiv mayor from the positions of all local self-governments. actually, before our event today, our broadcast today, we had an event, in particular with european partners, where

representatives of all associations were present. self-government, at which , in particular, it was announced that today vitaliy klitschko announced to our european colleagues that we have 128 heads of communities to be removed from their posts, which is an absolute lie, and it is impossible to choose another word, why is he making these political remarks, i don't know but i think that this definitely does not contribute to unity, which is one of the topics of today's broadcast and a sure guarantee, including the success of ukraine, despite the fact that yes, we have problems in some specific things, and of course, due to budget problems, we sometimes you have to find difficult compromises with local self-government, as a person who personally traveled through six regions during the past two weeks, from kherson to lviv oblast, khmelnytskyi oblast, i do not see critical tension that could exist, especially in the state of current issues, in particular the budgetary , which exists in ukraine as a result of russia's attack on us full-scale, so i am clear for myself,

including a person. which will take control of the team individually for decentralization from the borderline position of a separate vitaliy klychka, the mayor of kyiv, from the position of local self-government in ukraine, although i admit that there are cases that i also do not like, thank you, mr. vitaliy, mr. volodymyr, please , if possible, i really would not like us to focus exclusively on kyiv, i will give another example, an example that i know well, due to the fact that i know this person well, so i will give the example of chernigov, we are talking about acting mayor oleksandr lomak, whom i know well as an activist from the orange revolution of 2004, an activist of the revolution, dignity, and it is obvious that he became acting of the mayor's duties, precisely because, in a very strange and far from legal way, the city manager was removed from the management of the city, then the adventures began, which consisted in the fact that the central government tried in every possible way to create in the city,

to stop the activities of local councils, to create a military administration, to transfer all the powers from the local authority of the local council to the military administration, for this, searches took place, for this the deputies of the same oleksandr lomako were detained, repeatedly searched, criminal cases were opened, and this is definitely not something that resembles some cooperation or attempts to cooperate with, local self-government and central. let me remind you that we are actually talking about the city that heroically defended itself last year from the russian invaders, from the russian aggressors who tried to seize this place, we are talking about those people, directly, like oleksandr lomakov, who participated in the defense of this city, now for about a year they have been trying to repel attacks precisely from kyiv, from the central, from the central authorities, who are trying in principle in manual mode , simply break the local self-government there

, there are no reasons, no grounds for liquidation, there is no suspension of the local government there, except for the desire, again, the authorities to establish their control over this specific body of local self-government, well, here it arises, sir sergey, i will have a reply right away , please look, i’m saying, i don’t like the chernihiv case, but let’s have such a government, the government, sir, the mayor of chernihiv was removed by the court, not because of some general authority . through the court, although it is not clear to me, this is a court decision, i speak honestly about it, now regarding the taking away of powers from the local self-government bodies in chernihiv, it did not happen, because in order for this to happen, you and i understand very well that the parliament has only the verkhovna rada can make the appropriate decision the authority to take away, in fact, has the possibility to take away the authority from the local council and transfer it to the military administration, you and i did not do this, why did such

a rule arise. mr. volodymyr, do not interrupt why such a rule appeared in our legislation, because in march of the 22nd year, when we changed the legislation on local self-government during martial law, we, including me personally, personally with your colleague by faction artur garasov, issued a rule that the transfer of powers without a decision of the parliament is impossible, it was by the way, then the work of the servant of the people and european solidarity is joint, therefore, despite the existence of a court decision and a rather complicated and strange case, which definitely does not brighten the history of local self-government, i would ask that we do not complicate things and do not talk about that some kind of general power is bad, yes there is a court precedent, bad judicial practice, and i don't like this case either, but nevertheless it does not mean about criticality, usurpation or any similar things, thank you, but there are a lot of questions... .