Sunday, 1 April 2012

Russia’s arctic future- The heli-doctors of the tundra

The helicopters can never stay in one place for long.

I’m in an ambulance speeding away from the central hospital in Salekhard, the capital of the Yamalo-Nenets Autonomous Region in Russia’s far north. We skitter down rough, snowy tracks and pile out into a storm of icy wind. It comes from the downdraft of a helicopter’s rotas, blasting snow into our faces. I follow the doctors and am ushered urgently inside by a pilot beckoning from the door. They’re ready to go and there’s not even time to take it all in.

I am allright, by the way. As we lift up to the thrub of this Soviet workhorse’s blades I’m thinking about our destination, a tiny village even further north called Laborovaya, the kind of place you think people wouldn’t actually live in at all. But they do. A baby is sick there and the doctors have been called.

The trees beneath us are, like their human counterparts here, frontier dwellers. They’re thin and squat, starved of nutrients by the winter climate and the permafrost under the ground. They stand in wind blasted belts and clusters that diminish even further as we cross the tundra.  And yet as we fly north over the endless expanse of snow drifts, we see outposts of humanity here as well.  A village that might in the short summer be a small river port. A railway and road with a few lorries and a train picking their lonely way between distant loading points. And at last, as even the human settlements dwindle, we see our village, clinging to an elevation in the surrounding tundra.

A village in the tundra on the way north.

The last transport route we passed, with lorries and trains travelling long, lonely routes. 

Laborovaya, swept by the wind on its small escarpment.

When we touch down a local takes us on his skidoo to the village centre. Laborovaya has maybe two hundred residents but it serves a wide area as a contact point for groups of Nenets, a nomadic people who were herding reindeer here long before the Russians arrived.    

A legacy of the Soviet Union is that most of these small settlements have a small government building in them that acts as a doctor’s surgery and general administrative point. Two parents were waiting inside. One father had brought in his child with red eyes and an unknown complaint that had struck a number of times before. Another woman, Svetlana Laptander, had come from her home in a nomadic tent with her crying baby son. The baby was fine but she had problems with her breast and couldn’t feed him. The doctors decided they would all have to go in the helicopter back to hospital. Svetlana wasn’t happy about this. She’d been to hospital before. “They kept me there for a month,” she complained. “All I wanted to do was go back home. The deer need us to look after them.”

Doctors inspect this child that has been brought in with a repeat complaint of red eyes and a temperature.

Head doctor of the service Vladimir Brodsky consults with his colleagues on what to do with the children.

Svetlana Laptander and her baby son are taken to the helicopter. She's not happy about leaving her home and reindeer but agrees to go.

On the way back we saw some of the herders tents out in the tundra. We landed to meet them and check their health. They invited us inside and I saw inside the only space the Nenets have that’s separated from the snow and cold outside. Around a steaming pot on the stove seven family members sat on blankets and chatted. All were healthy enough with some family member or other regularly ducking in or out of the wind. Having established all was well enough here we were already being beckoned back to the helicopter. The pilots have a difficult time here. They can’t refuse a call if they can fly and they have to negotiate treacherous weather conditions, sometimes flying right up to the edge of Russia’s arctic coast. If they can’t fly or land the service has monster truck type ambulances called ‘trackles’ and even makes use of ex-army tracked vehicles to navigate winter storms and summer swamps to try and reach wounded villagers or herders. They don’t always succeed. The chief doctor of the regional service, Vladimir Brodsky, tells me how one of his patients died in the helicopter. And everyone in the service knows of the burnt patch of ground where a helicopter crashed trying to land, killing the doctors on board.

Our first glimpse of Nenets herders on the tundra beneath.

As we draw closer we see that the Nenets have come out to see us as well.

Vladimir Brodsky greets the herders outside their tents.

Inside the family gathers to chat, tired or otherwise.
We can only stay a few minutes before it's back to the helicopter .

 There has been controversy over whether this service is worth the effort. The Soviet Union tried to put all of its nomadic peoples into villages. They stayed for a while but their life here is governed by the movement of their reindeer herds. When their herds moved away from the villages that had been built for them, they moved away and abandoned them. Some have suggested the Nenets be encouraged, or even forced into reservations like other nomadic peoples elsewhere in the world. There it would be easier and cheaper to make sure they are well cared for, goes the logic. Vladimir Brodsky says the air medical service costs 400 million roubles (nearly $14 million) a year to run. But he rejects the idea that’s it’s a waste of money, saying that the Nenets might be hard to find but that their way of life shouldn’t be degraded. “These people work hard. They are good people with real value for Russia. The least we can do for them is to provide this service.”

Vladimir Brodsky and his fellow doctors and assistants are well used to their loud, rattling trips to the furthest reaches of the Russian far north.

When we landed I was straight back in an ambulance. The pilots had their kids to pick up from school. The patients had to be taken in to a ward for a proper checkup.  The weather doesn’t look like it’s going to get much better for Russia’s air medical service. The villages and herding camps don’t look like they’re going to get any closer. And it doesn’t seem like the pilots or doctors will have much of a let up in the pace. As I thanked the last pilot he replied, “you’re welcome, come back again.” He was smiling and content, ready to fly out once more as part of the lifeline of Russia’s north.


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