While the government is directly involved in treating COVID-19 in Abkhazia, most often, a diagnosis means a heavy financial burden on the shoulders of the patient's family.
‘[When the PCR test confirmed coronavirus], I went to the outpatient centre, which was opened in Sukhum by MP Alkhas Jinjolia. Now this centre is supported by the Ministry of Health and COBERM [an EU and UN project in Abkhazia], as far as I know’, says Nadezhda Borovikova.
Borovikova, a resident of Sukhum (Sukhumi) told OC Media that she spent just over ₽3,000 ($40) on COVID-19 treatments.
‘All the services there are free of charge. They hook you to an IV, give injections and consultations’, said Nadezhda. ‘But for the medicine itself, you have to bring your own. From the more expensive medicines, I only had to buy vitamins and a hepatoprotector. Five IVs cost me ₽500 ($6.90)’.
But not everyone is lucky enough to recover with these treatments.
Alias Ubiriya, also a resident of Sukhum, did not sign up for a free PCR test when he suspected he had coronavirus; he said it can take up to 3–5 days to make an appointment with your doctor and then get tested. In order to save time, Alias went to a private laboratory where he paid ₽2,500 ($34) and got his results in a day, confirming he was infected.
Just like Nadezhda, he first went to an outpatient centre. There he was hooked to three IVs. But his temperature continued to rise, and the attending physician insisted on a CT scan, which also cost Alias ₽2,500 ($34).
The CT scan showed only 10% lung damage, but his symptoms continued to get worse with each passing day, and the doctor suggested hospitalisation in the Gudauta COVID centre.
There, Alias’s family had to buy him an expensive drug, Ilsira for ₽55,000 ($750). When it became clear that the treatment was not working, they bought Actemra, an immunosuppressant, for ₽140,000 ($1,900).
‘There are no expensive drugs in the public hospitals’, says Alias’s spouse, Inna. ‘Doctors are exhausted and do their best, but if there is no medicine, no amount of attention will help’.
‘I had to stay in the hospital to look after my husband. After the Actemra IV drip, he needs to lie on his stomach with a catheter for three days. He needs someone to take care of him, and there are not enough medical workers. So I stayed here at my own risk and peril’.
Almost all patients with moderate and severe cases of COVID-19 have relatives staying with them in hospital. Gugutsa Vardania, a journalist for a local TV channel, takes care of her mother. Every day she uploads photos and stories to Facebook showing hospital life, and how difficult it is for the doctors.
A lack of facilities
More than 4,000 people are currently ill with COVID-19 in Abkhazia, and around 200 new cases are detected every day. So far, 307 people have died during the pandemic. However, the statistics do not include those who went to Russia or Georgian government-controlled areas for treatment.
Vaccination is offered in Abkhazia free of charge, however, all 6,500 doses of the Sputnik V vaccine sent by Russia have now run out, and it is unclear if or when a new shipment will arrive. According to MP Alkhas Jinjolia, he has received information that there will be no more humanitarian supplies from Russia. He intends to ask for help from international organisations.
Several MPs have criticised the government’s response to the pandemic. According to MPs Valery Agrba and Garry Kokay, despite doctors struggling to cope with the number of COVID patients, additional funds have been delayed since May.
Not everyone is lucky to be in the hospital at a time when all the necessary medications are available. However, more often than not, there are drugs in the hospitals that are sold to patients.
‘There are now two bottles of Aktemra in the refrigerator of the hospital, but they don’t belong to the hospital and cost ₽140,000 ($1,900) each. This is what the doctor said when she offered to sell it’, says Alias’s spouse, Inna.
An employee of the Ministry of Health of Abkhazia told OC Media that people travelled to buy such medications to sell on.
‘Many go to Georgia, take several bottles of Turkish-made medicines and bring them here. In Russia, they’re already scarce, you can't just buy it, they’re sold to those who need it. This is essentially a black market, but on the other hand, it's good that there is at least some opportunity to buy medicine’, they said.
According to Health Minister Eduard Butba, the ministry buys expensive drugs, but they are sold out faster than a hospital pharmacy is being updated.
‘There are certain criteria for prescribing these drugs … this is decided by a council of doctors on the spot’, Butba said in an interview with local tv station Abaza TV.
Butba noted that if there is a drug in question in the hospital, then it is prescribed, if not, then relatives are notified about this. According to him, all the drugs are traceable and there is no question that hospital medicines are going to the black market.
In addition to drugs, COVID-19 patients often require periodic testing. Most of the tests can be taken free of charge. In Sukhum, a general blood test and a coagulogram are done at the Infectious Disease Hospital. But there are some blood tests that are only checked in private laboratories.
Because of the high number of tests being carried out and limited laboratory facilities, patients sometimes spend from ₽5,000–₽10,000 ($68–$140) several times during their illness to monitor their main vital signs.
The Ubiria family say they are not yet thinking about how they are going to pay off the ₽200,000 ($2,700) in debts incurred from Alias’s treatment; for now, the main concern is for him to get well and get out of the hospital.
The primary geographic terms used in this article are those of the author’s. For ease of reading, we choose not to use qualifiers such as ‘de facto’, ‘unrecognised’, or ‘partially recognised’ when discussing institutions or political positions within Abkhazia, Nagorno-Karabakh, and South Ossetia. This does not imply a position on their status.