arrival et. al.

Hello Everyone,

While I mean this blog to be more than just a virtual way for me to spill my guts to who ever will listen, I did want to start off with a general notice of my arrival, safety, and relative happiness. I arrived in Kyiv about a week ago, and I was taken directly to my apartment in the center of town by my company's driver-- pretty corporate for a reproductive health NGO, but I'm beginning to realize that "professionalism" is kind of distilled down to symbolic things here. And I was certainly greatful for a ride, so I am not complaining.

I live in the middle of the city, about 4 blocks from the main drag (Kreshatik street) and about 10 mintues from all of the major attractions (mostly churches... cathedrals sort of dominate the landscape. Actually the architecture here and in Russia sort of tells the story of the history of the place: there are all sorts of cathedrals left over from when the church really ran the show. These sit next to larger Soviet concrete buildings-- the ugly, gray kind-- left over from the USSR. And now all sorts of enormous glass and steel buildings are shooting up, exidence of the growing wealth (in some parts of the population) and arrival of business. Anyhow, I live right downtown in a "historical building" in a comfortable apartment with tall ceilings and big windows. It's pretty chilly right now, since the city does not turn on the municipal heat until mid-October. My roommate is great, very easy to live with.

My job is proving to be a lot different than I thought it would be, in a good way though. The reproductive health situation here is completely different from that in the US: the abortion rate is far higher than any other European nations or the US and there is little to no stigma attached to it. However, the majority of the population relies on traditional (rhythm method, LAM, and wihtdrawal) rather than modern (hormones, IUDs, condoms) contraceptives. The goal of the project that I am working with is to lower the abortion rate by instead promoting modern birth control, primarily the pill. (I have a little bit of a problem with this, since I have some objections to the pill and the way it is widely and irresponsibily prescribed.) This is difficult though, since the Ukrainian health care system is completely top-down and "free," meaning that doctors and buildings are paid for, but nothing else. We are trying to promote government, clinical, and pharmeceutical reform, but it is difficult when there is political chaos in general and no incentive for the system to change. The project has done quite a bit though, including training several health care practioners and pharmacists, helping to pass the Reproductive Health of the Nation Program, and establishing a partnership with pharmaceutical companies to get affordable birth control into pharmacies.

My job consists mostly of writing, and right now I am working pretty closely with a consultant who is helping the Medical Post-Graduate Institute to develop a new kind of approach to teaching health care management. It sounds dry, I know, but is actually pretty interesting. There is all this talk about how the health care manager is really the patient advocate, which is half stupid business school speak and half kind of interesting.

Another interesting point that I will elaborate on further: NO ONE speaks Ukrainian here. In fact, I spoke Ukrainian in a restaurant and got laughed at. All of my Ukrainian friends speak Russian, and so, it seems, does everyone except for the people at my nationalist-leaning university (I got yelled at for speaking Russian there... jeez louise).

In any case, this place is a trip. In the two weeks I have been here, I have seen a bar fight (some guy ripped off his shirt and broke a chair over another guy's head!), a Communist party rally (Fascism will not stand!), a Ukrainian Nationalist rally, and been snuck into a concert by a creepy-looking guy with bad teeth. So that's that for now. I'm still having difficulty understanding that I LIVE here, but I assume as more of my dreams occur in Russian and I start to curse Ukrainian bureaucracy the way the locals do it will sink in.

Rachel