Presenter: Valya is barely audible - her voice disappeared when the pain was unbearable.
Marina Meshkova, Valya's mother: She screamed every night from this pain, so much so that she lost her voice and got hoarse.
Presenter: There are seventeen courses of chemotherapy behind, but the tumour is still growing. The pain is getting worse for Valya. At such moments, the girl needs to be given morphine urgently, literally at the exact second. But between the life-saving drug and the pain in all hospices and hospitals in the country - there is such a thick stack of magazines.
Arif Ibragimov, oncologist: "Each tablet is accounted for separately, where the serial number, date, patient surname, medical history number, drug series, and drug quantity are indicated."
Presenter: Oncologist Arif Ibragimov throws up his hands – until you record everything, by law, you can't give the patient the drug because it's a narcotic. Therefore, in the cabinet with drugs, there are cameras, safes, and bars on the windows and doors.
Presenter: "First record, then take?"
Arif Ibragimov, oncologist: "Yes."
Presenter: "Is this fundamental?"
Arif Ibragimov, oncologist: "Oh."
Presenter: Sighing, speaking on this topic, the founder of the Hospice Aid Fund "Vera" Nyuta Federmesser – an extraordinary choice between "first save from pain" or "first draw up a report on the received drugs".
Nyuta Federmesser, head of the Moscow Palliative Care Centre, founder of the Hospice Aid Fund "Vera": "Ambulance stations across the country require their staff and teams so that after each injection of morphine, the team returns to the station and correctly writes off the drug, filling in all these journals. Instead of going to the next patient, the team returns to the station and deals with paperwork."
Presenter: "How much medicine did you take, how much is left, sign everywhere – 10 patients, this pair of hours of reports. If the document is suddenly filled out incorrectly, well, the person got tired, he didn't come into the profession to write, then the doctor or hospital is liable under the article "Violation of drug trafficking." The police can come with a check at any moment. The same happened with the hospice "House with a Lighthouse."
Lida Moniava, co-founder of the "House with a Lighthouse" Fund: "They found problems in how we keep these journals. For example, one of our journals was not stitched and certified, and the Ministry of Internal Affairs told us that they always find mistakes in the journals of medics, that in their experience, no one has ever kept all the journals correctly."
Presenter: "But the problem is not only in checks and fines but also in the availability of many drugs, says pediatric oncologist Alexei Maschan."
Alexei Maschan, pediatric oncologist: "If here, in the clinic, where there is access to narcotics, I can do this within half an hour, then my colleague who treats palliative patients, say, in the district, he is in a completely different situation. The days, weeks, if not months before getting adequate pain relief begin here."
Presenter: "That's why the district doctor often tries not to deal with pain relief. We are not talking only about small towns. Here is a story from St. Petersburg: Evgenia spent weeks trying to get medicine for her relative."
Evgenia Kolpachkova, patient's relative: "The problem was that we could not get prescriptions for morphine in any way officially, through the clinic. Clinics are afraid to prescribe them. Meanwhile, the patient moans, sweats, and lies with a cold cloth on his forehead."
Presenter: "The charity fund helped to negotiate with the clinic, and sometimes home palliative care services do this."
Vladimir Vavilov, Chairman of the Board of the Regional Public Charitable Foundation for Children's Aid: We will always rush to the aid - our mobile service - will relieve the pain; if not, we will try to call the clinic and prescribe.
Presenter: And what about cities where there are no hospices or separate mobile services?
Lida Moniava, Co-founder of the Fund " House with a Lighthouse":Parents of children who are not pain-free in hospitals or at home often call us. And we start to unravel all this, but indeed, doctors avoid prescribing narcotic drugs.
Presenter: And so it will be until the law admits that relieving a person's pain equates to carrying out narcotics trafficking. We need to simplify the system of accounting for narcotic drugs in hospitals and hospices.
Nyuta Federmesser, Head of the Moscow Palliative Care Centre, Founding Member of the Hospice Aid Fund "Vera": we have to fill this in, we have to teach this, every nurse of mine has to know all this. The first two pages of this order contain a list of regulations we must understand and comply with. We do not have a separation in terms of legislation between the circulation of medical and non-medical narcotics.
Alexey Maschan, Pediatric Oncologist: Until the country accepts as an axiom that the medical circulation of narcotics has nothing to do with the problem of drug addiction or drug dependence, nothing will move.
In the children's hospice " House with a Lighthouse", Valya asks her mother to put a small pillow under her legs, which are disobedient but endlessly numb. Her eyes close by themselves; she is about to fall asleep - this is the effect of painkillers. Perhaps it was to Valya's piercing scream that the nurse ran and did not finish writing something in the report, making a choice that is understandable to every doctor - first of all, to relieve the patient from the most humiliating state for a person - pain, which will not go away by itself.
Olga Knyazeva, Vlad Abbasov, Svetlana Kostina, Daria Rybakova and Sergei Prokofiev,
First Channel
Marina Meshkova, Valya's mother: She screamed every night from this pain, so much so that she lost her voice and got hoarse.
Presenter: There are seventeen courses of chemotherapy behind, but the tumour is still growing. The pain is getting worse for Valya. At such moments, the girl needs to be given morphine urgently, literally at the exact second. But between the life-saving drug and the pain in all hospices and hospitals in the country - there is such a thick stack of magazines.
Arif Ibragimov, oncologist: "Each tablet is accounted for separately, where the serial number, date, patient surname, medical history number, drug series, and drug quantity are indicated."
Presenter: Oncologist Arif Ibragimov throws up his hands – until you record everything, by law, you can't give the patient the drug because it's a narcotic. Therefore, in the cabinet with drugs, there are cameras, safes, and bars on the windows and doors.
Presenter: "First record, then take?"
Arif Ibragimov, oncologist: "Yes."
Presenter: "Is this fundamental?"
Arif Ibragimov, oncologist: "Oh."
Presenter: Sighing, speaking on this topic, the founder of the Hospice Aid Fund "Vera" Nyuta Federmesser – an extraordinary choice between "first save from pain" or "first draw up a report on the received drugs".
Nyuta Federmesser, head of the Moscow Palliative Care Centre, founder of the Hospice Aid Fund "Vera": "Ambulance stations across the country require their staff and teams so that after each injection of morphine, the team returns to the station and correctly writes off the drug, filling in all these journals. Instead of going to the next patient, the team returns to the station and deals with paperwork."
Presenter: "How much medicine did you take, how much is left, sign everywhere – 10 patients, this pair of hours of reports. If the document is suddenly filled out incorrectly, well, the person got tired, he didn't come into the profession to write, then the doctor or hospital is liable under the article "Violation of drug trafficking." The police can come with a check at any moment. The same happened with the hospice "House with a Lighthouse."
Lida Moniava, co-founder of the "House with a Lighthouse" Fund: "They found problems in how we keep these journals. For example, one of our journals was not stitched and certified, and the Ministry of Internal Affairs told us that they always find mistakes in the journals of medics, that in their experience, no one has ever kept all the journals correctly."
Presenter: "But the problem is not only in checks and fines but also in the availability of many drugs, says pediatric oncologist Alexei Maschan."
Alexei Maschan, pediatric oncologist: "If here, in the clinic, where there is access to narcotics, I can do this within half an hour, then my colleague who treats palliative patients, say, in the district, he is in a completely different situation. The days, weeks, if not months before getting adequate pain relief begin here."
Presenter: "That's why the district doctor often tries not to deal with pain relief. We are not talking only about small towns. Here is a story from St. Petersburg: Evgenia spent weeks trying to get medicine for her relative."
Evgenia Kolpachkova, patient's relative: "The problem was that we could not get prescriptions for morphine in any way officially, through the clinic. Clinics are afraid to prescribe them. Meanwhile, the patient moans, sweats, and lies with a cold cloth on his forehead."
Presenter: "The charity fund helped to negotiate with the clinic, and sometimes home palliative care services do this."
Vladimir Vavilov, Chairman of the Board of the Regional Public Charitable Foundation for Children's Aid: We will always rush to the aid - our mobile service - will relieve the pain; if not, we will try to call the clinic and prescribe.
Presenter: And what about cities where there are no hospices or separate mobile services?
Lida Moniava, Co-founder of the Fund " House with a Lighthouse":Parents of children who are not pain-free in hospitals or at home often call us. And we start to unravel all this, but indeed, doctors avoid prescribing narcotic drugs.
Presenter: And so it will be until the law admits that relieving a person's pain equates to carrying out narcotics trafficking. We need to simplify the system of accounting for narcotic drugs in hospitals and hospices.
Nyuta Federmesser, Head of the Moscow Palliative Care Centre, Founding Member of the Hospice Aid Fund "Vera": we have to fill this in, we have to teach this, every nurse of mine has to know all this. The first two pages of this order contain a list of regulations we must understand and comply with. We do not have a separation in terms of legislation between the circulation of medical and non-medical narcotics.
Alexey Maschan, Pediatric Oncologist: Until the country accepts as an axiom that the medical circulation of narcotics has nothing to do with the problem of drug addiction or drug dependence, nothing will move.
In the children's hospice " House with a Lighthouse", Valya asks her mother to put a small pillow under her legs, which are disobedient but endlessly numb. Her eyes close by themselves; she is about to fall asleep - this is the effect of painkillers. Perhaps it was to Valya's piercing scream that the nurse ran and did not finish writing something in the report, making a choice that is understandable to every doctor - first of all, to relieve the patient from the most humiliating state for a person - pain, which will not go away by itself.
Olga Knyazeva, Vlad Abbasov, Svetlana Kostina, Daria Rybakova and Sergei Prokofiev,
First Channel