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The urgency of justice
Written by   
, 06 2004

By Galina Mursalieva

In Novaya Gazeta

DR. ROSHAL: We have not even begun to heal the human tragedies in Russia

ImageTheres a bottom rung being put on the social ladder. Thats the impression that Im getting. They tell me that theres no bottom rung, that its simply the marketplace, another country, different conditions, and that everythings different now. But Id like to know how its different? I was, by the way, chairman of the coordinating medical council for the White House (Russian parliament building) defenders in 1991, Icouldve died, as could everyone there. Who knew how it would all turn out back then? And Ishould know: what was it Icouldve died for? Later it all turned out so monstrous, just take a look at our industry, at agriculture, at public health

Public health, certainly, worries the man speaking more than anything because he is a physician. What have they not called this doctor? He is the worlds pediatrician, and an FSB officer, and a national hero, and

The man Iam speaking with is a member of the Presidential Human Rights Commission, which he entered even before Nord-Ost. He is the director of the Moscow Research Institute on Urgent Pediatric Surgery and Trauma, a professor, and a doctor of medical science. He is the legendary Leonid ROSHAL.

I dont want to turn things back. I was 55when for the first time in my life Ileft the country! Perestroika opened up the world to me, but the country the whole time was solving tactical problems, while there was no strategic thinking going on. Here, take a look at these papers Dont you see? The World Bank in 2002allotted Russia only 336million dollars for public health. And one of the projects here is public health reform, so everything that we see is being done with the International Banks money. The Strategic Research Center is using this money and its mainly the economists doing it, not the physicians. Certain people are dictating how you and Iare going to live, and in such a way theyre introducing ideas foreign to us about public health.

But, Leonid Mikhailovich, money is money it cannot hurt public health.

In the first published project on the Russian Ministry of Health website we were supposed to destroy all childrens polyclinics and obstetrical-gynecological advice bureaus. I spoke to the president about this. I said that Article 41of the Russian Federation Constitution guarantees free medical service in government and municipal facilities. If theres a desire to do something else, then it means that one must first change the constitution. We are now preparing a working conference where, in part, well discuss the legislative project concerning government guarantees of medical assistance. There well also discuss laws related to public health.

Its planned for the Minister of Public Health and Social Development, Mr. Zurabov, to speak first, and share his thoughts and conceptions on development. Later, perhaps, Ill speak if they let me. Then well divide into 23groups and move to different rooms: village medics, physicians in out-patient clinics, emergency medical specialists, heads of city hospitals, chief physicians in polyclinics, heads of district, regional, and republic hospitals, directors of research institutes, and theyll give their expert evaluation on everything that is going on, and work out specific plans.

Am Ito understand that these groups will either support you, or Zurabov?

What do Ihave to do with it? Before Zurabov there was Minister Shevchenko, against whom Ispoke rather sharply. Now theres Zurabov and our relationship, unfortunately, also has some misunderstandings. I still cant understand where hes trying to take us. People ask me: What sort of minister is it that you need? I need one wholl answer for public health, and, it follows, wholl make sure the people of Russia dont suffer another great catastrophe. Im hoping that therell be a reasonable compromise found at the conference, a compromise between the government and the public.

You are speaking like a specialist about an urgent condition?

Exactly! Our public health needs urgent assistance! Now here this conference will take place with the participation of the Ministry of Economic Development and Trade, the Ministry of Finance, as well as the Strategic Research Center. We hope to receive a truly expert evaluation of what has already been done and what is being done. Well ask colleagues: what are the most serious problems, in your view, that need solving? What kind of financing is more rational? Would a system of directing and organizing public health bother you?

I personally believe that the creation of a new Ministry of Public Health and Social Development is a blow to medicine, because we have lost professional vertical management (of public health). We have suffered many misfortunes in the administrative reforms as they are now presented in public health. Its simply that the people who made these reforms didnt have elementary knowledge about the organization of public health. Their motto was: lets wreck everything, and later One cant play such pranks on the nation. But a shortage of x-ray film? The provision of technical resources? Not long ago Iread a document from the accounting department: 80percent of the medical devices in the country have become unfit for use. But Zurabov assures me in front of the president that public health needs no more money He doesnt see the mechanism, how they can be wasted. He laughs, and thats all. Im very frightened when people think in macro-categories, because they cant imagine the social consequences of their own ideas, even if they are brilliant. So here Zurabov maintains that a budget prevents the head of an organization from working. But Im the director of an institute, the budget doesnt bother me one bit. What bothers me is when theres no money in the budget. At a conference he asked me: Do you want me to go to a medical institute? As if physicians dont know how to handle money, that only financial officers and economists can.

But you know how?

Every hospital chief physician, who in the course of this decade has twisted in the wind due to lack of money, who managed to preserve little islands of normal public health, can out-do any financial officer. And Im against them making behind the scenes decisions that in the end affect terribly the level, the quality of medical service. I dont worry about pay as you go medicine and Ihave nothing against it. But let it be for those who can pay for the service, let them have two toilets for every person, two televisions, even three if they need it. BUT IWANT THE LEVELS OF DIAGNOSTICS AND TREATMENT IN PAY AS YOU GO AND FREE MEDICAL FACILITIES TO BE THE EXACT SAME. Especially in the medical care of children. With joy they bring out the numbers, that 40percent of the money spent on public health comes in from extra-budgetary sources, i.e.: from pay as you go medicine. They say, how nice: extra-budgetary expenditures will increase, while budgetary ones will decrease. But the budgeted expenditures serve millions, while the pay as you go serves only a few thousand rich people, and each person from those thousands, of course, uses up more money than someone from the millions. So how can the financial people and the economists even bring up such numbers? They cant even evaluate an indicator of public health in the GNP, which is two times lower than international standards.

You butted heads over questions of management and organization of governmental public health. I can imagine how important this is, and how much work went into it. How did you shift gears after Beslan?

This is work, a specialty. Catastrophes and terror acts are for me a continuation of my usual life. They once asked me: did my life change after Nord-Ost? But the year of Nord-Ost, before this tragedy Iflew to Afghanistan 3times after the earthquake, Iwas in Israel where theres the Intifada, Iwas in Kaspiysk where there was a terror act on May 9th. I live this way my whole life, Im always doing urgent matters, and so Idont have any kind of daily routine. I cant plan a trip to the theater, Inever know if Ican be at a friends birthday. I often get home at 1or 2 in the morning, and Iget up at 7am.

Before Nord-Ost and especially during those days you were an absolute hero in the eyes of the public. Your moral authority was not doubted by anyone in the country. But later you went over to the authorities side, why? Why would you, a person with a worldwide name, need this?

In our society, to have ones own independent opinion or judgment is difficult they beat at you from one side or the other. But its important either way not to lose face, not to fake it. Im an independent person, and, if Isee injustice, right away Ill speak about it, no matter how itll be taken. Its been said: Putin wanted to kill the hostages! But this is a lie, and absolute lie, Isaid so and heard: Ah, hes speaking on the presidents behalf! Lickspittle! But at the same time there were the signatures of thousands of simple people who voted to award me the rank of Hero of Russia. Average readers, everyday readers of Arguments and Facts, they chose me as the The National Pride of Russia. This means that they understand that everything Ido, Ido as an independent person who feels the urgency of justice.

People died from the gas, but you said that the gas was harmless

I didnt say it like that. I said that you couldnt call the gas lethal. In that case, all gases we use for anesthesia need to be called lethal. Theres a huge difference between this and the gas that the fascists used to suffocate innocent people in gas chambers. Theres this understanding of individual tolerance. In operating rooms we also work with narcotic gases. We use them for analgesia. Any anesthetic, including the use of Fentanyl, sometimes people, to our great misfortune, die from the anesthetic. This is well known in medicine. At Dubrovka 130people died. This is awful. Now Ill use the terrible definition medical losses. They are calculated in wars, catastrophes, and earthquakes. Theyre greater in number, and more tragic, but if the gas hadnt been used, then all 800people wouldve been blown up.

But everyone knows that Barayev and his people at the moment of the assault were not preparing to blow up anything.

You couldnt negotiate with them, check for yourself, Italked to them more than anyone else. They practically held me hostage when Iwent there the first time, and Isat up there with everyone on the balcony for six hours. I was saved by an English journalist who asked: Where is the doctor? They said: He left. And then the journalist started talking about me. How Iwas the worlds pediatrician, how Itreated all kinds of children, and even saved Chechen kids. And they let me go. When Iwas leaving Iasked if theyd let me in another time, and Iwas happy when they replied in the affirmative. Because while Iwas sitting there all those hours Iwas able to ask everyone who needed what: someone needed to change contact lenses, someone asked me to get feminine hygiene packets, someone else medicine. And two hours later Ireturned with medicine. And then Irepeatedly brought in everything needed.

One preacher on his website wrote: Judas Roshal did not bring medicines to the hostages, but poison, he wanted to poison all the hostages. What, should Isue him in court? Never.

By the end of the third day the terrorists began to get nervous. This is for sure. On the last night they killed one and mortally wounded another, while they managed to save a third woman, a pediatrician.


Are you serious?

Ill repeat once more that Im asking you to believe it. Id answer yes. Because Id see in it a chance at life, while otherwise, no, Iwouldnt see

Otherwise, for example, the withdrawal of forces from Chechnya?

Chechnya is a complicated matter. Im one of the first, from the start, in an interview on NTV with Boris Koltsov at Urus-Martan during the first Chechen war Iwas strongly against this war. But then there was Budennovsk. And what? Was there less blood?

But at Nord-Ost they destroyed them, and what? Did Beslan not happen?

You must try to negotiate with terrorists, but you can never come to their decisions. The French, who refused to fight in Iraq, found themselves in a difficult situation. They had journalists kidnapped there and they gave in and paid a huge ransom. You pay and then tomorrow theyll kidnap others. You dont pay and they cut off heads. And then how can president look into the eyes of the French people?

You know what terrorism is to me? Here, Ive asked myself this question. Is it shahidki (suicide martyr women) wrapped up in explosives belts? But back during the Great Patriotic War (WWII) they went up to enemy tanks all covered in grenades, and these are our national heroes. Were they terrorists or not? No. Terrorism is when innocent people die. People die sometimes who are of the same faith, even the same political persuasion. There was a hostage at Nord-Ost named Fatima Shakhova, a Moslem woman. Shes a physician and did much good there. I found all the doctors who were there, who saved others; Ishowed the people that they were heroes. Everyone received the Order of Courage, and one posthumously, but not her.

How do you explain this?

I cant find any other explanation, other than stupidity and foolishness. I wont rest until shes decorated, Ill write to the presidents administration over and over. She shouldve been decorated first! But Ihad to put my name on the line to get her away from the interior ministry, to convince them that she wasnt with the terrorists. Afterwards she defended her masters thesis brilliantly, but then one of the big papers went and buried her as a terrorist. Later they issued a retraction. They gave me the job title of FSB officer; go read Chechen Press on the Internet. There they wrote: FSB colleague Doctor Roshal. Then this newspaper with great pleasure started to exaggerate about everyone who had a bad relationship with me before this. It was specially planted; they wanted to put me down. Though its true that one friend of mine before Chechen Press said for everyone to hear that had he been a terrorist, he wouldnt have let me go, since Iknow too much. Later at one of the conferences Imet Patrushev and Isaid: Say hello, Iam one of your new colleagues. Tell me, what FSB officer could tell Putin in the presence of the prosecutor general and the armed forces ministers that he didnt agree with the arrest of Khodorkovsky? Not long ago Ispoke out loud against an impermissible declaration by the prosecutor general, that they needed to arrest a terrorists entire family. Its simply awful to hear this from a prosecutor.

Officers from the FSB during Nord-Ost offered to put a micro-camera in my buttonhole. I refused. By the way, the terrorists later searched me and looked from this micro-camera, even in my stethoscope, to say nothing about buttonholes.

But they say that at Beslan you confiscated film from journalists. It this true or not? Did it happen?

Its true. I didnt just confiscate film, but held negotiations with the terrorists, made ready the medical facilities for the possible arrival of wounded, and repeatedly consulted on all 200wounded children in Vladikavkaz. But Ireally confiscated the film. This is the absolute truth. I was ready to kill one of them!

A journalist? For what?

Imagine this: theres a huge flow of wounded, horror, hurrying around, seriously ill Im out in the street in front of the admissions department, and Im looking at the wounded, deciding, with the other physicians, who needs to get into intensive care right away, who to send to the operating room. The people are in a panic, vehicles are arriving one after another, bringing in more and more victims, and here at the worst time this Russian journalist, representing, it turns out later, some American company, gets right in the blood with his camera. Heres the blood and heres the camera. I lost it and shouted: What are you doing?! Whoare you?! Giveme that film! It was shameless! I still have this film, by the way, and Ican show it to you if you wish. There were also the boys from RTR and NTV taking pictures, but from further away. They conducted themselves a bit more delicately. I also confiscated their films so that they couldnt say: He confiscated from some, but not from others. But when things had calmed down that night, Ireturned them all to them that very same day. There was another group that was working impudently, cynically. I couldnt confiscate their film: they were four big strapping men and a camera operator, so physically Icouldnt. They wouldnt even identify themselves. They didnt say what channel they were from. They said something about me not wanting the world to find out whats going on here. No tears, just like robots. The people there were crying, they couldnt endure it all, and in place of assistance, participation, and sympathy there were all these journalists pointing television cameras at their mutilated children. Thisis inhumane! I had to act this way. From the point of view of ethics, at the very least.

Here you speak about ethics, but let us once again return to the events of two years ago, to the moment when, Iwill say straight out, my disappointment in you, the legendary Doctor Roshal, began. Remember: people were rushing about the morgues, looking for their loved ones, while the authorities at the time were giving medals to Chekists who successfully coped with the hostage rescue operation Then you got a medal, and you handed your medal to the president. From the standpoint of ethics, what was this?

Lets put things in order. The president gave me an award several months after what happened, and no one was rushing about the morgues. I had already buried two kids and was howling at the cemetery like a Beluga. Further: Ibelieve that Ididnt do anything spectacular and that they were decorating me for nothing. Every person can judge my act for himself, depending on his desire. Not a single Chekist received an award alongside of me. Kobzon was decorated along with me, but my lifes ethnics even before Nord-Ost and after Nord-Ost and before Beslan and after Beslan, well, Im not ashamed of them.

Listen! It seems that the whole time here Im just making excuses for myself. Ive never done this before in my life, and Ive nothing to make excuses for. I decided to answer all your questions openly. As far as disappointments in life, well, unfortunately they happen. What to do about it? Too bad.

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