Dr Semyon Galperin spent a decade in medical research in Russia and as much time in the United States, working at top hospitals and research companies.
Despite his expertise, Dr Galperin was recently given a stark ultimatum from the Moscow hospital where he works: leave or stay on as a lowly hospital attendant.
Dr Galperin’s job is being eliminated as part of a sweeping reform in which at least 28 Moscow hospitals are to be closed and up to 10,000 medical staff sacked, an overhaul that officials say is needed to modernise a decrepit Soviet-era health system. On Sunday, thousands of doctors and their patients are set to march against the reform as part of the first mass social protest in Russia in nearly a decade – a threat to President Vladimir Putin, who faced down a wave of political protests launched in 2011 and is now struggling with a faltering economy.
The doctors’ rebellion started early this month, when thousands took to the streets to protest against the redundancies and hospital closures. Aware of the potential fallout from this protest, last week Mr Putin asked the Moscow government to reconsider the reform as his human rights council hosted a round-table discussion with prominent doctors and trade unions that were not consulted when the reform was launched.
At Moscow’s Hospital 11, Dr Galperin is vowing to stay on even if that means working as an attendant: “I can’t leave work because we decided to fight till the end.”
Moscow officials say they are only complying with a 2010 Russian law designed to help hospitals complete a transition from the Soviet-era economy and make them self-reliant by cutting budget subsidies to a minimum. Moscow Health Care Department spokeswoman Elina Nikolayeva defended the loss of jobs as inevitable: “Some of the doctors who are being fired are underqualified. Some of them don’t have enough workload.”
The doctors’ unrest is particularly problematic for Mr Putin because almost all of them are state employees – the core of his support base. Moscow officials are carrying out the healthcare reform in order to make good on Mr Putin’s election pledge to boost the livelihoods of public servants – including a vow to make doctors’ salaries twice that of the average employee by 2018.
Ukraine crisis: A timeline of the conflict
Ukraine crisis: A timeline of the conflict
1/22 30 November 2013
Public support grows for the “Euromaidan” anti-government protesters in Kiev demonstrating against Yanukovych’s refusal to sign the EU Association Agreement as images of them injured by police crackdown spread.
2/22 20 February 2014
Kiev sees its worst day of violence for almost 70 years as at least 88 people are killed in 48 hours, with uniformed snipers shooting at protesters from rooftops.
3/22 22 February 2014
Yanukovych flees the country after protest leaders and politicians agree to form a new government and hold elections. The imprisoned former Prime Minister, Yulia Tymoshenko, is freed from prison and protesters take control of Presidential administration buildings, including Mr Yanukovych's residence.
Genya Savilov/AFP/Getty Imageses
4/22 27 February 2014
Pro-Russian militias seize government buildings in Crimea and the new Ukrainian government vows to prevent the country breaking up as the Crimean Parliament sets a referendum on secession from Ukraine in May.
Sean Gallup/Getty Images
5/22 16 March 2014
Crimea votes overwhelmingly to secede from Ukraine and join Russia in a ballot condemned by the US and Europe as illegal. Russian troops had moved into the peninsula weeks before after pro-Russian separatists occupied buildings.
6/22 6 April 2014
Pro-Russian rebels seize government buildings in the eastern cities of Donetsk, Luhansk and Kharkiv, calling for a referendum on independence and claiming independent republic. Ukraine authorities regain control of Kharkiv buildings on 8 April after launching an “anti-terror operation” but the rest remain out of their control.
7/22 7 June 2014
Petro Poroshenko is sworn in as Ukraine's president, calling on separatists to lay down their arms and end the fighting and later orders the creation of humanitarian corridors, since violated, to allow civilians to flee war zones.
8/22 27 June 2014
The EU signs an association agreement with Ukraine, along with Georgia and Moldova, eight months after protests over the abandonment of the deal sparked the crisis.
LOUISA GOULIAMAKI/AFP/Getty Images
9/22 17 July 2014
Malaysian Airlines flight MH17 is shot down over eastern Ukraine, killing all 298 people on board. Ukrainian intelligence officials claim it was hit by rebels using a Buk surface-to-air launcher in an apparent accident.
10/22 22 August 2014
A Russian aid convoy of more than 100 lorries enters eastern Ukraine and makes drop in rebel-controlled Luhansk without Government permission, sparking allegations of a “direct violation of international law”.
11/22 29 August 2014
Nato releases satellite images appearing to show Russian soldiers, artillery and armoured vehicles engaged in military operations in eastern Ukraine.
12/22 8 September 2014
Russia warns that it could block flights through its airspace if the EU goes ahead with new sanctions over the ongoing crisis and conflict
13/22 17 September 2014
Despite the cease-fire and a law passed by the Ukrainian parliament on Tuesday granting greater autonomy to rebel-held parts of the east, civilian casualties continued to rise, adding to the estimated 3,000 people killed
14/22 16 November 2014
The fragile ceasefire gives way to an increased wave of military activity as artillery fire continues to rock the eastern Ukraine's pro-Russian rebel bastion of Donetsk
15/22 26 December 2014
A new round of ceasefire talks, scheduled on neutral ground in the Belariusian capital Minsk, are called off
16/22 12 January 2015
Soldiers in Debaltseve were forced to prepare heavy defences around the city; despite a brief respite to the fighting in eastern Ukraine, hostilities in Donetsk resumed at a level not seen since September 2014
17/22 21 January 2015
13 people are killed during shelling of bus in the rebel-held city of Donetsk
18/22 24 January 2015
Ten people were killed after pro-Russian separatists bombarded the east Ukrainian port city of Mariupol
19/22 2 February 2015
There was a dangerous shift in tempo as rebels bolstered troop numbers against government forces
20/22 11 February 2015
European leaders meet in Minsk and agree on a ceasefire in eastern Ukraine beginning on February 14. From left to right: Belarus President Alexander Lukashenko, Russian President Vladimir Putin, German Chancellor Angela Merkel, France's President Francois Hollande and Ukrainian President Petro Poroshenko.
MAXIM MALINOVSKY | AFP | Getty Images
21/22 13 February 2015
Pro-Russian rebels in the city of Gorlivka, in the Donetsk region, fire missiles at Ukrainian forces in Debaltseve. Fighting continued in Debaltseve for a number of days after the Minsk ceasefire began.
ANDREY BORODULIN | AFP | Getty Images
22/22 18 February 2015
Ukrainian soldiers repair the bullet-shattered windshield of their truck as their withdraw from the strategic town of Debaltseve. Following intense shelling from pro-Russian rebels, Ukrainian forces began to leave the town in the early hours of February 18.
Brendan Hoffman | Getty Images
Moscow healthcare officials are focusing on promoting neighbourhood clinics that will provide comprehensive care and keep people out of hospital beds. The reforms were not discussed with the medical community and the details only became public in October following a leak to the press.
At Hospital 11, where Dr Galperin works, 136 out of its 320 medical staff, mostly doctors, were given the notice and the hospital is to be closed by April. Asked about the hospital’s closing, the Deputy Mayor Leonid Pechatnikov told a session of the presidential human rights council last week that the hospital “monopolised” the treatment of multiple sclerosis in Moscow, making it impossible to get treatment elsewhere. Dr Galperin and his colleagues say they provide multiple sclerosis treatment that cannot be obtained elsewhere in Moscow. Their suggestion to set up a multiple sclerosis clinic on the grounds of the hospital to keep the expertise and equipment in one place has not received a response.
The presidential human rights council has called for a halt to the redundancies and insisted that the reform violates a constitutional right to free healthcare.
Ales Kochevnik, 29, was diagnosed with multiple sclerosis two years ago. Treatment allows her to live a more normal life, albeit one interrupted by fits that can leave parts of her body temporarily paralysed. “They taught me to walk five times,” the artist says of Hospital 11. On a recent afternoon, Ms Kochevnik went to Red Square to lay down on its pavement in protest. Supporters stood by, each carrying an IV drip. One held a poster reading: “A hospital without doctors is a mortuary.”