Wednesday, November 15, 2006

I hadn’t been to Kiev for a while. The last time was before the Eurovision song contest – an event of enormous symbolic importance to countries on the periphery of Europe but, I suspect, to few others.
Kiev had changed enormously from how I remembered it. It is now a vibrant European city, with shops selling a vast array of luxury (and presumably, for most people, unaffordable) goods. The McDonalds restaurants were packed and despite the cold, the streets thronged with young people enjoying themselves.
The reason for being here was to attend a conference on demography in the former Soviet Union. The conference had been put together by colleagues from Ukraine, Russia and France and provided an opportunity to get up to date on the latest thinking about health in this region. The LSHTM team (Dave Leon, Susannah Tomkins, Ellen Nolte, Francesca Perlman and myself) were presenting papers on a range of topics including premature mortality and inequalities in Russia, health care in Ukraine, and translating evidence into policy.
There were many fascinating presentations, and much to think about. The demographic crisis facing this region was encapsulated in one slide showing the predicted population growth of Vietnam and the decline in Russia, so that by 2050 the population living in the small area that is Vietnam will exceed that in the vast territory of Russia.
However, some of the most interesting papers were on Ukraine, a country that looks both east and west, as we were reminded during the orange revolution. As expected, the geographical divisions are reflected in patterns of health.
On the final day of the conference we had a reminder of the importance of history. A small riot broke out in the main square between those who had fought with the communists and those who had fought with the Ukrainian nationalists during World War II. It was a stark reminder that Ukraine remains a divided country in ways other than its health.