INMED

INMED Academic
INMED CME

Agape Unlimited

Russia

Overview

Moscow is home to a large number of urban poor, who are often elderly and who rely upon insufficient pensions. Moscow is also home to many Muslims from Central Asia and some one million Africans. Russians often lack proper nutrition and adequate health care and thirty percent do not have access to needed medicines or live within reach of a road.

Since 1993, Agape Unlimited has been providing homeless shelter clinics, nursing home clinics, clinic for African immigrants, and a model primary care clinic. Agape Unlimited also makes medical expeditions to offer healthcare to some of Russia’s most isolated people. A strong emphasis is made on healthcare education throughout all these services, to benefit both Russian and international learners.

Location

Agape Unlimited is headquartered in Moscow, population eight million, and has centers in Saint Petersburg, population six million, and on a 200-acre farm a two-hour drive south from Moscow. Russia spans an area twice the size of the United States, and is home to people of extreme ethic and cultural diversity. According to the Joshua Project, in Russia alone there are 179 different people groups.

The months of June, July and August are most warm, around 23 °C (73 °F), occasionally as high as 30 °C (86 °F). Winter lasts from November through March with temperatures falling to approximately −10 °C (14 °F), though there may be days of warmer temperatures.

Become familiar with Russian culture, history and economy by reviewing the Wikipedia Russia Profile. Rich resources for Russia health information include the Institute for Health Metrics and Evaluation IHME Russia Country Profile and the World Health Organization Global Health Observatory Russia Data.

Both urban and rural Russians often lack proper nutrition and adequate health care. Russian statistics document that thirty percent of the population does not have access to needed medicines, and one out of three Russian villages is not connected to the outside world by a road of any kind. Many rural people live in homes with no floors, no running water, or central heating of any kind. Moscow itself is home to a large number of urban poor, who are often elderly and rely upon a pension fund that is insufficient for daily life. Moscow is also home to many Muslims from Central Asia and some one million Africans.

People served by Agape Unlimited are a broad range of socioeconomic groups, including middle-income to low-income, as well as many immigrants from Africa and Asia. Their medical conditions are often similar to those medical conditions commonly seen among low-income persons in the United States and Western Europe, including diabetes mellitus, obesity, coronary artery disease, and chronic lung diseases.

Russian is the standard language. Among Africans in Moscow, French is most common language. Russian physicians working with Agape Unlimited speak English, as do some of the other Agape Unlimited staff. Non-Russian speaking volunteers are assisted with interpretation.

Since 1993, Agape’s work can be summarized with four words: Going – where no one wants to go; Helping – those no one cares about; Sharing – God’s love with everyone; and Teaching – others to do the same. Today these values are manifested through medical care services that include:

  • Homeless shelter clinic, held three to four times each week. This shelter has 400 beds for short-term residents and 800 beds for long-term. The shelter is government run, but churches provide food and caretakers. In the wintertime the shelter is most full, and many persons require wound care from frost bite, lots of prior amputations. Medical care is provided free of charge.
  • Nursing home clinic, held three to four times each week.
  • Clinic for African Immigrants, hosted by a Moscow church two to three days per week. This clinic also serves a number of Central Asian Muslims residing in Moscow.
  • Medical Center Agape, a full-time for-profit clinic offering primary care in a model practice setting.
  • Saint Petersburg Family Medicine Clinic
  • Agape Farm: a rural farm clinic outside of Moscow, with its home for aged out orphans. A Canadian nurse lives there and serves in the villages.
  • Medical expeditions to rural locations in Russia, offered about twelve times each year. Medical and non-medical people travel in small, individualized teams of 4 to 6 people, including translators, to remote, isolated villages, places where no one else wants or cares to go. Teams travel by a variety of means, including trains, private cars, and public transportation, horse sleigh, snow mobile, reindeer sleigh, 6×6 trucks, or river boat.

Agape Unlimited is led by David DeShan, a family physician faculty at University of North Texas. Dr. DeShan is accompanied by a full-time staff that includes thirty-five Russians, three Russian physicians, and six Americans. Agape Unlimited primary care clinic are also staffed by several specialists (neurology, cardiology, dentistry) that work in conjunction with the primary care physicians.

Those with PT and OT skills will have special opportunity work with the rehabilitation centers at homeless shelter and nursing homes, where many patients suffer debilities associated with stroke. PTs and OTs can also teach Russian family physicians such skills.

Internet access in Moscow is good. Guests are provided a cell phone for local communication.

INMED invites all participants to consider raising extra funds to financially support this facility. While such efforts are not required, they provide opportunity for INMED personnel to become involved in this important aspect of international healthcare.

Travel and Logistics

Agape Unlimited will arrange for pickup and drop off from one of the three international airports in Moscow.

For current information please visit the Russian embassy website appropriate for one’s home nationality. United States citizens can obtain current visa information from the website of the Russia Embassy in Washington, DC.

Agape in the United States will assist with visa matters, which include a required letter of invitation from Russia and the use of a visa agency to expedite applications. Generally, six weeks are required to obtain a Russian visa.

One should consult with their personal physician before traveling, and refer to the CDC Travel Website for the most up-to-date health information. Russia does not generally pose any particular health risks. All routine vaccinations should be up-to-date, and a sufficient supply of any prescription medications should be carried.

Travelers are advised to refer to the United States State Department Website for the most up-to-date nation-specific travel information, and to regularly review Current Travel Advisories.

Agape Unlimited makes medical education a very high priority, emphasizing care that is practical, relevant, patient-centered, and evidence-based, as well as care that addresses mental, social, and spiritual needs.  This philosophy is manifested through learning experiences for both Russian and international healthcare personnel.

Medicine education opportunities are offered to Russian medical students and family medicine resident physicians. Agape Unlimited also hosts two primary care education conferences each year, and enjoys relationships with the Moscow Regional Research Clinical Institute (MONIKI), Moscow Oblast Regional Training Hospital System and the Department of Family Medicine.

Agape Unlimited also regularly host healthcare learners from PRIME, John Peter Smith Hospital Department of Family Medicine, University of Utah Department of Family Medicine, and University of North Texas Health Science Center, and others.

For a one-month experience, those in medicine can generally expect to experience about 10 days of indigent care, 3 days in the rural clinics, 2 days in the profit clinic, days in medical education seminars, and 2 days in the Russian medical system visiting a medical school. 

Previous INMED Learners who served at this training site include these Graduates.

For housing guests, Agape Unlimited has four apartments located next to one another. Guest can shop and cook for themselves, or dine out. An Agape Unlimited staff physician couple live in the same apartment complex and can provide assistance. A translator/guide is also provided in the beginning, but after about a week of orientation most guests can travel by themselves via the nearby Moscow subway.

Agape Unlimited has a standard code of conduct to which all learners and guests must adhere.

Weekends are normally unscheduled. Learners are encouraged to explore Moscow, especially the Russian Art Museum, Red Square, and the Kremlin. Moscow is a green city with lots of parks. Saint Petersburg on the coast is available via a fast train. Agape Unlimited can provide a guide/translator for such outings.

Visitors should bring copies of all healthcare profession licenses, diplomas, or certifications. A carry-on bag should be packed that contains essentials items just in case one’s luggage becomes lost. Bring clothes appropriate for the weather.

Note: Not all INMED learners post a blog regarding their international service-learning. Only completed blogs are listed:

Steven Duncan

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