Wednesday, October 24, 2012

Getting Medical Tests Done in Ukraine

I recently needed to get some blood and medical tests done in Ukraine. I'd never done more than visit a doctor once in a blue moon for some specific problem. What I'd done in the past was to call the Insurance for Foreigners hotline (when I had this insurance) and tell them I was ill. Then they arranged a time and place for me to visit a doctor. This time around I didn't have any insurance and wanted to do some preemptive medical investigations, so I needed to take a different approach.

I was aware that everything I wanted to check up on can be arranged through private clinics. But choosing among a myriad of seemingly identical clinics is a nightmare, so I waited till I left Kiev for Sevastopol to get the work done there. I also figured the prices would be lower.

Sure enough, the number of private clinics in Sevastopol was somewhere between 5 and 10, which made it a lot easier to choose. Still, it was a bit daunting investing the different clinics and trying to make the best decision.

Finally, I went in for my first blood tests. I walked in, asked for the price list, and a few minutes later told the administrator which ones I wanted. I paid at another window, brought the slip back, and was directed into the testing room. Five minutes later I was out. I left my email with the administrator to get my results by email.

This first experience was very encouraging given the simplicity of the process. The registration process was quick and easy and no documents were necessary. Once I got the results back, I decided to see some doctors. I chose a different clinic on a whim and set up my first appointment over the phone. I ended up staying with this clinic. Luckily, in Sevastopol most medical services are provided in a specific neighborhood, making it easy to save time by scheduling doctors visits or analyses for a certain time of day.

The procedure for seeing a doctor is more complex than for doing blood tests. You need a passport, and they create a new account for you. Your citizenship doesn't matter. In Kiev these accounts are almost always on the computer, but the clinic I visited in Sevastopol actually registered me in a dedicated paper booklet that they recorded all my visits in and stored in an expansive shelf in the registration room.

The cost of seeing a doctor varies with the specialist, but it is currently about 100 to 150 UAH (12-19 USD) for the first visit and half that for follow-up visits if they take place within a month of the previous visit. 20 minutes are usually allotted per visit. It's wise to get there 10-15 minutes early in order to register at the front desk and pay for the visit before it's your time to see the doctor.

Both doctors I ended up seeing seemed reasonably professional. One was particularly responsive and listened carefully to what I was saying, and was positive about my online research in the field. I had read positive reviews about the doctor online on some Sevastopol Internet forum. The other doctor was also professional but was less positive about my online research, suggesting that "too much reading can make you think you're ill, blah blah blah." I had to defend my efforts and explain that I'm not prone to hypochondria. This doctor would get lower ratings from me because she seems less attuned to her patients' needs, but she was still sufficiently professional.

It was interesting to read what doctors had written after each appointment with me when I came in the next time, picked up my account booklet and carried it to the doctor for our visit. I took photos of these notes for my personal records.

Both doctors then gave me recommendations — направления — indicating that I should get this or that test done just in case. I then took these to the places they recommended and had the tests done.

My experiences at these specialized labs were also relatively positive. At the first one, there was a confused crowd of people trying to figure out which line was for registration and which was for testing. I marvelled at the poor organization, given that each week the same thing must happen over and over again, and no one at the center takes it upon themselves to at least put clear instructions on the door. Nonetheless, the testing procedure itself was relatively quick and painless.

All along the way I thought of how much money and probably time I was saving over doing the same tests in the U.S., and the fact that at each step along the way I could ask questions and get additional information and was not simply an object on a conveyor belt.


Now that this experience is behind me, I know that addressing health concerns in Ukraine is not difficult at all, and I won't be tempted again to keep putting things off because I don't understand the system. I also feel comfortable about not having health insurance of any kind. Pretty much any problem that has any likelihood of arising can be properly dealt with for a few thousand dollars at most. Having this amount of savings would seem to negate the need for insurance.

The second main lesson learned is that no matter which country you are in, you must take responsibility for your own health into your own hands. You cannot expect to meet a doctor who will examine all areas of your life and identify the cause and effect relationships between diet, lifestyle, emotional life, relationships, stress levels, and your health issues, whatever they may be. Each doctor focuses on his particular specialization and medical solutions to specific problems within that field. So, self-education is essential in order to see the bigger picture and avoid overdependence on doctors who often aren't sure of their diagnoses and lack perfect information about their clients.

More on Healthcare in Ukraine at

Friday, May 11, 2012

The English Language Conquest of the World

As the electronic, cultural, and economic interconnectedness of the world increases, more and more languages of regional importance are losing ground against English, which is now the indisputable global leader. There are very few contenders left that can be considered languages of international communication: Spanish (Latin America), French (France, Quebec, and parts of Africa), Arabic (however, the various dialects of Arabic are quite different, making communication difficult), Chinese (east Asia; some competition between Mandarin and Cantonese), and Russian (former USSR). All of these languages are losing ground to English as their respective regions of dominance increasingly interact with others. Even Chinese will likely not obtain anything near the status of English, as its citizens are learning English at a much faster rate than the rest of the world is learning Chinese. With its outmoded non-phonetic script and challenging tonality, the barriers to learning Chinese are high, whereas English is more accessible to beginners.

The most recent "casualty" in this competition of international languages is Russian, which used to be the primary language of international communication across much of Eurasia. Within as little as 10 or 20 years, its importance could fall to the level of, say, German — a language studied by people outside of Germany, Austria, and Switzerland primarily as a hobby rather than an economic necessity.

While national languages have grown modestly in importance as a result of measures to sideline Russian in Ukraine, the Baltic states, and the Transcaucasia region, the primary — and perhaps surprising — beneficiary has actually been English. English is now the language children are learning in school instead of Russian, it is a popular language for all sorts of public events, and — as opposed to Russian — is hardly ever perceived as a threat by nationalists. One can hold nearly any public event in Kiev in English without hearing complaints from Ukrainian "patriots," while similar events in Russian often draw public disapproval. It is prestigious and fashionable to give businesses and events English names and practically taboo to give them Russian ones except for the most stalwart historically Russian-speaking regions. Any event or entity that has any sort of international orientation is now automatically written in English. It is as much a gesture to increase the perceived importance of the event or entity among locals as a pragmatic measure to ensure that any influential international guests do not experience the slightest linguistic discomfort. The discomfort of non-English speaking visitors/clients is typically not taken into consideration.

In places where it used to be standard practice to duplicate street signs and metro information in Russian, this is now being done in English, and the Russian signs are gone. Across much of the former Soviet periphery, the generation under 20-25 years of age is growing up with better English skills than Russian. Even in countries that use Cyrillic or national alphabets (Armenia, Georgia), people usually send text messages in Latin characters and often post things on Facebook in their respective languages using Latin characters, or simply write in English. Increasingly, younger travelers from former Soviet states are speaking English rather than Russian with locals in other former Soviet states — for instance, Ukrainian-speaking Ukrainians or Estonian-speaking Estonians who visit Georgia. In 10 years or so, English will probably have replaced Russian as the dominant regional language in the Transcaucasus and Baltic states. In other words, Azerbaijanis in Georgia or Lithuanians in Latvia will use English to get around and do business more than Russian. This is where current trends are pointing.

Within countries as well, English is gaining cultural influence faster than most national languages can keep up. This is particularly true in smaller or poorer countries which don't have large and powerful economic and cultural institutions churning out lots of interesting products in the national language. So, for instance, rather than using or creating domestic websites or software, locals use international ones whose default language is English. Instead of getting their own academics to write textbooks for students in the local language (which may require inventing new terminology), many universities make use of foreign textbooks and learning aids, which are usually in English. Much other literature is translated from other languages, usually English. Instead of listening to their own bands, youth listen to "international" music, which means more English. They look up names and information in English online because there is so much more information available. There aren't enough translators, cultural adapters, writers, musicians, home-grown academics and scientists, etc. to meet demand.

The smaller the country, the greater the proportion of materials from English-language sources present in the infosphere. Of former Soviet states, only Russia appears to be populous and dominant enough economically, culturally, and academically to produce enough of its own information products in most spheres. For instance, there are Russian social networks that compete regionally with Facebook (Vkontakte and Odnoklassniki) and Russian-made search engines that compete regionally with Google and are even trying to go international (Yandex). Russia also has, by far, the best-funded science and research institutions (science is all but dead in many post-Soviet states) and the greatest software and literary output of the post-Soviet states. Even in Russia, though, cumulative adoption of English-language culture and information products within Russia is clearly greater than adoption of Russian-language culture and products outside of native Russian speaking regions of Eurasia.

As English comes closer to becoming the single global lingua franca and more and more products are produced in English relative to other languages, individual countries progressively lose their cultural self-containedness and self-sufficiency. The larger and more powerful the country, the longer it can "hold out" against the wave of externally produced English-language culture and information. In general, the smaller a country, the faster and more thoroughly it "internationalizes." In Georgia, for instance, academia and technology are too weak and too poorly funded and staffed to keep up — linguistically — with scientific and technical progress. There are now many things that can't be properly discussed in Georgian because the vocabulary just isn't there. Hence, Georgians are particularly receptive to foreign language penetration — before Russian, now English — and are more outward looking than Russians or even Ukrainians. There was even a serious initiative to make English the second official language despite an almost complete absence of native English speaking Georgian citizens. Throughout the process of foreign linguistic assimilation Georgian has remained the language of traditional culture and values: the dinner table, relationships, music and poetry, rural life, etc.

Even in larger countries with plenty of economic clout, such as Germany, Japan, or Russia, the relative importance of national languages is still eroding as people increasingly look outside their home countries for information and cultural and intellectual products. This process of "opening up to the world" is commonly viewed in a positive light; we have all heard the platitudes that "there is so much we can learn from each other" and "cultural exchange enriches everyone involved." However, contrary to popular belief, cultural exchange is more often one-sided than not, and often extremely so. The incentives for people from the less-dominant culture to learn from and absorb the more-dominant one are greater than vice versa. Imagine a group of equal numbers of American and Ukrainian youth who spend a year together at some isolated camp. Who will gain more from the experience? Will the Americans end up speaking Ukrainian or will the Ukrainians end up speaking English? Will the experience prove more valuable for the Americans in their future careers or for the Ukrainians? Anyone who's been to Ukraine knows that Ukrainians are more susceptible to English-language cultural influence than Americans are to Ukrainian culture. How many non-Ukrainians have been tangibly "enriched" by Ukrainian culture compared to Ukrainians who have been enriched by international (i.e. English-language) culture? Whichever area we look at, we see that far more Ukrainians are being drawn into the predominantly English-language international cultural realm than vice versa. Cultural exchange is really not two-directional, and the people who promote it are usually spokesmen for the dominant culture who have the privilege of experiencing a "taste" of different cultures for "personal enrichment," while people in the less dominant culture are subject to a total onslaught of new information, values, practices, and cultural products coming from the developed West, along with the necessity of learning English to increase their material opportunities in life.

This same pattern of unequal cultural "exchange" holds true even in more powerful countries such as Germany, Japan, and Russia, mentioned above. Consider how so many people in creative professions adopt the use of English to "reach a global audience," and how few of their counterparts in other countries adopt the other language to reach audiences in that country. For instance, there are far more German bands that sing in English than bands from non-German speaking countries that sing in German. In nearly every area of life there are economic and social benefits attached to the use of English and consumption of English-language cultural and information products. Movement in the opposite direction — from a dominant culture to a less dominant one — in contrast, only confers individual benefits or niche economic benefits. Expats from more dominant cultures who settle in less dominant ones tend to be viewed with an incredulity that is proportional to the difference in the level of dominance of the two cultures aggregated with the difference in per-capita GDP. For instance, an American who has settled in Germany might be a bit of an oddity, one who starts a business in Kiev or even Moscow raises many eyebrows, but one who moves to a village in Siberia merits a detailed, sentimental report on national television. In contrast, immigrants from Ethiopia, Ukraine, Russia, Germany, or Japan who speak fluent English barely arouse curiosity in the U.S. Few people question their motivation for immigrating or display much interest in their mother culture and tongue.

The future
It is safe to assume this powerful global anglification trend will remain in place as long as there is a high degree of global economic and cultural interconnectedness and of international travel. Anything that reduces interconnectedness — such as major wars and massive economic downturns — could reverse this trend temporarily (or, in theory, permanently if the upheaval is global in scale). The last bastions of non-English regional usage will probably by China and Latin America, which have large populations already speaking, more or less, a single common language and are geographically removed from the dominant West. It appears no longer crucial to the anglification trend that the U.S. (or U.K., pre-WWI) is the world's most powerful economy. Enough people now speak and use English outside native English-speaking countries that English is perceived more as the language of international communication than as the language of Americans, Brits, Canadians, Aussies, and Kiwis.

If interconnectedness continues to increase and English achieves the status of a universal language of international communication, a number of interesting consequences are conceivable. First, interest in learning foreign languages other than English may drop because there is no longer any necessity, and all other competing regional languages have been displaced. Second, English may gradually take over more and more functions within individual countries, eventually reducing local languages to a kind of everyday vernacular. First this will be done in politics, because it will save costs in paperwork and translation. The academic community will also find it more efficient to just publish most things in English for the sake of information interchange with colleagues worldwide. Public events involving participants from different countries will also be easier to organize and conduct in English. English could eventually become the language of public life and institutions within countries as well, which would elevate it to the status of Latin — a language that originated in west-central Italy, became the public language of western civilization, and remained the language of scholarship and administration across Europe for well over a thousand years after the fall of the Roman Empire.

Friday, March 9, 2012

Learn about Studying in Ukrainian Institutions of Higher Education

On March 29-31 there will be an open-house of Ukrainian colleges and universities (62, from 13 regions of Ukraine) as well as 50 foreign institutions (mainly European). This presentation seems to be geared towards cooperation between institutions with the goal of attracting foreign students, but if you are already in Ukraine and interested in attending a Ukrainian university, this would probably be an excellent chance to talk to people directly and get some useful information. The complete announcement is below, in Ukrainian. The address is the "Ukrainian House" building on Khreschatyk Street, 2 (European Square).
29-31 березня 2012 року в Києві у приміщенні Центру ділового та культурного співробітництва "Український дім" (вул. Хрещатик, 2) відбудуться: щорічна міжнародна спеціалізована виставка "Освіта та кар'єра - 2012" та виставка закордонних навчальних закладів "Освіта за кордоном".  В виставці «Освіта та кар'єра - 2012» приймуть участь 62 українські вищі навчальні заклади з 13 регіонів України, понад 50 закордонних навчальних закладів з Польщі, Греції, Німеччини, Чехії, Кіпру, Великої Британії, Туреччини, Литви, Латвії, Росії, США, Мальти, Австрії, Франції, Нідерландів, Фінляндії, Естонії, ОАЕ. Також у виставці візьмуть участь 20 міжнародних організацій та освітніх агенцій.  31 березня 2012 року (субота) об 11.00 в рамках виставки відбудеться презентація освітніх програм українських вищих навчальних закладів. У презентації приймуть участь представники міжнародних відділів українських вищих навчальних закладів. Запрошуємо до участі у презентації представників освітнього та культурного співробітництва іноземних представництв в Україні, іноземних фірм та представництв, які займаються набором студентів для навчання у вищих навчальних закладах України.  Участь у даній презентації надасть можливість налагодити співпрацю та обмінятись контактами з представниками міжнародних відділів вищих навчальних закладів, дізнатись про програми навчання та перелік спеціальностей ВНЗ тощо.  Участь у презентації є безкоштовною.