The Chicago/JHI group was escorted on a tour of the hesed building, viewing various service centers, such as an office from which repair services for elderly clients are coordinated.19 In common with every other group tour of this facility in which the author has participated, this tour was somewhat disorganized and confusing, the disorder stemming in large part from the narrowness of hesed corridors and the inability of tour participants in such circumstances to remain in contact with the tour leader. Further, hesed clients waiting for various services on the second floor, where most forms of assistance are offered, inadvertently blocked access to areas of interest.

More successful was a meeting in a third-floor auditorium where Natan Gomberg, Director of Hesed Avot, was able to present a systematic overview of hesed activities. A film depicting hesed services also was shown. According to information provided, the hesed offers services in four areas. Its food programs are extensive, including the provision of food parcels to 8,000 individuals in the city and 1,000 in the oblast on a monthly basis. An additional unspecified number of clients receive parcels on four occasions each year in connection with major Jewish holidays. Seven warm homes in Kyiv and nine in the region serve other elderly two to four times each week, providing nutritious meals and socializing experiences in private apartments. 1500 individuals are served hot meals in communal settings (ten programs in Kyiv, 12 settings in outlying areas) six days each week and take-home food provided for Shabbat, and 650 homebound clients receive seven home-delivered meals each week.

Hesed social and cultural activities include various clubs and activities, holiday observances, and a library. Social services include home care for 1500 clients, provision of medical equipment (such as walkers and wheelchairs) through a loan program, and repair of home appliances and other items. Social service workers are trained in a hesed Institute for Communal Workers, which offers various courses in the hesed building.

Recognizing the Chicago/JHI group special interest in medical services, an extensive time period was assigned to a presentation featuring this fourth service area. Rimma Semionova, regional medical coordinator for the hesed, was candid in her explanation of hesed medical services. The nature of these services, she said, is humanitarian, rather than professional. Under Ukrainian law, it is illegal for the hesed to provide direct medical services. About 35 volunteer physicians in Kyiv and ten in the periphery provide consultation, counseling, and triage. They often serve as a liaison between clients and specialized clinics or hospitals, assisting clients in obtaining the direct medical services that they require. Almost all such doctors are older, retired from active clinical practice; although classified as volunteers, most receive small stipends from the hesed for their work. Ms. Semionova acknowledged that the qualifications of many hesed physicians are limited; an annual medical conference organized by Dr. Ted Myers of JDC, she said, is of questionable value because its content is beyond the comprehension of hesed doctors.

Technically, hospital services are provided free of charge to Ukrainian citizens, said Ms. Semionova. However, most hospital physicians demand fees for professional services, and patients are expected to bring their own medicines, bed linens and food as well as pay for nursing and other needs. Waiting lists exist for many types of surgery. The hesed maintains special relationships with a private clinic and a public hospital, assisting clients in gaining admission and providing some financial assistance to individuals through a small emergency fund when necessary. It also maintains ties to the Institute of Gerontology (see below).



Rimma Semionova is the regional medical coordinator for the hesed. Although not a physician, Ms. Semionova has a professional background in medical research.

Because many hesed clients cannot afford medicine prescribed by local clinics, the hesed maintains its own small pharmacy. However, its supply of medicines is limited because importing medicine is very expensive and it is illegal for the hesed to purchase medicine at wholesale prices.

A hesed official also gave a brief explanation of the Mazel Tov program, which enrolls 640 children under three years of age in 13 heseds in Kyiv and Kyiv oblast. Services provided include the lending of baby equipment (such as strollers), educational activities, parents clubs, and some assistance from hesed pediatricians.

Following lunch in the hesed dining hall, Chicago/JHI travelers formed two groups to visit elderly home-based clients of the hesed as well as the homes of Mazel Tov children. The elderly individuals did not appear to fulfill all of JDC’s own requirements for hesed care; certainly they were elderly, but they were neither isolated nor indigent. One lives in a roomy centrally-located apartment near the hesed and is visited regularly by adult children.20

12. Following the lengthy visit to the JDC hesed and to hesed clients, the Chicago/JHI participants proceeded to the Jewish Agency Gateway to Aliyah (Shaar l’Aliyah) Center. Eli Yitzhaki, the Chief of Mission of Jewish Agency for Israel operations in Ukraine, explained JAFI operations in Ukraine to the group.21

Mr. Yitzhaki stated that JAFI assumes that between 250,000 and 300,000 Jews remain in Ukraine. The largest Jewish population centers, he said, are the following: Kyiv, 100,000 Jews (105,000 in September 2000); Dnipropetrovsk 41,000 (44,000); Odesa, 33,000 (36,000); Kharkiv, 30,000 (34,000); Donetsk, 18,000 (20,000); Simferopol, 9,000 (11,000); and Lviv, also 9,000 (10,000).22 Almost 286,000 Jews emigrated to Israel from Ukraine between 1989 and the end of 2000, he said. Seventy percent of these olim (immigrants to Israel) are under the age of 44.

The Chicago/JHI group observed a number of JAFI programs in progress in the Gateway to Aliyah Center. These included a Hebrew ulpan class, a computer class for children, a young people’s Israeli dance club, and an Internet café for university students.

A young man in an ulpan class (right) sings a Rosh Hashanah song in Hebrew. Children learn computer skills in the JAFI computer laboratory (below). Older youngsters participate in an Israeli dance troupe (below right).

Two physicians associated with the Jewish Agency spoke with the Chicago/JHI group. One, a cardiologist, meets with each group of olim in the airport as they are about to depart for Israel; he is responsible for ascertaining their readiness to fly. The second, an obstetrician/gynecologist, is responsible for summer camp and winter seminar programs. Both physicians were asked to comment on contemporary Ukrainian health care. One doctor said that the recent privatization of the Ukrainian health system has generated two classes of physicians and two classes of patients; in each case, one can differentiate between those involved in private health care and those using public health services. The field of medical insurance remains seriously underdeveloped in Ukraine, he continued, thus severely limiting the ability of average Ukrainians to access the private health sector. He noted that the field of family practice does not exist in Ukraine; Ukrainian doctors are “too specialized,” a situation that begins in medical school as students begin to specialize at fairly early stages in their medical school careers.

Commenting on the financial realities of Ukrainian health care, the second physician said that “everything” is available, but that few people can afford to access what is available. Advanced medical technology, he said, is concentrated in a few specialized medical institutes and is not available to most patients. However, he noted, “all” Ukrainian doctors are “very highly qualified, especially dentists.”23 In response to a question about potential assistance from American physicians, the second Ukrainian doctor observed that access by local physicians to medical information on the Internet is very limited and said that Ukrainian doctors could benefit from post-graduate seminars presented by American physicians.

13. The Chicago/JHI group began September 7 with a visit to The Institute of Gerontology of the Academy of Medical Sciences of Ukraine. The Institute is directed by Dr. Vladislav Bezrukov, who speaks fluent English and whose approach to work is far more Western in character than Soviet. Dr. Bezrukov has had substantial experience in the West, including employment of the United Nations Center for Social Development and Humanitarian Affairs in the mid-1980s and collaborative work with Northwestern University and other American institutions.



Dr. Vladislav Bezrukov (with pointer) shows Dr. Edward Linn an item of interest in the Institute museum.

Founded in 1988, the Institute undertakes research in the biology of aging, clinical gerontology and geriatrics, and social gerontology and public health. It operates numerous laboratories, research centers, therapy units, and auxiliary clinical subdivisions, such as an outpatient clinic and a physical therapy service.

19.  Repairs are made on watches and clocks, shoes, household appliances, etc.
20. Escorting hesed visitors to residences of relatively healthy and comfortable clients seems to be a practice of the Kyiv hesed. In this case, with visiting physicians, and in a similar visit one year previously, with visiting social service professionals, visits to such individuals may have been counter-productive. Both physicians and social service professionals expect that opportunities provided them will respect their credentials and experience.
21. See pp. 5-7.
22. The figures in parentheses are those provided to the Chicago group of social service professionals who visited Kyiv almost exactly one year previously, in September 2000.
23. The Chicago/JHI physicians listened to the two Ukrainians without challenging any of their assertions.