The Demographic Crisis in Ukraine

February 2003
Newtopia Magazine

In 1995, my first journalistic mentor recommended that I try writing a piece on the demographic crisis in Ukraine. All I had to say then was, "What crisis? My best high school friend is about to give birth, and at least a dozen other acquaintances are also pregnant. We're gonna have plenty new babies real soon!"

I'm now aware of the issue's extreme complexity, but sometimes I'm still wondering whether the crisis is my fault to some extent. Ukraine's fertility rate has plummeted to 1.3 children per woman, yet my own fertility rate is even lower so far (zero). I lived in Russia during the Ukrainian census of 2001 and obviously haven't gotten into the database, exacerbating the already alarming demographic situation (minus one more Ukrainian).

Abstract thinking isn't one of my strengths when it comes to writing about post-Soviet population decline. I pretend to be following the conventional steps - I make the unthinkable numbers real by supporting them with real people's stories; I put the real people's stories into perspective by introducing experts' opinions and by throwing in the unthinkable numbers -but inside, I'm confused. How can I explain anything to anyone when all that has to be explained is happening to me or around me?

I don't give up right away, though.

To warm up, I skim headlines of a number of stories I've downloaded for preliminary research. They are all about Russia, Ukraine's neighbor: 'UNEARTHING THE RUSSIAN WAY OF DEATH' (by Michael Church, the Independent, January 15, 2001); 'DISREGARD FOR HEALTH IS KILLING RUSSIANS' (By John Daniszewski, the Los Angeles Times, December 16, 2001); 'THE DEATH OF A NATION' (By Andrew Meier, the Time Magazine (Europe),January 22, 2000); 'A PEOPLE SKATING ON THIN ICE' (by John O'Mahony, the Guardian, February 3, 2001); 'DEAD SOULS' (by Murray Feshbach, the Atlantic Monthly, January 1999).

I'm overwhelmed, and I haven't started reading yet.

To gain perspective, I move on to my favorite resource: the U.S. Census Bureau's international demographic database, a user-friendly online collection of estimates and projections for 227 countries and areas of the world. My goal is to find as many countries as possible that have fewer births and more deaths per 1,000 population than Russia.

The only such country, it turns out, is my native Ukraine. According to the 2003 estimates, it has 9.9 births/1,000 and 16.4 deaths/1,000 (while Russia has 10.1 births/1,000 and 14 deaths/1,000). Bulgaria's situation is as grave: 8 births/1,000 (fewer than in Ukraine) and 14.3 deaths/1,000 (more than in Russia).

Before I am bogged down in further amateurish scrutiny of statistics, I note that Russia's annual rate of natural increase (-0.39 percent) is higher than that of Bulgaria (-0.63 percent) and of Ukraine (-0.65 percent). The fact that Russia's making headlines in the Western media while Ukraine and Bulgaria don't, may have a simple explanation: Russia (pop. 145 million) possesses nuclear arms, whereas Ukraine (pop. 48 million) and Bulgaria (pop. 7.5 million) are harmless; even if Russia is dissolving at a slower rate, the impact may still be way too powerful.

I continue looking at the 2003 birth and death rate projections.

Birth rates in Bulgaria, as well as 12 other European countries and Japan are lower than in Ukraine, yet their mortality statistics are nowhere as gloomy as ours. Ukraine's death rate places the country alongside the world's most destitute nations. Chad has the same 16.4 deaths per 1,000 population as Ukraine, which is the lowest rate among the worst off 25 African states and Afghanistan. But Chad's birth rate is 47.1 births/1,000 - and it's not an exception among these drought-, poverty- and war-ridden countries. Afghanistan has 40.6 births/1,000; Rwanda - 41.1 births/1,000, Mali - 47.8 births/1,000, and Niger sets the world record at 49.5 births/1,000 (or five times Ukraine's rate). Botswana's birth rate is "only" 25.5 births/1,000, while its death rate is the highest in this group (31 deaths/1,000), which makes it the only African country experiencing a natural decrease of population.

By now, I seem to begin losing any perspective I may have gained. One sign of this is that the death rate statistics remind me of how a man at a New Jersey grocery store once asked me, "Ukraine. is it somewhere in Africa?"

So finally, I attempt reading those apocalyptically headlined stories about Russia, keeping in mind that they are as much about Ukraine.

"Over the past 10 years, Russia has been hemorrhaging humanity at a rate unprecedented for a modern, industrialized nation, except during times of famine or war," writes John O'Mahony.

"So much of the shrinking Russian population may soon be so ill that long-term solutions to the country's political, economic, and military problems will be inconceivable," concludes Murray Feshbach, a renowned U.S. demographer and former Sovietologist.

At first, this kind of reading scares me to death, but eventually I develop a sort of immunity to it. I realize that I'm ready to interview Ukrainian doctors and ordinary people - even though I don't feel like it. I know what questions need to be asked, but I also know most of the answers. Very unjournalistically, I identify with those poor souls O'Mahony and Feshbach are dedicating epitaphs to.

What if I, or someone I know here, is one tiny drop in the post-Soviet human hemorrhage?

Not necessarily, anyone truly versed in statistics would tell me. Such fear is even more irrational than the fear of flying. What am I so worried about, anyway? That by 2050, if the U.S. Census Bureau's forecast comes true, Uzbekistan will replace Ukraine as the second-largest former Soviet country? But even if its population expands from today's 26 million to 48.5 million 47 years later, Ukraine isn't just going to vanish. We'll still have about 38 million people then, which seems like a lot.

This coming spring, the daughter of my high school friend will turn 8. She is bright, healthy and beautiful, and when I think about her, it seems easy to ignore the fact that, since the year she was born, Ukraine has lost some 7 percent of its population, or more than 3 million people. Nothing matters as long as this one little girl is there. And, of course, there are so many more kids in Ukraine - in 2000, the U.S. Census Bureau counted nearly 5 million, from newborns to 9-year-olds. If at least some of them are as cool as my best friend's daughter, then Ukraine's got a future!

But it's foolish to be so optimistic, and it is difficult, too. When I read that only about 25 percent of Russian children are born healthy, I find it a bit too abstract to really make my heart sink. My best friend's daughter and other lively kids I see around serve as an imaginary shield that's fending off the horrible implications of health care statistics.

There is another little girl, however, who makes the numbers - those 75 percent of sick children - come alive for me.

In 1997, when I lived in Iowa City, I became close with the family of a visiting Ukrainian history professor. His daughter - just like the daughter of my Kyiv friend - was 2.5 years old then. At the hospital where she was born, back in Ukraine, she had been infected with staphylococcus, and by the time I met her, she'd had two cases of pneumonia, each followed by numerous complications.

The girl's temper tantrums, which often included screaming and kicking, are among my most vivid and persistent memories of her. I've never felt as helpless as I did then: she wasn't unhappy about some childish problems; through sobbing, she seemed to be trying to spill out her two and a half years of constant pain. Neither her despairing parents, nor doctors could bring her relief. On her good days, though, she liked to sit at the kitchen table and scribble something in her tiny pink notepad. I loved asking her what she was doing, because she always replied, with much of her father's intellectual superiority: "I'm writing a dissertation."

In 1995, when she was born, her father was juggling three jobs in Ukraine. He was freelancing for a newspaper, selling imported sweaters and coats at a wholesale market, and teaching at a university. The university often received its state-budget funding belatedly, and the professor often didn't see his 100-dollar monthly salary for months. In order to feed his wife, infant daughter, teenage step-son and himself, he turned into a moonlighter, which to some extent affected the quality of his teaching: sometimes, he was so exhausted he was dozing off during seminars he was conducting.

The state-run hospital, in which the professor's daughter was born, also lacked sufficient funding, and the quality of its services suffered as a result, too. Nurses used to feed several newborns from the same bottle, without sterilizing it, and were rude to the women who failed to bribe them, causing some to lose their breast-milk supply. After the professor's daughter was delivered and taken away to a separate baby room, a nurse approached the professor's wife and lied to her that her baby had an abnormally short neck. Although the girl's neck later turned out to be perfect, her immune system was shattered by the staph infection. Breast milk would have been crucial for restoring the girl's health, but her mother didn't have any because of the shock inflicted on her by the nurse, who was just trying to make a living.

Throughout 1997, I was busy reading all I could find about the Armenian Genocide of 1915 and other more or less recent atrocities. I couldn't imagine stories more depressing than those in the books and journals that filled my apartment. But this Ukrainian family turned everything upside down for me. Suddenly, the genocide images turned distant and blurry, replaced in the foreground by the sickly little girl, my own memories of dilapidated Ukrainian health care facilities (which I had repressed as soon as I arrived in Iowa) and a scary revelation that in six months I would be back in Ukraine.

I decided to write about this family, putting their experience into perspective. I interviewed several American health care professionals who had visited Russia on a USAID-funded family medicine development program. Although they held their Russian colleagues in high esteem for persevering in very difficult circumstances, their assessment of the general state of post-Soviet health care field left little room for optimism.

"The equipment, which we would consider disposable, was re-used just out of necessity. It really was something that I would have expected to see in the United States in the 1930s or maybe in the 1940s," one of the doctors told me, meaning not just the bottles for newborns but also syringes, bandages and rubber gloves.

"Cats were used for rodent control in all the hospitals we observed," said another.

- How awful, - thought the Americanized part of my self on hearing this last observation. - What an incredibly graphic reminder that there is nothing surprising in the fact that we are dying out.

- But cats are better than rats, aren't they? So much cleaner, and cute, too, - argued my Ukrainian self, dormant up till then. - If you don't mind a cat on your kitchen table, why are you so opposed to having one at the hospital?

Soon afterwards, the Ukrainian history professor provided me with a confirmation that there could be more than one view on just about anything in the world. By then, I had finished reading and writing about genocide and was slowly recovering. But one day I slipped and found myself watching an astonishing film, Welcome to Sarajevo, which made me cry as I hoped I'd never have to again. When I told the professor about this totally unforeseen experience, his reaction was as stunning. He said: "Well, actually, Bosnians are much luckier than we are - because their genocide received so much publicity, while our [state-imposed] famine [of 1932-33] remains virtually unknown to anyone but a bunch of scholars."

The Ukrainian famine, by some estimates, wiped out about 10 million people, and the efforts to let the world know about this tragedy are yet to be made. And I can't wait for this time, when my historian compatriot would be able to announce that justice has been done and the famine victims have become as "lucky" as the Bosnian Muslims. I only hope that he isn't getting too upset about the fact that Russia's demographic crisis is getting all the attention now, while Ukrainians are left in oblivion again.

I wish I could look at the world from a mountaintop, as the history professor did. Then I'd be able to consider his little daughter very "lucky," despite all the pain she'd been through, because as an infant, she managed to survive - something that 22 out of 1,000 babies in Ukraine fail to accomplish, according to the U.S. Census Bureau.

If my abstract thinking skills were stronger, I'd write a much more logical piece. Maybe one day I'll do better. For now, however, I'll try to learn from Anton Chekhov's A Journey to Sakhalin, a 1894 treatise documenting the appalling conditions to which the Russian government subjected people exiled to this insular penal colony.

"In order to make my task easier and to save time, I've been kindly offered assistance," Chekhov wrote in Chapter III, "but since my main goal in carrying out the census wasn't to obtain the results per se but, instead, the impressions inherent in the information gathering process, I accepted extraneous help on very rare occasions."