International medical center «NEVRON»

17, Habarovskaya Str.; Vladivostok; 690078; Russia.

"Genetic resources and health status of Indigenous Peoples of Primorsky region"

The main objective of the International Medical Center (IMC) "Nevron" is to prevent and detect the early stages of nervous system diseases and to reduce its incidence. In addition, Nevron pays special attention to social activities, health, social and economic problems, as well as to international issues in the field of medicine. In December 2011 IMC Nevron began to work in the new social direction, joining the UN Global Compact. This initiative allows companies to ensure that it operates concerning ten universal principles of human rights, labor standards, environmental protection and fighting against corruption. Performing the decision of the international conference "The Global Compact in the Russian Federation: Business and indigenous peoples", IMC Nevron launched the project "Genetic resources and health status of Indigenous Peoples of the Primorsky Territory."
This is a long-term incremental project, which aims to improve the level of health, life and to preserve the unic genetic potential of indigenous peoples in Primorsky region. Improving the quality of life and socio-economic conditions of indigenous peoples will contribute to the implementation of joint programs for the development of eco - and ethno-tourism, the interaction of both Russian and foreign experts in the field of wildlife conservation. The implementation of these programs will help create jobs, develop infrastructure and improve the socio-economic status of communities, as well as preserve the cultural heritage of indigenous peoples of the region.
At the start of a project Medical Center "Nevron" held a meeting with the Association of Indigenous People of Primorsky region and parties discussed possible cooperation. The urgency of this problem is not in doubt, given the position of indigenous peoples in our region. Nevron and Association of Indigenous People of Primorsky region entered into Agreement on joint work in the project. An important step next was to attract the attention of the public, local authorities and health care institutions. IMC "Nevron" organized volunteer expedition to Krasny Yar village and prepared an analysis of health indicators of the local indigenous population. This information was brought to the village administration, representatives of indigenous community "Tiger" and authorities of regional hospital. During these meetings parties developed mechanisms of cooperation and mutual assistance for the implementation of the project.
The next stage of the project was the formation of the budget and seeking additional funding, which is needed for purchasing medical equipment and medications to the village hospital. IMC Nevron applied to the leading pharmaceutical companies and have already reached an agreement on the program “Temperance point” to reduce alcohol abuse of the indigenous population.

1. Ethnological note

For many centuries, the village of Krasny Yar have been a place of compact residence of Udege people, indigenous peoples of the Primorsky region in Russian Far East, descendants of the Tungus people of Primorye. They keep a special traditional way of life, which includes hunting, fishing, herding, gathering of wild plants - based on their traditional economy. Udege living in the upper confluents of the Ussuri river, primarily engaged in hunting. Fishing played a decisive role in life of Udege, who has been living in the basin of the Sea of Japan and the major confluents of the Ussuri and Amur river.

2. Ussuri taiga and the Bikin River

Forest land in the area of Bikin lower stream is the largest territory in the world untouched by people. Here is the only natural corridor of cedar-broadleaf forest, and it’s the only place where the Russian and Chinese populations of the Amur tiger live . Here, at the same time grow Korean pine, oak, ash and other trees, inhabited by the Japanese and black cranes. Ten species of birds from the Red book of the world and more than twenty from the Red Book of Russia nest at the territory of Bikin river. This forest was declared a territory of traditional environmental management in 1993, and in June, 2009 it was leased to indigenous communities for harvesting pine nuts. In November 2010,territory was included in the tentative List of World Natural Heritage by UNESCO.
For many centuries the Ussuri Taiga was the only family and home for all groups of Udege tribes. And as soon as the house was subjected to destruction, indigenous peoples bagan to disappear. Over the past 40 years during deforestation ethnic groups of Udege decreased from 8 to 4. In Primorye, the forest is preserved only where the indigenous peoples live, where they have their traditional economy, because they don’t let manufacturers to intrude on their traditional earth.

3. Key factors affecting the decrease in the level of health of Indigenous Peoples of Primorsky region.

Team of doctors of IMC "Nevron" ( Mikhailichenko N., Chernyak N., Rodionova L.) organized an expedition (March, 2012) for physical examination and collection of medical information of Krasnyi Yar village residents.
Currently the population of village is 639 people, 124 of them are children under the age of 16. In 2011 six children were born, mortality was 9 people. In the last 10 years there has been a constant decline in population, leading to the extinction and aging of the community. In addition, we can see the gender disbalance – men are 65 more than women, and this situation also affects the low birthrate. National identity in the village is various: Udege - 70%, Nanai - 25%, the remaining 5% are Orochi and Evenks. Families have several children, mainly five and more people.
Medical Service is represented by the small cottage hospital, which more than 5 years has no qualified medical staff, and only nurses provide medical care to the residents of the village. Also, hospital has no necessary diagnostic equipment and laboratory; nursing and treatment rooms and small pharmacy are available. Funding of the hospital by the government is extremely low, it’s only 5000 rubles per month (about 165 US $). In urgent cases, patients are taken to the hospital in Luchegorsk which locates about 200 kilometers away from the village, the way through the bumpy road in the forest. There is a constant risk that transporting patient can die during this way, nevertheless there is no air medical service. Residents have no possibility to apply for professional medical help, that’s why all diseases have chronic progressive nature, often compounded by self-medication and uncontrolled drug administration.
It is important to note that Udege people live in the special climatic conditions with a sharp temperature drop: harsh snowy winter with a decrease in temperature to 47 degrees Celsius and very hot summer.
Traditional food of Udege is not rational for a person, they eat a lot of meat of wild animals (wild boar, roe deer, red deer, musk deer), to a lesser degree of river fish, and there is absolutely not enough dairy products, fruits and vegetables. Preference is given to the raw food diet of meat and fish (steak), an abundance of salt and hot spices.
One of the negative factors of life and health of Udege people is alcohol. Introduced to the Udege culture from China and Russia, alcohol was the most malicious enemy, since the enzyme alcohol dehydrogenase is a deficit in a given ethnic group. That’s why indigenous peoples, who abuse alcohol,rapidly become depended from the alcohol and it leads to serious diseases of the heart and brain. Mortality on the basis of alcoholism among indigenous peoples in the past five years has increased by 3 times. Of the examined inhabitants there are obvious signs of alcohol dependence syndrome in 57.3% of the population. It’s found that they prefer to treat their dependence mainly in non-governmental agencies and applying to the so-called "healers", because there is no registration and fewer requirements for treatment. Currently in remission after the various types of treatment there are 18.6% of the population, in spontaneous remission 16%, on the stage of active depending - 38% of population. The informational support for drug abuse treatment is completely absent in the village, there is no medical examination of the population, systematic therapeutic measures are not carried out. Particularly alarming situation is among adolescents and women, which threatens the existence of small ethnic groups. The majority of women consume alcohol, even during pregnancy, and it immediately affects the health of the younger generation, more than 60% of children have congenital abnormalities of CNS, heart, connective tissue, gastrointestinal tract, musculo - skeletal system, 10% of children recorded Clinic fetal alcohol syndrome (FAS .)
Among Udege people in Krasny Yar following diseases became common: cerebrovascular disease (74%) and heart (97%), diseases of the spine and joints (64%), tuberculosis (36%), parasitic diseases (72%), alcoholism (57%), ARI (56%). Less common are cancers (28%), mental retardation (18%), and trauma (22%).
Genetic resource of strong and good people who can easily adapt to the most difficult environmental conditions, able to appreciate and understand their taiga, to serve and worship her, to share their invaluable experience to future generations - ruthlessly killed and goes into oblivion, like other small indigenous peoples, previously existing in the North. Genetic potential of Udege is unique: people, known throughout Russia and abroad as writers, artists, anthropologists, doctors, artists, choreographers, starting out their biography from the village of Krasny Yar. In order to stop and prevent this sad outcome, it is necessary to take immediate action to improve the quality of life and improve indigenous health.

4. The overall program of reconstruction and development of Krasny Yar village and Udege people.

The initial and most important task of management is the preparation and adoption of a strategic plan for the village of Krasny Yar, a specific five-year term with the possibility of mobile additions in the case of the relevant circumstances, but not inconsistent with the planned parameters.
The following measures should be taken:
1) To revive the spiritual life of the village and its cultural traditions, learning the national language. The village needs House of Culture, library, creative souvenir mug with learning and traditional crafts, the museum of nature and history, ethnic ensemble;
2) information service should play an important role- there is a necessity to install high speed internet access throughout;
3) In the present conditions one of the areas corresponding to the character of a traditional nature, may become an environmental and ethnographic tourism, as well as thematic training or practice for ecologists, biologists, zoologists, wildlife enthusiasts. Hunters are known for their impeccable knowledge of the taiga territories and experience to survive in difficult conditions, Udege for centuries served as guides, hospitable hosts and assistants in the movements of a complicated route in Ussuri taiga;
4) Special attention should be given to the assistance in the organization of small and medium-sized enterprises in order to help the maximum number of villagers to participate in economic activities;
5) Create more jobs for women: guides for eco - and ethno tourism, seasonal work in the youth camps, masters of needlework, sewing national clothes. In turn, men, free from hunting and fishing, can work in construction brigades, in the shops for the manufacture of furniture, pottery shops, etc.;
6) Learn a foreign language for mutually beneficial cooperation with foreigners;
7) The most important task is assumed control of the rational use of the taiga resourses based on relevant scientific advice, and create all necessary conditions for the users of land and forest. Natural resources - national treasure for the ethnic group, and it is necessary to require an appropriate attitude toward them;
8) To attract the youth to work in rural areas, to stop migration, provide affordable housing;
9) Prepare a profitable program for immigrants, especially those who have the "necessary" for the occupation of the village;

Medical aspect of the rehabilitation of the indigenous peoples of the Primorsky Territory involves the following steps:
1) Restore the local hospital and medical service;
2) It is necessary to implement screening to identify patients with coronary heart disease and hypertension (ECG, echocardiography, blood cholesterol, lipid profile, blood sugar);
3) Engage to work in a rural hospital- doctors, volunteers, young professionals, perhaps "on watch" method. Offer to central hospital, one of the major cities or medical institution to take the patronage of the local hospital;
4) Organize a "telemedicine" through the Internet;
5) Create a program in the village "Temperance Point," and to establish information on the provision of treatment and prevention of alcoholism and drug addiction;
6) Prepare consultants from convalescent patients and to establish psychosocial support groups and complete taboo on alcohol;
7) Organize a school to educate a healthy lifestyle. Create a system of rewards to the families who lead a healthy lifestyle.
Given that this project has been developed for the first time and has a long-term prospects, and is primarily aimed at maintaining a single-ethnic group of people, we can assume it unique, and the work of doctors, volunteers of IMC Nevron exclusive of its kind. This is unique people, unique nature and the ecological situation, unique culture and way of life, destruction of civilization. As with any business started, the project faces certain obstacles, both from the administration, and from commercial organizations who do not understand the nature and importance of this issue at this stage. This is a story that should be honored, and we hope that through our work, there will be more like-minded people who will care about the future fate of a small nation and the fate of wildlife in general.

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