Medicine in the "fog of war": what the Crimean officials are hiding

The pro-Russian Ministry of Health of Crimea is in no hurry to submit an official report on its activities and evaluation of the effectiveness of the implementation of state programs. Despite the fact that such a document was published in February for the year 2022, the results of last year were presented only at the level of a public statement by the Minister of Health of the Russian Government of Crimea, Konstantin Skorupsky. What is wrong with the data from the speech of the head of the Crimean Ministry of Health, which numbers were not processed and why it can be connected to the "fog of war" - read in this text.
The Numbers Game
On December 29, 2023, the Minister of Health of the Russian Government of Crimea, Konstantin Skorupski, summarized the annual results of work. He specifically noted that the "funding for healthcare in the Republic of Crimea in 2023 amounted to 69.1 billion rubles." It turned out that the stated amount is more than three times higher than the data from the pro-Russian Ministry of Finance of Crimea contained in the report on the implementation of the consolidated budget. It is noted that last year, 21.8 billion rubles were spent on healthcare.
At the same time, the Ministry's statement states that 9.1 billion rubles were directed towards "modernizing the regional healthcare infrastructure and improving the material and technical base of medical organizations." However, the day before, Deputy Minister of Health of Crimea, Anton Lyaskovsky, in an interview with Russian propagandists, reported that 1.6 billion rubles were allocated for the development of healthcare in 2023.
Furthermore, Konstantin Skorupski provides numerous pieces of information about the number of capital repairs, purchased machinery and medical equipment, as well as new healthcare facilities that have been put into operation - 67 hospitals and maternity wards and 15 medical clinics. At the same time, the official emphasized that this is the cumulative result of several state and targeted programs. Such a note significantly complicates the verification of the authenticity of the published figures.
Taking into account the fact that the data on the website has not been updated for two years and that the planned indicators for new outpatient clinics amount to only four facilities, and according to another program, there is only budget expenditure alignment and last year's transfers in the form of a 68-page Excel table.
Despite this, an analysis of budget plans has found that in 2023, the Department only ensured funding for the construction of 51 primary-level facilities. This figure correlates with the data from an interview with Deputy Minister of Health of Crimea, Anton Lyaskovsky, who stated that 50 healthcare institutions were opened in 2023. Thirdly, the exaggerated indicators regarding the construction of outpatient clinics from Skorupski's speech were not reflected in official documents.
What did the minister omit?
Despite dedicating so much attention to the construction of new medical facilities in his speech, the head of the department did not say a word about the fate of 10 emergency medical stations in Sakhi, Yevpatoriya, Sudak, and some villages. Skorupski stated that their opening was planned "in the near future," as early as April 2023. Pro-Russian propaganda media outlets repeatedly reported that ten stations would be built in 2023.
In October, the Russian head of Crimea, Sergei Aksenov, called for the dismissal of officials from the state public enterprise "Investstroy Republic of Crimea" for failing to meet the deadline for building emergency medical stations. In December, the director of the Crimean Republican Center for Medicine and Emergency Medical Care, Halina Buglak, reported that only two new stations were opened in 2023, including the station in Razdolnoye, whose opening was announced in parallel with the construction of the other ten.
Additionally, the statement from the Russian Minister of Health of Crimea makes no mention of the shortage of medical staff. 
"This year, 732 specialist doctors, 146 physicians, and 586 mid-level medical and pharmaceutical workers have been engaged," Skorupski stated, without specifying how many resigned or how many staff positions are still vacant. In his interview, his deputy, Anton Lyaskovsky, also avoided details, mentioning only that "by the end of 2023, medical organizations in Crimea will receive the necessary staff in 90 percent of cases."
However, a month and a half later, the Russian head of Crimea, Sergey Aksyonov, stated that the peninsula lacked 500 doctors and around 1,000 junior and mid-level medical staff. Considering that the total number of doctors in Crimea in July 2023 was around 6,500, the staff's fill rate does not exceed 81 percent.
Furthermore, attention is drawn to the minister's claim that more than 9,000 patients received rehabilitation assistance. The statement specifies medical rehabilitation. However, for some reason, the report from the head of the Crimean Ministry of Health does not mention the total number of patients who received not only medical but also rehabilitation in spa resorts and sanatoriums. This is particularly noteworthy compared to official data from 2022 when over 34,000 Crimeans were covered by rehabilitation programs.
The last inconsistency can be explained by the fact that sanatoriums and spa resorts for rehabilitation in Crimea were actively used last year to improve the health of Russian military personnel involved in the war against Ukraine. In this case, disclosing the total number of patients who received referrals to sanatoriums and spa resorts in 2023 as part of the rehabilitation program can reveal the overall extent of the use of these facilities for the needs of the Russian military.
As early as July, human rights activists from the organization "Krim SOS" claimed that the sanatoriums were filled with military personnel of the Russian army. They also reported that the Republican Medical Center named after Semaško was given for the needs of the military. Furthermore, as early as February 2023, Crimean officials announced plans to open departments for military personnel in the city of Sakskaya and hospitals for physiotherapy. A closed report from the Human Rights Initiative "IRADE" (the text of which is available to editors) also mentions several other civilian health facilities on the peninsula where Russian soldiers injured in the war zone in Ukraine are treated alongside civilians.
The Center for National Resistance has announced that an increasing number of hospitals are being converted into medical facilities for military needs. "The healthcare system cannot withstand the burden of hospitals due to the large number of wounded Russian soldiers. This affects the quality of medical services provided to the civilian population," the report from the unit under the command of the Special Operations Forces of the Armed Forces of Ukraine states.
These circumstances could serve as a reason for the apparent "fogginess" in the year-end summary by the Ministry of Health of Crimea, as well as explain the absence in the public domain of important indicators such as the mortality rate from diseases, especially cardiovascular diseases. These and other crucial figures, which provide a general overview of the state of healthcare in Crimea, are not present in the department head's address or in the data of the Crimean administration of the Federal State Statistics Service.