21 December 2000
As the second winter under siege sets in, Grozny today is a living hell. It is another world, some dreadful Hades you can only reach through the Looking Glass. There are no signs of civilisation among the ruins, apart from the people themselves. More important are the ideas and expectations that rule here. For some, laying mines has become a more familiar activity than cleaning their teeth. Going out into the streets of Grozny increasingly resembles a step towards the abyss. Going back to your apartment can be like a trip to the next world.
Grozny City Hospital No 9, the only hospital still continuing to admit the city's wounded, is the most accurate mirror of all that is going on in this blockaded city at the end of the twentieth century.
An Apartment-Minefield
Like a small hunted animal, Isa Shashayev peers out from under the blanket drawn up to his chin. All he does is shift his suffering gaze from the hospital wall on the right to the wall on the left. He maintains an expressive silence. The doomed look in his eyes is that of someone who's decided to drown himself. Isa is 25.
"When they brought him in there were splinters dangling from his calf. They looked like a fan. His legs were torn and shattered, one foot had gone and the other was barely attached," explains traumatologist Hasan Khadjiev.
In half-empty Grozny this winter there are hardly any doctors. Anyone who is able has got as far away as they can from these heartrending horrors. Hasan stayed behind, though, and his motives were deeply ideological. He offers such a clear and simple explanation that it's awkward to press for any clarification:
"Who if not me? Knowing my skills as a surgeon and having taken the Hippocratic oath, I was obliged to remain. From a surgical point of view, I mean."
Naturally. Today Hasan is one of three traumatologists on whom all Grozny depends – this appalling contemporary Stalingrad where every day the mines take their cruel and merciless toll.
Yet what happened to Isa is not at all straightforward. It isn't the usual story of one of the city's inhabitants who went out to find bread and water and was crippled when he accidentally stepped in the wrong place. The way Isa lost his leg is a particularly cynical story, which, alas, is growing more typical of life in the Chechen capital.
During the daytime on 6 December he came home to check on his half-destroyed apartment, which had not been repaired for use this winter. (Isa's family are living scattered among relatives and acquaintances, while the men try to patch up the shattered walls.) Isa had just lifted a board from the floor when there was an explosion. Some visitor had packed away an anti-personnel mine there, as a present for the owners.
Such atrocious cruelty did not occur the previous winter in Grozny, nor this summer or autumn. Mined apartments typify the present winter. There may be some logic behind it, but it is the thinking of humans who have lost all normal decency.
"Who benefits? Who's doing such a thing? Why put mines in apartments and people's homes?" I ask.
"So that they don't return," Isa answers with difficulty, not wanting to say a word. He prefers not to speak and the words are as hard to drag out of him as the fragments embedded in his legs. "So that people go anywhere but back to their homes. So that Grozny closes down."
A grim-looking nurse who has come into the ward joins in:
"Usually the mines are planted by those who want to take over the apartment. Neighbours. They want to improve their own living conditions. Actually, Isa was lucky. My aunt died from the mine left in her flat. She was killed outright."
The nurse has come in to fix up a drip for Isa's fellow patient, Musa Shapayev, a 30-year-old from Alkhan-Yurt, not far from Grozny. Musa was caught in crossfire on the same day, 6 December, when he was driving through Argun in his car. No one knows who was firing at whom. He was hit in the head but managed, barely conscious, to get away from the shooting. He then crashed his car into a telegraph post.
"Our motto is: Be extremely careful when entering your apartment – it's a minefield," Musa tries to make a joke of it.
His lips even curve to form a smile. But not for long.
Doctor Hasan asks me to come into the next ward. There Asya Khasuyeva, a smiling fair-haired beauty, is trying for the first time to get back on her feet. Asya and her family had returned home from the refugee camp in Ingushetia, to Okruzhnaya Street in Grozny's October district. She was walking in front, the children a little way behind, so she took the full impact of the explosion. She is only now learning to stand: it will take a great deal longer for her to walk again. The doctors performed three operations, trying to reconstruct her legs from what remained and restore some feeling. Even so she now has only half of her left leg which is covered in scars, while the right has no foot.
"Where are the children?"
"My husband took them back to Ingushetia. They're waiting in a tent there, hungry and cold, and they don't go to school. But they're alive. People don't lay mines for each other there."
Salman's Band
There are as many different Salmans as there are Ivans. Some make it hard to live, others help people survive. Judging by appearances Salman Raduyev,71 who was formerly thought to be mentally ill, is now quite cured and lives far more comfortably in Lefortovo prison than the patients in Grozny Hospital No 9. There is another Salman, though, who is today probably the most popular doctor in Chechnya. Salman Yandarov heads the traumatology and orthopaedics department at the hospital and is already a legendary figure.
Yandarov is 62. He had everything in St Petersburg – a career, a professorial chair, a clinic and research facilities, students and admirers, medical congresses, published articles, and all the brandy and receptions that go with the job. He lacked for nothing. When it became clear, however, that there were no surgeons left in Chechnya and that more and more people were being crippled and injured by mines, Professor Yandarov renounced all the pleasures and temptations of civilised medicine and returned to the city he had left 40 years before. What does he possess today?
Nothing. To begin with, he has no home. Between operations and his tours of duty he moves from one friend to another, and they give him shelter and food. He is also without money. A short while back doctors were given a month's salary for the first time in half a year.
But that is not the most important thing, Salman and Hasan Khadjiev assure me. The hospital is crammed with the most seriously injured patients: amputees suffering from gangrene and sepsis, to which are added the penniless soldiers who urgently need operations.
But Hospital No 9 has absolutely nothing with which to get people back on their feet, let alone equip them with artificial limbs. There are no reagents for the X-rays, no medicines, no serums to combat gangrene, no Ilizarov appliances,72 nor even anaesthetics. "It's absolutely surreal," says Salman Yandarov in the sad, slow, deliberate tones one adopts when speaking at a funeral. "Call it what you will, but one thing it's not is medicine in the late twentieth century. We're dragging people back from death with our bare hands. We have none of the things that are usually considered the achievements of traumatology in the last 50 years. We've returned to the 1950s as far as our methods of work are concerned."
Hamsat Elmurzayev, a 58-year-old traumatologist joins the discussion: "Tell them the most important thing, Salman! Methods? What methods? We're analysing urine samples here by taste and appearance. Just like in Ancient Greece. We don't even have reagents for analyses. It's inconceivable!" Hamsat is the third doctor on whom all depend in today's mine-ridden city. Every morning, as soon as the curfew ends, he goes out to the road leading from Starye Atagi to Grozny and tries to get a lift into the city. The distance is 24 kilometres. He used to have a house in the very centre, next to Minutka Square, but it was struck by a penetration bomb and now Hamsat has to pass several army posts where, like everyone else, he receives a daily portion of humiliation.
"I am a doctor," he tells the soldiers, who with deliberate slowness flip through his passport in search of rouble notes inserted between the pages. "I am in a hurry to get to my patients. Let me through."
The reply ("Stop!") is rude and categorical. So Hamsat stands there waiting, because there is no 50-rouble note in his passport. How could there be? Long ago it was reported to Moscow that the money to pay medical salaries had been transferred, yet the heroic doctors at Hospital No 9 have not had a sight of any for months. The only ones who remain, therefore, are the idealists. The rest have long since disappeared in search of a better future.
"Do you know how to carry out an operation, when you don't have the essential range of anaesthetics that any accident and emergency hospital like ours should have?" asks Dr Elmurzayev.
I don't know. They tell me the kinds of things that happen: the doctors are forced to break the law (according to the letter of our Criminal Code) rather than violate the Hippocratic oath.
Let me describe one of these crimes of salvation. It's obvious that no other narcotic substances, apart from those officially licensed, should enter the republic. Chechnya is a restricted area surrounded on all sides by checkpoints and army posts where a body search has replaced the morning shower. A private trader who tried smuggling drugs in those circumstances would be buying a one-way ticket to jail.
Official statements by Russia's Ministry of Health indicate that the Ministry of Health in Chechnya is receiving more or less the quantity of anaesthetics it requires. They're just not reaching the hospitals. Having legally passed all army posts and borders, accompanied by Health Ministry documentation, the narcotics immediately become a commodity for private dealers. You need an operation? Pay them. Who? Naturally they are front-men for someone else, these private chemists. Although neither doctors nor relatives of the wounded have the right to do so (it's a criminal offence!), they buy narcotics from under the counter. What choice do they have? Someone is already on the operating table: he's bleeding and at that moment the chemist appears, while the cost of every passing second could be the life of your patient.
Incidentally, this also applies to the seriously wounded soldier who has been brought to Hospital No 9 from one of the surrounding posts because there is no time to get him to the military hospital at Khankala. The doctors all chip in and then someone runs off to buy the necessary anaesthetics.
Why, you ask, does the health system force Drs Salman, Hamsat and Hasan to work in such conditions? Who's making a profit here? Where is Uvais Magomadov, the Minister of Health for Chechnya?
What can be taking up all of his time and energy?
Like everyone else in government, Magomadov prefers to keep well away from the hell that is Grozny and is sitting things out in Gudermes. Only when important officials from Moscow pay a visit to Chechnya does Magomadov return to Grozny. Then he is always with them, listening resignedly to the outraged cries of the patients and doctors who demand that he "do anything, but do something". After which he returns to his other affairs.
Next, a consignment of humanitarian aid is sent to Gudermes, to Mr Magomadov, thanks to the generosity of those same important officials: medicine, Ilizarov appliances, bandages, disinfectant, plaster of Paris . . . Many thanks. Above all from the members of Magomadov's family, because they lack nothing in this world. The reason is that these precious gifts can only be obtained hereafter from private chemists. Their prices are astronomical and people are forced to mortgage their apartments and houses so that one of their relatives can have an operation.
Why doesn't the prosecutor's office in the republic do something? It is also based in Gudermes, like Magomadov. The revolting and shameless behaviour of local officialdom, which now has its hands on the money and the goods, is as typical of Chechnya today as the ubiquitous anti-personnel mines and the ceaseless gunfire. The war has thrown up its Salman Raduyevs, its Salman Yandarovs and also its Uvais Mogamadovs. The only remaining question is which of them will win?
The patients in the wards are always better informed than the doctors. They begged me to expose this lawless and shameful situation so that people in Moscow finally understand: Hospital No 9 is the only place where operations are carried out today in Grozny and so medical supplies should be sent there directly, by-passing the warehouses of the Chechen Ministry of Health. They should be handed over directly to the doctors; otherwise everything they need to save people will only be available outside, in the market place.
There is one other reason for the very difficult situation now affecting Hospital No 9 and the health system in Chechnya as a whole. As is our custom, it is ideological in nature. At the federal Ministry of Health in Moscow it is hardly a secret that an unspoken principle reigns in every official's office. Why should any of them get upset and make efforts to send something down to Hospital No 9 if it is only going to help wounded Chechen fighters? This attitude has such a hold on our officials that it paralyses any attempt at control or supervision: the medicine was sent, and that's an end to it. There wasn't very much of it? Well, perhaps not. The military also add their arguments: "The Chechens are the ones laying mines and explosives, and they're the ones who get blown up. Serves them right."
"Nonsense," retorts Dr Yandarov, "I should know. If there are a great many fragmentation wounds then it means the victims are civilians. You'll find that in any textbook. In this hospital 95 per cent of the patients are suffering from shrapnel wounds, the rest from bullet wounds. As concerns wounded Chechen fighters I don't believe these fairy tales about hundreds of them crossing the mountains into Georgia and Azerbaijan, and then going on to Turkey. That's rubbish. You couldn't carry the seriously wounded across our mountains; they'd die before you got over them. That means that most of the fighters would surely be brought to us. Yet nothing of the kind is happening. So this war is being fought against civilians. I should know."
"But they say the fighting is over."
"The fighting continues. If there's no fighting then who are my patients?"
Everyone is tired of this war. Even of talking about it. At least, in my native Moscow. When you tell even very close friends and relatives on your return about that other world you are met with disbelief. A shadow of doubt crosses their faces and they think to themselves: "There she goes again, making up these hellish stories. Don't bother us. You'd do better to start thinking about the New Year celebrations."
All right, I'll give it some thought. But what will Isa Shashayev do now with the rest of his life? A 25-year-old Chechen, he stepped on a mine in his own apartment. For the last ten years he has faced the uncertainties, unemployment and the lack of a future that is life in Chechnya since 1991. Now, to crown it all, he is permanently disabled.
"What am I going to do, you ask?" says Isa. He retreats into his thoughts, sinking ever deeper beneath the blanket. "I'll play the bandit, of course. You lot don't expect anything else of us, do you. . . ?"
GROZNY