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Trip of the First Lady to Kazakhstan, Kyrgyzstan, Uzbekistan, Russia, and Ukraine, November 9-8, 1997 (David) [Binder][7]
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Trip of the First Lady to Kazakhstan, Kyrgyzstan, Uzbekistan, Russia, and Ukraine, November 9-8, 1997 (David) [Binder][7]
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Noa Meyer's Files
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Withdrawal/Redaction Sheet Clinton Library DOCUMENT NO. SUBJECT/TITLE DATE RESTRICTION AND TYPE 001. reports bios (13 pages) C 10/1997 P1/b(1) 002. report Government Structure (1 page) nd P1/b(1) COLLECTION: Clinton Presidential Records First Lady's Office Speechwriting (Noa Meyer Subject Files) OA/Box Number: 13007 FOLDER TITLE: The Trip of the First Lady to Kazakhstan, Kyrgystan, Uzbekistan, Russia, and Ukraine, November 9-18, 1997 (David) [Binder] [7] 2012-0869-S kc959 RESTRICTION CODES Presidential Records Act [44 U.S.C. 2204(a)] Freedom of Information Act - 15 U.S.C. 552(b)| P1 National Security Classified Information [(a)(1) of the PRA b(1) National security classified information |(b)(1) of the FOIA] P2 Relating to the appointment to Federal office [(a)(2) of the PRA] b(2) Release would disclose internal personnel rules and practices of P3 Release would violate a Federal statute [(a)(3) of the PRA] an agency [(b)(2) of the FOIA] P4 Release would disclose trade secrets or confidential commercial or b(3) Release would violate a Federal statute |(b)(3) of the FOIA] financial information 1(a)(4) of the PRA b(4) Release would disclose trade secrets or confidential or financial P5 Release would disclose confidential advice between the President information |(b)(4) of the FOIA] and his advisors, or between such advisors [a)(5) of the PRA] b(6) Release would constitute a clearly unwarranted invasion of P6 Release would constitute a clearly unwarranted invasion of personal privacy [(b)(6) of the FOIA| personal privacy |(a)(6) of the PRAJ b(7) Release would disclose information compiled for law enforcement purposes [(b)(7) of the FOIA] C. Closed in accordance with restrictions contained in donor's deed b(8) Release would disclose information concerning the regulation of of gift. financial institutions [(b)(8) of the FOIA] PRM. Personal record misfile defined in accordance with 44 U.S.C. b(9) Release would disclose geological or geophysical information 2201(3). concerning wells |(b)(9) of the FOIA] RR. Document will be reviewed upon request. UKRAINE: CHILDREN'S ISSUES Deteriorating conditions. Children in Ukraine, along with the elderly, are bearing the brunt of the country's economic and social decline. Many families are no longer able to afford a balanced diet for a child's physical development. Since 1996, the production of baby food and juices, vitamins, and vitamin- fortified milk has decreased significantly. Social stresses within families caused by un- and underemployment, non-payment of wages, alcoholism and disease, have led to sharp increases in spousal and child abuse - this combined with an already high divorce rate. Adoption. Public concern over the fate of children adopted by foreigners triggered a new adoption law providing for thorough court examination of each case and follow-up monitoring of the children's well-being. In general, the adoption process appears to be going smoothly in most of Ukraine. In the last year, 46 Ukrainian children have been adopted by American families. Children of Chornobyl. Eleven years after Chornobyl reactor number nine exploded, the effects of this tragedy can be seen in numerous children who suffer from radiation sickness manifested by a drastic rise in the occurrence of thyroid cancer. Congenital birth defects in the Chornobyl area are also abnormally high. (The radiation levels in Kiev today are normal.) A major portion of Ukraine's budget is devoted to dealing with the consequences of Chornobyl through various clean- up, social and healthcare programs. The U.S. and the G-7 are sponsoring major programs to stabilize the damaged reactor and its surrounding "sarcophagus," and to deactivate the Chornobyl complex by the year 2000. Children's rights. The Ukrainian government is publicly committed to the defense of children's rights, but it has struggled to implement its agenda. Guaranteed public education and free health care for children, with special benefits for children affected by Chornobyl, are the stated goals. There is no societal pattern of abuse of children, but trafficking of children for sexual exploitation is on the rise. Pediatric Health. Approximately one-fifth of the Ukrainian population is under 18 years of age. The Ministry of Health estimates that forty percent of all children are experiencing "abnormal physical development" - demonstrating growth patterns and organ functions that are outside the normal range. Respiratory disease accounts for more than half of childhood morbidity, followed by skin disease, and diseases of the nervous system. Children still suffer from vaccine-preventable diseases. Government reports indicate that 30 percent of all children need psychological help. UKRAINE: HEALTH ISSUES Overview. As in most of the former Soviet states, health care in Ukraine is in crisis. Life expectancy is dropping, infant mortality is rising, and the general health of the population is declining. Health education is also deteriorating due to low salaries, supply shortages and inadequate facilities and equipment. General measures of health (e.g., WHO) rank Ukraine among third world countries statistically, despite the presence of a large medical care and medical training system. Ukraine has one doctor per 222 people and a total of 3,900 hospitals (with 679,000 beds), 7,000 state run out-patient clinics and 50 private clinics. Respiratory diseases, heart ailments and alcoholism are the major adult afflictions. Since 1992, incidence of tuberculosis, diphtheria and cholera has increased sharply. High cost. Health care services are funded almost entirely by the government and are delivered very inefficiently. The government plans to spend three percent of GDP on health care in 1997. The emphasis is on in-patient care, with long hospital stays the norm. Preventive medicine has been neglected. Moreover, physicians -- most of whom are women -- are often assigned tasks that could easily be carried out by less-trained health professionals. Hospital administrators are almost uniformly male. There is a clear need to reduce the number of hospitals and staff. Pharmaceuticals. Ukraine's dependence on suppliers in other former Soviet republics for most pharmaceutical raw materials has resulted in serious shortages since the breakup of the USSR. Domestic manufacturing meets less than 20 percent of the country's pharmaceutical needs. Ukraine lacks production facilities for some essentials, such as oncological drugs, cardiovascular medicines and vaccines. In 1997, availability of the simplest antibiotics, hypertension medications, insulin, and other medications improved somewhat, but prices increased dramatically. Major multinational pharmaceutical companies have begun marketing their products, but the prices charged limit availability to the wealthiest consumers. Patients are required to supply their own medications for hospital stays. AIDS. Although few deaths from AIDS have been recorded in Ukraine, accurate data are not available and the incidence of sexually-transmitted diseases and AIDS is believed to be increasing. Ukraine recently saw a sharp increase in newly infected injecting drug users in cities bordering the Black Sea. HIV-positive persons in Nikolayev, for example, rose from 1.7% of injecting drug users to 56.5% during 1995. The potential for the infection to spread, particularly to women, is worrisome given low condom usage and sexual trafficking in Ukrainian women. Trafficking to Western Europe, Turkey and the Middle East is reputedly common. Resources for prevention, counseling and availability of prophylactics are extremely limited. Combined with sexual promiscuity among the young, the potential for a sharp increase in AIDS cases is large. Ukraine and Health Care Epidemics of infectious diseases plague Ukraine - the worst epidemics are AIDS, TB, STDs and Hepatitis. The Ministry of Health is asking the World Bank for help in all these areas. TB already infects one-third of the world's population, 50 million of whom have drug-resistamt strains of TB. Approximately 3 million people will die from TB this year. Rates of TB have nearly doubled in the last 5 years in Ukraine-they are now five times the rate of the US. Odessa oblast has the highest rate of TB in Ukraine with 52.2/100,000 cases in 1996 compared to 25.5/100,000 for Kiev City. There are 12,000 recorded cases of AIDS out of a population of 52 million This is the highest number of official cases of any country in the FSU. AIDS, HIV, and STDs are all on the rise in Ukraine due to unsafe sexual practices, prostitution, and intravenous drug use. As in Russia, the actual numbers of AIDS cases may be as much as 10 times higher- these are just official numbers. Maternal and Child Health. There are striking - and ominous - indicators of the deteriorating condidtion of maternal and child health Infant and maternal mortality continue to be a serious indicator of the health crisis. The Health Minister singled this issue out recently because of its urgency. The facts and figures singled out in the Bader letter of September 30 remain accurate with respect to the major crisis as the result of the lack of pharmaceuticals, diagnostic equipment, and even "off the shelf' items for hospital emergency rooms. Page 36 LEVEL 2 - 17 OF 311 STORIES Copyright 1997 Newsday, Inc. Newsday (New York, NY) October 26, 1997, Sunday, ALL EDITIONS SECTION: NEWS; Page A04 LENGTH: 4801 words SERIES: CRUMBLED EMPIRE, SHATTERED HEALTH. First in a series. HEADLINE: CRUMBLED EMPIRE, SHATTERED HEALTH / DIAGNOSIS: CRITICAL / IN THE REMNANTS OF THE USSR, HEALTH CARE IS IN A DEADLY STATE OF SHAMBLES (NS BULLDOG EDITION) CRUMBLED EMPIRE / SHATTERED HEALTH / THE COLLAPSE OF HEALTH CARE IN THE FORMER SOVIET UNION. NEWSDAY COVER PHOTO BY VIOREL FLORESCU- (PATIENT IN A RUSSIAN HOSPITAL) BYLINE: Laurie Garrett. STAFF WRITER; Others making key contributions to the series were Newdsay's Moscow Bureau chief, Susan Sachs; former bureau chief Ken Fireman; research Tami Luhby; and staff writer Delthia Ricks. DATELINE: TSKHINVALI, GEORGIA BODY: IN THE SERIES. Today, Newsday begins a series of stories by Pulitzer Prize-winning reporter Laurie Garrett and photographer Viorel Florescu on the collapse of public health in the former Soviet Union at a time of dramatic social upheaval. The stories will appear in the news section, in special reports in the Discovery section and online at http://www.newsday.com. Researching the story led Garrett and Florescu to Moscow, Kiev and St. Petersburg, as well as locations as far-flung as Tallinn, Estonia, in the Baltics; Ulan-Ude on the Russo-Mongolian border; Nor'ilsk, 175 miles above the Arctic Circle in Siberia; war-torn Ossetia, on the Georgian frontier; Chernobyl, Ukraine; and Bohemia in the Czech Republic. TSKHINVALI, GEORGIA Most of the patients have been sent home because the vast medical complex has no heat. The nurses are huddled around a burning log in a makeshift fireplace carved out of a cement floor. But up on the fourth floor of Republican Hospital, remarkably, medicine is still being practiced. Two surgeons are performing a hernia operation with uncommon skill - and uncommon speed. As a doctor anesthetizes the patient with an ether-soaked handkerchief and a nurse keeps him breathing with a hand-operated ventilator, the scrub nurse scoops up a pile of bloodied surgical instruments and carries them to a basin of pink water that has been standing uncovered for hours. Working barehanded, she dunks the instruments in the water, swishes them about and returns them to the operating table with no further effort at sterilization. A moment later, one of those instruments is inside the patient, clamping off a section of intestines. The operation is finished in less than 10 minutes. When the surgeons are complimented on their speed, one replies: "It's not a matter of choice. We must TM TM TM LEXIS:NEXIS® LEXIS·NEXIS' LEXIS:NEXIS® A member of the Reed Elsevier plc group A member of the Reed Elsever plc group A member of the Reed Elsevier pic coup Page 37 Newsday (New York, NY), October 26, 1997 go fast. The generator only supplies 15 minutes of electricity for the lights." This provincial hospital is far removed from Russia's great cities, and Georgia has fared far worse than most former Soviet republics since the union split apart in 1991. But while the problems here may be especially acute, they are not atypical. Throughout this vast ex-superpower, the health care system once touted by the Soviet leadership as an exemplar of "the human, caring face of socialism" is a shambles. Life expectancy rates have plunged precipitously, driven downward by a deadly combination of spreading disease, alcohol and drug abuse, poor nutrition, chronic underfunding of medical facilities and isolation from Western scientific advances. In one year alone, 1993, the life expectancy at birth for Russian males dropped from 61 to 58, according to the World Health Organization. Russia's death rate in 1995 was 1.6 times greater than its birthrate, triggering a decline in its population unprecedented in post-war times, and the premature death rate for adults has more than doubled since 1960, according to government data. The impact of this crisis is also falling heavily on those most vulnerable: the region's children. They suffer from high rates of birth defects, disease and mortality, bear the brunt of their parents' drug and alcohol abuse and are often denied medicines because of a belief that they are "weakened" and cannot handle certain antibiotics or vaccines. As a consequence, they are far less likely to reach adulthood than their Western European counterparts, according to UNICEF. Children in Russia, the largest of the former Soviet republics, are 2 1/2 times more likely to die before age 5 than American children, global health experts say. Some doctors find this unbearable. At the Leningrad Republican Infectious Disease Hospital, for instance, Dr. Paul Sergeyev tenderly strokes the blond head of 9-month-old Natalia, who was abandoned by her HIV-positive, opium-addicted mother as soon as she was born. "We can't know for sure whether a child is infected with HIV until 3 years old, II he says with a frustrated shake of his head as he gently places Natalia back in her crib. "We have no money for genetic testing. We have no money for anything. " Dr. Lev Mogilevsky, co-director of an infectious disease treatment facility in the Ukrainian city of Odessa, sums up the situation succinctly: "We can no longer control or manage disease, he said. "It manages us." An eight-month examination by Newsday that ranged over 4,500 miles, visiting 20 cities in five formerly communist countries, has found that this once-proud health care system has become a casualty of the region's wrenching historic transition. It's not clear how quickly this occurred, because past health care claims by the communist government were unreliable at best, fabricated at worst. But it is crystal clear the system today is collapsing, unable to adapt to a non-authoritarian society where individual choice reigns, power is decentralized and economic realities constrain choices. And while most experts are focused on the profound economic and political problems plaguing the region, it is also TM TM LEXIS:NEXIS' LEXIS:NEXIS' LEXIS·NEXIS' A member of the Reed Elsevier pic group A member of the Reed Elsevier plc group A member of the Reed Elsevier pk group Page 38 Newsday (New York, NY), October 26, 1997 clear that the collapse of public health is potentially just as destabilizing. Here's what Newsday found: - Infectious diseases long thought to be under control or largely extinct in the developed world have swept through former Soviet republics in a rolling series of epidemics, producing disease rates far exceeding those in Western countries. These diseases - which include tuberculosis, hepatitis, cholera, typhoid and influenza - have been spread by chronically poor medical hygiene and sanitation, as well as misuse of antibiotics. The tuberculosis rate, for instance, is 10 times the rate in the United States, and growing. - The long decades of government-enforced isolation from the rest of the world have bred a striking ignorance of many modern medical advances among health care professionals, and a widespread public belief in unscientific folk remedies. For example, only 60 percent of Russian children under age 5 have been fully immunized - according to World Health Organization standards - against the six most common vaccine-preventable diseases, in large part because of opposition from parents and doctors who believe children with the mildest health problems should not be vaccinated. The U.S. rate, meanwhile, is above 95 percent. - The former health-care delivery system - inefficient, expensive and authoritarian, but widely accessible - has all but collapsed in the wake of a massive funding crisis, and little has been done to replace it. The Russian government, for example, currently earmarks less than 2 percent of its annual budget for health services, compared with nearly 20 percent in the United States, resulting in chronic shortages of supplies, deteriorating physical facilities and late payment of wages to personnel. In most hospitals visited by Newsday, strapped officials had stopped ordering rubber gloves and paper towels to save money. - Long-term environmental problems are taking a growing toll on the public's health. In St. Petersburg, for instance, officials acknowledge they can no longer supply safe water to the city, a problem that resulted this summer in more than 500 cases of dysentery. In Russia as a whole, the Environment Ministry has concluded half the nation's drinking water supply is unsafe. - Hundreds of thousands of new patients are now entering the health system due to an unprecedented surge in drug abuse, which has fueled an explosion of HIV and hepatitis and compromised part of the region's blood supplies. There are few public education programs on the dangers of sharing needles, for instance, within a huge region in which two-thirds of AIDS patients are drug users. "We broke old mechanisms which managed society and health care, and we didn't create new ones, we didn't know how to," Mogilevsky added. "Now health care is on the brink of complete ruin. The crisis threatens to engulf not only the 280 million people who live in the republics that once composed the Soviet Union but, because of immigration patterns and political interdependence, large parts of the rest of the world as well. For as the incidence of infectious disease increases, neighboring nations in Europe and popular immigration destinations such as the United States and Canada become increasingly worried. TM TM LEXIS:NEXIS® LEXIS·NEXIS' LEXIS·NEXIS® A member of the Reed Elsevier plc group A member of the Reed Elsevier pin group A member of the Reed Elsevier plu group Page 39 Newsday (New York, NY), October 26, 1997 One World Health Organization official called a 1995 diphtheria epidemic in Russia "the biggest public health threat in Europe since World War II." Just as ominously, there is concern that the health care crisis will provide potent new ammunition to ultra-nationalist politicians who argue that American-style democracy and cooperation with the West have failed and that only a revival of authoritarianism can solve Russia's problems. "How can the society, the economy, the military bear such a burden?" asked Murray Feshbach, a Georgetown University demographer who has studied Russian trends for years. "Will it lead to social disarray? Can the economy survive? Will a conservative military-type leader decide to overthrow the government? Why are these not viable possibilities if one looks at Russia from the demographic and health prism, and not just the political and economic dimensions?" There is some evidence that this concern is well-founded. A poll ranking the concerns of Russian citizens earlier this year found that declining public health had risen to fifth (from ninth in 1995) and was cited by 29 percent of those responding as their top concern (up from 16 percent two years ago). Opponents of the present Russian government are seeking to exploit health care as a political issue. Communist leaders routinely blame Western-style capitalism for the surge in infectious diseases, alcoholism and drug abuse. They argue that the nation's strength and security have been compromised, citing government statistics that one in three army recruits are now rejected for health reasons, as opposed to 1 in 20 in 1985. And Russia's most prominent nationalist leader, Alexander Lebed, apparently has incorporated the issue into his standard stump speech. "Tuberculosis has increased - it's a rampant wave, Lebed barked in his gravelly baritone during a recent talk to a group of supporters in the Siberian city of Irkutsk. "We have to stop this rampant increase. We need to deal with AIDS too - we cannot wait There are skyrocketing infectious diseases. We must stop that - now. " But translating such stern rhetoric into reality may prove difficult for any politician, even one as accustomed to command as Lebed, a former army general. And if Lebed has any doubts of that, he might have a chat with a fellow Afghan war veteran named Konstantin. In 1993, two years after Konstantin was discharged from the military, communist and ultra-nationalist rebels seized the Russian White House in defiance of President Boris Yeltsin's order disbanding the old Soviet-era parliament. Konstantin grabbed his old army rifle and manned the barricades. The rebellion was crushed, and Konstantin wound up in Butirka Prison, charged with treason. When his case finally came up for judicial review last January, a judge dismissed the charges and ordered him freed. But by that time Konstantin had contracted tuberculosis, a huge and growing risk in Russia's grossly overcrowded jails and prisons. The treatment he received was erratic and ineffective, and the disease eventually spread from his lungs to his liver, kidneys and heart. Today, Konstantin, 39, who won't allow his last name to be used, lies dying TM TM LEXIS:NEXIS® LEXIS:NEXIS' LEXIS:NEXIS® A member of the Reed Elsevier pk group A member of the Reed Elsevier pic group A member of the Reed Elsevier pic Page 40 Newsday (New York, NY), October 26, 1997 in a bed at the Moscow Tuberculosis Research Center, his disease beyond the reach of any drug. "It's like a joke, a particularly Russian joke, he says. "In principle, I was given a death sentence." The rampant growth of tuberculosis among Russia's huge prison population - estimated to be as many as one million out of a total population of 140 million - is one of the engines that have driven the country's overall TB rate to a level at least 10 times greater than that in the United States. And while Russian scientists debate how to cope with the epidemic, those who care for TB victims in provincial facilities across the far-flung nation often work in the face of heartbreaking shortages. In one such facility, in the city of Ulan-Ude, capital of Buryatia, a region of Russia just north of Mongolia, Dr. Galina Dugarova cares for patients housed in three unheated log cabins. Patients must supply their own pajamas and bed linens; supplies of antibiotics and other medicines are erratic at best. "They are all going to die," Dugarova says as she ministers to four patients in the facility's intensive care ward. "We cannot treat them We would like to give them four drugs and some protein, but we have no money and they have no money. They are sentenced." As ominous as the TB epidemic is, it is just one of the infectious diseases that have swept through Russia and other former Soviet republics in recent years. While statistical comparisons over time are difficult because Soviet-era data were notoriously unreliable, both domestic and foreign experts agree that many diseases have registered alarming increases. Diphtheria, for example, infected 200,000 people in the region and killed 5,000 before it finally slowed down last year, thanks in part to a major international effort spawned by fears that the contagion would spread to other parts of the world. Polio rolled into Azerbaijan in 1991, Uzbekistan in 1993 and war-ravaged Chechnya in 1995. Hepatitis is now SO common throughout the former Soviet Union that it is regarded as endemic rather than epidemic. Influenza hit the region so hard in 1995 that the entire Ukrainian government was forced to shut down for a week. Typhoid infected 20,000 in the central Asian republic of Tajikistan last year, much of it surfacing in drug-resistant forms. Russia's second largest city, St. Petersburg, is currently coping with dual epidemics of cholera and dysentery for the third time since 1993. While there are many reasons for these contagions, one source is health care practitioners and medical facilities themselves, according to Western experts who have studied the problem. "I can't tell you how surprised I was by their lack of infection control, said Howard Cohen, former executive director of Coney Island Hospital in Brooklyn, which serves as a "sister" institution to a hospital in Odessa. "In the operating room they had commonly used soap bars, commonly used towels. Surgeons were going from one patient to another without washing. " Sometimes, lack of funds is the culprit, as in a children's hospital in St. Petersburg that suffered several outbreaks of internally generated infections last year. Investigators discovered that the cash-strapped facility had ceased TM TM LEXIS:NEXIS' LEXIS·NEXIS' LEXIS:NEXIS® A member of the Reed Elsevier plc group A member of the Reed Elsevier plc group A member of the Reed Elsevier plc group Page 41 Newsday (New York, NY), October 26, 1997 buying paper towels and rubber gloves. But in other cases, simple lack of knowledge born of isolation from Western colleagues is at fault. Cohen and others say most Russian and Ukrainian doctors believe airborne bacterial spores are the major source of infection within hospitals, whereas Western practitioners learned years ago that unsterile hands and instruments were the main culprits. "For seventy years, public health here was linked to ideology instead of science,' said Regina Napolitano, chief of infection control for Coney Island Hospital. "Now they're paying the price." In some parts of the region, these problems are exacerbated by the misuse of antibiotics, leading to the emergence of drug-resistant strains of bacteria. Dr. Ed O'Rourke of Boston's Children's Hospital, an expert in infectious diseases who has visited Russia and other ex-Soviet republics on many occasions, says physicians there often "simply add one antibiotic on top of another" without any particular rationale. 'Rourke has been urging doctors in the region to revamp their system for controlling infectious diseases, but fears he's made little impact. "It's as if they have horses and carriages but want diesel trucks,' he said. "And we're trying to tell them that what they need to do is forget about these diesels and use the horses and carriages properly." Another key source of the epidemics is a plummeting rate of vaccination against infectious diseases that began in the 1980s and has continued unchecked into the current decade. Part of the blame for this lies with Soviet-era health officials, who trained pediatricians to withhold vaccinations from children with minor ailments - or merely a family history of a disease - on the theory that such "weak" children would be harmed rather than helped by inoculation. One scientist, Dr. Galena Chervonskaya, carried this theory to extreme lengths, arguing that domestically produced diphtheria and pertussis vaccines were contaminated with poisons. Her views were publicized in a mass-circulation newspaper, further depressing the vaccination rate - and opening the door to the likes of Boris Nikitin. Nikitin, 82, was trained in engineering, not pediatric medicine. But he has proclaimed himself an expert in child rearing, and his influence in Russia is often compared to that of Dr. Benjamin Spock in the United States. His "Nikitin Doctrine" holds that most clothing and medical treatment weaken children. "Nature has designed a certain stage in child development when natural immunity is formed, Nikitin says as he plays with his naked 6-month-old granddaughter outdoors on a chilly afternoon. "This natural mechanism is called children's infections. So this immunization of society is a great medical mistake." A similar attitude toward medical science can be found at an AIDS clinic in the Ukrainian capital of Kiev, where a patient named Viktor rejects the drug AZT in favor of another "treatment": a bullet-shaped piece of tin taped to his TM TM LEXIS·NEXIS' LEXIS:NEXIS® LEXIS:NEXIS® A member of the Reed Elsevier pic group A member of the Reed Elsevier plc group A member of the Reed Elsevier plc group Page 42 Newsday (New York, NY), October 26, 1997 chest. The 38-year-old postal worker explains he received the apparatus from a local healer who invented it "to measure biocurrents from my body. She charges the currents with a piece of tin, which we call a bullet. And the bullet counters my negative biocurrents." Such unscientific credulity can, of course, have tragic consequences. But given their history, citizens of the former Soviet Union might be forgiven their willingness to trust street healers over certified scientists. For most of their lives, the health care system was run entirely by the state - the same state that was systematically befouling their air, water and soil in its headlong race to create an industrial and military superpower regardless of human cost. The grim results of these policies can be found throughout the former union - from the ruined Reactor No. 4 at the infamous Chernobyl power station, to the 50 secret cities where nuclear weapons production has left a deadly legacy of contamination, to the toxic shroud that envelops scores of industrial cities like Angarsk. Angarsk, a Siberian city of 280,000, is ringed with aging chemical factories, oil refineries and energy production plants. The forest around the city has been denuded by acid rain; the landscape is webbed with rusting petroleum ducts. The sky is perpetually gray. The air smells of sulfur and methane and leaves an acrid taste in the mouth. "It's my perfume, one woman says sourly as she waits for a bus. Some Russian scientists believe that this rampant environmental degradation, when combined with the political disasters that have stalked their century, has permanently damaged the raw human material of the nation and damaged the population's health. In the industrial regions of Siberia, for example, the incidence of adult leukemia and Hodgkin's disease is nearly twice that seen in Western Europe. Overall, Russians are 1.8 times more likely to die of cancer than are Americans. "The Russian gene pool is destroyed,' asserts Dr. Askold Maiboroda, dean of the Federal Medical University in the Siberian city of Irkutsk. "First, there were Stalin's slaughters of millions of people, the most creative and intelligent people. Then more good people perished in the gulags And now we suffer an environmental assault unlike anywhere else. We are weakened. Our genes are damaged. You cannot expect much from the Russian people; do not ask much of us. " This attitude of passive hopelessness helps fuel another scourge: widespread and growing alcohol and drug abuse. Alcohol consumption, traditionally high among Russian men, has increased 600 percent in the nine years since the Soviet government called off an effective but highly unpopular anti-drinking campaign. During that time, deaths from alcohol poisoning and cirrhosis rose by 300 percent and 250 percent respectively. And many younger Russians, caught in the pyschic backwash of their society's unprecedented transition, have turned to hard drugs to relieve their angst. TM TM LEXIS:NEXIS® LEXIS:NEXIS® LEXIS·NEXIS® A member of the Reed Elsevier plc group A member of the Reed Elsevier plc group A member of the Reed Elsevier pl. proup Page 43 Newsday (New York, NY), October 26, 1997 "Look at that drunken idiot!" a teenager shouts to his laughing buddies as they watch a sodden man try to enter a Moscow subway through the exit turnstile. "Only fools drink bad vodka!" The teenagers, it turns out, are high themselves - but not on vodka, good or bad. They ve been doing a popular opium-based drug called poppy straw. Hundreds of miles east of Moscow, in the Siberian city of Novosibirsk, another group of young people has gathered in a nightspot called the 888 Club to drink, smoke and contemplate their uncertain futures. "I'm just a human, rolling through life," says 20-year-old Sevi. "I'm totally against drugs. My choice is vodka. I'm an alcoholic!" A bit later, the group is asked, "What is a Russian?" Alex, 18, has a ready answer: "Drinking. And loneliness. No one is lonelier than a Russian.' This existential glibness may sound hip and trendy in the mouths of young people. But when damaged, alienated people grow older and begin families, continued alcohol abuse can reap a harvest of misery, especially for the children of such parents. Vanya's parents were such people - chronic alcohol abusers who battled ferociously and sometimes violently when they drank. After one such bout, they separated. Vanya's mother brought him to Moscow's bustling Byelorussky train terminal when he was 9, let go of his hand, and disappeared into the crowd. When the police finally picked Vanya up last year, he had survived two winters by begging and sleeping in phone booths. Now, the 11-year-old boy lives in a children's shelter, trying to master the involuntary blinking and bed-wetting that remains with him as a reminder of his life on the streets. Similar stories can be found throughout the former Soviet Union. At least 700,000 children are homeless in Russia, according to government data, and a recent UNICEF report predicted the number is likely to mount. Alcoholism, the report said, "not only directly affects the child's well-being, it also tends to increase family conflicts, stress-related paternal mortality' and other types of breakdowns. " And children caught in the toils of these problems are likely to be the most vulnerable to infectious diseases. The rate of childhood tuberculosis in former Soviet republics, for example, is now at its highest level since antibiotics-based treatment was introduced in the 1950s. In Ukraine, the second largest republic, the incidence of diagnosed TB in those aged 14 and younger has doubled during the past six years. At the Kiev Institute of Pulmonology, where many of these children are treated, staff members are up against familiar obstacles - chronic shortages of money, drugs and diagnostic resources. In a ward in the institute, a woman named Galina lies quietly next to her 5-year-old grandson, Janya, bundling against the sick boy to ward off the chill of the unheated room. The lights have also been turned off in daylight to save electricity costs, making it difficult for Galina to read to the child on this TH TM TM LEXIS·NEXIS' LEXIS:NEXIS® LEXIS:NEXIS® A member of the Reed Elsevier plc group A member of the Reed Elsever plc group A member of the Reed Elsevier plc proup Page 44 Newsday (New York, NY), October 26, 1997 overcast afternoon. "The situation is just dreadful," says Dr. Viktoria Kostromira, the institute's director of pediatric services. "The government should take drastic action immediately, or we will have a huge epidemic." But such relief is unlikely, given the tight fiscal constraints that governments in Ukraine and every other former Soviet republic now face. And so the health care crisis deepens, statistical indices worsen - and those responsible for coping with the problems issue increasingly pointed warnings. "We want to make it clear to everybody that the national security of the country is threatened,' said Dr. N.F. Gerasimenko of the Academy of Medical Sciences in a speech to the Russian parliament earlier this year. "The situation is catastrophic It's even worse than it was in Russia one hundred years ago." TOMORROW: The Tuberculosis Epidemic Expected Life Span. Comparing life expectancy at birth, in 1995, in Russia and the former Soviet republics with the United States and several other western nations Life expectancy. Male Female. Russia 58 72. Armenia 68 74. Azerbaijan 66 75. Belarus 64 75. Estonia 65 76. Georgia 69 78. Kazakhstan 64 74. Kyrgzstan 63 72. Latvia 63 75. Lithuania 63 75. Moldova 65 73. Tajikistan 66 66. Turkmenistan 62 69. Ukraine 64 74. Uzbekistan 66 72 United States 74 80. Canada 76 82. Germany 73 79. France 74 82. United Kingdom 74 79. Italy 75 81. SOURCE: World Bank 1997 World Development Indicators Measuring Health. Comparing Russia with the United States by several measures of health and health care. All statistics are from 1994, unless otherwise noted Health care expenditures (as a percent of gross domestic product, 1990-95) Russia 4.8%. United States 14.3% People per physician. (1993) Russia 222. United States 421 Infant mortality. (deaths per 1,000 live births, 1995) Russia 18. United States 8 Death rate (all ages). (deaths per 100,000 population). M F. Russia 1,765.2 1,369.5. United States 919 839 Malignant neoplasms (cancer) (deaths per 100,000) M F. Russia 243.9 167.1. United States 220.7 190.5. Cerebrovascular disease (stroke) (deaths per 100,000) M F. Russia 227.7 350.9. United States 47.4 69.8. Pneumonia and flu. (deaths per 100,000). M F. Russia 32.5 9.7. United States 29.4 33.1. Tuberculosis of the respiratory system. (deaths per 100,000). MF. Russia 26.7 2.9. United States 0.5 0.3. Infectious and parasitic diseases. (deaths per 100,000) M F. Russia 35.6 8.8. United States (1992) 12.2 12.5. Diabetes mellitus. (deaths per 100,000). M F. Russia 6.3 13.1. United States 21.8 19.5. SOURCE: 1995 World Health Statistics Annual, a publication of the World Health Organization; Statistical Abstract of the United States, 1996; Centers for Disease Control and Prevention, TM TM LEXIS:NEXIS® LEXIS:NEXIS® LEXIS:NEXIS® A member of the Reed Elsevier plc group Q A member of the Reed Elsevier pk group A member of the Reed Elsevier plc group Page 45 Newsday (New York, NY), October 26, 1997 National Center for Health Statistics. Newsday Photos by Viorel Florescu- 1) Quick Cleanup. A nurse at Republican Hospital in Tskhinvali, Georgia, cleans instruments between surgeries by swishing them in a basin of water that has sat uncovered for hours. 2) Heartbreaker. Dr. Paul Sergeyev of Leningrad Republican Infectious Disease Hospital holds 6-month-old Lisa, who was abandoned by her HIV-positive mother. 3) Stretched. At Republican Hospital in Tskhinvali, Georgia, above, doctors perform an emergency surgery using generators and a manual pump. 4) At left, a piece of cloth that serves as a face mask and a pair of rubber gloves have been left to dry on a radiator at a tuberculosis hospital in Ulan Ude, Buryatia, where they will be reused. 5) Compassion. Dr. Igor Boychenko and nurse Galina Efremova talk to a patient at Ukraine's Odessa Oblast Hospital, now a sister' to Coney Island Hospital in a deal that is benefiting both. 6) A mother's warmth. Above, an unidentified woman tends her newborn baby at a hospital in Kurta, Georgia, in a former schoolroom with just a wood stove for heat. 7) At left, an unidentified man fills two buckets with water from a street pump in Irkutsk. Most homes in the Siberian city do not have running water. 8) TB Tests. Dr. Ludmila Ierbadaeva handles sputum samples in a TB lab in Siberia. There is no money for gloves, masks or for her salary. 9) Cold Comfort. A patient at a TB hospital in Tskhinvali has gotten a log to burn on the floor for warmth. GRAPHIC: Newsday Charts- 1) Expected Life Span. Comparing life expectancy at birth, in 1995, in Russia and the former Soviet republics with the United States and several other western nations. SOURCE: World Bank 1997 World Development Indicators. 2) Measuring Health. Comparing Russia with the United States by several measures of health and health care. All statistics are from 1994, unless otherwise noted. SOURCE: 1995 World Health Statistics Annual, a publication of the World Health Organization; Statistical Abstract of the United States, 1996; Centers for Disease Control and Prevention, National Center for Health Statistics. (see end of text) Newsday Photos by Viorel Florescu- 1-9) see end of text for captions. 10) Newsday Cover Photo by Viorel Florescu- (a patient in a Russian hospital; NS bulldog edition) LANGUAGE: English LOAD-DATE: October 26, 1997 TM TM TM LEXIS:NEXIS® LEXIS:NEXIS® LEXIS·NEXIS® A member of the Reed Elsevier plc group A member of the Reed Elsevier pk group A member of the Reed Elsevier group Page 46 LEVEL 1 - 18 OF 18 STORIES Copyright 1997 Newsday, Inc. Newsday (New York, NY) October 26, 1997, Sunday, ALL EDITIONS SECTION: NEWS; Page A42 LENGTH: 752 words SERIES: CRUMBLED EMPIRE, SHATTERED HEALTH. First in a series HEADLINE: CRUMBLED EMPIRE, SHATTERED HEALTH / FOR YEARS, A SECRETLY SICK SYSTEM BYLINE: By Susan Sachs. MOSCOW CORRESPONDENT DATELINE: MOSCOW BODY: MOSCOW Demographer Leonid Rybakovsky remembers the day that health statistics died in the former Soviet Union. It was 1976 and, in an Orwellian turn of phrase, the Communist Party central committee had created a "Commission on the Non-Publication of Data." "I was on this commission," said Rybakovsky, now, as then, the director of the federal Center of Demographics. "There were also generals from the Ministry of Defense and people from the ministries of central planning and economics,' he said. "A general got up and said to us all: We must not reveal the number of boys being born in the Soviet Union. Our enemies could use this information. We must make it a state secret. " There was no arguing with a general, Rybakovsky recalled. And so statistics about Soviet births by gender were classified. So was all information about life expectancy. Scientists in the know, like Rybakovsky, even had to sign a pledge never to reveal data about the state of the Soviet citizen's health. "It reflected the Soviet attitude toward human beings," he said. "We couldn't talk about public health SO the problems were never dealt with." The paternalistic mania for secrecy in the Soviet Union produced a generation of health-care workers who knew that the country's medical system was sick but could do nothing about it. Soviet researchers, for example, sometimes studied the ecological disaster areas dotting the country and their effect on public health. But not until a few years ago were the studies acknowledged and, in some cases, acted upon. TM TM TM LEXIS:NEXIS LEXIS:NEXIS' LEXIS:NEXIS® R A member of the Reed Elsevier pic group A member of the Reed Esever pk group R A member of the Reed Elsevier plc group Page 47 Newsday (New York, NY), October 26, 1997 "Fifteen years ago we did ecological research, but the studies were stuck in a cupboard, said Larissa Shcheplyagina, a Moscow pediatrician who has worked with children affected by the Chernobyl nuclear power plant explosion. "Leaders changed. Times changed. But the statistics stayed in the drawer." These days, she believes people are listening. Last year, Shcheplyagina headed a study of 3,500 children under the age of 14 in the highly polluted city of Klin, the birthplace of the composer Tchaikovsky, about 50 miles north of Moscow. The water, soil and air is polluted with sulfur dioxide, mercury, heavy metals and other contaminants from heavy industry. The study found alarming rates of asthma, chronic digestive diseases and endocrine system problems in young residents. "These children begin to fall ill from the day they are born, " said Shcheplyagina. "But now the local authorities have instituted a special project for diagnosis and treatment of ecological diseases. You could say that one of our achievements is the right to call a spade a spade.' In the new Russia, there are mountains of health statistics - more than the average person can digest. And they are, almost universally, bad news - catastrophic, even - when compared with the rosy propaganda that most Russians grew up believing. "In 1964 and 1965, our life expectancy for both men and women was as good as in the major industrial countries of the West," said Rybakovsky. "It was a period when we had combatted mass epidemics. Then everywhere else in the industrialized world, they began to improve the health system. In Russia, we only increased the number of beds. " The overall decline in the quality of health services, according to Russian health officials, really began in the 1970s, dubbed by subsequent historians as the "period of stagnation." It was the time of Leonid Brezhnev, the Communist Party general-secretary whose own health deteriorated over the years to the point that he was barely aware of what was going on around him. One tragic legacy of the period is the widespread incidence of iodine deficiency in Russia, which occurred because of the suspension in the 1980s of public health measures to counteract a natural shortage. The effect can be seen in the worsening health of young children - thyroid problems, low birth weights, mental retardation. By 1980, the average life expectancy at birth for Soviet males was 61.4 years, down from the 1965 post-war - peak of 65 years. By 1984, the death rate was 11.6 per 1,000 population, up from the low of 7.2 deaths per 1,000 in 1964. But the conspiracy of silence remained. While the death rate now is considered astronomically high by global health experts, it was also "very high in 1980, said Vladimir Shkolnikov, deputy director of the Russian Center for Demographics. But even then, he said, "I couldn't talk about it. Nothing was allowed to be published.' TM TM LEXIS·NEXIS' LEXIS·NEXIS' LEXIS·NEXIS® A member of the Reed Elsevier pk group A member of the Reed Elsever pk group R A member of the Reed Elsevier plc group UKRAINE: U.S. ASSISTANCE PROGRAM OVERVIEW Objectives. The primary mission of U.S. assistance to Ukraine is to help Ukraine succeed in the fundamental restructuring of its economic and political systems. The U.S. supports the economic and political reforms essential to dismantling the vestiges of a centralized, planned economy and establishing a stable democracy with a prosperous market economy, while maintaining social welfare and stability during and beyond this transition. Specifically, the U.S. assistance program seeks to catalyze an improved environment for business, investment, and trade while simultaneously encouraging environmentally sustainable development; promoting the democratic transition through strengthened rule of law and fostering of a civil society; and creating a more secure social safety net, including humanitarian assistance to the weaker segments of society. Funding. From 1991 through 1996 the USG obligated over $1.3 billion to assistance programs in Ukraine. For Fiscal Year 1997, approximately $225 million was budgeted for Ukraine from the Freedom Support Act (FSA). Through USAID, technical assistance is provided to such fields as economic restructuring, agriculture, environment, health, democratic reform, and private sector development. Programs such as the Peace Corps and the transport of humanitarian assistance are also funded from FSA. In addition, S51 million in Nunn-Lugar funds was provided in FY97 to assist Ukraine with nuclear dismantlement, non-proliferation programs, and industrial partnerships. The assistance budget for FY98 will likely be commensurate with FY97 assistance levels. Transition to a market economy. On the macroeconomic level, USAID provides technical assistance and training to help Ukraine formulate sound fiscal policies, fair tax systems and enforcement, transparent and accurate budgeting, customs regulations conducive to trade, and regulatory bodies that encourage savings and investment. USAID is assisting Ukraine to develop a civil code which would provide a legal foundation for basic business activities and reshape the banking system. Privatization and restructuring of existing state-owned and managed enterprises, development of capital markets, the encouragement of new business start-ups, and the easing of the regulatory and fiscal burdens on all enterprises are essential strategic steps towards a market economy. Linkages to USG-funded venture capital and lending programs, such as the Western NIS Enterprise Fund and the Eurasia Foundation, complement the full range of business services. The U.S. Department of Commerce (DOC) Special American Business Internship Training (SABIT) program provides training and financial services to Ukrainian professionals through placement in U.S. firms. DOC's Business Information Service (BISNIS) encourages and facilitates business partnerships between U.S. and Ukrainian companies. USDA's Cochran Fellowship Program provides short-term training to public and private sector specialists. There are currently about 190 Peace Corps volunteers serving in Ukraine, primarily in the areas of business development and English language instruction. The USG is providing expertise to restructure Ukraine's electric power monopoly and its coal sector. Working with its G-7 partners and the EU, the U.S. is seeking to develop an engineering solution to the sarcophagus which covers Chornobyl's destroyed Unit 4 reactor (preventing the release of radioactivity to the environment) and enhance operational and fire safety at all nuclear reactors in the country. Transition to democracy. The U.S. is assisting Ukraine to become a nation in which government policy and activity reflects the needs and wishes of an informed citizenry. USIA's exchange programs support this effort by providing over 8,000 Ukrainians the opportunity to meet U.S. counterparts. A. new initiative, Community Connections, will bring Ukrainian entrepreneur, legal, and government officials from 10 regions to establish linkages with U.S. counterparts. Through USAID support to civic groups, NGOs, political parties, and democratic free unions, the U.S. seeks to strength civil society, local government capacity, long- term viability of an independent media, and competitive and fair political processes, including elections. Support for the social sector. Political support for reform risks evaporation unless affordable programs can help protect Ukraine's most vulnerable citizens. USAID is helping to facilitate the price increases necessary to improve the quality of social services, laying the foundation for a sustainable social insurance system. USAID also helped set up a means-tested housing subsidy program which helps Ukraine's neediest while reducing Ukraine's fiscal problems. The program is now being replicated nationally. USAID and USEPA support pilot projects in developing reliable supplies of potable water; pest and pesticide management in agriculture; energy efficiency audits; and waste minimalization USEPA recently provided Ukraine with a mobile radiation laboratory to help delineate areas of the country which suffer excessive radiation levels. Through mid-1997 the U.S. has directly provided or facilitated delivery of over $475 million in U.S. humanitarian assistance to the Ukrainian people, including excess military humanitarian commodities and food assistance under USDA's Food for Progress Program. Refugee and migration assistance. The UN High Commissioner for Refugees (UNHCR) and the International Organization for Migration (IOM) both provide assistance to Ukraine as part of the follow-up to the 996 International Conference on Refugees and Migration in the CIS. The U.S. has contributed $15.6 million to the $90 million UNHCR/IOM Joint Appeal for the CIS. Migration and refugee assistance to Ukraine included in the Joint Appeal totals $7.3 million which includes money for humanitarian aid to refugees, self-help assistance to minorities (such as the Crimean Tartars) returning to Ukraine, and support for Ukrainian government efforts to strengthen its own migration management capacity. UKRAINE: ENVIRONMENTAL ISSUES While the most public environmental issue in Ukraine remains the nuclear legacy in general, and Chornobyl in particular, Ukraine has other significant environmental issues. Nuclear contamination. The long-term health consequences of nuclear contamination in Ukraine remain undetermined and controversial, but a large "exclusion zone" near the site of the Chornobyl reactor remains sufficiently contaminated that human use of these areas is restricted. Given the long and continuing use of nuclear power reactors of unsafe design, this issue will be important well into the future. The U.S. has been active in assisting Ukraine in nuclear remediation and safety. In particular, we have been working to improve reactor operations and to phase-out the oldest and least safe units. Chornobyl Shelter. Experts believe the temporary, 20-story concrete shelter enclosing the radioactive ruins of the reactor which exploded in 1986 could collapse, releasing radiation into the environment. The G-7, under U.S. chairmanship, and Ukraine have devised a $750 million plan to make it safe and environmentally stable. The Vice President and President Kuchma will chair an International Pledging Conference on the Chornobyl Shelter November 20 in New York to secure contributions. Industrial pollution. Ukraine suffers the same industrial pollution found throughout Central Europe and much of the former Soviet Union. Abandoned waste and manufacturing sites, as well as operating ones, are a significant problem. This and a deterioration of the basic infrastructure has presented an immediate problem of lack of potable water and basic sanitation services. These environmental problems are related to general economic weakness and the slow development of local government, which normally addresses this type of environmental issue. Environmental activism. While Ukraine faces many environmental problems, it seems willing to try to address them, and the public is engaged in a public debate on the issues. In fact, environmental activism is helping provide some impetus for reform of local government, which we wish to encourage. UKRAINE: U.S. EMBASSY The American Embassy in Kiev is located on a quiet street two kilometers north of the city center. The Chancery building was constructed in the 1950s to house Communist Party and Komsomol (Communist Youth League) headquarters of one of Kiev's neighborhoods. The U.S. Embassy opened in 1991 and occupied the present building on January 23, 1992. In December 1992, the "America House" cultural center, with a reference library and computer facilities, was opened. America's diplomatic mission to Ukraine consists of 125 U.S. government employees representing the State Department, Agency for International Development (USAID), United States Information Agency (USIS), Department of Defense, Peace Corps, Foreign Commercial Service, Federal Bureau of Investigation, and the Treasury Department. Ukraine is host to one of the largest Peace Corps programs in the world. The program began in 1992, and currently has six full-time American employees and 160 volunteers. USAID, USIS, the Peace Corps, and the Foreign Commercial Service are housed in separate office buildings. Ambassador William Green Miller Deputy Chief of Mission James Schumaker USAID Director Gregory Huger Public Affairs Officer Mary Kruger Defense Attache Colonel Bruce Berry Peace Corps Director Joroslav Dutkewych Senior Commercial Officer Andrew Bihun Legal Attache Michael Pystozymuka Senior Treasury Advisor David Darby UKRAINE: JEWISH CEMETERIES History of intolerance. Ukrainian history includes an unfortunate legacy of intolerance toward minorities. The Jews of western Ukraine were regularly subjected to forced migrations - "pogroms Millions of Ukrainians were exterminated in Stalin's forced labor camps. Ukraine was singled out for a disruptive campaign that ruined its once-rich agriculture and led to a massive famine in the 1930s that killed millions of Ukrainians of all origins. Post-Soviet Ukraine has begun to take steps to address previous wrongs. While the human rights record has recently improved, historic anti-Semitism remains a serious concern. Bilateral agreement. In 1994, Ukraine signed an agreement with the United States to preserve cultural sites important to both countries. While this agreement was not specifically aimed at any particular ethnic or religious group, early on, the rehabilitation of Jewish cemeteries became the first focus of efforts. Jewish cemeteries. Under Jewish religious law, a cemetery forever a sacred site. In L'viv, decades before the Nazi occupation, the historic central cemetery was full and closed to new burials. A new cemetery on the city outskirts served the Jewish community. The Nazis used gravestones from the central cemetery as paving blocks for roads. The visible elements of the cemetery were destroyed, but most of the graves remained undisturbed. After the Nazis were defeated, the Soviets took control of L'viv and turned the site into a large marketplace. Thus, the current use of the L'viv marketplace is considered an ongoing desecration and an affront to the Jewish community. This pattern was repeated in numerous communities throughout Ukraine (and eastern Europe generally). Competing priorities. The issue of restoration of cemeteries -- in L'viv and elsewhere -- must take place in the context of present-day realities. Many U.S. Jewish organizations prefer to focus on the needs of the small communities of Jews still living in Ukraine, giving restoration of cemeteries a lower priority. Orthodox Jewish leaders tend to give precedence to the cemetery issue both on religious grounds, and because some of the greatest rabbinical scholars of the 17th and 18th century are buried in what are now unmarked graves. Resident Jews tend to fear an anti-Semitic backlash if too much emphasis is put on Jewish religious needs and requirements - they urge restraint in dealing with the Ukrainian government. Dealing with the problem. The Ukrainian government has ordered an absolute freeze, or moratorium, on any construction or privatization of sites that have been identified as Jewish cemeteries, either presently or in the past. A Joint Cultural Heritage Commission has been established to oversee identification of Jewish cemeteries and non-Jewish cultural heritage sites throughout Ukraine, and to seek a mutually-agreed means of addressing the cemetery problem. Future steps. International Jewish groups have already indicated a willingness to provide resources to repair, restore, preserve, and protect Jewish cemetery sites in Ukraine. We estimate that there are over 2000 such sites in Ukraine, many in places where there are few or no Jews left. This issue is on the agenda of the Joint Commission on Cultural Heritage, envisioned by the 1994 bilateral agreement, which next meets in Washington this fall. THE CENTRAL JEWISH CEMETERY IN L'VIV Setting. Following the Nazi invasion in 1941, the occupying German forces flattened and paved over the central Jewish cemetery in the heart of L'viv. (This cemetery space had long been filled to capacity with graves, and several greatly revered Jewish sages were buried there.) After the war, the central city market was built, mostly involving kiosks and metal sheds, on the cemetery site. Over the intervening decades, at least one several-story building was built on the grounds - now used as the meat and dairy market - as well as several smaller permanent structures. Adjacent to these grounds is a hospital complex of several buildings which are embellished with Jewish symbols and inscriptions. This was the Jewish hospital, and now serves as a maternity hospital. We know that no graves lie under the hospital complex, as the Jewish residents of the last century would never have constructed anything atop graves. The whole area is immense, with the aggregate dimension of several football fields. Construction issues. In the summer of 1996, construction started on the land just between the market and an adjoining hospital complex. International protest stopped this construction, whereupon the Kuchma government articulated its intention for a national freeze on any construction or privatization on Jewish cemetery sites. In September and October, 1996, a mixed commission of local and GOU officials met in L'viv and determined that the market should be moved and the cemetery in some way memorialized. An AID study completed on August 8, 1997 estimated the project cost between $4 and $12 million. The mayor of L'viv is believed to be committed to this project, which is viewed, if done well and sensitively, as a boon to the city on several levels. The site. Apart from the actual movement of the market from the cemetery grounds, still blocked by lack of funds, the major issue remaining is the form the preserved cemetery would take. Care must be taken to insure that, while Jewish law and sensitivities are abided with, a forbidding, impenetrable wall not be erected around the perimeter of what was for decades the busiest place in town, thereby risking fomenting discord among L'viv's Jewish and Ukrainian communities. The form, function, and accessibility of this space are very much at issue. The cemetery itself cannot be recreated as it was, as the headstones are all gone. If the term "memorial park" is to be the operative one, it must be designed, constructed, and utilized with great care, mixing legitimate religious requirements with real-world considerations of access by Jews and non-Jews alike. For this, we will look to the leadership provided by the U.S. Commission for the Preservation of America's Heritage Abroad; to Michael Lewan, Rabbis Morris Sherer (Agudath Israel) and Chaskel Besser, and others. Meetings that State Department officers have attended lead us to believe that Rabbis Sherer and Besser understand the art of the possible, that they will impose by their own moral authority the proper amount of restraint, and that the most Orthodox and Hasidic rabbis will defer to their judgment (within reason). Restoration costs. We have long discussed with the Jewish Orthodox leadership the eventual need for significant financial contributions by the Jewish community in L'viv and elsewhere. Recognizing the cardinal principle that Ukraine's Jews should not be asked to buy back their own cemeteries, the costs of restoration are a different matter. If the cash-strapped GOU and local governments act to protect the estimated 2,000 Jewish cemeteries across Ukraine, much of the cost of subsequent preservation must fall to the Jewish community, particularly that part of the world Jewish community in the United States and Israel that has been leading this effort. We believe this point to be inherent to this discussion, and to be a matter of at least implicit agreement. UKRAINE: ARRIVAL STATEMENT I am delighted to be in Ukraine again and am looking forward to spending time with my friend Ludmila Kuchma. L'Viv has always been a link between east and West and it is fitting that I have the opportunity to visit here following several days in Central Asia and Russia. In the United States we are proud that our society is a "melting point" in that blends diverse communities together into a strong society that has stood for the same ideals and I want to see how you are making it work. I am looking forward to spending time with some of these communities and to visiting the landmarks that speak of L'Viv history. I am also eager to meet with Ukrainians and Americans working together at the L'Viv oblast hospital. UKRAINE: DEPARTURE STATEMENT I am grateful to have had the opportunity to spend time with the people of Ukraine. I am especially touched by the hospitality shown by Ukraine's First Lady, Ludmila Kuchma. I decided to come to L'Viv because it has been a multi- cultural, multi-ethnic city for centuries. The ability to create a society that tolerates - even celebrates - differences is one of the great strengths the United States and Ukraine have in common. Our shared values were evident as I visited the L'Viv Oblast Hospital and saw the work that our healthcare professionals are doing together. I want to again thank the people of Ukraine for their hospitality and to reaffirm the admiration of the American people for the great strides independent Ukraine has made in developing a democratic society which fully honors human rights. PUBLIC THEMES - PRESS THEMES (UKRAINE) "FAMILY FEMINISM" IN UKRAINE: "FAMILY FEMINISM" IS A TERM THAT CERTAINLY APPLIES IN UKRAINE. THE STRONG FAMILY VALUES FOUND IN UKRAINE AND FEMINIST GOALS ARE COMPLETELY COMPATIBLE. THE COLLAPSE OF COMMUNIST INSTITUTIONS PUT AN EVEN GREATER BURDEN ON WOMEN IN THIS SOCIETY. REDUCED FAMILY INCOMES, ABSENCE OF AN ETHICAL CODE TO BE TAUGHT IN THE SCHOOLS, STRESSES BROUGHT ON BY ECONOMIC DECLINE - THESE ARE ALL BURDENS THAT UKRAINIAN WOMEN HAVE SHOULDERED FOR THEIR FAMILIES. THESE PROBLEMS MADE IT NECESSARY FOR PARENTS, ESPECIALLY MOTHERS, TO PROVIDE EVER MORE GUIDANCE TO CHILDREN. AS THROUGHOUT MUCH OF THE WORLD, THE WOMEN OF UKRAINE BEAR THE BRUNT OF CHANGES IN SOCIETY. IT IS IMPORTANT THAT SOLUTIONS TO UKRAINE'S SOCIAL AND ECONOMIC PROBLEMS INCLUDE WOMEN'S INPUT. WOMEN UNDERSTAND THE PROBLEMS, AND THEY CAN HELP FIND SILUTIONS THAT WORK. THAT IS THE ESSENCE OF "FAMILY FEMINISM: EMPOWERMENT IN POLITICAL AND SOCIAL SPHERES BASED ON STRONG FAMILIES AND A STRONG ETHICAL AND MORAL FOUNDATION DIFFICULT Q'S AND A'S (L'VIV) Q. What has the U.S. done to persuade L'Viv authorities to restore the ancient Jewish cemetery? (The cemetery was desecrated by the Nazis, then converted by the Soviets to a marketplace - now, one of L'Viv's largest.) A. IN 1994, THE UNITED STATES AND UKRAINE ENTERED INTO A FORMAL, BILATERAL AGREEMENT ON PRESERVATION OF CULTURAL HERITAGE. THAT AGREEMENT SERVES AS THE BASIS FOR REACHING SOLUTIONS ON DIFFICULT ISSUES LIKE THE FATE OF JEWISH CEMETERIES, AND THE RECOVERY OF UKRAINIAN CULTURAL SYMBOLS THAT HAVE MADE THEIR WAY TO THE UNITED STATES. UNDER THE LEADERSHIP OF VICE PRESIDENT GORE AND PRESIDENT KUCHMA, THE U.S. -UKRAINE BINATIONAL COMMISSION IS ADDRESSING THE ISSUE OF THE L'VIV CEMETERY, AND THE OTHER QUESTIONS I MENTIONED. WE NEED TO FIND SOLUTIONS THAT TAKE INTO ACCOUNT THE GREAT HISTORICAL AND RELIGIOUS IMPORTANCE OF THE SITES AND ARTIFICATS IN QUESTION, AND ALSO THE NEEDS OF THE PEOPLE OF L'VIV. FIRST LADY'S TALK WITH FIRST LADY LIUDMYLA KUCHMA (UKRAINE) THANK YOU FOR YOUR WARM GREETINGS ON MY BIRTHDAY YOUR OBSERVATION ABOUT THE CLOSE LINKAGE BETWEEN THE EQUALITY OF WOMEN AND DENMOCRACY WAS SOMETHING I FEEL VERY DEEPLY AS WELL. I'M DELIGHTED THAT WHEN WE TALK ABOUT DEMOCRACY AND WOMEN'S RIGHTS, WE CAN TALK ABOUT THE CLEAR UNDERSTANDING IN UKRAINE OF THEIR INTER-RELATIONSHIP. MUCH OF WHAT UKRAINE HAS ACHIEVED IN THIS REGARD RESULTS FROM YOUR EFFORTS AND THOSE OF PRESIDENT KUCHMA. AS YOU MENTIONED IN YOUR LETTER, I HAVE SPOKEN OUT ABOUT OPENING DOORS FOR WOMEN - ABOUT HOW THIS IS ACHIEVED THROUGH THE CREATION OF A DEMOCRATIC SOCIETY. IT HAS ALWAYS BEEN CLEAR TO ME THAT THE FULL POTENTIAL OF ANY SOCIETY CAN ONLY BE REALIZED WHEN OPPORTUNITIES FOR WOMEN AND MEN ARE EQUAL. YOU KNOW, ONE OF MY CLOSEST ADVISERS IS OF UKRAINIAN HERITAGE, SO I FEEL I HAVE SOME SENSE OF HOW OUR TWO GREAT NATIONS COMPARE. THROUGHOUT THE LONG YEARS OF COMMUNIST OPPRESSION, UKRAINIAN-AMERICANS REMAINED LOYAL TO THEIR LANGUAGE, CHURCHES AND VALUES. THEY HELD ONTO THEIR CULTURAL IDENTITY. THE IDEA OF UKRAINE'S INDEPENDENCE REMAINED STRONG IN MY COUNTRY, PARTICULARLY IN THE CITIES WHERE UKRAINIANS GATHERED - CLEVELAND, PHILADELPHIA, NEW YORK, CHICAGO. THESE UKRAINIAN AMERICANS WERE ABLE TO KEEP U.S. FOREIGN POLICY ORIENTED TOWARD UKRAINE'S EVENTUAL INDEPENDENCE THROUGH SOME VERY HARD TIMES. I'M PROUD THAT THE PRESIDENT AND I HAVE BEEN ABLE TO PRESIDE OVER THE PERIOD OF UKRAINE'S EMERGENCE AS A FREE AND DEMOCRATIC COUNTRY. FIRST LADY'S MEETING WITH UKRAINIAN PRESIDENT LEONID KUCHMA THE PRESIDENT ASKED ME TO CONVEY HIS GREETINGS. HE APPRECIATED THE MEETING YOU AND HE HAD IN NEW YORK IN SEPTEMBER, AND HE'S LOOKING FORWARD TO HEARING FROM THE VICE PRESIDENT AFTER YOU SEE HIM IN JUST A FEW DAYS. UKRAINE'S EMERGENCE AS A FREE, INDEPENDENT STATE, SECURE IN ITS BORDERS, HAS BEEN A TOP PRIORITY FOR THE UNITED STATES SINCE UKRAINE GAINED INDEPENDENCE SIX YEARS AGO. THE COMMITMENT OF THE UNITED STATES, AND THE AMERICAN PEOPLE, TO THESE PRINCIPLES REFLECTS THE DEEP RESPECT WE HAVE FOR THE UKRAINIAN PEOPLE. YOUR HISTORY OF STRUGGLE AGAINST OPPRESSION AND TRAGEDY HAS MADE YOU STRONG, EVEN IF NOW, CONDITIONS ARE DIFFICULT. MY COUNTRY HAS TRIED TO HELP IN MANY WAYS - BY PROVIDING POLITICAL SUPPORT FOR UKRAINE INTERNATIONALLY, BY BRINGING UKRAINIAN STUDENTS TO THE U.S., BY PROVIDING FINANCIAL AID, AND BY SENDING OUR BEST TECHNICAL EXPERTS AND OUR PEACE CORPS VOLUNTEERS TO HELP YOU REBUILD. OUR HOPE IS THAT UKRAINE'S TRANSFORMATION TO A MARKET- ORIENTED ECONOMY WILL ACCELERATE, TO BRING THE BENEFITS OF THE TRANSFORMATION TO THE GREATEST NUMBER OF PEOPLE AS QUICKLY AS POSSIBLE. ONE OF THE ISSUES I WILL BE EMPHASIZING DURING MY VISIT IS ONE ON WHICH YOU AND MRS. KUCHMA (LIUDMYLA) HAVE SHOWN REAL LEADERSHIP. THAT IS, THE NECESSITY FOR A COUNTRY IN TRANSITION LIKE UKRAINE TO MAKE FULL USE OF ITS HUMAN RESOURCES BY OPENING OPPORTUNITIES TO WOMEN. CLEARLY, THERE ARE VAST DIFFERENCES BETWEEN THE SITUATION FOR WOMEN IN THE MAJOR CITIES AND THE COUNTRYSIDE, so THE DEGREE OF PROGRESS WILL VARY. BUT I'M PLEASED TO LEARN OF YOUR COMMITMENT IN THIS AREA. ANOTHER ISSUE I WILL BE DISCUSSING IS ONE THAT'S BEEN RAISED IN THE EUROPEAN UNION CONTEXT - THAT IS THE PROBLEM OF SEXUAL EXPLOITATION OF WOMEN. AS YOU KNOW, MANY YOUNG GIRLS FROM UKRAINE, RUSSIA AND POLAND HAVE BEEN ENTRAPPED IN SITUATIONS WHERE THEY FIND THEMSELVES IN THE MIDDLE EAST OR THE WEST AND ARE FORCED INTO PROSTITUTION OR INTO SEX-ORIENTED ROLES THAT THEY NEVER SOUGHT. ORGANIZED CRIME ORGANIZATIONS ARE BEHIND MANY OF THESE OPERATIONS. WE HOPE TO HELP UKRAINIAN ORGANIZATIONS TO BEGIN TO EDUCATE YOUNG WOMEN ABOUT THIS DANGER AND TO EQUIP THEM TO DEAL WITH THE SITUATION IF THEY ARE CONFRONTED WITH IT. I DECIDED TO COME TO L'VIV BECAUSE IT HAS BEEN A MULTI- CULTURAL, MULTI-ETHNIC CITY FOR CENTURIES. THE ABILITY TO CREATE A SOCIETY THAT TOLERATES - EVEN CELEBRATES - DIFFERENCES IS ONE OF THE GREAT STRENGTHS THE UNITED STATES AND UKRAINE HAVE IN COMMON. WE BOTH HAVE LARGE COMMUNITIES OF CITIZENS WHO SPEAK A DIFFERENT LANGUAGE OR COME FROM DIFFERENT ETHNIC OR RELIGIOUS BACKGROUNDS. WE HAVE CREATED A "MELTING POT" IN THE UNITED STATES THAT BLENDS THE COMMUNITIES TOGETHER INTO WHAT WE CALL THE TYPICAL AMERICAN. YOUR GOVERNMENT HAS STOOD FOR THE SAME IDEALS AND I WANT TO SEE HOW YOU ARE MAKING IT WORK. BIOS Ukraine "hornobyll KIEV Eviv Kharkiv President Dnipropetrovs" Odesa Leonid Kuchma (elected July 1994) Date of Independence: 1 December 1991 Population: approx. 51 million Cabinet of Ministers Key Ukrainian Officials Prime Minister Valeriy Pustovoytenko First Deputy Prime Minister Anatoliy Holubchenko Ambassador to the US Yuriy Shcherbak Deputy Prime Minister/ Labor Minister (social policy) Mykola Biloblotskyy Chief of Staff Yevhen Kushnaryov Deputy Prime Minister (economic reform) Serhiy Tyhypko General Affairs Oleksander Volkov Deputy Prime Minister (humanitarian affairs) Valeriy Smoliy National Bank Chairman Viktor Yushchenko Agriculture Minister Yuriy Karasyk National Security Secretary Volodymyr Horbulin Cabinet of Ministers Anatoliy Tolstoukhov State Commission for Enterprise Yuriy Yekhanurov Coal Industry Minister Stanislav Yanko National Bureau of Investigation Vasyl Durdynets Culture Minister Dmytro Ostapenko Procurator General Oleh Lytvak Defense Minister Oleksandr Kuzmuk Security Service Chairman Volodymyr Radchenko Economics Minister Viktor Suslov State Property Fund (Acting) Volodymyr Lanovyy Education Minister Mykhaylo Zgurovskyy Nat'l Agency for Reconst. & Devel Roman Shpek Energy Minister Oleksiy Sheberstov UN Perm Rep Anatoliy Zlenko Emergency Situations/Chornobyl Aftermath Valeriy Kalchenko Environmental Protection/Nuclear Safety Yuriy Kostenko Rada (parliament) Family and Youth Affairs Valentina Dovzhenko Chairman Oleksandr Moroz Finance Minister Ihor Mityukov Deputy Chairman Viktor Musiyaka Foreign Affairs Minister Hennady Udovenko First Deputy Chairman Oleksandr Tkachenko Foreign Economic Relations/Trade Serhiy Osyka Health Minister Andriy Serdyuk Selected Rada Commissions and Chairmen Industry Minister Vasyl Hureyev Information Minister Zinoviy Kulyk Organized Crime and Corruption Hryhoriy Omelchenko Interior Minister Yuriy Kravchenko Defense and State Security Volodymyr Mukhin Justice Minister Susanna Stanyk Nuclear Policy and Safety Mykhaylo Pavlovskyy Science and Technology Volodymyr Semynozhenko Finance and Banking Viktor Suslov Transportation Minister Valeriy Cherep Basic Indies & Social Devel. of Regions Valeriy Cherep Foreign Affairs/CIS Relations Borys Oliynyk Budget Issues Mykola Azarov Econ. Pol. & Admin. of Nat'l Economy Oleh Taranov September 1997 Withdrawal/Redaction Marker Clinton Library DOCUMENT NO. SUBJECT/TITLE DATE RESTRICTION AND TYPE 001. reports bios (13 pages) c 10/1997 P1/b(1) COLLECTION: Clinton Presidential Records First Lady's Office Speechwriting (Noa Meyer Subject Files) OA/Box Number: 13007 FOLDER TITLE: The Trip of the First Lady to Kazakhstan, Kyrgystan, Uzbekistan, Russia, and Ukraine, November 9-18, 1997 (David) [Binder] [7] 2012-0869-S kc959 RESTRICTION CODES Presidential Records Act - (44 U.S.C. 2204(a)| Freedom of Information Act 15 U.S.C. 552(b)| PI National Security Classified Information |(a)(1) of the PRA] b(1) National security classified information [(b)(1) of the FOIA] P2 Relating to the appointment to Federal office |(a)(2) of the PRA] b(2) Release would disclose internal personnel rules and practices of P3 Release would violate a Federal statute |(a)(3) of the PRA] an agency [(b)(2) of the FOIA] P4 Release would disclose trade secrets or confidential commercial or b(3) Release would violate a Federal statute |(b)(3) of the FOIA| financial information [(a)(4) of the PRA b(4) Release would disclose trade secrets or confidential or financial P5 Release would disclose confidential advice between the President information [(b)(4) of the FOIA] and his advisors, or between such advisors |a)(5) of the PRA] b(6) Release would constitute a clearly unwarranted invasion of P6 Release would constitute a clearly unwarranted invasion of personal privacy [(b)(6) of the FOIA] personal privacy [(a)(6) of the PRA b(7) Release would disclose information compiled for law enforcement purposes |(b)(7) of the FOIA] C. Closed in accordance with restrictions contained in donor's deed b(8) Release would disclose information concerning the regulation of of gift. financial institutions [(b)(8) of the FOIA] PRM. Personal record misfile defined in accordance with 44 U.S.C. b(9) Release would disclose geological or geophysical information 2201(3). concerning wells |(b)(9) of the FOIA] RR. Document will be reviewed upon request. Withdrawal/Redaction Marker Clinton Library DOCUMENT NO. SUBJECT/TITLE DATE RESTRICTION AND TYPE 002. report Government Structure (1 page) nd P1/b(1) COLLECTION: Clinton Presidential Records First Lady's Office Speechwriting (Noa Meyer Subject Files) OA/Box Number: 13007 FOLDER TITLE: The Trip of the First Lady to Kazakhstan, Kyrgystan, Uzbekistan, Russia, and Ukraine, November 9-18, 1997 (David) [Binder] [7] 2012-0869-S kc959 RESTRICTION CODES Presidential Records Act - [44 U.S.C. 2204(a)| Freedom of Information Act - 15 U.S.C. 552(b)| P1 National Security Classified Information [(a)(1) of the PRA] b(1) National security classified information [(b)(1) of the FOIA] P2 Relating to the appointment to Federal office |(a)(2) of the PRAJ b(2) Release would disclose internal personnel rules and practices of P3 Release would violate a Federal statute |(a)(3) of the PRAJ an agency [(b)(2) of the FOIA] P4 Release would disclose trade secrets or confidential commercial or b(3) Release would violate a Federal statute [(b)(3) of the FOIA] financial information |(a)(4) of the PRA] b(4) Release would disclose trade secrets or confidential or financial P5 Release would disclose confidential advice between the President information [(b)(4) of the FOIA] and his advisors. or between such advisors [a)(5) of the PRA b(6) Release would constitute a clearly unwarranted invasion of P6 Release would constitute a clearly unwarranted invasion of personal privacy [(b)(6) of the FOIA] personal privacy [(a)(6) of the PRA] b(7) Release would disclose information compiled for law enforcement purposes [(b)(7) of the FOIA] C. Closed in accordance with restrictions contained in donor's deed b(8) Release would disclose information concerning the regulation of of gift. financial institutions [(b)(8) of the FOIA] PRM. Personal record misfile defined in accordance with 44 U.S.C. b(9) Release would disclose geological or geophysical information 2201(3). concerning wells [(b)(9) of the FOIA| RR. Document will be reviewed upon request. MAPS Ukraine Russian population" Oblast boundary" (percent) D Boundaries snown are rhose that existed a: the time of the 1989 census. 40 and above 20 to 40 0 200 Kilometers Less than 20 Belarus 0 200 Miles a Based on 1989 census Russia Poland KIEV * Kharkiv Slov. Luhans'k Kirovohrad Hung. Dnipropetrovs'k Donets' Zaporizhzhya sujejuno Moldova Mykolayiv Odesa Romania Crimea Russia Sevastopol Ukraine. the second-largest country in Europe, is slightly smaller than Texas and consists of fertile plains and plateaus with mountains in the west (the Carpathians) as well as in the Crimean Peninsula in the south. Ethnic Ukrainians constitute approximately 70 percent of the population with the majority being located in western Ukraine. Ethnic Russians comprise approximately 20 percent of the population and are generally found in eastern Ukraine and the Crimea. Although Ukrainian is the official language of the state. Russian is also widely spoken. especially in eastern Ukraine. Even though Ukraine's agricultural and industrial sectors have declined substantially over the last several years. the country's resources continue to support exports of some agricultural products. ferrous metals. chemicals. and machinery. The country's major economic vulnerability continues to be its heavy dependence on imported energy. primarily from Russia. 744282 (R00173) 10-97 Ukraine's Current Administrative Structure Russia Lithuania Oblast boundary 0 100 200 kilometers 0 100 200 Milles Belarus Poland Russia Volyns'ka Rivnens'ka Chernihivs'ka KIEV Sums'ka Zhytomyrs'ka L'viv Kyvivs'ka Kharkiv L'vivs'ka Poltavs'ka Kharkivs'ka Ternopil's'ka Luhans'ka Slovakia Khinel'nvis'ka Ivano- Cherkas'ka Luhans'k Frankivs'ka Uzhhorod Vinnyts'ka Kirovohrads'ka Hung. Dnipropetrovs'ka Donets'ka Donets'k Zakarpats'ka Chernivets'ka Mykolayivs'ka Moldova Zaporiz'ka Odes'ka Odesa Khersons'ka Romania Russia Respublika / Krym Sevastopol Serbia Bulgaria Unclassified 733223 (ROM/3) 994 EVENTS IN L'VIV UKRAINE 002 authentic document from this part of the Ukrainian state. attempts at organizing lew- world is written in Hebrew, the so-called ish National Autonomy under Ukrainian na- 51,465,000 II 400.000 "Kievan letter" (930 CE). Later this Russian- tionalist auspices were stifled. speaking community was absorbed by the During the early Soviet period, Ukraine Yiddish-speaking immigrants who came to (together with Belacus) became a center of DEMOGRAPHY claimed Viddish as their mother tongue). The Ukraine from Central and Europe. Large num- Viddish culture, albeit devoid of any religious The Jews of Ukraine constitute the third larg- average age is close to 45. bers of Jews came from Poland after it colo- content. Yiddish schools, theaters, newspa- est Jewish community in Europe and the fifth HISTORY nized much of the area in the 16th and 17th pers and publishing houses were established. in the world. Jews are mainly concentrated in The idea of = distinct Viluainian jewry has centuries. AC that time lews played an impor- : as was the "Institute of Jewish Proletarian Kiev (110,000), Dnepropetrovsk (65,000), been revived. In former times Jews living in tant role in the economic life of the country. Culture in the L'kraine", attached to the Ukrai- Kharkov (47,000) and Odessa (45,000). Jews various parts of the territory of present-day especially as managers, agents, and in the ex- nian Academy of Sciences. Toward the end of also live in many of the smaller towns. West- Ukraine had identified themselves as Russian, port-import trade. Later, in 1648-9, the Jews the 1930's, during the Stalinist purges, near- em Ukraine. however, has only a small rem- Polish, Galician, Romanian, Bessarabian, of Ukraine bore the brunt of the Chmielnicki 1). all of these institutions were liquidated. nant of its former population, with Lvov and Hungarian or even Austrian lews- and more rising against the Pol- Throughout this Chernovtsy each having only about 6,000 recently. as Soviet Jews. ish gentry. in which time. religious and Zi- Jews. The majority of Jews in present-day Jewish-Khazarian settlement in Kiev can tens of thousands of onist activity was Ukraine are native Russian-Ukrainian speak- be traced to the 10th century- preceding the Jews lost their lives. forced underground. ers, and only some of the elderly speak Yid- unification of the region and the crystalliza- In the 19th centu- By the late 1930's. al- dish as their mother tongue (in 1926, 76.1% tion of Ukrainian national identity. The first ry. Ukraine, as a part Ter a thorough crack- W.J.C.NY of the Pale of Settle- down, most of those Gathering at the monument to the victims of Babi Yar. 1992 ment. was densely involved in propagat- populated by Jews. ing religious obser- Despite restrictions, vance or Zionism had Jews played a promi- been arrested. nent role in the devel- The Soviet author- opment of commerce ities established four and industry in the Jewish autonomous region, and especially districts in the south- 11/07/97 FRI 17:14 FAX 1212 755 5883 in the growth of its em part of the repub- major cities such as lic and in the Crimea. Kiev, Odessa and These settlements Kharkov. Many of the lasted until World most important Jew- War II, when they ish thinkers of the Torah Crowns. Lver, 1764/65 and 1773 were overrun by the modern age were (inscription dates) Germans and their Silver. cast. repousse, engraved. parcel-gilt. born there. inhabitants mur- semi-precious stones. glass states Ukraine was the dered. More than half venue of some of the worst of the pogroms the lews living in Ukraine were wiped out. The pe d under Tsarist Russian rule. Later. Jews of Ukraine account for a great pro in Il War and during the struggle for tion of the Soviet victims of the Holoca an independent Ukraine about 100 nnn leve with the work slaughter taking also st.. 003 ing Jews were often met with hostility. and the ing of antisemitic graffiti, and sporadic at- ISRAEL Bratslav Chassidim converge on Uman to repression of Jewish cultural and spiritual life tacks on Jewish property. On a state visit to Ukraine and Israel have enjoyed full diplo- daven at the Rebbe's tomb and the town reac- was especially severe in Soviet Ukraine. More- Israel, the then President Leonid Kravchuk matic relations since 1991. quires some of its former ambience. Other over, Kiev became a center for antisemitic publicly apologized for his compatriots' role Aliya - Since 1989, 168,263 Ukrainian fews places of interest include synagogues and publicistic activity. in the bestial murder of Jews during the Ger- have immigrated to Israel. burial grounds scattered throughout the The collapse of Communism and the re- man occupation. SITES' country (most in a poor state of repair). and creation of an independent Ukraine set the RELIGIOUS LIFE. Among the sites which attract large numbers the site of the massacre at Babi-Yar, on which stage for the revitalization of Jewish life. The Since the collapse of the Soviet Union, reli- of Jewish visitors is Uman, the burial place of an imposing monument has been erected. Ukrainian government has been sensitive to grous lite has undergone a revival, and Jewish Rebbe Nachman of Bratslav, and Gadyach, the needs of Ukrainian Jewry. Still, the pre- communities in many cities and towns were the tomb of Rabbi Shneur Zalman, the Alter Association of Jewish Organizations carious economic situation has been a deci- reconstituted. Synagogues and mikvao/ are Rebbe - the founder of the Lubavitch and Communities of Ukroine Korskaya Str. b. 252049 Kier sive factor in the aliya of Ukrainian Jews. now functioning in all cities and towns with a Chassidic movement. Every year thousands of Td. 7 USA 276 3431. Fin 7 044 271 7144 COMMUNITY significant Jewish population. Religious lead- The leading umbrella organizations are the ership is provided by a number of foreign rab- Embassy Association of Jewish Organizations and G.P.E.- S. Lest Ukrainki 34 /cwish Coancil of Ukraine bis. The Ukrainian government recognizes Kier 252195 Nimosukaya St. 7. 252103 Kicr 103 Communities of Ukraine and the Jewish the authority of the Ukrainian Chief Rabbin- Tel. 7 044 295 6216. Fax 7 048 294 9748 Trl. 296 3961. Fax. 295 9604 Council of Ukraine. The community is made ate, which is located in Kiev. A network of Jew- up of many different Jewish religious and cul- ish religious schools has been opened and few- W.J.C.NY tural groups, including various Zionist orga- ish education is available to all who seek it. nizations. Leading international Jewish orga- Kosher meat is produced locally and other nizations have established branches in items are imported. The JDC and other lew- Ukraine. ish and Israeli organizations have been active The Jewish population is in decline, largely in sponsoring Jewish activities. Generally due to emigration and the ageing process. The The horrible slaughter at Babi Yar inspired the great Russian speaking, Jewish religious life is stronger in writer, Yergeny Yevtushenko. to pen a powerful ude In the community, together with international Jew- Ukraine than in Russia. victims. It later became the theme of composer Dimitri ish welfare groups, is striving to alleviate the CULTURE AND EDUCATION Shostakovitch's 13th Symphony. In 1963 both the poet and the poverty of the many destitute Jews in the There are 78 Jewish schools in the country in composer were denounced by the Saviel authorities. 45 cities, among them 13 day schools (in "No gravestone stands on Babi Yar: 11/07/97 FRI 17:15 FAX 1212 755 5883 country, a large portion of whom are elderly. Among the community's priorities is secur- Chernovtsy. Dnepropetrovsk, Kharkov, Kiev, Only coarse earth heaped roughly on the gash. Such dread comes over me; I feel so old, ing the return of nationalized Jewish property. Lvov, Odessa, Vinnitsa and Zapozoshye) and Old as the Jews. Today / am a Jew... Antisemitism has been manifested by sec- 65 Sunday schools. Courses in Hebrew are Now / 80 wandering, as an Egyptian slave; tions of both the Ukrainian and Russian popu- offered in many places, and there are many And now / perish, splayed upon the cross lations. The problem is especially acute in the outlets for those who wish to express their I am that little boy in Bialystok Western part of the country, including the city artistic creativity. Much of the Israel-oriented Whose blood flows, spreading darkly on the floor. of Lvov, which has been a traditional center The rowdy lords of the saloon make sport, activity is directed by the JAFI offices. The of nationalist extremism. There, glorification Reeking alike of vodka and of leek... International Solomon University in Kiev has On Babi Yar weeds rustle; the tall trees of the deeds of Germany's Ukrainian collabo- an enrollment of some 800 students. Among Like judges loom and threaten... rators is proceeding apace. Several number of its departments are those of Jewish culture All scream in silence; I take off my cap illegal extremist organiza exist, yet their and history. And I feel that I am slowly turning grey. activities are tolerated. publications Several newspapers and journals are pub- And I too have become a soundless cry Over the thousands that lie huried here 11/07/97 FRI 17:15 FAX 1212 755 5883 W.J.C.NY 004 607 LUZZATTO, SAMUEL DAVID 608 acquaintance with and line feeling for the Hebrew language. hand. unlike foreign merchants. they were completely under the result of intensive hiblical studies. helped Luzzatto with the control of the gover ment and would not transfer their his linguistic and grammatical researches (see Prolegomenti profits outside the state. This was the first apologetic work ad 111/11 grammarica ragionata della lingua chraten (1836: of its type and the first in which economic arguments were Prolegomena 11) il Grammar of the Hebrew Language brought forward systematically in order in advocate the 1896): Grammatica della lingua chraica (1853-69: Hc. toleration of the lews. A reply to the work was published by brew 1901): Elementi grantmaticali del caldeo hiblico the Christian priest Malchior Patontritti under the title (1865: Grammar of the Biblical Chaldaie Language Breve Risposia " Sincine / (16.12). A Hebrew 18760. or bibliographical importance are his Opere del translation Was published in Jerusalem in 1950: and an De Rossi (1868) and You Yose] (1864). a catalog of English translation 11:15 prepared early in the 18th century the Almanzi collection. Luzzatto also published Avnei by the English deist John *Toland (though not published). Zikkaron. on the Hebrew tombstone inscriptions of who used Luzzatto's arguments lavishly in has book of 1714 Toledo (1841). being the first to treat epitaphs as an advocating the naturalization of the Jews. 11 is now known important primary source for lewish historical research. An that the book was written III great speed when : dangerous autobiography of Luzzatto appeared in 1882 (Hebrew in crisis developed for the Venetian Jews owing 10 the Ha-Moggid 1858 62: German 1882). and memorial discovery of large-seate commercial frauds in which some volumes in Italian (Commemorazione. 19011 and in leading families were im offected. German 1900g, There are J number Luzzatto also wrote an Italian treatise 111 which he of collections of his articles such as Beit hu-Ozar (3 vols., vindicated the authority of tradition and of the Oral Law 1847. 1888. 1889) and Peninei Shadal (1888): but much of (now lost. hut referred 1.) by Samuel Aboab in his responsa, his scholarly work remains scattered over various periodi- Devar Shamel (1702) n. 152). He is said 10 have also written cals. pamphiets. works of other authors. and much has Trattato delle opinioni " dogmi degli chrei e' dei riti lora never been published. An edition of all his Hebrew writings principali (Fuerst, Bibliotheca. 2841 and, together with was begun in 1913 (Ketavim but was not Leone we Modena. a work on the Karaites (Woll. completed. Bibliotheca. vol. 3. 347). He is also reputed to have had Biblingraphy: 1. Luzzatto, Catalogo ragionato can riferimenti agli considerable competence as a mathematician. Luzzatto's altri vilui writti " inediti (1881): S. Baron. in: Seler and (1953). punil. the apostate Giulin Morosini. reports in his della 40-63: N. Rosenbloom, Luzzaria's Ethic " Psychological Interpre- Fede several instances of his liberal mind and outspoken- tation of Judaism (1965): S. Werses. in: Melasse) 10. Dierei Bikkorer ness in matters of religion, shown for example when in 1049 re-Hagut. 5 6 (1965). 703 15: D. Rudavsky, in: Tradition. (1965). he arbitrated in a dispute between 1111 former Marrinos no. 3. 21-44: Samuel David Luscatto 1800- 1865. Exhibition IIII the Occasion of the 100th Anniversary of his Death arranged by B. about the "seventy week of Daniel. He is also said 10 have Yaron. Catalog (Hcb. and Eng.. Jerusalem. 1966): RMI. 32 spoken contemptonusly of the Kabbalah and to have (1966). no. 9 10 (all articles dedicated in studies of Luzzatio): S. disbelieved in the preservation of the Lost Ten Tribes. Morais. Italian Hebrew Literature (1926). 78 152. (A.T./Ep.] Christian contemporaries. misunderstanding his Freedom of spirit, reported that 10 was prevented h! force from LUZZATTO, SIMONE BEN ISAAC SIMHAH (1583 embracing Christianity an his deathhed. 1663). Italian rabbi and author. He was born. probably in Bibliography: S. D. Luzzatto, Autobiogratia (1882). 12 17. Venice. of a well-to-do family of German origin already 33 36: Y. F. Baer. Galu, (1947). 83 92: 1., Blau. Leo Maderias established in the region for many generations. Luzzatto Briele und Schriftstucke (19117). index: S. Luzzatto. Ma'amar all was ordained in 1606 and served as rabbi in Venice for 57 Vehudei Fenezeah (1951). prefaces by Bachi and S/ulwas: III Memoria di A Saverdati (1936). 99 113: C. Rath. Fenice (1930). years. The attluent dircumstances of his family made it 227 31: F. Secret. Kahbanistes Chrétiens de 1.1 Renaissance (1964). unnecessary for him 10 waste his energies in miscellaneous 328: Szulwas, in: HUCA. 27 (1949). 18 20 (11eh. DI.1: Steinschnei- work in supplement his livelihood. as was the case with his der. in: MGWJ. 43(1899). 1181. [C.R.] contemporary and associate Leone *Modena. after whose death in 1648 he became senior rabbi of the community. LVOV (Pol. Lwow: Ger. Lemberg). man city of Lum Unlike Modena he objected to the presence of gentiles at his oblast. Ukrainian S.S. R. sermons in the synagogue. though he had some non-Jewish The Early Settlements. II is thought that the first Jews in pupils. including. for a month in 1646. the French mystic Lvov arrived from Byzantium and the southeast. After the Charles de Valliquerville. Shortly after this. he became conquest of the lown by Casimir III of Poland (1340). they involved in a drawn-out dispute with the lay leaders of the were joined by Jews from Germany and Bohemia who gave community over the question of rabbinical ordination. on the settlement its Asheenazi character. A1 the end of the which he insisted in having a deciding voice. Among his 14th century. there were two communities in Lvov. the responsa was one (no longer preserved) which permitted older and larger. the "Holy Congregation Outside of the travel by gondola in Venice on the Sabbath. His work Walls," founded in 1352: and the second. the "Holy Socrate myero dell'humano sapere dedicated to the Doge Congregation Within the Walls." situated in the Jews' (1651). written in dialogue form with Socrates as the Street and first mentioned in 1387. Large lires occasionally principle interlocutor. is an attempt to demonstrate that swept both communities and they were only able to repair human reason is impotent unless assisted by revelution. their quarters after cor troversies with the townspeople (this There is nothing specifically Jewish about this work. which occurred in 1494, 1527. 1571. 1616. cle.). In 1550. 352 Jews shows a considerable degree of competence in philosophy lived inside the city wells in 29 houses. while 559 lived in 52 and in the classical literature (though not in Greek). and is a houses outside the town. in the vicinity of this suburban remarkable exemplification of the degree of culture prevail- quarter. a Karaite alement existed until 1457. ing at this time in the Italian ghettos. His most important The Jews of Lvov played an important role in trade publication. however, was his work. Discorso circa it stato between the Orient and the West. for which the town was an de gl hebrei el in particular dimoranti nell'inclita virià di important transit center. They were equally well represent- enetra (1638) in which he put forward reasoned arguments ed in the wholesale trade with the interior of the country. for the toleration of the Jews especially on economic They also leased estates, operated brandy distilleries and grounds. He argued that they performed functions that breweries. acted as customs and tax agents. and loaned could be achieved by no other element. while on the other money 111 the nobility and the king. During the second hall 005 11/07/97 FRI 17:16 FAX 1212 755 5883 W.J.C.NY 609 LVOV 610 "Red Russia" (Gaficia, i.e., Western Ukraine) and Podolia- Bratslav region. and its community leaders represented the whole region at the *Councils of the Lands, By the electoral system of the community. a limited number of the wealthy descendants of noble families were assured of long periods in office. From 1684 to 1772. In the *Chmielnicki massacres of 1648 14 and the successive wars of the second half of the 17th and early 18th century. the Jews of Lvov. especially those who lived outside the town. suffered great losses in life and property. Their houses were at the mercy of the enemy and they were compelled to seck refuge within the town. Generally the Jews played an active part in the defense of the town. During Chmielnicki's siege in 1648 and the Russian siege of 1655. the attackers demanded that the Jews be delivered into their hands. Meeting with the refusal of the townsmen. they settled for a large ransom. During the whole of this period. the townsmen's struggle against the control of trades and crafts by the Jews CO1 tinued. The latter's efforts in expand their quarter came under special attack. The Jewish quarter consisted of only 49 building lots and the houses built on them were 100 small 1) accommo- date the established inhabitants and the refugee. from many wars. All the efforts of the townsmen to contine the Jews 10 Figure I. Drawing of the Tax Synagogue of Lvov. built in 1582 their quarter and to restrict their trade were in vain. for the by Isuue h. Nuhman after the plan of an Italian architect. From nobles usually supported the lews. At this time the Jens 1. Halperin (ed.). Beil Yisrael e-Polin. Jerusalem, 1954. also opened shops in the center of town. During this period. of the 16th century, the commercial agents of Don Joseph war damages, ransom payments, the costs of court cases, "Nasi were netive in Lvov. However, the number of Jews the necessity to rebuild damaged houses. and the decline of who.engaged in international trade and in large concerns Lvov in favor of other commercial centers brought about was very limited and the majority earned their livelihood as severe economic crises In 1727 the community owed the shopkeepers, peddlers, and crafismen. The rights of the municipality 438.410 zlotys. while in 1765 their debts (1) the Jews of Leon were based on letters patent granted by the noblemen. the elergy. and the religious orders amounted to kings of Poland. They were in constant contlict with the 381.999 doiys. and those to the municipality (1) 820.409 townsmen over their rights to trade. especially in the retail zlotys. Although direct and indirect communal taxes were branch. and (1) engage in crafts. Fortunately the royal raised the community was unable to become solvent. decrees issued as a result of pressure from the townsmen According in the census of 1704/65. 6.142 Jews lived in were rarely absolute and the nobility often succeeded in Evox over two-thirds of them outside the town walls having them amended. In 1493 King John Albert restricted and only 57 of the 3.060 men were self-supporting. the Jews 10 two branches of the wholesale trade: *textiles When Shabbateanism began 10 spread in Russia. David *livestock In 1503 and 1506 King Mexander Jagellon Halevi at. 1607). are her din of the congregation outside the ed the Jews freedom to trade at the markets and fairs walls. sent his son and stepson to "Shabbetai Zevi: they 11 as the right to benefit from the reductions accorded returned his enthusiastic supporters. After Shab betai Zevi's 111 other citizens. King Sigismund I restricted Jewish trude apostasy. his adherents in Lvov were excommunicated (1521). then accorded unlimited trading rights (1527). and (1722). In 1754 Leib Krisse (Kriss), right-hand nan of the finally revoked the permit (in the same year). This uncertain pseudo-messiah Jacob "Frank, came to Lvov to propagate state of affairs continued throughout the whole period. the Frankist message. Frank himself arrived in The lown in Temporary compromise agreements on the question of December of 1755. but he was compelled In leave, ^ trading rights were concluded between the municipality and disputation with the Frankists was held in 1759. The the Jews in 1581. 1592. and 1602. The renewal of these spokesman for the lews was R. Hayyim Kohen Rapoport. agreements and the determination of their exact contents her din of the town and region. were usually accompanied by protests from the townsmen. During the 18th century. the importance of the Lvov The Jewish crafismen were also under constant pressure community declined and its authority was recueed. The from Christian artisans. limits of the provincial council's authority were also The Community and its Institutions. The two congrega- restricted after the annexation of Podolia (i) Tur ccy (1772). tions of Lvov maintained separate synagogues. In Galicia itself. the expansion of the surrounding commu- and charitable institutions. They shared the cemetery (first nities (Zholkva. Brody) further limned the authority of the mentioned in 1411). and the Karaites were also buried Lvov community. At the meeting of the provincial council there. From 1600 (1) 1606 there was a violent conflict in 1720. it was declared that Two. the men of the province. between the Jews and the Jesuits over the synagogue which have no further portion or inheritance in the holy had been constructed (in late Gothic style. after the plan of congregation of Lvov and the rabbi who will be nominated an Italian architeet) by the philanthropist Isaue h. Nahman by it." At the meeting of the council in Berezhany in 174) (founder of the famous "Nachmanovich family) in 1582. the rubbinate of the province was divided into two regions The Jesuits claimed that the land on which the synagogue and the (11' 1151 din of Lvov held office in only one of them. Was constructed was their property. The Jews were Conflicts within the community over the distr bution of victorious and the synagogue. which was named the Caz taxes, the election of rubbis, and other affairs rest in the (or "Di Cildene Roiz" after one of the daughters of the intervention of the secular authorities to a greater degree Nachmanovich family who died mysteriously). remained than in the past. Menahem Simhah Emir anuel de standing until the Holocaust. Lvov was the center of Jongh (d. 17021. a member of a Large family of physicians 11/07/97 FRI 17:16 FAX 1212 755 5883 W.J.C.NY 006 611 LVOV 612 Orenstein. During the 1830s a violent dispute broke nut over the question of a change in the traditional Jewish dress. In 1844 a Reform Temple wills opened and Abraham Kohen of Hohenems, Austria. was appointed as preacher. He was also made director of the German-Jewish school opened during the same ye: Γ. The Orthodox were vigorous- ly opposed to him and their opposition gained momentum after the authorities confirmed him as rubbi of the province in 1847. ^ year later he and his family were poisoned and Orthodox fanaties were accused of having committed the crime. The assimilationst intelligentsia circles of Lvov identi- Ged themselves with German culture. and in 1868 the "Shomer Isruel organizatio was formed. with its ideologi- call organ. Israelin The invement was opposed by the Doresh Shalom society. feunded in 1878 and disbanded 0 Figure 2. The Great Synagogue outside (he walls of Lvov. following short while later. and after is by the *Aguddat Ahim (1883). the pogroms of 1918. Isract Photo Archives. Jerusalem. which called for assimilati in into Polish culture. is organ was the Ojezyzun ("Fatherland"). Toward the end of the and himself court physician in King John III Sobieski, was century. the move toward Polish assimilation gained in highly influential during the seennd half of the 17th century. strength and the Jewish representatives from Lvov in the He was the Thesi Ere: Israel" (the chief treasurer of the Austrian parliament joined the Polish camp. During the funds for Ere Isruel collected in Poland). a parnas of the 1870s Orthodox circles organized themselves within the Councils of the Lands. and the holder of many public framework of the Mahrike Hadas. in which the Hasidim offices. were predominant. Lvov was the home of Hertz Homberg. From 1772 to 1914. The Jewish population of Lvov rose Within the framework of his educational activities. four from 18.302 in 1800 to 26,694 in 1869. and 57.000 (28% of schools for boys. three for girls, and a teachers' seminary the total population in 1910. According to the 1820 headed by Aaron Friedenthal were founded there. All were census. 55% of the Jews engaged in commerce (the majority closed down with the liquidation of Homberg's educational as shopkeepers and retail traders) and 24% in crafts. The network in Galicia in 1806. Jewish children. however. began 745 Jewish craftsmen included 249 tailors. 133 furriers. 51 to attend general schools. Legal restrictions against the bakers. and 34 goldsmiths. The Jews of Lyov controlled the attendance of Jews in secondary schools and universities wholesale trade between Russia and Vienna. Some were were removed in 1846. There were then many lews in the army purveyors, or wholesale dealers in tobacco. cereals. liberal professions. including distinguished lawyers and and sult: others owned flour mills: and Jews pioncered physicians, From the emancipation period. there were industry and banking in the town. Lvov Jewry suffered us a numerous cases of apostasy in Lvov. Between 1868 and result of the economic crisis in Galicia during the 19th 1907. 713 Jews abundoned their faith. while 86 Christians century. After 1772 the townsmen's struggle (1) restrict were converted to Judaism. In 1874 there were 69 registered Jewish rights of residence and trade were supported by the hadurim in the city and the first "reformed heder" theder Austrian authorities. From the beginning of the 19th metakkan) in which 381 pupils studied. was founded in century only the wealthy and educated merchants who had 1885. An institute for religious studies opened in 1910. adopted the German way of life were authorized to live During the Austrian period the lwo congregations in outside the Jewish quarter. In 1848 the Jews were allowed 10 Lvov merged into a single community. which from the participate in the elections 111 the municipal council. but 1830s was led by moderate assimilationists. These included their representation was limited to 15% and later to 20% In Immanuel Blumenfeld. Meir Jerahmeel Mieses. and Emil spile of the religious equality granted in the Austrian "Byk. Rabbis who helc office in this community were Empire in 1849. the municipality continued (0 eviel the Joseph Soul Nathansor. Zevi Hirsch Orenstein. Isane Jows from the retail trade. and the Christian artisans' guilds Auron Ettinger (see E inger Family). Isane "Schmelkes. struggled against Jewish artisans. The prohibition on and Aryeh Leib Braude. The preachers at the temple were acquiring real estate was abolished in 1860. and after the Dr. S. A. Schwabacher. Dr. Y. B Lewinstein. Dr. Ezekiel *Sejm of Galicia had revoked all discrimination against Caro (who in 1909 was confirmed as rabbi of the Jews the municipality of Lvov was compelled to annul chose community together with R. Isane Schmelkes), and Dr. S restrictions opposed to the Austrian constitution of 1867. Gutmann. During the late 19th and early 20th centuries. the Intensified anti-Semitie tendencies then prevalent among power of the assimilationists declined and nationalist- the Poles and Ukrainians of Lvov and the vicinity were Zionist influence began to be felt. The first Zionist societies. partly caused by the assimilation of the upper strata of the Mikra Kodesh and Zion. were Formed in 1883 and 1888. Jews to the ruling German culture. They formed the nuc-cus of the all-Galician Zionist TRENDS WITHIN THE COMMUNITY. Hasidism made organization. Periodicals and newpapers were published: headway in Lvov at the end of the 18th century. and Przyszlose. Wichód. Ha-Kurmet. Der Feker. and Toghtar although no zaddikim settled there they occasionally visited Activists in the Zionist societies included Reuben Birer. the town. In 1792 and in 1798 there were open clashes Joseph Kobak, David Schreiber. Abraham and Jacob between Hasidim and their opponents. During the 1820s. a Kokas. and Adolph *Stand. The first moves were made busidic shill was founded and in 1838 (here were seven toward a Jewish workers' movement and artisans' unions, such prayer rooms. As the Haskalah movement penetrated while some joined the P.P.S., the Polish workers' move- Lvov. an anonymous herem was proclaimed in 1816 against ment: the representat ve of this group was Herman a group of maskilim and especially against Solomon Judah Diamand. *Rapoport. Benjamin Zevi Nutkis, and Judah Leib Pastor: From 1914 to 1939. \Vith the outbreak of World War I. it was only as a result of pressure from the authorities that it thousands of refugees arrived in Lvov from the regions was rescinded by the (11 her din. Jacob Meshullam bordering on Russia. The entry of the Russian army into 11/07/97 FRI 17:17 FAX 1212 755 5883 W.J.C.NY 007 613 LVOV 614 the city in August 1914 was accompanied by robbery and hatred of the Jews and in murdering them. An insited mob looting. the closure of Jewish institutions. and the taking of attacked the Jews for three days. Thousands of lews were hostages. With the return of the Austrians in June 1915. put in jail. where they were cortured and murdered. During Jewish life was resumed. assistance to the refugees was July several hundred Jewish public figures and outh were organized. and the public institutions functioned once put to death: over 2,000 Jews were shot in "Akrion more. In November 1918. when the Poles and the Petliura" (July 25..27). On July 15, the Jews were ordered to Ukrainians fought for control of eastern Galicia, pogroms wear the yellow badge, and at the beginning of August il broke out in Lvov: 70 Jews lost their lives and many were fine of 20,000,000 rubles ($4,000,000) was imposed upon wounded. It was then, when the German. Polish. and them. Jewish property was confiscated and looted and in Jan nationalistic cultures were in conflict, that the August the desecration and destruction of synagogues and risks of assimilation were made manifest to the Jewish cemetries was curried out. ^ Judenral was appointed by the authorities, headed by During the period of independent Poland (1918 39). the Joseph Parnes, who was killed shortly afterware when he community of Lvov was the third largest in Poland and one refused to supply the Nazis with a quota of men or forced of its most important centers. From 99,595 in 1910 the labor, A similar fate was in store for two of his three number of Jews increased to 109.500 (33% of the total successors: the last chairman of the Judenrat. Ebersohn. population) in 1939. In the struggle between the Poles and was executed together with the other members of the the Ukrainians. each side accused the Jews of supporting council in February 1943. Under German supervision. the the other, The rise of anti-Semitism and the severe Judenrat handled taxes. social welfare. and food and economic situation were rellected in every sphere of Jewish housing control. A Jewish police force came into being as a life. The economic crisis was also illustrated by the special department of the Judenrat: in the course of time it reduction in community taxes: from 497.429 zlotys in 1929 was manipulated by the Nazis to serve their own aims. On in 310.481 dotys in 1933. During this period. LVOV had Aug. 1. 1941. Eastern Galicia was incorporated into the three Jewish secondary schools with instruction in Polish: a General Government. Poland, and all anti-Jewish restric- Hebrew college for advanced studies in Judaism (Tounded tions that had been in forcein western Poland for th: past two in 1920). first directed by Moses *Schorr: il nationalist-reli- years were now also applied 10 the Jews of Lvov (see "Holo- glous school. MaTaT (Mi-Ziyyon Tele Torah): a vocation- caust. General Survey). Labor camps were set up in the city al school: many hadarim. and a valumed wrah. There were and vicinity, where many Jews were either murdered outright many Ashkenazi synagogues and basidie prayer rooms. The (especially young people) or died as a result of the inhuman newspapers Chwila "The Moment"). Lemberger Toghlat. conditions prevailing in the camps. In November 1941 the and Opinia were published. The community was governed Jews of Lvov were all concentrated in 0 special cuarter of by assimitationists in confition with the Orthodox, while for the and subjected to starvation. the greater part of this period the Zionists formed the In March 1942 about 15.000 Jews from Lvov were opposition. In national polities, the Lvov members of the deported 10 Belzec extermination camp. The big Aktion. Polish parliament adopted al moderate line. They opposed however, took place from August 10 to 23. in which 40,000 the minorities bloc and were among the initiators of the Jews perished. Following the Aktion the S.S.-Grup penfueh- Ugoda (see also O. "Thon and H. Rosmaryn), the agree- rer Fritz Katzmann ordered the establishment of :1 ghetto, ment with the Polish government (1925). The Orthodox. completely sealed oil and surrounded by a barbed-wire especially the Hasidim of Belz. 38 well as the rich Jews. Tence. The overcrowding caused a series of epidemics which supported the government majority list. [A.RU] killed thousands of ghetto inmates. In further Aktionen (November 1942 and January 1943), another 15,000 Jews Printing. After the hest partition of Poland (1772). which were murdered, some in Belzec and others in the Janowska Galicia under Austro-Hungarian rule. the government Road camp. The rest of the ghetto inmates. some 20,000 Jewish printers to transfer their presses from *Zolkicw people. were restricted to a portion of the ghetto Designated (Zholkva) to the Galician capital of Lvov in order to facilitate as the Jewish camp and the Judenrat was liquidated. In the their *censorship. The first 10 move were W. Letteris and H. last thrown (June 1943). which resulted in the deat of most D. Mudpis, the latter producing Elijah Levita's Pirker Eliyahu of the surviving Jews. the Jows offered armed resistance. In in 1783. The house of Madpis brought out a new edition of the Talmud (1859-68) and a seven-volume Shulhan Arukh places where the Nazis encountered guntire and hand with standard commentaries (1858-61). still one of the best grenades, they poured gasoline on the Jewish houses and set editions (a similar one was printed by J. L. Buluban and his son, them in llames. The 7,000 Jews who survived the massacre who began printing in 1839). In 1785 J.S. Herz set up his press. were dispatched to the Janowska Road camp. Apart from a which produced a good edition of Maimonides' Mishneh Turah few Jews in labor camps. Lvov and the environs were made (1805 11). Madpis' granddaughter. Judith Mann-Rozanes, also *juleprein. ^ lew hid in the "Aryan" part of the city. moved from Zolkiew, while her son, M. H. Grossmann, con- tinued printing until 1858. About 20 other printers were active in I.vov in the century and :1 half before the outbreak of World War 11. making the city one of the main centers for the production of Hebrew books. not only for Lastern Europe but for the Balkans as well. (En.) Holocaust Period. In September 1939. at the beginning of World War 11. Poland was partitioned between Germany and the U.S.S.R.. and Lvov became part of Sovier Ukraine, But after the outbreak of the German-Soviet War. the Germans captured the city (July 1941): it then had :1 Jewish population of about 150.000. including thousands of refugees from the Nazi-occupied western part of Poland. The Incal Ukrainian population welcomed the German troups. while Stefun Bandera's units joined up with the Figure 3. Farm in the Lvov region. C. 1925. Courtely Jewish invading forces and played a major role in stirring up Colonization Association. Tel Aviv. 11/07/97 FRI 17:18 FAX 1212 755 5883 W.J.C.NY 008 615 LVOV 616 CENARTEX, "Zionist activities." Organized maggah baking was prohib- ited in 1959. and in the same year pressure was brought to CHWILA WYDANIE PORANNE hear on the local mohalin. to induce them to sign a agremplarza 15 declaration promising to abandon circumcision In the Jewish cemetery only a small section was kept intact and used for burials. In 1962 several hundred Jews were arrested for "economic crimes." In hill year several articles were BIALA KSIEGA published in the local Ukrainian newspaper. Lrieska Pravda. demanding the closure of the only remaining Strejk generalny Zydów W Palestynie synagogue on the pretext that it served as a meeting place for "speculators" and other criminals. It was in fact elosed Tel Awiwie strelk potrwa 10 dnil toward the end of that year. and all synagogue officials were arrested and charged with "economic crimes." The com- munity slaughterhouse was handed over In a local munici- pal organization. In 1965 In Jews addressed a petition in Figure 4. Masthead and headlines of the Lvov Jewish newspaper. Prime Minister Kosygin asking (i) he given a place for Chwile ("The Moment"), May 18, 1939. with news of il Jewish worship. They were allotted a building site, hut the financial general strike in Palestine protesting the British White Paper. burden of crecting a new synagogue was too great. In 1969 Courtesy Central Zionist Archives. Jerusalem. the militia broke into private minyanim and dispersed them by force. E.BR.] JANOWSKA ROAD CAMP. The camp. a place of torture Bibliography: J. Carn. Gesch.chte iler Juden in Lemberg (1894): S. and murder. was set up on Janowska Road in October Buber, Aushei Shem (1895. repr. 1968): Dubnow. Hist Russ. index 1941. One part of the camp contained quarters for the S.S. S.V. Lembers: S. An-ski. Hurt an Yahadur be-Polin 11. Bukavina men and camp police. and .1 prison barracks whe latter also (1929). 119-28. 183. 203. and passim: Lwow. Zydowska garina served as a transit camp for departees to Belzee extermina- wyznamowa (1928): M. Balaba 1. Zydzi beawsey na pezelomie in 17 tion camp). The other part contained workshops which in wickow (19(kg): idem, in: Studja twowskie (1932). 41 65: idem. the course of time developed into a special unit. the Ger- Geshikhie fim Lemberger Progresion Templ (1937): Neiwelt. in: man Armament Works (DAW: see *S.S. Enterprises in the Pinkes Galitsve 1925 45 (1945). 117 26 and passim: Yaari. in: KS. East). Designed as a forced labor camp for Jens from Lvov 17 (1939/40). 95 108: 21 (1915). 299 300: L.. Chasannvich (ed.). Les Pagrames anti-juifs 8" Fologue "I in Galice (1919). 47 73: and the area. Janowska in fact became an extermination Kart. in: 1. L. Fishman (ed.). Arint ve-timmahar he- Fisrael. : (1946). camp. Tens of thousands of Jews from Eastern Galicia were 290 344 (incl. bibl.): 3. Tenenhaum. Galitsve Mayn Alle Heyor brought there. some of whom were murdered on the spot (1952). index: Thon. in: Pirkei Galizyah (1457). 343 85: N. M. and others sent on to Beizee Prisoners were killed in many Gelber (cd.). EG. 1 (1956). incl. hibl.: idem. Totedor ha-Tenrah instances for the "entertainment" of the murderers. Yes in ha-Ziyyonit be-Galizyoh. 1873 1918 (1958). index: H. N. Dembit- spite of the conditions. the Jews created cultural activities in zer. Netion Yoli (1960). 156. PRINTING: Balahan, in: the camp and prepared for armed resistance. The Germans. Sancina-Bluetter. 3 (1929/30). 17-21: A. Youri, in: KS. 17 under the threat of possible resistance. liquidated the camp (1939/40). 95A: (1945). 2991.: H. D. Friedberg. in: EG (1956). 539M. HOLOCAUST: S. Sien The Promise Hiller Kept (1945). in at surprise Aktion on Nov. 20. 1943. Only a lew 9.179: L. Weliczker-Wells, Canowska Road (1963): I. Lewin, Alin individuals escaped. The special conditions prevailing in mi-Specia (1947): P. Schnec) in: Davar (Nov. 5. 1946): t. Brand. Lvov - 21 hostile Ukrainian population. the lack of forests in in: Yedi'or Yad Vashem. ::5 26 (1961). 17.18: HG. 4 (1956). the area in provide shelter. and the absence of it Incal 539-766: Eduyyor, 1 (1963). 195-216: Forfuits hilériens- partisan movement precluded the rise of organized Jewish Documents officiels (1945). 201 32: M. M. Borwiez. Universeter resistance. However, a few sporadic and isolated attempts chird (1946): idem. Literatura " abozie (1946): J. Hescheles. to resist were made. Some Jews ned to the remote forests. Oczyma dziewezyme (1946): S. Gogolwska. Sckolu but in most instances the local peasants handed them over okracienstivea (1964). to the Nazis. Some instances of resistance have been recorded. e.g., during the liquidation of the ghetto and one LVOVICH, DAVID nwn as Davidovich: 1882 1950). in the Janowska road camp. In one instance, a group of leader or the territorialist-Socialist movement and of cump prisoners charged with the disposal and cremation of *ORT. Born in southern Russia and brought up in an corpses attacked and killed several of the German guards. assimilationist environment, Lvavich first became uc- ^ few dozen prisoners then escaped. hut most of them were quainted with Jewish alfairs and the Jewish workers' caught and murdered. movement when he visited Minsk in 1903 and came into When the Soviet forces entered in July 1944. a Jewish contact with the *Polalei Zion. After he left Russia he committee was established to help the survivors. or the maintained relations with the Herot group founded by N. 3.400 Jewish survivors who registered with the committee *Syrkin. In 1905 he visited Ere% (stacl and on his return he by the end of 1944. only 820 were from l.vov ghetto itself. abandoned general Zionism in lavor of territorialism. Most of the survivors settled in Israel. after wandering After joining the Zion.st-Socialist Workers' Party (S.S. or through Europe. while the rest emigrated 10 other countries Z.S.). he founded the S. S. League abroad and established overseas. Some of the ashes of the Lvov martyrs were taken student groups in Germany. ^ member of the party's to Isruel and interred at the Nabalat Yizhak cemelery near committee in Odessa I'r im late 1905. he was the lender of its Tel Aviv, *self-defense group during the October pogrom. At the S.S Contemporary Period. ^ monument in the memory of convention in Leipzig (1906). he represented that trem Jewish victims of the Nazis. with inscriptions in Hebrew, which connected the future realization of territoriatism will Yiddish. and Russian. was crected shortly after World War the unavoidable turn of the course of Jewish emigratio 11. In the 1959 census 29.701 Jews were registered in the from the towns toward agriculture and concentrate Lvov oblast. 5.011 of whom declared Yiddish to be their colonization. He later worked for un active policy in it mother tongue. In the city, a center of Ukrainian national- organization and regulation of emigration. As the repr ism. an anti-Jewish atmosphere prevailed in most spheres of sentative of the S.S. at the conventions of the Jewi: life. In 1957 several Jewish students were arrested for Territorialist Organization (see "Territorialism) he " 009 11/07/97 FRI 17:18 FAX 1212 755 5883 W.J.C.NY 1513 UKRAINE 1514 weekly Ha-Shomer ha-Za'ir. and was editorial secretary of their numbers had increased 10 at least 150,000: in the .11 ha-Mishmar (1943-47). From 1953 he was the literary census of 1764. 258,000 Jews were cnumerated. though in editor of Sifriat Poutim publishing house. fact their number was over 300,000. In 1847. according to Ukhmani published many articles and essays on literary topics, official sources. there were almost 600,000 Jews in the and wrote J number of books. which are collections of essays, Ukrainian regions belonging 10 Russia (the provinces of among them Le-Ever ha-Adam (1953). Tekhanim ve-Zuroi (1957). southwestern Russia Volhyniu, Podolia, and Kiev: of Kolor Adam (1967). and dial Laylah Laylah Ani (1968). a book ol "Little Russia" Chernigov and Poltava: and of "New poetry. He was one of the editors or the literary anthology Dur ha-tre: (1958). and together with S. Y. Penueli edited the English Russia" Yekaterinoslav Dnepropetrovsk), Kherson, retion Hebrew Short Stories (1965). and Taurida), though they actually numbered up to [G.K.] 900.000. According to the population census of 1897 (the first general census in Russia). there were Jews in MERGE (Pol. Wilkomierz: Rus. Vilkomir). city in these regions, 9.2% of the total population of the Ukraine, Lithuaman S.S.R. The Jewish community of Ukmerge is The census of 1926 enumerated 1,574,391 Jews in the first mentioned in I document of 1685. In the census of Ukraine, subsequent to the detachment of half of the 1766. 716 Jews were counted there. and by 1847 their province of Volhynia (the second half was then within the number had risen 10 3.758. the majority of whom were horders of Poland). hall of the province of Tourida, and a engaged in commerce and crafts, including turning. The small section of the province of Chernigov, while several community of Uknicrge was renowned for its conservatism, districts of the Don region had been incorporated into it. M. 1... "Lilienblum Inved there during the 1860s and it was The Jews then constituted 5.43% of the total population of there that he began his public career and Interary activity. the Ukraine. The consus of 1939 enumerated 1.532,827 Jews The community continued 11) develop and by the 1880s the in the Ukraine (4.9% of the total). According 10 the census number of Jews reached 10.000. ^ period of decline of 1959. which also included the Jews of the regions which followed. however. when the town was bypassed by the had passed 10 Russia after World War 11 (easter Galicia. milrouds which were built at that time. In 1897 there were northern Bukovina, Subcarpathian Ruthenia). there 7.287 Jews (54% of the total population) and 6,390 (49%) in were 840,319 Jews in the Ukraine (2% of the total). According 10 this census. which was generally regarded as underestimating their numbers, Jews were concentrated in the towns of Kiev (153.500). "Odessa (106.700 Kharkov (84,000). Dnepropetrovsk (52,800). "Chernovts, (Czernow. itz: 36,500), Lvov (24,700). and Donetsk (21,000). About 80% of the Jews of the Ukraine declared their mother longue as Russian. about 17% (142.240) as Yiddish. and only about 3% as Ukrainian. Development and Distribution of the Jewish Settlement. The Jewish settlement in the Ukraine preceded the unification of the area and the formation of th: Ukrainian nation, Jewish settlements already existed on the banks of the River Dnieper and in the east and south of .he Ukraine and the *Crimea in the periods of the Khuzar kingdom, while ancient Jewish communities were only es ablished in School for Jewish shoemakers in Ukmerge. photograph 1937-38. the west. in Volhynia and "Red Russia" (eastern Galicia). csy Yad Vushem Archives, Y. Kamson Collection. Jerusalem. in the 12th century. or these the most ancient was apparently Vladimir-Volynski, II seems that the Russia" At the beginning of May 1915 the Jews were expelled mentioned in 13th-century rabbinical literato refers 10 from Ukmerge. together with those of the province of "Red Russia." These communities absorbed the Jewish Kovno. Some returned after the war and in 1923 there were migration from Germany and Bohemia caused by the 3,885 Jews (37% of the population). During the period of persecutions and massacres of the 14th (the Black Death) independent I ithuania (1918 -40). Jowish life-in Ukmerge and 15th centuries: later. Jews were drawn to the Ukraine prospered. A yeshivah ketannah (preparatory yeshivah) which by the colonizing activities of the Polish nobility that prepared pupils for the larger Lithuanian yeshivot was intensified in the 16th 10 17th centuries with the con- established and there were also TWO secondary schools, solidation of the rule of Poland-Lithuunik over the Hebrew and Yiddish. The last rubbi of Ukmerge. R. Joseph region. The important role taken by the Jows in the Zussmanowitz (ol' Palestinian birth). ranked among the economic sphere in this colonization made the Ukraine one most promient Lithuanian rabbis, With the annexation of of the Jewish centers in Poland-Lithuania. The number of Lithuania to the Soviet Union in June 1940, religious and the communities there increased from 25 during the 14th nationalist Jewish life was systematically destroyed. ^ year century to 80 in 1764. Even the Chinielnicki assucres in later. Ukmerge Tell into the hands of the Germans. On Sept. 1648 49 did not halt Jewish migration to the Ukraine and 18. 1941. the Jews remaining in Ukmerge. together with they played a prominent role in its economic recovery those of the neighboring towns. were assembled in the during the second half of the 17th and the 18th centuries. nearby forest and massacred. After the Ukraine was annexed by Russia, according 10 the Biblingraphy: Stawnik generaticzay kritestwa pulskiege. 13 census of 1764. about 15% of the Jewish population lived in (1893). 535 41: Yuhadul Lita. 3 (1967). 303-6. [Y.S.] provinces having communities over 1,000 Jews, while in other provinces-Volhynia, Podolia, Kiev, and Brats- UKRAINE (Rus. Ukraina). Union Republic in the lav -their proportion Was only 11%. The census of 1897. southwestern U.S.S.R. At the close of the 16th century however. shows that 72% of the Jewish population there there were about 45.000 Jews (out of the 100,000 Jews who were living in 262 communities of more than 1.000 persons. were then presumably in the whole of Poland) living in the which. taken together with the communities h: ving more eastern regions of Poland which were inhabited by than 500 Jews, meant that 37% of the Jewish population Ukrainians Before the *Chmielnicki nuissacres of 1648 49 there lived in towns and townlers in which the Jews formed 11/07/97 FRI 17:19 FAX 1212 755 5883 W.J.C.NY 1515 UKRAINE 151 Figure 1. The Provisional National Assembly (ussembly or Ukrainian Jews) which look place in Kiev. November 1918. Those present included: 1) Solomon Joseph Levin: 2) Eliezer Kaplan: 3) Alexander Goldstein: 4) Menahem Ussishkin: S) Vladimir Ze'ue Tiomkin: 6) Jacob Latzky-Bertholdi: 71 Max Schatz-Anin: 8) Noah Barou: 9) Samuel Tchernowitz: 10) Hillel Zlatopolsky: 11) Abraham Devidson: (2) Isruel Bur Ychuda (Idelson): 13) Jacob-Zerubavel (Vitkin): 14) Moses Litvicov: 15) Ben Adir (Abraham Rosin). Courtesy A. Rafacti-Zenziper Archive for Russian Zionism, Tel AVIV. an absolute majority and 22% in localities where they or a sector of their economy. Jews also engaged in avenda formed 40 50% of the total population. In contrast. in the there in the collection of customs duties and taxes. and part of the Ukraine which lay beyond the Differ, in the played an important role in the export and import trade in provinces of Poltava and Chernigov (where about 225,000 the region. The Cosseck authorities of the part of the Jews lived and constituted a majority in about (\\\) places Ukraine annexed by Russia beyond the Dnieper opposed only and 40% of the total population in three others). 65% the frequent expulsions of the Jess from there 11717. 1731. of the Jewish population lived in 39 communities of more 1740. 1742. 1744). and argued in favor of their Free than 1.000. The same situation obtained in "New Russia" admission 10 the Ukraine (1728. 1734. 1764) stating that the (the provinces of Kherson. Yekaterinoslav. and Tourida) Jews promoted the region's trade. When the Ukraine (with where over 500,000 Jews lived: 760 of the Jewish the exception of eastern Gaheia) became part of the Pale of population was concentrated in 58 communities of over Settlement after the partition of Poland-Lithuania. the Jene 1.000. and Jews formed a majority only in their agricultural continued to play a con siderable and dynamic role in the settlements. In 1897 Jews constituted 309 of the urban economy of the region In 1817. 30% of the factories 111 population of the Ukraine. 263 of them living in 20.10wns. Ukraine were owned by Jews. They were particulark active in each of which there were over 10,000 Jews. in the production of "atenholic beverages. In 1872. before After the abolition of the Pale of Settlement. with the the anti-Jewish restriction 111 this sphere. 906 of those October 1917 Revolution, the civil war. and the disorders occupied in distilling were Jews: 56.6% in sawmills, 48.85 which accompanied ii. more than 300.000 Jews left the in the *inbacco industry and 32.5% in the *sugar industry. Ukraine for other parts of the Soviet Union. Hence they Only a limited number of Jews were occupied in heavy formed only 5.4% of the total population and 229 of the industry. where they were generally employed as white-collar urban population of the Ukraine in 1926. and 4.19 and workers. In 1897 the occupational structure of the Jewish 11.7% respectively in 1939. In 1926. 446 of them lived in 20 population of Ukrame was 43.39 in commerce: 32.24 in towns. each having over 10.000 Jews. while in 1939. 399 crafts and industry 2.96 in agriculture: 3.79 in commun- lived in the four enties of Odessa. Kiev. Kharkov. and cations: 7.30 in private services (including porterage and Dnepropetrovsk. This intensified urbanization did not. the like): 5.8% in public services (including the liberal however, give them predominance in the cities. since there professions): and 4.8% of no permanent occupation Under also was a stream of Ukrainian peasants From the villages the Seviet regime. by 1926. it had become 20.6% in arts and into the towns. which assumed a pronounced Ukrainian crafts: 20.6% in public services (administrative works. character. 15.3% workers (including 6.6% industrial workers): 13.35 For the history of Ukrainian Jewry after World War I in commerce: 9.2% in agriculture: 1.65 in liberal profes- and in the Holocaust see Russia. sions: 8.9% unemployed: 7.3% without profession: and Economic Situation. The migration of Jews from the 3.2% miscellaneous (pensioners, invalids. etc.). The propor. western provinces of Poland 10 the Ukraine in the 16th tion of lews in various administrative branches was 40.65 century was mainly due to their economic role in the in the economic administration and 31.9% in the medical- *arenda business ())] a large or small scale Hence, the sanitary administration. After large numbers of Jews had Ukraine became a region where Jews managed a consider- been absorbed under the Five-Year Plan 10 heavy industry able proportion of the agricultural economy. administering respecially the metal and automobile industries). 117 the complexes consisting of a number of estates, single estates. artisan cooperatives (in which there were over 70.000 15 11/07/97 FRI 17:20 FAX 1212 755 5883 W.J.C.NY 011 1577 UKRAINE 1518 Jewish members 12.9% of the membership). and in National Council (the Rada), which in January 1918 agriculture (16,500 families in the cooperative farms). the proclaimed the separation of the Ukruine from Russia: this proportion of lews living in villages rose to 14% of the episode came 10 an end in August 1920. when the Red Jewish population. Army completed the conquest of the Ukraine. During this Hatred of the Jews. When the Jews settled in the Ukraine Time the leaders of the Ukrainian nationalist movement during the period of Polish rule. they found themselves attempted 10 reach an agreement with the Jews. They between nummer and anvil: under the arenda system the established relations with the leaders of Zionism in custern Jewish lessee administered the estate in the name of the Galicia. and jointly waged il struggle against Polish tims in Polish landowner. and. if living in the town. he found his the Ukraine. During this period the Jews were represented CUS among the nobility. officials. the Catholic clergy. in the Rada (with 50 delegates), II secretarial for Jewish and cal army garrison. To the enslaved peasants and affairs was established (July 1917). and at law passed on reber Cossacks. Ukraimians, and Greek-Orthodox the "personal national autonomy" for the national minorities, Jewish lessee appeared both as an intidel and an alien an among which the Jewn were included. The Jewish ministry emissary of the Polish Catholic noblemen who sought 10 (M. "Silbertarb was the first minister: he was succeeded by dominate them. The Ukrainian townsmun was jeulous of J. W. Latzki-Bertholdi) passed a law providing for his urban rival. the unbelieving Jew. whose success was due democratic elections 10 the administrative bodies of the to the assistance of the foreign and hated Polish regime. In communities (December 1918). is Jewish National Council times of rebellion and war, this hatred and jealousy was was formed. and the Provisional National Council of the vented in severe persecutions and horrifying massacres. Jews of the Ukraine was convened (November 1918). These such as the Chmielnicki massacres of 1648-49, when over institutions were short-lived. In July 1918 the autonomy 100.000 Jews were brutally killed and almost all the was abolished. the Jewish ministry was dissolved and the communities of the Ukraine were destroyed, and the pogroms which then took place. without the Ukrainian persecutions of the *Haidamaks in the 18th century. which government taking any effective measures 10 assure the were more limited in scope but even more terrible in their security of the Jewish population -proved that the whole of cruelty. These massacres, whose perpetrators were admired this project had been directed more at securing the as national heroes. gave rise 10 at popular tradition of haired assistance of the Jewish partics in order to achieve complete toward the Jews in the Ukraine: it was nurtured by the separation from Russia than at really developing 1 new nerease of the Jewish population in the country. by its positive attitude toward the Jews. economic position. and later by the propugation of the Religious and Social Movements in Ukrainian Jewry. Russian language and culture by Jews an act which the Ukrainian Jewry became a l'ocus of religious and social nationalist Ukrainian intellectuals (the 'Ukrainophiles") Terment within Judaism from the late 17th century. The regarded as collaboration with the "Museovite" Russian massacres and sufferings endured by the Jews in the government in its campaign against their awakening as at Ukraine also introduced spiritual and social Trends. The eparate nation. This tradition of hatred toward the Jews messianic agitation which followed the massacres of found its expression in both Tolk songs and literature (T. 1648 49 paved the way for the penctration of Shubbatean- Shevehenko: N. Gogol). in historiography (N. Kostoma- ism. while at the time of the Haidamak persecutions and the or). and in political thought (M. Dragomanov). The revival of *blood libels, the Frankist movement made its Nationalist and Socialist Party of the Ukraine was also appearance, and *Hasidim as inaugurated by Israel b. Eli- invired with anti-Jewish feelings. The pogroms of 1881-82 ezer Ba'al Shem Tov developed and spread rapidly through roke out and spread through the provinces of the Ukraine: the country. After the pogroms of the 1880s, the Uk raine after 1917, in the Civil War and under the regime of S. was not only the birthplace of the Hibbat Zior, the Pet the "Socialist" government). about 100,000 Jews Bilu. and the Am Olam movements but also of the ered in the Ukraine (1919-20). as in the days of Dukhovno-biblcyskoye bratstvo ("Spiritual Biblical Broth- Chm ki and with the same cruelty. Two decades of erhood," founded by lacob Gordin and his circle) which Soviet regime did little 10 eradicate the hostility against the sought to "bring back' the Jews to the religious purity of lews: during World War 11 great parts of the Ukrainian the Bible and thus draw them closer to Christianity. Activist opulation wholeheartedly collaborated with the Nazis in and revolutionary trends were also prominent ir the terminating the Jews in the occupied Ukraine Hebrew and Yiddish literature which emerged in, the The Period of the Independent Ukraine and Jewish Ukraine during the 19th and 20th centuries. National Autonomy. The period from March 1917 to During the 192Us and the early 1930s three Jewish : ugust 1920 constitutes a special chapter in the history of districts were created in the areas of Jewish settlement in ne Jews of the Ukraine. The Ukrainians established a southeastern Ukraine Kalininskoye, Stalinskoye, and Zlatopol: see also Yevsektsiya). B.D.) After World War 11. During the last stages of Work War 11 and in the period after it. when Nikita Khrushchev was the ruling party man of the Ukraine, Ukrainian Jews who. during the occupation, Hcd or were cvacuated to Soviet Asia, began to stream back and claim their previous housing. possessions. and positions. They were met with outspoken hostility by most of the Ukrainians who had taken their place. The administration refused to interfore in favor of the Jews and generally showed "understanding" for the anti-Jewish reaction. even hushing up violent clashes (as, u.g., in Kiev). When Khrushchev became the uling figure in the U.S.S.R. after Stalin's death, and particularly gure 2. Members of the faction of the "illegal He-Halutz" on a in the 1960s. the traditional hatred of Jews in the Uk raine irm near Kiev. 1923. Courtesy Central Zionist Archives, Jeru- was again allowed to find free expression in pseudo-scie ntific literature (e.g.. the book by the professional anti-Semite 11/07/97 FRI 17:20 FAX 1212 755 5883 W.J.C.NY 012 1519 UKRAINE 1520 Trolim Kichko, Judaism without Embellishment, which up- 11 then goes on (1) consider the roots and stalks of a great variety 0 peared in 1963 under the auspices of the Ukrainian Academy vegetables and Truits, determining whether or not (ur to who of Sciences) and in various popular brochures and period. extent) they fall under the terms of rad and shomer. Chapter icals. This official anti-Jewish atmosphere prevailed in the continues this subject, ir. particular whether kernels. shells. husks. Ukraine during the whole postwar period. The only and encasing leaves are 0 he regarded as part of the Truit. Toward synagogue in Kharkov was closed down in 1948 and its the end of the chapter. the problem of *hekhsher is inuched upon i.e., the susceptibility of bod to ritual impurity. a subject dealt will aged rabbi sent 10 a labor camp. in Kiev the only remaining in detail in tractate Makhshirin. Chapter 3 continues with the synagogue was put under severe surveillance of the secret subject of hekhsher. introducing also the associated notion of police. more than in other Soviet cities. Yiddish folklore mahashavah. i.e., the intent 10 use the respective foods (vegerable (11 concerts and shows were almost completely hanned from meat) for human consuription. Then there is J detailed discussion the Ukrainian capital. Kiev. though they were allowed to of various cases where one of the elements. bekhsher of lake place occasionally 11) Ukrainian provincial lowns. mahashavah. or neither al them, or both. are required in order to An interesting reaction to this trend "from above" make the food susceptible to impurity. became noticcable in the late 1960s among Ukrainian Most of the laws in this tractate are found seattered among the intellectuals who openly strove to achieve more freedom other tractates, e.e., Tasural 1:1 +; 8:9: Terml Your 3:1 3: and in civil and national rights. Though engaged 11) defending the Ukrainian character of their republic against Trus- sification." some of them went out of their way in emphasize their solidarity with Jewish demands for the revival of Jewish culture and education. They also identified with the Jewish attempt to keep alive the remembrance of the Holocaust against the official policy of obliterating it. Young Ukrainian writers, most of them Communist Party members. expressed this new trend in Ukrainian national thought in various ways. and even in labor camps after their arrest for "bourgenis nationalism." A particular impression was made in 1960 by the speech of the writer Ivan Dzyuba in *Babi Your on the unniversary of the massacre (October 29). It was published only in the West, but it became widely known among Jews and educated non-Jews in the Ukraine. From 1969 some Jewish families in Kharkov, Kiev, and Odessa were allowed to leave the U.S.S.R. for Isruel. Biblingraphy: 1.1. Malyshevski, Yevrei yuzhnoy Rusi i Kiyeve X-XII vekakh (1878): Arkhiv yugo-zapadung Rossil. 5 pl. 2 (1890): M. Zilberfarb, Dos Yidishe Avtonomyc in Ukraine (1919): L. Khazanovich, Der Yidisher Ministerium un di Yidishe Khurbn in Ukraine (1920): E. Heifetz, The Staughter of the Jews in the Ukraine in 1919 (1921): J. Lestschinsky, Dus Yidishe Folk in Tsifern (1922): idem. Ma-Yehudim he-Rusyah ha-Soyyetit (1943): A. Druyanow (ed.). Reshummot, 3 (1923): L. Teheri- kower, Antixemitizm in Purramen in Ukraine 1917 1918 Engraving for the tracta 6 Ukgin. which deals with cirual impurity (1923); Committee of Jewish Delegations. The Pograms in of husks and stalks etc., from a title page of the Hebrew-Latin the Ukraine under the Ukrainian Governments, 1917 1920 Mishnah illustrated by Mich, Richey. Amsterdam. 1700 04. (1927): E. D. Rosenthal, Megillat ha-Tevah. 3 pts. (1927 Jerusalem. J.N. U.L. 31): H. Landau. in: YIVO Shrijin far Ekonomik un Statistik, I (1928). 98 104: Eshkol. Engiklopedvah Yesre'elit. (1929). Makhshirm. R. Sumson of Sens (in his commentary at the begin. 1054 83: J. Kantor, Di Fldishe Batelkerung in Ukraine (1929): J. ning of Tohoron suppes that Ukzm logically precedes Tohorol. Shatzky, in: YIVO Historishe Sektsye. Grevres Takh (1938): L. which continues with the subject matter of Chgin's linal chapter Zinger. Dos Banayle both (194)): R. Dinaburg. in: Zinn. S 10 The laws of Chain were known to he very difficult to understand (1943-45): S. Ettinger, ibid. 20(1955). 128 52: : (1956). 107 42: and when Rav Judah studied it he would say. "we see here R Mahler, Toledot ha- Yehidim be-Polin (1946): 1. Halpern, Beit questions of R.iv and Simuel." In Horayal 136 it is related tha Yorral Polin. (1948). 80 91: Dubnow, Divrei, 7 (repr. 1958): several rubbis strove 111 umbarrass the nasi Simeon h. Gamaliel h: O. S. Brik. Ukrayinsko-yevreysky (1961): S.I. challenging him to teach them Okain. If the reference is 111 the Goldelman. Jewish National Automomy in Ukraine. 1917 1020 tractate and not to the individual laws, 11 proves that at least part (1968): V. Chornovil. The Chornovil l'apers (1968). 222-6 (speech of the Mishnah were edited before Judah ha-Nasi. According 11 of Ivan Dzyuba). (En) Epstein. Mishnuh 3:2 represents the revised opinion nl Akiva (el Tosefta 3:2) and Mishnah 3: represents the VIEW of Meir. The Coselta also consists of three chapters. but man, UKZIN (Heh, EXPY: "Stalks"). 12th and last tracture in the paragraphs in 11. such as and 3:6 14, are not direct) order Tohorot in the Mishnah and the Fosefta. There is no related 10 any Mishnah: and even when there is a correlation, in Gemara. either in the Babylonian or the Jerusalem order of the Tosefta does not correspond 10 that of the Mishnah. I Talmud. Okzin deals. in three chapters, with the problems may he noted that the view of Resh (Simeon h.) Lakish, placing of ritual impurity affecting roots. stalks. husks. shells, Tohoror as the sixth and last order of the Mishnah. having bee accepted (Shab. 310). UK appears as the last tractate of the whol kernels. etc., and the importing of the uncleanness to the Mishnah (as well as of the Talmud and Tosef(a). II is an unusur Truits to which they are attached. This tractate was subject with which to round off the Oral Law. According 1. considered one of the most difficult even in talmudic times Maimonides. its posit on does not express any particula (Ber. 20a: Hor. 13h). appreciation for this tractate: on the contrary "it has been left 1. Chapter distinguishes first between yod ("handie") and shomer the end," he says. "beesuse it is based on rabbinical speculation ("protection"). the former referring 10 that part of the Truit which without any foundation in the Bible" (Introduction 10 Zernim) T one holds when eating the fruit, and the latter to such parts as give the Mishnah a litting close. later editors of the Mishnah adde protect the fruit: both are relevant 10 the question of ritual purity. an aggadic passage to the original text of Ukgin. speaking of gre: November 17 - Lviv, Ukraine Event: A USG contracted IL-76 will arrive in Lviv on November 6th carrying approximately $650, 000 in humanitarian cargo donated through the U.S. private volunteer organization the Children of Chernobyl Relief Fund. Most of this cargo is destined for the Lviv Regional Childrens Pediatric Center and includes neonatal resucitation equipment, medicines and medical supplies, and an ambulance. Also on this aircraft is 5 pallets of cold weather clothing and relief supplies orgainized by Congresswoman Kaptur of Ohio from the Anastasia Fund and the Toledo Sister Cities organization. Suggested talking points relating to this relief flight are: O In the area of neonatal care, I am pleased that on November 6th a USG contracted IL-76 delivered humanitarian cargo destined for the Lviv Regional Childrens Pediatric Center. Thanks to Nadiya Matkiwsky and the Children of Chernobyl Relief Fund for their continued commitment to the people of Ukraine and this humanitarian project in Lviv. O This mission was the 53rd airlift of humanitarian commodity to Ukraine since 1992 funded through the Department of State as part of a continuing humanitarian program called Operation Provide Hope. I am especially pleased to see that the recepients of this assistance are the children of Ukraine. O Over the last five years Operation Provide Hope has worked with over 400 U.S. private volunteer organizations to deliver donated humanitarian commodity to the Newly Independnt States (NIS) It is estimated that by the end of this calendar year Operation Provide Hope will have delivered over $2 billion in assistance to the twelve NIS countries. This cooperative effort goes well beyond global politics and humanitarian programs and is a shining example that the people of the U.S. care for and support the people of Ukraine and the rest of the NIS during a critical period of change. O To date this Operation Provide Hope has delivered over $300 million in humanitarian commodity to the people of Ukraine from donors throughout the United States. Tour/Discussion at L'viv Oblast Clinical Hospital L'VIV, UKRAINE EVENT: Visit to USAID/AIHA Partnership Sponsored Neonatal Resuscitation Training Center and Neonatal Intensive Care Unit at L'viv Oblast Hospital with First Lady of Ukraine DATE OF EVENT: November 17, 1997 DURATION: 11am - 12:15pm LOCATION: L'viv Oblast Clinical Hospital UI. Chernigivska, 7 290010 L'viv-10, Ukraine Tel: (0322) 75-50-21 Fax: (0322) 75-78-15 NEONATAL RESUSCITATION TRAINING CENTER DIRECTOR: Dr. Dmytro Dobriansky NEONATAL INTENSIVE CARE UNIT HEAD: Dr. Olga Detsyk AIHA CONTACTS: Washington DC: James P Smith, AIHA Executive Dir. Tel: (202) 789-1136 Fax: (202) 789-1277 Kiev: Dr. Oksana Khartonuk, AIHA Regional Dir. Tel: (011-380) 228-5375; (011-380) 229-2324 BACKGROUND: L'VIV NEONATAL RESUSCITATION TRAINING CENTER AND NEONATAL INTENSIVE CARE UNIT The USAID/AIHA supported partnership between Henry Ford Hospital (Detroit) and L'viv Oblast Clinical Hospital has been addressing infant mortality and morbidity problems since its inception in 1993. Programs developed by the partnership include a model Neonatal Resuscitation Training Center (NRTC) to train health care workers throughout the region in assessment, prevention, and newborn resuscitation protocols and a model Neonatal Intensive Care Unit (NICU) and regional neonate transport system. The NRTC focuses on preventing and immediately intervening in birth distress of American International Health Alliance FLOTUS - L'viv, Ukraine 11/05/97 Page 1 of 7 otherwise normal infants while the NICU and transport system addresses the needs of critically ill or premature babies. Together, these programs are significantly decreasing both mortality rates and developmental disabilities in the Oblast. Having proven their success regionally, the programs are now being replicated by the partnership and the Ministry of Health of Ukraine elsewhere in the country. Similar replication efforts are being undertaken by AIHA partnerships in the Russian Federation and Uzbekistan. Neonatal Resuscitation Training Program and Center (NRTC): The L'viv-Detroit partnership developed a model Neonatal Resuscitation Training Center that was officially opened in January 1997. The Center is responsible for disseminating knowledge and conducting monthly training courses in neonatal resuscitation, as well as gathering statistics from those medical institutions whose personnel are trained at the Center. Neonatal resuscitation training provides health care professionals with a set of basic skills in newborn care which has become part of the standard practice in delivery rooms across the United States and Western Europe. This training enables practitioners to assist newborns when they experience difficulty breathing on their own. Implementation of neonatal resuscitation skills in delivery rooms and birth houses will serve to not only decrease infant mortality rates, but also to reduce the number of developmental disabilities that can occur as a result of oxygen depravation in the first minutes of life. The model for neonatal resuscitation training in Ukraine was established by the L'viv Oblast Clinical Hospital (LOCH)/Henry Ford Health System Partnership in L'viv to complement activities in neonatal care which had been initiated in 1993. The center utilizes the training curriculum of the American Heart Association/American Academy of Pediatrics Both the Textbook of Neonatal Resuscitation and the Instructor's Manual for Neonatal Resuscitation were translated into the Ukrainian language by physicians at LOCH and will be utilized by existing and future training centers in Ukraine. Based upon the L'viv success, a national program in Ukraine was initiated with the cooperation of the Ministry of Health (MOH) following the First Annual Neonatal Conference in L'viv in 1996, which focused on primary resuscitation of the newborn. Five regions have been identified by the MOH to establish training centers in Ukraine. Using the model created in L'viv, AIHA and the Ukrainian MOH opened the second training center in Ukraine in Kiev on October 23, 1997 (Ambassador Morningstar, Mr. Pressley and Ambassador Miller attended the opening). Additional centers will be opened in Odessa and Donetsk, Ukraine during 1998. US personnel have already trained instructors from these American International Health Alliance FLOTUS - L'viv, Ukraine 11/05/97 Page 2 of 7 centers and teams of NIS and US partners will evaluate preliminary courses after the centers open. Preliminary evaluation of the data collected in the L'viv region, as well as on-site evaluations, clearly indicate the effectiveness of the neonatal resuscitation training provided by the center in L'viv. Building upon three years of partnership activity in neonatology, the Center began offering courses in the Fall of 1996 and in its initial year, has trained approximately 400 health care professionals in neonatal resuscitation. Students include neonatologists, obstetricians, midwives, pediatricians, and hurses. During the first 6 months of 1997 data collected from L'viv and the L'viv Oblast showed a mortality of 7.8/1000. In 1993 the official infant mortality was 13.5/1000. Although this is a small sampling - 2,753 births, it shows a 40% decline in mortality. These results are consistent with international studies that have shown 30% declines in both mortality and developmental disabilities as a result of the introduction of neonatal resuscitation training. Equipment and supplies purchased with USAID funds for the Training Center include training manikins, intubation heads and other relevant medical supplies, as well as student manuals, slides, other educational materials and related multi- media equipment. Neonatal Intensive Care: NICU and Center staffs have been trained extensively in modern methods of neonatal care over the last three years. This has been accomplished through numerous partnership exchanges from 1994 to the present and through national AIHA/USAID-sponsored conferences held in L'viv in 1996 and 1997. The partners have worked to establish a Level III Neonatal Intensive Care Unit to meet the needs of critically ill and pre-term infants and organized transportation systems and protocols to allow the L'viv Oblast Clinical Hospital (LOCH) to effectively serve newborn needs from throughout the city and the L'viv Oblast. This has been accomplished by redesigning the existing 48-bed unit and establishing eight intensive care beds complete with cardio-respiratory monitoring, capability for providing mechanical ventilation, controlled intravenous therapy, and central blood pressure monitoring and supportive treatment. Development of a Neonatal Lecture Series by the US partners was the foundation for education of the LOCH staff. A collaborative practice model for physicians and nurses for care at the bedside was developed as well as one for Unit management. A Nurse Educator position was developed, in addition to the Head Nurse role, to support the education and role development of the bedside nurse. A Collaborative Practice Committee, which utilizes quality management tools introduced by the US partners, meets monthly to solve Unit problems and address practice related issues. American International Health Alliance FLOTUS - L'viv, Ukraine 11/05/97 Page 3 of 7 The US partners, with the help of the members of the Ukrainian Village Corporation in Warren, Michigan, who raised $12,000 in local contributions to purchase a new infant transport isolette, established an effective transport system for sick infants in the L'viv Oblast in 1996. The transport system allows for premature and seriously ill newborns delivered within an 80-mile radius of the LOCH to be transported safely. Previously, many of the infants died in transit from cold, stress, and lack of oxygen. Note: The Ukrainian Village is a nonprofit housing association that owns a seniors housing development in the City of Warren, a northern suburb of Detroit. Warren is the site of the largest concentration of Ukrainian-Americans in southeast Michigan and the development is the home of many elderly people of Ukrainian descent. The group sponsors a number of social activities and is especially active with Democratic state and national legislators such as Mr. Bonier. The group has been working with the Henry Ford Hospital as part of the partnership's community outreach. To further enhance the transport system, a newly donated Ford Transit ambulance (valued at $27,000) for use with the infant transport isolette will arrive in L'viv this week and be officially handed over during the First Lady's visit. Contributions to Henry Ford Health System to support the ambulance donation are being made by Ford Motor Company, Ford of Europe, and the Ford Dealership in Kviv, Ukraine: Winner of Ukraine. The development of the transport system has been actively supported by the L'viv Oblast Health Department which created new regulations regarding the transport of infants, thereby ensuring that sick infants will be transported to LOCH from birthing centers and community hospitals throughout the region in a timely fashion. Outreach education for district hospital personnel has been established as physicians from LOCH are consulted on neonatal care during transports. Physicians and nurses from district hospitals also come to LOCH for two weeks of bedside training with the staff of the premature baby unit. Since the inception of the neonatology program in 1994, the total value of the Detroit partner's donations of equipment and supplies to the Neonatal Intensive Care Unit (NICU) and the Neonatal Resuscitation Training Center has been over $1 Million. A total of $1.5 million in donations has been made to the partnership as a whole. EVENT SUMMARY: The visit will include a brief VIP tour of the Neonatal Resuscitation Training Center and the Neonatal Intensive Care Unit conducted by the Center Director and the Head of the NICU, as well as other relevant staff members. Brief American International Health Alliance FLOTUS - L'viv, Ukraine 11/05/97 Page 4 of 7 descriptions of the training course and the services available at the NICU will be given. There will also be an opportunity to talk with patients and their families. Stage I: Arrival and Greeting (11:00 - 11:05) The First Lady and Ambassador Miller will be met at the portico by the First Lady of Ukraine, Ludmila Kuchma, the Hospital Director, Dr. Boys Kryvko, the US partner representatives, Dr. Sudhakar Ezhuthachan and Christine Newman, RN, and Dr. Mykola Khobzei, Head of the L'viv Oblast Health Administration. Dr Khobzei will present the First Ladies with flowers. The First Lady of Ukraine is a vocal supporter of maternal and child health care programs in general and the L'viv Oblast Clinical Hospital and the Center's concept in particular. She and her staff have previously visited the Training Center and the NICU and we anticipate that she will be eager to participate in the visit with the First Lady of the United States. Stage II: Tour of the Neonatal Resuscitation Training Center (11:05 - 11:20) Dr. Kryvko will lead the First Ladies up the stairs to the Neonatal Resuscitation Training Center on the second floor where the Center Director, Dr. Dmytro Dobriansky, will greet them. US Ambassador Miller, and two representatives from the Detroit partnership will accompany the First Ladies on the tour (see list of participants in Group A below). Skill demonstrations, a brief description of the training course, and data on the results of training will be presented by the Center Director, Center staff and US partners. The Head of the L'viv Oblast Health Administration Dr. Mykola Khobzei, Ambassador Morningstar of the State Department, Mr. Pressley and Mr. Huger of USAID and James P. Smith, AIHA Executive Director and others (Group B) will follow behind the tour. Stage III: Tour of the Neonatal Intensive Care Unit (11:20 - 11:40) Dr. Kryvko will escort the First Ladies and Group A to the Unit where they will be greeted by the Head of the Unit, Dr. Olga Detsyk. Dr. Detsyk will give the First Ladies a tour of the Unit, explanation of the services that are available, and program outcomes. Stage IV: Meeting with Former Patients and Families (11:40 - 12:00) Dr. Kryvko will lead the First Ladies to the administrative rooms on the first floor where they will meet with former patients and their families and a group of current patients from the pediatrics wing of the hospital. Mrs. Clinton may want to use this opportunity to give small gifts to the children. The First Ladies will American International Health Alliance FLOTUS - L'viv, Ukraine 11/05/97 Page 5 of 7 also have an opportunity to see some of the equipment and supplies that have recently been donated by the US partners. Stage V: Brief Remarks (12:00 - 12:10) Dr. Kryvko will lead the First Ladies to the auditorium on first floor where the First Lady of the United States will have an opportunity to acknowledge the Ukrainian health and government officials and other USAID health programs as she wishes both the L'viv Oblast Clinical Hospital Center and NICU and other health programs success (USAID to provide talking points in advance). At this time, Mrs. Clinton will also be able to acknowledge the generous gift of a new ambulance neonatal transport vehicle by Ford Motor Company. Keys to the new ambulance will be presented to Dr. Kryvko by Mr. Ronald Plomp of Ford and two of his colleagues from Ford in a brief, 2-minute turnover ceremony. (Note: if the weather permits, this turnover ceremony will be held outside after the First Lady exits the building.) Stage VI: Exit and view donated ambulance and isollete (12:10 - 12:15) As the First Ladies exit the building, Dr. Kryvko will briefly describe the transport system, including the recently donated Ford ambulance/transport unit. The ambulance will be parked in front and to the side of the entrance. See turnover ceremony above if weather permits. List of Participants: Stage I: First Lady of the United States, Hillary Rodham Clinton First Lady of Ukraine, Ludmila Kuchma Dr. Borys Kryvko, Head Physician, L'viv Oblast Clinical Hospital Dr. Sudhakar Ezhuthachan, US partner representative Christine Newman, RN, US partner representative Dr. Mykola Khobzei, Head, L'viv Oblast health Administration Stage II and III: Group A: First Lady of the United States, Hillary Rodham Clinton First Lady of Ukraine, Ludmila Kuchma Ambassador William Miller, US Ambassador to Ukraine American International Health Alliance FLOTUS - L'viv, Ukraine 11/05/97 Page 6 of 7 Dr. Borys Kryvko, Head Physician, L'viv Oblast Clinical Hospital Dr. Sudhakar Ezhuthachan, US partner representative Christine Newman, RN, US partner representative Group B: Ms. Melanne Verveer Ambassador Richard Morningstar, State Department Mr. Donald Pressley, USAID Mr. Greg Huger, USAID James P. Smith, Executive Director, American International Health Alliance Dr. Mykola Khobzei, Head, L'viv Oblast Health Administration Stage IV: First Lady of the United States, Hillary Rodham Clinton First Lady of Ukraine, Ludmila Kuchma Dr. Borys Kryvko, Head Physician, L'viv Oblast Clinical Hospital 10 - 15 former patients and family members Stage V, VI: Groups A and B and additional invited guests (USAID/US Embassy to provide list) Ford Representatives: Mr. Ronald Plomp, Mr. Christoph Sieder, Mr. Dan Kulchyckj (?) American International Health Alliance FLOTUS - L'viv, Ukraine 11/05/97 Page 7 of 7 L'viv, UKRAINE - DETROIT, MICHIGAN PARTNERSHIP AIHA's Medical Partnership Program between Henry Ford Health System in Detroit, Michigan, and L'viv Oblast Clinical Hospital (LOCH) and the L'viv Medical Institute in L'viv, Ukraine, funded through a cooperative agreement with the United States Agency for International Development (USAID). has existed since April 1993. In addition to the Neonatal Intensive Care Unit and Neonatal Resuscitation Training Center visited by the First Lady, the partnership has focused upon rheumatic fever, urology and emergency care. Rheumatic Fever: A coordinated L'viv Oblast-wide initiative to identify and develop protocols for the diagnosis and treatment of rheumatic fever and its major sequelae, rheumatic heart disease is underway. This includes the collection and analysis of demographic-based data concerning the location and incidences of rheumatic fever outbreaks. and the targeted use of antibiotics for primary and secondary prophylaxis. Urology: US partners have conducted training in transurethral resection (TURP) of the prostate and bladder and in related infection control and nursing practices. Dissemination of this information has resulted in the completion of over 200 transurethral surgeries at LOCH. Further, training and donated equipment have allowed L'viv surgeons to successfully develop a urodynamics laboratory at LOCH and perform laparoscopic cholecystectomies. These improvements have contributed to a reduction in average length of stay from 20 to 5 days. Emergency Care: Exchanges have focused on evaluating and improving the integration of pre- hospital and emergency receiving department care at LOCH. Training was provided in critical care resuscitation, patient tracking and management, physical layouts of an emergency receiving department, record keeping, and quality assurance. In addition, the L'viv staff observed physician- nurse collaboration and the role of the nurse in a busy emergency department. Concentrated efforts are being made to provide training in acute toxicological emergencies. A copy of a computerized data base system (Poisindex) was provided to LOCH together with five computer monitors to help develop ? regional toxicology OTHER AIHA ACTIVITIES: In addition to the L'viv-Detroit partnership. AIHA supports five additional partnership programs in Ukraine. These include: (1) L'viv-Buffalo, (2) Odessa- Coney Island, (3) Kiev-Philadelphia, (4) Donetsk-Orlando, and (5) an EMS partnership - Coney Island-Kiev. SUMMARY PROGRAM DATA: Total Partnership Exchange Days: 2,348 days Value of In-kind Partner Contributions: $1.5 million Value of Donated Equipment and Supplies: $1.5 million WOMENS HEALTH L'viv's Smallest Success Story BY SUDHAKAR EZHUTHACHAN, MD. DCH. AND CHRISTINE NEWMAN, MS. RNC he infants are tiny enough to fit in the palm a nurse's hand, with hearts barely the size 1 of a walnut and underdeveloped lungs struggling for oxygen. But with the help of the American partners at the Henry Ford Health System (HFHS) in Detroit, Michigan, these babies at the L'viv Oblast Clinical Hospital (LOCH) in L'viv, Ukraine now have a fighting chance. "Little things really do count," tologist with the Ministry of said LOCH neonatologist Zori- Health. Good management of ana Salabay, referring to the im- low birth weight babies at part- provements made in neonatal nership hospitals in UVIV pro- techniques that have helped save duced some early positive results, the lives of hundreds of prema- added Sulima. ture infants. For example, last year 70 per- From increased training of cent of the 80 newborns in criti- ctors and nurses to the use of cal condition brought to the mechanical ventilators, the Eviv- NICU at LOCH within their first Detroit partnership has improved three days of life survived. In the level of infant care, not only at 1995, the NICU had a 45 percent the Premature Baby and Neona- survival rate for transported in- tal Intensive Care Units (NICU) fants weighing under one kilo- within LOCH, but to infants gram, compared to a 25 percent A nurse holds the tiny hand of a premature infant at LOCH. throughout the oblast. The part- survival rate at regional birth nership created a successful framework for care by adapting the houses. The use of modern approaches to improve newborn care at principles of regionalization - a system of care based on the lev- LOCH has decreased length of stay from 32.1 davs in 1993 to 29.8 el of risk for the baby - used in the United States since the 1950s days in 1995. but new to Ukraine. Very ill babies from throughout the region Prior to 1993, Eviv Oblast did not have a neonatal intensive HOW come to LOCH for treatment care unit. Partners selected neonatology as the most critical area In 1993. infant mortality in Ukraine was 13.5 per 1.000 live of focus for the partnership to respond to the high infant mortal- births, compared with 8.2 per 1,000 live births in the United States, ity level in Ukraine. The partnership's four-part model addresses all and 4.4 per 1,000 live births in Japan the lowest in the world. the responsibilities of a Level 111 (the most intensive) regional However, unlike in the United States and lapan, the data from neonatal center as outlined in the "Guidelines of Perinatal Care." Ukraine do not include infants weighing less than 1.000 grams published by the American Academy of Pediatrics and the Ameri- meaning that the mortality rate is higher than the statistics indicate. can College of Obstetricians and Gynecologists, including clinical "We are fighting for every child's life," explained Head of the service, education, quality assurance and unit management. 'viv Oblast Health Administration Mykhola Khobzei. An important initial step in the creation of the unit was the de- The high infant mortality rate, coupled with declining birth velopment of the Collaborative Practice Committee, comprised ares, have made improved care for premature babies a priority for of unit nurses and physicians to oversee issues as they relate to pa- the Ukraine Ministry of Health, said Elena Sulima, MD, chief neona- tient and staff concerns and analyze outcomes. Members of the Photo by Suchakar Lynuthachan 1 15 1 COMMONHLALID 1996 WOMEN S HEALTH immittee were educated on principles seven days were transported to LOCH. In Education: The Key to Success of quality management and encouraged most instances. however, they arrived very The most important component of 1:- 10 use them to run their monthly meet- sick and cold (with a body temperature viv's model and the key to establishing a ings, identify priority issues and analyze less than 35 degrees Celsius), and in some high-quality Level 111 neonatal unit is edu- results. instances, efforts to keep the infants warm cation. Educational efforts included the do with hot water bottles resulted in exten- velopment of .1 neonatal curriculum and Technical Advances in Care clinical bedside training for physi- In 1995. an eight-bed intensive cians and nurses. Consisting of 40 care area was established at the Pre- ТУДРОСТі lectures and instruction outlines. mature Baby Unit, and was equipped slides and audio-visual equipment with equipment donated from the donated by HFHS, the curriculum health care community in south- provided a template for continuing eastern Michigan, local equipment education efforts within the region. vendors and colleagues within the Practical bedside training in intuba- Henry Ford Health System. tion, chest tube insertion, umbilical Advances in technology intro- catheter insertion and suturing was dueed in the neonatal unit at LOCH an essential part of the curriculum. A included mechanical ventilation, library of western medical and nurs- regulated oxygen delivery, continu- ing literature - books and journals ous positive airway pressure through donated by HFHS employees, Toron- the nose, cardio-respiratory and to Children's Hospital and several gen saturation monitoring, con- others - also was established at aled infusion therapy, photother- LOCH. Similarly, teaching videos, a any (including use of a biliblanket television and a video cassette 10 keep the baby warm), and ap- recorder were donated by US part- propriate dosing and administra- ners to assist with meeting the staff's tion of antibiotics. Guidelines for educational needs. Over 160 health clinical practice were developed and care providers from LOCH have translated into Ukrainian, and are been trained in neonatal resuscita- available as a pocket-sized reference A mural in Kiev's Obstetrical and Gynecological Hospital No. 3 promotes tion techniques. Supplemental, for unit staff. happy, healthy babies. Ukrainian-language course material Introduction of mechanical ven- was also produced for staff with the tilation was not without problems, how- sive burns. Hypothermia is still a frequent aid of Malteiser Humanitarian Aid Orga- ever, use of mechanical ventilators drained problem since most infants are transport- nization. existing meager oxygen supply, and voltage ed by car. "L'viv neonatologists are the first who differences made transformers essential. A regional infant transport program, have applied the new approaches to the care With increasing experience on the use of is key to effectively transporting sick in- of the newborn," explained Nina Goida, this technology, the average duration of fants to LOCH. A donation from Detroit's MD, head of the Department of Maternal ventilation has increased over time, and Ukrainian community last winter helped and Child Health Care at the Ukrainian ventilated infants have been surviving in with the purchase of an infant transporter, Ministry of Health. greater numbers. which now can carry critically ill newborns Speaking at the May 1996 regional con- One of the main issues identified by to the LOCH referral center from distant ference on neonatal resuscitation and re- the partnership is the inability to ensure birth houses and hospitals (see COMMON- gionalization, Goida encouraged neona- sick infants reach the regional center HEALTH, Winter 1996). Reliable ambulance tologists to develop programs modeled after a timely fashion. Typically, only those support is needed, however, to ensure that the LOCH program, which has introduced critically ill infants who lived longer than this effort continues uninterrupted. "a practical level of skills" to neonatologists COMMON FAIL 1996 1161 Photo courtesy 01 Verian Towenstein WOMENS HEALTH in 10 measure urine concen- Morbidity and mortality data collection 111 Regionalization of Care tration. and blood gas analysis Ukrame is currently not consistent with that changes which necessitated of western nations. Level I Uncomplicated care major alterations in patient care Recently. a policy change in the Eviv Level Il Care of moderately ill documentation. Oblast required that all infants who die. in- Level III High-risk care Imytro Dobriansky, MD. a cluding those less than 1,000 grams, be eval- neonatologist at LOCH, and unted by a pathologist. This modification will Level III Referral Centers Level III care + neonatal Andrew Tooziak, MD, a post- allow data comparisons with western nations. transport and regional graduate student 31 the Eviv Computers donated to the partnership outreach education Medical Institute and LOCH, have aided the staff in developing a program designed a bedside flowsheet to that provides them an extensive database on and "affected declines in early neonatal mor- document patient data in the NICU, mod- many aspects of patient care. Staff physicians tality" at the LOCH Premature Baby Unit. cling it after the one used at Henry Ford enter data into the computer on all patients at These early positive outcomes prompted the Hospital. The information documented by the time of discharge. Using this data, trends Ministry to work with AIHA to introduce the nurses is readily available to the physi- can be identified in the newly instituted prac- the LOCH Neonatal Resuscitation Program cians, who also use the flowsheet to write tice of mechanical ventilation and care mod- throughout Ukraine, Goida concluded. daily orders. This has greatly improved both ified if needed. The computer support has fa- LOCH physicians and nurses realized that communication and collaboration between cilitated regular communication through in order for clinical care to improve, the ex- physicians and nurses, contributing signifi- e-mail with colleagues in Eviv. This allows us isting role of the bedside nurse would have to cantly to better patient care. to have an ongoing dialogue about issues and be altered. A nurse educator position was Education of support service staff in ra- aid in problem solving in a very expeditious wated within the unit to help ensure sus- diology, pharmacy and microbiology also and cost-effective manner. hable improvements in care and provide addressed specific needs of sick infants, be- Though partner efforts have resulted ongoing education to nurses. The unit's first cause if these staff do not function at peak ef- in improvements in care, critical problems nurse educator, Olha Vlad, participated in ficiency, the critical care provided to these remain that threaten the ability to sustain an intensive, one-month training program at infants could be jeopardized. the changes and successes achieved. The HFHS and continues to provide ongoing Outreach efforts to neonatologists and need for a steady stream of supplies, more education and support to nurses in the nurses in the Eviv region culminated in the equipment and last but not least the NICU in Eviv. creation of two- to four-week training pro- attitude of continuously challenging old, And the outcomes of these courses are grams in patient management and bedside ineffective practices cannot be underesti- significant, noted Salabay. "We accomplish care. Physicians and nurses from district mated. We continue to be amazed at the more in our unit thanks to the expanded hospitals in western Ukraine visit LOCH for dedication and commitment of our col- role of our nurses." training. In addition, their realization that leagues despite an unending series of ob- Nurses in the unit now provide bedside small babies had a chance to survive at stacles. We have learned that collabora- care to small, sick infants on ventilators, and LOCH has resulted in earlier transport of tion, not only between the partners, but .re responsible for routine monitoring of small and sick infants. with other departments, organizations and vital signs, interpretation of monitor and Parent education is an essential compo- the community, is vital to ensure that qual- bedside laboratory data, listening to breath- nent of the neonatal education program. ity care can be provided even to the tiniest, ing through a stethoscope, endotracheal suc- This includes conducting ongoing classes most fragile patients at LOCH tioning to clean the trachea, initiating IV for parents and providing informational therapy, and monitoring central blood pres- brochures on important issues related to Sudhakar Ezhuthachan. MD. DCH. and Christine sure. Nurses in NICU also perform basic their infant's care. Newman, MS. RNC. are US partners from the Hen- !!' Ford Health System. Department of Pediatries. bedside laboratory testing, including mi- Division of Neonatology and the Department of sedementation rates to determine if a Evaluation of Program Outcomes Nursing (Detroit, Michigan). Dmytro Dobriansky, '!' has an infection, hematocrit to deter- Collection of accurate data is the only MD. assistant professor at Eviv Medical Institute and it neonatologist at LOCH. provided numerical mine hemoglobin count, urine specific grav- way to evaluate any program or change. data. 1 17 1 COMMON FAIL 1996 UKRAINE: L'VIV CLINIC SCENESETTER Tour and brief discussion at Neo-Natal Center of the L'Viv Clinical Oblast Hospital on Monday, November 17, 11:15 a.m. - 12:30 p.m. Attendees will include dignitaries and staff from the Neo-Natal Center and L'Viv Oblast Special Hospital for Children and Frank Zelazny of the Peace Corps. You will present humanitarian aid shipments to doctors from both hospitals. You will then tour the neo-natal facilities and talk with staff. You will proceed to the training room and hold a brief discussion regarding children's emergency care with Boris Kryvko (head of the hospital), Olha Deksyk (head of the Neo-Natal Center), Dr. Alexander Mendiuk (head of the Special Hospital) and doctors. BACKGROUND Both facilities have benefited from partnerships with U.S. organizations. Several staff members from both hospitals have been trained in the U.S. The Neo-Natal Center is an American International Hospital Association partner hospital with the Henry Ford Clinic in Detroit. TALKING POINTS I am pleased to visit the L'Viv Oblast Clinical Hospital and see first hand the results of your partnership with Henry Ford Health System in Detroit, Michigan. I cannot help but be impressed by both the systemic and comprehensive approach to newborn care that you have taken and by the great success that has resulted. As has been outlined to me, you have integrated the training of health care workers in assessment, prevention and newborn resuscitation skills with a new regional transport system. This will assure that very ill babies can be brought to the hospital from throughout the region for high quality treatment. Your innovative work to address the special needs of critically ill or premature babies has significantly reduced both rates of mortality and developmental disabilities in the region. And it has done so in a manner that is affordable in the long run. The result of this effort - a mortality rate of only 7.8 per thousand for the first six months of 1997 and a reduction of over 30 percent since the partnership began - are something we are all very proud of. With results like this, I was not surprised to learn from Ambassador Morningstar that the Ministry of Health is working with USAID and AIHA to replicate the basic neonatal resuscitation training center concept throughout Ukraine. I understand that the trainers for these new centers are being trained here in L'Viv. This replication of successful model programs in close collaboration with local and national governments is indicative of the maturation of our assistance programs in Ukraine and the continuing evolution of our relationship as strategic partners. Over the course of the past four years the partnerships here in L'Viv, Kiev, Odessa and Donestsk have developed a number of model programs improving the quality of care and the efficiency and organization of the delivery of that care. When I was in Kiev several years ago, I saw first hand the model prenatal and birthing education programs that the partnership with the University of Pennsylvania had developed. I understand that the Kiev partnership effort is in the process of expanding to include a comprehensive women's wellness center and a breast cancer screening program and that similar women's centers will open early next spring here in L'Viv. I attended the opening of women's wellness centers in Central Asia last week. The model that has been developed, with its mix of health education, screening, early diagnosis, treatment and follow-up for women of all ages, stands at the forefront of international efforts to address the health care needs of women. By replicating this model in three Ukrainian cities, American-Ukrainian health partnerships are taking an important step toward changing health practices in the country as a whole. What impresses me most during my short visit this morning is the way in which you have accomplished these results - through partnership. The comprehensive, multi-faceted programs that I have just seen don't happen automatically; they take a tremendous commitment of resources from many, many different sources. It is often the case that "how" we accomplish something is as important as "what" we accomplish. This is true in this instance, where the governments and health care providers of our two countries have come together in partnership to develop innovative solutions to problems we face as individuals and as human beings. As I have seen in my previous visits in this region, these volunteer-driven partnerships make a real difference in people's lives - here and in the United States. You should take great pride in what you have accomplished and in how you have accomplished it - together in a partnership that unites our people in common purpose and to common benefit. 6/12/97 THU 10:44 FAI 201 376 4988 CHILDREN OF CHORNOBYL 002 6/12/1997 02:53 2288365 ICCF UKRAINE PAGE 02 MIHICTEPCTBO ОХОРОНИ ЗДОРОВ'Я УКРАЇНИ MINISTRY OF HEALTH OF UKRAINE 06. 97 No 11/105 Ha No June 10, 1997 Mr Richard Morningstar Ambassador and Special Advisor on Assistance to the NIS to the President and Secretary of State Washington, D.C. 20520 Dear Mr Morningstar: I am writing you to ask for your support in combating the unprecedented high rate of infant mortality in Ukraine. As you know, this has been a matter of extreme concern to President Kuchma and to ukrainian health authorities. Negative combination of economic hardships, the long-term effects of Chornobyl, and other environmental factors have led to a devastating drop in birth rates as well as increase of infant mortality in our nation. Our experience showed that today Ukraine cannot cope with its current health crisis using the outdated Soviet technologies. There is a critical need to introduce basic commodities that will allow health institutions to function effectively. We need an aggressive, cost effective approach which can combat infant mortality at a fundamental level. Our physicians cannot fight this emergency without involvement of last generation of antibiotics and sophisticated diagnostic equipment, such as fetal heart monitors and incubators, or intensive community. I have been closely working with the Children of Charnobyl Relief Fund since 1990 following their programs since then. CCRF's most recent neonatal equipment shipments to the children's hospitals in Chernihiv, Dnipropetrovsk, and Lviv have actually increased the capacity of these hospitals in theirs attempt to attack the problem nitially and, thus, drew great appreciation from President Kuchma I believe that CCRF remains the only organization that has the right knowledge, structure, contacts, operating network at the spots and resources to implement the Women's and Children's Health Care Initiative that will be able seriously combat existing problem of birth rate in Ukraine launching a program that will be self sustainable. Україна 252021. KHIB . аупиця Грушевського, 7 7 Hrushevsky Street. Kiov 252021. Ukraine TEL. (044) 293-6194 FAX (044) 293-6975 - TELEX 131360 TAMPO 06/12/97 10:47 TX/RX NO. 1397 P.002 /12/97 THU 10:45 FAI 201 378 4988 CHILDREN OF CHORNOBYL 003 /12/1997 02:53 2288365 ICCF UKRAINE PAGE 03 de I do hope that with your support this campaign will possess great potential to increase infant survival and reverse some of the bleak demographic trends sweeping our nation. This would leave a lasting legacy of your much appreciated tenure with the Office of NIS Assistance. In this context I am asking for your help in securing funding necessary to onable CCRF fully implement this health initiative in Ukraine and in such a way to assist in reversing the current situation with birth rate. Respectfully yours, actionshy Prof. Anddj Serdiuk, M.D., Ph.D., Minister 06/12/97 10:47 TX/RX NO.1397 P.003 Remarks on Jewish Heritage UKRAINE: JEWISH CEMETERIES History of intolerance. Ukrainian history includes an unfortunate legacy of intolerance toward minorities. The Jews of western Ukraine were regularly subjected to forced migrations - "pogroms." Millions of Ukrainians were exterminated in Stalin's forced labor camps. Ukraine was singled out for a disruptive campaign that ruined its once-rich agriculture and led to a massive famine in the 1930s that killed millions of Ukrainians of all origins. Post-Soviet Ukraine has begun to take steps to address previous wrongs. While the human rights record has recently improved, historic anti-Semitism remains a serious concern. Bilateral agreement. In 1994, Ukraine signed an agreement with the United States to preserve cultural sites important to both countries. While this agreement was not specifically aimed at any particular ethnic or religious group, early on, the rehabilitation of Jewish cemeteries became the first focus of efforts. Jewish cemeteries. Under Jewish religious law, a cemetery is forever a sacred site. In L'viv, decades before the Nazi occupation, the historic central cemetery was full and closed to new burials. A. new cemetery on the city outskirts served the Jewish community. The Nazis used gravestones from the central cemetery as paving blocks for roads. The visible elements of the cemetery were destroyed, but most of the graves remained undisturbed. After the Nazis were defeated, the Soviets took control of L'viv and turned the site into a large marketplace. Thus, the current use of the L'viv marketplace is considered an ongoing desecration and an affront to the Jewish community. This pattern was repeated in numerous communities throughout Ukraine (and eastern Europe generally). Competing priorities. The issue of restoration of cemeteries -- in L'viv and elsewhere -- must take place in the context of present-day realities. Many U.S. Jewish organizations prefer to focus on the needs of the small communities of Jews still living in Ukraine, giving restoration of cemeteries a lower priority. Orthodox Jewish leaders tend to give precedence to the cemetery issue both on religious grounds, and because some of the greatest rabbinical scholars of the 17th and 18th century are buried in what are now unmarked graves. Resident Jews tend to fear an anti-Semitic backlash if too much emphasis is put on Jewish religious needs and requirements - they urge restraint in dealing with the Ukrainian government. Dealing with the problem. The Ukrainian government has ordered an absolute freeze, or moratorium, on any construction or privatization of sites that have been identified as Jewish cemeteries, either presently or in the past. A Joint Cultural Heritage Commission has been established to oversee identification of Jewish cemeteries and non-Jewish cultural heritage sites throughout Ukraine, and to seek a mutually-agreed means of addressing the cemetery problem. Future steps. International Jewish groups have already indicated a willingness to provide resources to repair, restore, preserve, and protect Jewish cemetery sites in Ukraine. We estimate that there are over 2000 such sites in Ukraine, many in places where there are few or no Jews left. This issue is on the agenda of the Joint Commission on Cultural Heritage, envisioned by the 1994 bilateral agreement, which next meets in Washington this fall. THE CENTRAL JEWISH CEMETERY IN L'VIV Setting. Following the Nazi invasion in 1941, the occupying German forces flattened and paved over the central Jewish cemetery in the heart of L'viv. (This cemetery space had long been filled to capacity with graves, and several greatly revered Jewish sages were buried there.) After the war, the central city market was built, mostly involving kiosks and metal sheds, on the cemetery site. Over the intervening decades, at least one several-story building was built on the grounds - now used as the meat and dairy market - as well as several smaller permanent structures. Adjacent to these grounds is a hospital complex of several buildings which are embellished with Jewish symbols and inscriptions. This was the Jewish hospital, and now serves as a maternity hospital. We know that no graves lie under the hospital complex, as the Jewish residents of the last century would never have constructed anything atop graves. The whole area is immense, with the aggregate dimension of several football fields. Construction issues. In the summer of 1996, construction started on the land just between the market and an adjoining hospital complex. International protest stopped this construction, whereupon the Kuchma government articulated its intention for a national freeze on any construction or privatization on Jewish cemetery sites. In September and October, 1996, a mixed commission of local and GOU officials met in L'viv and determined that the market should be moved and the cemetery in some way memorialized. An AID study completed on August 8, 1997 estimated the project cost between $4 and $12 million. The mayor of L'viv IS believed to be committed to this project, which is viewed, if done well and sensitively, as a boon to the city on several levels. The site. Apart from the actual movement of the market from the cemetery grounds, still blocked by lack of funds, the major issue remaining is the form the preserved cemetery would take. Care must be taken to insure that, while Jewish law and sensitivities are abided with, a forbidding, impenetrable wall not be erected around the perimeter of what was for decades the busiest place in town, thereby risking fomenting discord among L'viv's Jewish and Ukrainian communities. The form, function, and accessibility of this space are very much at issue. The cemetery itself cannot be recreated as it was, as the headstones are all gone. If the term "memorial park" is to be the operative one, it must be designed, constructed, and utilized with great care, mixing legitimate religious requirements with real-world considerations of access by Jews and non-Jews alike. For this, we will look to the leadership provided by the U.S. Commission for the Preservation of America's Heritage Abroad; to Michael Lewan, Rabbis Morris Sherer (Agudath Israel) and Chaskel Besser, and others. Meetings that State Department officers have attended lead us to believe that Rabbis Sherer and Besser understand the art of the possible, that they will impose by their own moral authority the proper amount of restraint, and that the most Orthodox and Hasidic rabbis will defer to their judgment (within reason). Restoration costs. We have long discussed with the Jewish Orthodox leadership the eventual need for significant financial contributions by the Jewish community in L'viv L' and elsewhere. Recognizing the cardinal principle that Ukraine's Jews should not be asked to buy back their own cemeteries, the costs of restoration are as different matter. If the cash-strapped GOU and local governments act to protect the estimated 2,000 Jewish cemeteries across Ukraine, much of the cost of subsequent preservation must fall to the Jewish community, particularly that part of the world Jewish community in the United States and Israel that has been leading this effort. We believe this point to be inherent to this discussion, and to be a matter of at least implicit agreement. UKRAINE: JEWISH HERITAGE (VENUE TBD) SCENESETTER Remarks on Jewish Heritage at a location that is yet to be determined (possibly L'Viv State University) on Monday, November 17, 12:45 p.m. to 1:15 p.m. Attendees will include: Rabbi Bleich (Chief Rabbi of Ukraine), Mr. Sheykhet Meylakh (UCIS), Rabbi Bald (Rabbi of L'Viv), and Donna Winkleman of the Peace Corps. You will meet with Jewish leaders to discuss the role of Jews in the development of L'Viv as the "cultural capital" of Ukraine as well as the role of Jews in L'Viv State University. The discussion will also focus on the importance of education towards eliminating intolerance. BACKGROUND Until World War II L'Viv University was the site of a very active Jewish academic community. In 1925-26, for example, 35 percent of the students were Jewish. Many of the leading professors and researchers at the university were also Jewish. Mathematician H. Steinhaus started publishing the journal "Studia Matematica," which became a leading international publication in the field. The math department was mostly Jewish and very highly regarded. There were also world-class physicists, geologists, engineers, astronomers, geographers, biologists, historians, economists and legal professors. In the summer of 1941, upon the arrival of Nazi troops, 70 of the best professors from the University, the L'Viv Technical University, and the Medical University were abducted and shot. Note: You should be prepared to respond should the issue of the Jewish cemetery/market be raised. Moment of Remembrance at Ghetto Monument UKRAINE: GHETTO MONUMENT SCENESETTER Wreath Laying at the Ghetto Monument on Monday, November 17, 1:25 - 1:45 p.m. Attendees will include: Rabbi Bleich (Chief Rabbi of Ukraine) and others. In a solemn ceremony, you will acknowledge the memorial (by laying a wreath, placing a stone, or lighting a candle). BACKGROUND Rabbi Bleich will explain that Jews during WWII were led down this road to their deaths. The sculpture is entitled "Why?" and resembles a man holding his hands up to God. Government Ukraine-hosted Lunch UKRAINE: GOVERNMENT LUNCH SCENESETTER Lunch at a setting to be determined hosted by the government of Ukraine and will likely include Mrs. Ludmila Kuchma. President Kuchma may attend, but he will be leaving for the U.S. on November 18 and may not be able to participate. It may be sponsored by a Ukrainian candy company, Svitoch. Attendees will also include other government officials and local dignitaries. BACKGROUND Svitoch is an outstanding example of a successful Ukrainian company. Svitoch enjoys better name recognition than almost any other Ukrainian firm. Icon Restorers at National Museum UKRAINE: ICON RESTORATION INSTITUTE SCENESETTER Tour of Icon Restoration Institute or National Museum on Monday, November 17, 3:45 - 4:30 p.m. Attendees will include government officials and other dignitaries. The Institute is one of the world's leading facilities for restoring priceless icons. Part of the Institute's restoration staff recently moved to the National Museum. The Museum houses displays of 15th to 19th century Ukrainian icons. At the museum you may participate in restoring a work of art. BACKGROUND You will tour one of these two sites and view religious works of art that are currently undergoing restoration. Tour of St. George's Cathedral UKRAINE: ST. GEORGE'S CATHEDRAL SCENESETTER Tour of St. George's Cathedral on Monday, November 17, at 4:45 - 5:45. Attendees will include: Boris Gudziak (Vice Rector, L'Viv Theological Seminary) and other dignitaries. You will tour the cathedral, which is the "Vatican" of the Greek Catholic Church in Ukraine (also known as the Ukrainian Catholic Church). BACKGROUND The Greek Catholic church recognizes the authority of the Pope. The church represents a focal point of Ukrainian pride and nationalism. As such, many priests and members of the church were persecuted under the Soviet regime. St. George's was returned to the Ukrainian Catholic Church in 1990 after 44 years of compulsory Soviet-imposed Orthodox control. Dr. Gudziak and the Lviv Theological Seminary have been working on an oral history project that records the heroism and plight of Greek Catholics during the years of Soviet oppression. Constructed between 1774 and 1790, St. George's is an excellent example of Ukrainian stylized Baroque architecture. This church is the historic sacred center of the Ukrainian Catholic Church. American Community Event UKRAINE: MEET/GREET UKRAINIAN WOMEN SCENESETTER Meet and greet prominent Ukrainian women (parliamentarians, business leaders and activists) at the L'Viv Opera House after the speech from 11:15 - 12:00 noon. Attendees will be the same as those who attend the speech. UKRAINE: AMERICAN COMMUNITY IN L'VIV SCENESETTER An event with the American community will be held at the D'niester Hotel in the 2nd floor dining room on Monday, November 17 at 6:00 - 6:30 p.m. Attendees will include: Ambassador and Mrs. Miller, U.S. Embassy and USAID employees and Peace Corps volunteers and staff. BACKGROUND You will have a chance to meet and greet the local American community. Speech at Opera House 1003 UNCLASSIFIED UKRAINE: TRAFFICKING IN WOMEN On November 21, the United States Government and the European Union will formally launch a joint information campaign to combat the trafficking of women from and through Eastern Europe and the Newly Independent States of the Former Soviet Union (NIS). The USG and the EU began discussing such a campaign in April 1997 as a mechanism to expand migration activities within the context of the New Transatlantic Agenda and to address a common. serious problem which we face. At the U.S. - EU Summit on May 28, President Clinton highlighted both the despicable nature of the problem terming it as "modern day slavery" and U.S. BU resolve to undertake joint action to prevent it. The U.S. and the EU are developing the information campaign concept jointly and will implement it on separate, twin tracks in the region. The U.S. will sponsor an information campaign designed for Ukraine and will use the International Organization for Migration (IOM) as its implementing partner, while the EU will sponsor one in Poland, using a European non-governmental organization (NGO) as its implementing partner. While the two countries are considered as both source and transit venues for trafficking in women, they were chosen for this project not to single them out in this status, but as likely candidates for a successful and productive effort. The Government of Ukraine has responded enthusiastically to our proposal. Ukrainians already recognize trafficking in women as a problem for women who lack opportunity in the existing economic system. "La Strada" a European network of NGOs funded by the EU and the Dutch NGO, "STV, focused on preventing trafficking in Central and Eastern Europe has opened a branch office in Kiev. "La Strada Ukraine" has established a hotline in Ukraine for exploited women and has begun a small information campaign focused on young women who are finishing high school the group considered to be the most at risk. The U.S. EU information campaign will focus on providing information to both potential victime that they can protect themselves from exploitation, and to host-country officials, indigenous NGOs, and foreign consular officers to assist them in identifying and preventing potential problems. At the November 21 workshop hosted by the EU in Luxembourg, all involved parties the USG, EU Commission, EU Member States, EU implementing NGO, IOM, and the governments of Ukraine and Poland will review the information campaigns designed for Ukraine and Poland and will formally launch the joint initiative. Detailed components of the information campaigns will be further developed from December through February and will be implemented from mid-March through mid-May. We envision that the overall project will end with a USG-sponsored wrap-up workshop in June 1998 in Ukraine for all involved parties, as well as local NGOs, to evaluate the effectiveness of the campaigns in the two countries and to highlight their messages. If the project is successful, we hope to broaden the campaign to other countries in the region. UKRAINE: L'VIV OPERA HOUSE SPEECH SCENESETTER Speech at the Ivan Franko Opera House on Tuesday, November 18 at 10:00 - 11:00 a.m. Attendees: local dignitaries and prominent women in Ukraine. You will give a speech at the L'Viv Opera House, a beautiful example of Viennese style opera houses, built in 1897-1900. The Opera House seats approximately 1000. The audience will consist of prominent Ukrainian women, parliamentarians, local dignitaries, students, artisans and others (guest list TBD) BACKGROUND Zonta International Club of L'Viv, an association of professional women, will sponsor this event in coordination with the American Chamber of Commerce. Meet and Greet with Prominent Women