An Insight into Rural Health Care in Estonia.

Since the beginning of my medical studies I had always been curious about health care in different regions. What do hospitals look like? How do doctors and nurses dress? Whats is the level of patient care? So, whenever I visit a new country I do a bit of hospital tourism. During the last years I discovered that, similar to European metropolises, big hospitals appear to have a universal standard with differences only in minor details; unlike rural health care institutions.

Deployed in Tartu, the academic heart of Estonia not far from the Russian border, I had the chance to visit the town of Elva together with a geriatrician from Tartu who joins rounds once a week for consultation. As one of the few towns in Estonia, a country with roughly 1,3 Mio. inhabitants, Elva still has its own hospital - Elva Haigla. It is one of those small, countryside hospitals which still has an individual charme and is somewhat a time capsule: A soviet building with furniture from different centuries, medical technology from the last 20 years and the latest gizmos all supervised by staff which is keen to be very much up to date with all recent developments in the medical world, striving for optimal patient care.

I was greeted by a warm and welcoming athmosphere and all doctors happily translated conversations they had during rounds and explained to me the medical condition as well as the personal situation of patients. The majority of them were referred from the univerity hospital of Tartu following a procedure. Unlike busy clincs in big cities, hospitals like Elva Haigla have the capacity to rehabilitate and reintetgrate patients properly. This part is crucial for a functioning helathcare system. No matter how high-tech the procedure is, how advanced medications are or skillfull the surgeon operates - it is not going to cure a patient without proper rehabilitation.

Although playing such a crucial role, places like Elva suffer from insufficient funding, lack of staff and often have to be closed down leaving entire areas without sufficient healthcare. It puzzles me sometimes since I felt very comfortable and welcome at this place - unlike many university hospitals.

After seeing Elva and leaving it with a positive impression I am hoping that these places will be funded better in the future and promoted amongst young physicians to go there and take care of patients.

Jasper Frese M.D. IVY Project Partner at University Hospital - Tartu & Lübeck

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