08181
March 7, 2008

Playing catch –up

Russian Orthodox Church rapidly expands social ministries

by Jerry L. Van Marter
Presbyterian News Service

Margarita Nelyubova (left), who coordinates diaconal ministries in Moscow for the Russian Othodox Church, and Archbishop Mark, who is the church’s director for social ministries, talk about their work in the archbishop’s office at the Ecumenical Patriarchate in Moscow. Photo by Jerry Van Marter

MOSCOW — “I am so glad you’ve come to see me! I love company!” 88-year-old Marina tells me as I enter her small but comfortable room in the heart of this Russian capital city.

I’m stunned by her perfect English and ask where she learned to speak it so well. “I taught English for 50 years,” she replies.

Among Russia’s growing population of senior citizens, Marina is one of the fortunate ones. Thanks to renewed social ministries of the Russian Orthodox Church (ROC), she has found a home in an intimate four-bedroom apartment that is now an elder care facility sponsored by the state church.

This is a new form of ministry for the ROC, whose activities were severely restricted during the communist era that began with the Bolshevik revolution in 1917. Church activities were revived after the fall of the Soviet Union in 1991 but it was not until the adoption of the church’s Social Doctrine in 2000 that social ministries such as the elder care program really started to flourish, says Margarita Nelyubova — a delightful bundle of energy who oversees the ROC’s diaconal ministries in Moscow.

During a whirlwind day, she takes me on visits to Marina’s elder care, St. Alexei Hospital — the largest private hospital in the country, and new HIV/AIDS resource center that is trying to counter the rapid increase in HIV infections that is threatening the next generation of Russians.

Looking around in the entry hall of the non-descript apartment building in the center of this city, one would never know that it is home to a most innovative program for Russia. The four-bedroom facility includes three bedrooms that house two elder care residents each. The fourth bedroom accommodates the St. Dmitri Sisters — a lay sisterhood of nurses and other caregivers — who care for the six bedridden residents of the care facility.

Marina (left) a retired English teacher in Moscow, visits with St. Dmitri Sister Marina Nikolaevna Salnikova (center) and PC(USA) missionary Ellen Smith in her room at one of the Russian Orthodox Church’s elder care apartments. Photo by Jerry Van Marter

“Five of our six residents are over 90,” says Sister Marina Nikolaevna Salnikova. “They’re all confined to bed so they’ll be staying here the rest of their lives. Their families just can’t care for them they need more personal medical care than they can get in hospital.”

Typical elder care in Russia is provided in large facilities where individualized care is nearly impossible. The ROC began the model of utilizing small apartments for such care eight years ago, Nelyubova says, “because mostly what these folk need is loving care.”

Residents receive three meals a day — cooked in the apartments kitchen by a full-time cook —  plus constant care and monitoring by the St. Dmitri sisters and regular visits by doctors. A daily journal is kept on each resident.

“This is a service for me,” Salnikova says, “a ministry.”

The families of residents know and appreciate this. “Nearby relatives visit at least once a week,” Nelyubova says, “but there’s one husband who visits every other day. Some relatives live far away, but we have a priest who comes once a week so no resident goes without a visit for very long.” Worship with communion is offered every two weeks and there are parties at Christmas and Easter to which relatives are invited.

Such care is very expensive, Nelyubova says, “so we rely very heavily on donations and volunteers.” The St. Dmitri sisters — about 80 in all — also serve in orphanages, schools and soup kitchens. They receive their training at nearby St. Alexei Hospital.

A patient at St. Alexei Hospital in Moscow rehabilitates her broken hip with the assistance of a St. Dmitri Sisters nurse. Photo by Jerry Van Marter

This hospital in the heart of Moscow was established in 1903 “as a charitable hospital for incurable Christians,” Nelyubova says with a smile. Taken from the church shortly after the revolution, it became a military hospital during World War II and was returned to the Russian Orthodox Church in 1993.

The collapse of the Soviet Union in 1991 has led to an erosion of government-provided social services and so the demands on the hospital — the only one owned by the ROC and the largest private hospital in the country — are huge.

And expensive. “We opt for religious freedom, which means we get no government funding,” Nelyubova says. “It’s okay because we consider the spiritual care of our patients to be an important task and we also consider it important to restore a number of charitable causes that the government cannot afford to support.”

St. Alexei’s occupancy averages between 220 and 250 patients per day. It includes two oncology (cancer) wards, two neurological wards; a heart center, a diagnostic center and a nursing school that graduates 25-30 Christian nurses a year, most affiliated with the St. Dmitri sisters. Recently, says the hospital’s director, St. Alexei has added new programs to treat epilepsy, lung diseases and HIV/AIDS.

“In addition to being a hospital, St. Alexei has become the largest social service organization of the Russian Orthodox Church,” Nelyubova says. “Our main missions are to provide free care to those who need it and to provide the spiritual support that is an equally important factor in healing people.”

It’s a tough go, says the hospital’s director. Decades of Soviet neglect means the hospital is in substantial need of renovation and updated equipment. “We have not had substantial success here,” she admits. “Our main treasure is our people — the salaries are lower than government hospitals and much lower than private clinics,” she continues, “but our people love their patients and they love the Lord.”

The “master plan” calls for $60 million in renovations and equipment replacement. Hospital staff are undaunted. “There’s a Russian saying: ‘The only way to eat an elephant is piece-by-piece,’” the director says. “This is a very big elephant but with God’s help we will get what we need.”

The task is complicated because there are no western-style foundations in Russia and “there is no culture of donating to charity here,” Nelyubova says. “The government is trying to be more supportive, but most of our fundraising is by personal contact.”

Modern medicine, the director says, “is a technological chain with the patient simply a link in the chain. Our job is to remember the person and treat them holistically with love and respect. That’s what Jesus requires of us.”

Like most Russian institutions, the Russian Orthodox Church is playing catch-up to the accelerating HIV/AIDS infection rate in the country. The church’s HIV/AIDS resource center was established just a year ago and occupies a cramped office in a non-descript office building in Moscow.

Andrew Lorgus (left) and Olga Krasnikova (right) discuss the Russian Orthodox Church’s HIV/AIDS Resource Center ministry with PC(USA) missionary Ellen Smith in the center’s cramped but bustling office in Moscow. Photo by Jerry Van Marter

A staff of two — Olga Krasnikova and Andrew Lorgus — are assisted by a couple of young adult interns. So far, this hardy crew has conducted nine seminars, training some 200 priests and other church workers who are ministering with HIV-infected Russians and their families.

Equally important, Lorgus says, “we are also working with those who have worked in this area for long time so they don’t burn out.”

For many years, Nelyubova says, “the church refused to admit the problem of burnout. Now we are paying much more attention to it, targeting Christian social workers because no one was paying any attention to them.”

Krasnikova says an important task is to educate parish priests because they are the “gate-keepers” who decide if congregations and dioceses are going to really commit to such ministry. “We have trained 16 priests from four regions so far,” she says. “They didn’t know anything before this was very important. Now we are getting to lay leaders and seminarians, so that’s very good for the future.”

The ROC resource center has now been asked to develop a training program for the Russian army and air force.

More than one-half million Russians are registered with the government as HIV-infected, “but we multiply that number by five because only a few are registered,” Lorgus says. As in other countries, he says, the onset of the epidemic came primarily through intravenous drug use. “Homosexual transmission has never been more than 1 percent,” Lorgus says, “and now the most dramatic increase is heterosexual transmission.”

The ROC’s combination of educational and training programs is beginning to pay off, Krasnikova says. “Education reduces fear and now they are more willing to come to us because they know church people are more likely to understand than in the past,” she says.

“Now it’s important to train more priests because they are persons of such authority in our society,” she continues. “Only priests can provide the spiritual support that’s needed to patients, families and caregivers.”

The practical problem now, says Lorgus, is resources. “We just don’t have enough trainers to train the trainers that are being requested.”

As with other social ministries throughout Russia, the Russian Orthodox Church is reaching out to partners wherever they can find them. “Those who have received training are going back to their dioceses and starting regional resource centers and this is excellent,” Nelyubova says.

“Many practical relationships with other non-governmental organizations and government agencies to share ideas are resulting in many more people coming to our training,” she adds. “It’s just challenging, with such a small staff, to keep up with it all.”

Nevertheless, the efforts of the Russian Orthodox Church are impressive and inspiring, says Gary Payton, the PC(USA)’s regional liaison for Russia, Ukraine, Belarus and Poland. “These are such important steps — the elder care program, the hospital’s growing ministry, the HIV/AIDS Resource Center — because none of this was present before the Social Doctrine was adopted in 2000. It really is remarkable.”

To support the Presbyterian Church (U.S.A.)’s mission with partners in Russia such as the Russian Orthodox Church, click here.

For more information about and letters from PC(USA) missionaries in Russia and around the world, visit the Mission Connections Web site.