1. Match the following terms with their definitions.

1. facility	a. a specialist who treats patients with tuberculosis
2. ambulance	b. an institution for orphans and abandoned children
3. phthisiatrician	с. a medical or surgical practitioner without full profes­sional qualifications or status in some Eastern European countries
4. accident	d. death or destruction on a large scale, as from war, pla­gue, or famine; the number of deaths in a given period
5. orphanage	e. an infectious disease that may affect almost any tissue of the body, esp. the lungs, caused by the organism Myco­bacterium tuberculosis
6. accreditation	f. something designed, built, installed, etc. to serve a spe­cific function affording a convenience or service
7. feldsher	g. a disorder of carbohydrate metabolism, usually occur-
	ring in genetically predisposed individuals, characterized by inadequate production or utilization of insulin
8. tuberculosis	h. certifying smth as meeting all formal official require­ments; giving official recognition
9. diabetes	і a specially equipped vehicle for transporting the injured or sick
10 mortality	j an undesirable or unfortunate happening that occurs un­intentionally and usually results in harm, injury, dam­age, or even death

2. Translate the following sentences into Ukrainian.

1. Diabetes may result in excessive amounts of glucose in the blood and urine, excessive thirst, weight loss, and in some cases progres­sive destruction of small blood vessels leading to such complica­tions as infections and gangrene of the limbs or blindness.

2. Healthcare in Ukraine is funded almost entirely by general go­vernment revenues; it makes up 7.4 percent of the fund; 3.2 per­cent of the fund is made up by social insurance contributions from the wages of the employed and 3.3 percent is funded by private clinics and their private patients.

3. The unemployed, old age pensioners and people on long-term sickness benefit or maternity leave have to pay healthcare contri­butions but not as much as an employed citizen.

4. Lots of government funded medical facilities are of a poor stan­dard compared to Western standards; the medical equipment and facilities are in short supply compared to the high demand.

5. Many services, including doctors' and nurses' ones, unofficially cost a lot of money which makes health care in health centres not always affordable for the ordinary citizen.

6. Patients are admitted to hospital either through the emergency department or through a referral by their doctor.

7. A therapeutist examines a patient, assigns some treatment, pre­scribes some medicines and gives a medical certificate.

8. Ukraine's health care system is undergoing a complicated transi­tion period.

9. The number of HIV/AIDS cases in Ukraine reduced by 200 or 3.9 % to 4,900 in the period of January—November 2008, com­pared with the corresponding period of the previous year.

HEALTH CARE SYSTEM IN UKRAINE

Ensuring health care for the population is one of the key functions of the state set out in the 1996 Ukrainian Constitution, with Article 49 stating that "the state creates conditions for effective medical services accessible to all citizens".

Core components of the health care system in Ukraine include the Ministry of Public Health of Ukraine, responsible for setting national health policies, and certain specialized health care institutions directly managed and funded by it. The Ministry of Public Health is respon­sible for establishing the framework for the mandatory accreditation of public and private health facilities as well as licensing of health profes­sionals and pharmaceutical manufacturers and distributors.

Today, the heath care system is a complex multilayered system where responsibilities in health care sector are distributed among cen­tral government, 27 regional administrations, numerous municipal and district, township and village levels.

Primary health care facilities in Ukraine comprise more than 6500 facilities providing ambulatory patient care. The organization of pri­mary care delivery is based on the territorial-district principle. There is no strict distinction between primary and secondary care in Ukraine. Patients may seek care by a specialist directly without formal referral by their district physician and this opportunity is widely used.

Organization of secondary outpatient care is based on the territo­rial principle, with each polyclinic being assigned a defined area. Area residents are entitled to full diagnostics, examination and appropriate treatment and may be referred to the tertiary level when necessary. Tertiary care is provided mainly in regional hospitals and dispensaries. Larger multi-specialty hospitals are usually located in larger cities and may offer a fuller range of services. Treatment may be provided by physicians from both outpatient and inpatient departments of heal' facilities.

Accident and emergency care is provided by mobile teams of phy­sicians or feldshers. At present, ambulance stations face a number of problems due to insufficiently or poorly maintained vehicles, insuffi­cient funds to provide teams with necessary medicines and equipment for emergency care.

The Ministry of Public Health developed a strategy for gradual transition to basing primary health care on family medicine. Conven­ing all existing primary health care units according to the family medi­cine principle and setting up a network of general/family practices as proposed by the government program "Health of the Nation" will require substantial efforts.

Ukraine has one of the fastest growing HIV/AIDS epidemics in the world. About 1.63 percent of Ukrainian adults, or about 756,300 citizens, were estimated to be living with HIV/AIDS in 2007 but the statistics only reflected official cases. Another great challenge for the country is the continuing increase of tuberculosis rates. Every day in Ukraine specialists in tuberculosis (phthisiatricians) register about 100 new cases. One more serious problem is diabetes — about 1 million people in Ukraine suffer from this disease.

Ukraine is considered to be in a demographic crisis due to its high death rate and a low birth rate. A factor contributing to the relatively high death is a high mortality rate among working-age males from pre­ventable causes such as alcohol poisoning and smoking. The leading causes of death are cardiovascular and respiratory diseases, cancer, traumas, and accidents.

The majority of health care services are provided by publicly owned health facilities. Ukraine has more than 24,000 such institutions, in­cluding the national Sanitary and Epidemiological Service, spas and health resorts, health centers, orphanages, blood transfusion stations, centers for medical statistics, institutions for the training of heath per­sonnel and for postgraduate training of physicians, research institutes and institutions for professional training of middle-level health staff. The network of private health facilities is being developed as well.

In general, the system of health care delivery in Ukraine faces contradictions. It maintains financial and economic mechanisms that stimulate further expansion of the health facilities network and an increase in capacity, while at the same time experiencing a sharp re­duction of budgetary financing. The state in theory provides free healthcare for its citizens and long-term residents who become ill; however this is a serious problem for many parts of the country. Doc­tors' wages are extremely low and often ask for a fee. This makes healthcare difficult, as many citizens are on a low income, thus ag­gravating the problem of health care accessibility and affordability.