Sara Schwartzberg Smorodina is 98 years old. Severely hearing-impaired, she nonetheless greeted the writer with a dramatic declamation of Russian poetry. Ms. Smorodina attended a local Jewish grade school as a child and, after finishing a conservatory, pursued a career as a piano accompanist to a girls' gymnastic team. Although she retired in 1984, she is still in contact with some of the former team members, one of whom was visiting her when the writer was at Beit Baruch. Ms. Smorodinia outlived three husbands and her only child.

Beit Baruch has its own medical office for routine medical care. It is staffed by four nurses on shifts and two visiting physicians, all of whom will see patients in their rooms when necessary. Specialized care is available through the Jewish Medical Center (see below), which Ms. Laschenko described as essential in maintaining the high quality of medical service available to Beit Baruch residents. Located in a wing of Beit Baruch, the Jewish Medical Center is accessible without going outside. The complexity of offsite medical visits - van rides, waiting rooms, bureaucracy, necessary bribes - is traumatic for many elderly, so the Medical Center is a most welcome addition to the residence.

The ongoing financial crisis has led to some reduction in services provided by Beit Baruch, said Ms. Ruvinskaya. Although patients pay a significant portion of their pensions to Beit Baruch, the institution is dependent on subsidies from the local Chabad Philanthropic Fund and an allocation from the Jewish federation in Boston. Both organizations have reduced their contributions. Accordingly, Beit Baruch has dismissed one of its three caregivers, its part-time art therapist, and certain other personnel. Although the kitchen continues to serve nutritious meals, some reduction in food quality has occurred and residents have been asked to be careful about wasting food. And, of course, Beit Baruch has limited its intake of new residents.

One very bright note, said Ms. Ruvinskaya, is assistance from JDC through Esther Katz, the regional director of the Joint Distribution Committee. Ms. Katz is "golden" (золотая), Ms. Ruvinskaya stated. Ms. Katz has gone out of her way to contribute certain supplies, such as adult diapers and specific medications, to Beit Baruch, continued Ms. Ruvinskaya. It is due to the kind heart of Ms. Katz, not a changed policy of JDC, that Beit Baruch receives these much needed goods, said Ms. Ruvinskaya.[84]

40. The Jewish Medical Center opened in February 2012 in ground floor premises at the Beit Baruch Assisted Living Facility. Although housed in its own wing of Beit Baruch, it is accessible from inside the residence without going outdoors. It also has its own separate outside entrance so that non-resident clients and staff may enter and leave without disturbing Beit Baruch. JMC fulfills a longtime goal of the Dnipropetrovsk Chabad community to provide high-quality medical services to the Jewish population at low cost. The clinic also is open to non-Jews and does not discriminate in the provision of care.

Only one physician is employed by the Center on a fulltime basis, stated manager Vera Volchek. He is supported by one fulltime nurse, two therapists, and a rotating team of laboratory technicians. Additionally, a number of physician specialists hold regular office hours according to a posted schedule, said Ms. Volchek. JMC is licensed to provide both geriatric and pediatric care, but has been unable to find a qualified pediatrician willing to commute to a low-income area that is distant from the city center.

About 60 percent of the patients, Ms. Volchek continued, are referrals from the hesed under terms of a contract between the Center and the hesed for medical care of hesed clients. Increasingly, she mentioned, people from the neighborhood also are visiting the clinic. In response to a question, Ms. Volchek said that between ten and 30 individuals seek medical assistance at JMC each day. JMC does no adver-tising, except for small signs posted in the immediate neighborhood.

Vera Volchek, a professional health care manager, directs the Jewish Medical Center in Dnipropetrovsk. She is standing in the small lobby of the JMC.

Photo: the writer.

In addition to its contract work with hesed clients, JMC also manages the hip fracture/replacement program that was initiated by Boston physicians; it handles the logistics for surgery in a local hospital and supervises patient recuperation. (A local surgeon has been trained to perform the necessary procedures in a surgical suite equipped through the Dnipropetrovsk-Boston kehilla project.) JMC also serves the Beit Baruch population, performing initial examinations upon intake and then continuing care throughout the patient's stay at the assisted living center. Beit Baruch patients, said Ms. Volchek, are "like family to us."

The medical laboratory at JMC is sophisticated, boasting advanced diagnostic equipment and highly qualified medical technicians. All medical records are computerized, a rarity in Ukraine where most medical records are kept by hand in cum-bersome registers. Efficient computerized records deter the common practice of over-medication, a procedure that enables physicians to demand kickbacks from local drug companies and distributors. All professional personnel at JMC are well paid, aver community officials, to reduce the likelihood of corruption. Patients pay heavily discounted fees for service.

In response to a question, Ms. Volchek said that JMC requires additional equipment, such as another electrocardiograph machine, additional ultrasound devices, and certain items for the laboratory. However, she realizes that acquisition of these items is unlikely in the current economic climate. JMC is under great pressure to control costs, she said. The Jewish Medical Clinic is supported by the Philanthropic Fund of the Chabad Jewish community and a few private donors. According to Zelig Brez of the Philanthropic Fund, community leadership would like to find a donor willing to support development of another JMC, a much larger branch that will be located in available space within the centrally-located Menorah Center.[85] Transportation to the Beit Baruch JMC is simply too difficult and too time-consuming; a community bus makes a round-trip between the Menorah Center and JMC once weekly, but this service is inadequate. Given its lack of accessibility, it is unlikely that the Philanthropic Fund will support additional investment in the Beit Baruch installation.

41. Ahavat Israel was established in 2011 with a mission of bringing Jewish life to Jewish deaf and non-speaking individuals in Dnipropetrovsk. Having been approached by several individuals in this population group,[86] Rabbi Shmuel Kaminezki authorized establishment of such organization and asked Rimma Margolina, manager of the women's mikveh, to supervise it on a volunteer basis.

Ms. Margolina stated that approximately 30 deaf Jewish adults and eight deaf Jewish children and teens are members of the loosely-knit group. They often are joined by five hearing adolescents, offspring of parents who are severely hearing-impaired, and another six hearing teens who are interested in this population, perhaps because they have more distant relatives who are deaf or because they are generally sympathetic. Although Ahavat Israel operates some programs that include the entire group, Ms. Margolina said, it also organizes separate activities for those teens who are non-disabled.

Rimma Margolina, a well-known figure in the Jewish community, manages the women's mikveh. Although she has no back-ground in working with hearing-impaired individuals, she was asked by Rabbi Shmuel Kaminezki to direct an organization of deaf Jews.

Photo: the writer.

Ahavat Israel receives a small allocation from the Chabad Philanthropic Fund. Its members are employed in low-paying work and are unable to pay dues or program expenses. Thus, said Ms. Margolina, the activities of the group are severely limited. They have found a skilled sign-language interpreter who is willing to contribute some volunteer hours to assisting the organization, but the interpreter demands compensation for intensive work. They celebrate several Jewish holidays as a group, but they cannot afford to pay the interpreter for leading/interpreting a seder. Transportation also is a major issue, because many members live in remote areas and cannot afford transportation to a central location, such as the Menorah Center. Ahavat Israel has no office or program premises of its own.

The group used to meet twice monthly, said Ms. Margolina, but now meets only at holidays. Participants, she said, are eager for more programs and general socializing opportunities, but the lack of financial resources prevents additional activities.

42. The Jewish Women's Microenterprise Loan Fund, initiated with support from Combined Jewish Philanthropies of Greater Boston (the Jewish federation in Boston), continues to generate new small businesses in Dnipropetrovsk. All loans are processed through PrivatBank, a large Ukrainian bank controlled by two Dnipropetrovsk oligarchs, Hennady Boholubov and Ihor Kolomoisky.

Natalia Rier, director of the Microenterprise Loan Fund, receives dozens of applications for loans every year; about 75 percent of applicants complete the necessary paperwork, she said, but only about 10 percent present a satisfactory business plan and actually receive loans. Unsuccessful applicants usually have one or more of the following problems, Ms. Rier continued: (1) low educational level, leading to inability to comprehend very basic business information, local economic conditions, or business planning; (2) inadequate financial education; and/or (3) lack of computer skills. A local 18-hour ORT business course that teaches business accounting, business-related computer skills, website construction, marketing, and additional business-development capacity is very helpful, said Ms. Rier, but it also is costly. Necessary legal assistance is very expensive.

Natalia Rier has directed the Jewish Women's Microenterprise Loan Fund since its inception.[87]

Photo: the writer.