Russian health care still lags decades behind that of other Western countries.

Under-reported AIDS cases, widespread use of abortion and an increase in venereal diseases were some of the findings by Bermudian, Mrs. Marisa Sharpe on a recent trip to the former Soviet Union.

Until recently, a startling eight million abortions a year were performed in Moscow, she said. But better sex education generated by women's rights movements means the figure has been halved.

Mrs. Sharpe who practises infection control at the King Edward VII Memorial Hospital is the only Bermudian to certify in that field.

She represented Bermuda on a two-week fact finding trip in October, sponsored by the Practitioners in Infection Control and told of her trip yesterday to the Hamilton lions Club.

"The purpose of the trip was also to share information in infection control and to make recommendations as appropriate,'' Mrs. Sharpe said.

AIDS cases in Russia now number 14 but it is believed the problem is much more widespread.

Mrs. Sharpe blamed the problem of tracing AIDS cases on the size of the country.

Registered cases are believed to be confined to homosexual men and children infected through contaminated needles.

"Donated blood is now screened. Because of the belief that HIV is acquired through donating blood, Russians have resorted to paying people to donate. Of these, two donors have tested positive.'' Hospitals are still run under the state system where little or no attention was given to staff safety, upkeep of facilities or advanced technology.

The country is now looking toward a new system, in some cases based on private hospital care in the United States, but which will place a heavy financial burden on Russians.

"Most people, especially the elderly fear this change from socialism to capitalism and where there money is going to come from,'' Mrs. Sharpe said.

Fewer available government jobs means Russia suffers from "hidden unemployment''. Many Russians are forced to work part time.

"This has caused a decrease in salaries, an increase in poor living conditions and a decrease in the state of health,'' said Mrs. Sharpe.

Russian doctors earn on average $100 a month.

At present, infant deaths in Russia currently run at 19 per 1,000 births compared with six per 1,000 births in Bermuda.

And a decrease in the birth rate combined with a rising rate of mortality means Russia is currently experiencing a slow population growth.

Environmental pollution is a major health hazard and is thought to be linked to lower immunity to disease in Russians.

"Control of the environment is a major problem, especially in drinking water, air pollution, toxic waste and radiation,'' she said.

"Drinking water contained complex organic molecules. These molecules were found in mothers breast milk and soil.'' Outbreaks of food poisoning are linked to food kiosks around the city which do not adhere to health standards.

During the course of her visit, Mrs. Sharpe visited a number of hospitals.

While they were clean and orderly, they lacked equipment and were forced to use out of date medicines.

Clean syringes are used only for infectious cases -- otherwise they are reused, she said.

Bleach, used to sterilise equipment, corrodes the instruments which are difficult to replace.

"It is a question of doing the best they can with what they have,'' Mrs.

Sharpe said. "Staff do not get vaccinated. Immunity consists of getting the disease.'' Infection control systems were non-existent in Russian hospitals because staff have no education in disease prevention.

Some 25,000 specialists in infection control would have to be trained to fulfil the needs of all Russia's hospitals, Mrs. Sharpe estimated.

Under training of staff was another problem she said.

"Currently the average nurse only does two years of training. Doctors have total responsibility for patients but nurses have none. Nurses cannot even document an inpatient's chart.'' But one of the highlights of the visit Mrs. Sharpe said, was a visit to the Pasteur Institute, established in 1923 in St. Petersburg.

Research is conducted through joint ventures with France and Finland for ways to develop vaccines against certain diseases.

Mrs. Marisa Sharpe