A 12 Month Analysis of the Medical Workload of the Health Care Services provided to a Russian/US Joint Venture in Northern Russia
Authors: Wilder R.J. , Howe W. , James C. 
Published: December 2007

Abstract
In a joint venture with a Russian partner a US company has been involved in building a production facility in the tundra of Northern Russia, north of the arctic circle. Following an assessment of the health risks, and the local health facilities it was decided to establish medical clinics at the Arkhangelsk (Office HQ) and Ardalin (Production site) staffed by trained medical specialists (medics) who had previously worked on platforms in the UK North Sea. The medics were supported 24 hours per day by phone, by a group of physicians with experience in remote medicine.
In order to review the clinical workload and cost effectiveness of the service each medic kept a log of all consultations for medical problems. The log detailed date of consultation, location, name, company affiliation, occupation, medical condition, whether related to work, treatment and disposal e.g. back to work, bed rest, medical evacuation.
In this paper an analysis of the information provided in the medics' logs at Arkhangelsk and Ardalin is reviewed during a 12 month period during the construction of the facility. First aid and emergency treatments were given to expatriates and Russian employees. The results of the analysis highlight;–the justification for the provision of resource on site to deal with medical problems,–the difference between illnesses in expatriates and nationals,–the need for effective medical evaluations for fitness to work in remote areas,–the incidence of serious illness/injury requiring medical evacuation.
An assessment of the cost effectiveness is presented and recommendations made for future improvement.

Introduction
During the 1980's the company developed interest in the possibility of oil and gas exploration and production in Russia. The Timon Pechora basin in Northern Russia, which had already been established as an oil producing region, was targeted. Early activity was centred in Moscow where there was some access to adequate medical services.
By the early 1990's negotiations to partner with a Russian oil company, based in Arkhangelsk, North Russia, were finalised and a Joint Venture company was created. This resulted in an increased number of company employees and contractors visiting Russia. Activity centred on Arkhanglesk, where a rudimentary office was established, and in the Ardalin area of the Timon Pechora tundra, where seismic surveys and well testing of existing Russian wells were carried out. It soon became apparent that the local medical resource in Arkhangelsk was not sufficient and was non-existent in Ardalin.
It was therefore decided that groups of employees carrying out project work in the tundra would be accompanied by medics, chosen from existing staff who worked in North Sea Oil rigs. This proved successful in dealing with immediate medical needs, but as more expatriates began to arrive in the Arkhanglesk office location and as a production site had been chosen for development at Ardalin, it was decided to carry out a more in depth survey of the existing local health care services to establish systems for dealing with routine and emergency health problems. The E & P Forum report on "Health Management Guidelines" was used as an instrument for the study, which concluded that local resources were inadequate.
P. 347