An Impossible Choice

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Last week Russian forces entered Crimea under the pretense of protecting Russian nationals, despite no evidence of violence whatsoever. This week the war looks less likely, even if Crimean destiny is still uncertain.

However, some clarity has already emerged. No longer can Putin claim any pacifist moral high ground. We had a glimpse of his true persona, normally carefully hidden from the public: a KGB old guard, skilled in manipulation and intimidation. His affections towards Ukraine thwarted (even $15 billion could not buy a reciprocated feeling), he had to resort to trickery and force in Crimea to try and bring it back. Putin is now a modern-day Frollo: despised, ridiculed, isolated. Also apparently deluded, but such is the path of a dictator.

So here we are: with investors scrambling to get out of Russia and G8 meeting in Sochi effectively canceled, Cold War is suddenly heating up again. How does this development affect us, a US-based charity that helps cancer patients from Russia and the former Soviet Union?

For one, it makes our fundraising even more challenging. It is not easy to reconcile donating to Russian patients with Russia threatening to seize US assets. It takes a lot of explaining that patients face enormous hurdles trying to find and access good care. However, we have been very mindful in the past about structuring our programs in such a way as to maximize the good to the patients and minimize the contact with the Russian government.

One of our programs helps cancer patients find bone marrow donors in a German registry. The money we raise under this program is transferred directly to Germany. Another program helps patients find appropriate clinical trials that are not available in Russia. We help pay lodging costs for patients who participate in studies in Europe or the US. The last program issues one-time grants to families of children with cancer that have to travel abroad due to lack of appropriate therapy at home. We also help them settle in Houston when they choose to come here for treatment.

Practically all the funds we raise are spent on direct patient help outside of Russia. Until we start seeing better governance, we cannot in good faith conceive any long-term development projects with Russia's state-owned hospitals or research institutions. Corruption, lack of transparency, bureaucracy and the state's hostile attitude to NGOs are the barriers that we are unwilling to deal with.

Unfortunately, many wonderful Russian charities that do amazing work do not have this option. So for them, an uneasy question has to be answered: do we take on the government's job and do our best to help the vulnerable, but at the same time lessen the society's pressure on the government to change? Or do we push for political change and put our patients at risk if the charity gets in hot water with the authorities?

We are afraid that there is no right answer.