The problem was made worse after the Ministry of Healthcare issued an order in 2006 placing dialysis treatment under “specialized medical care,” meaning that the treatment had to be paid for out of regional rather then federal budgets. While richer regions could afford proper care, poorer areas were forced to cut facilities.

Yevgeny Ustupkin had to travel across Russia from Vladivostok to Moscow in order to receive the dialysis treatment he so urgently needed.

“It’s next to impossible to have dialysis treatment in Vladivostok; there is only one dialysis center in a hospital with 1,000 beds,” said the patient. “It puts doctors in such a position that they act like God and take decisions whether this patient will get dialysis treatment and live and the other will not.”

“There is no access to basic medications, doctors will not even tell you they exist because you cannot get it for free and few people have the means to pay for it,” he added.

Very often those who do survive receive so called “low-quality” dialysis treatment.

“A high-quality dialysis treatment has many components. First, a very pure water has to be used. 99% of our centers use water of terrible, unacceptable quality, absolutely unfit for a normal dialysis treatment,” revealed Lyudmila Kondrashova, Chairman of the Public Organization of Nephrological Patients. “And we need good specialists – unfortunately, we have only a handful of them who are competent. It is also about the quality of equipment.”

Lydmila receives many letters from patients who have shocking experiences to share.

“I’m 21 years old and I’m 156th in line for dialysis treatment. I’m not even sure I’ll live that long,” a patient from the city of Ryazan wrote her.

“The solution for dialysis was prepared in a square tank made from welded steel (they use similar tanks to water gardens in dachas),” wrote another patient from the city of Ulan-Ude. “This tank was placed in a checkroom, where there were hangers for overcoats. It was covered with boards. I saw myself that people dropped gloves or hats into it by accident.”

“It might sound like a horror film, but this is the reality in many of our regions,” Kondrashova said.

With hospitals under equipped and vastly under funded, dialysis treatment ends up becoming a game of chance. The Ministry of Health replied that the availability of dialysis procedures is within the jurisdiction of regional healthcare structures.

“Those people who have no connections or money to get treatment or go to Moscow, they stay and die. And it’s a long and painful death,” Ustupkin said.

Activists are calling for the government to put in place a nationwide program backed by the state which with proper financing could put an end to an existing system.