Doctors and medical staff, notoriously underpaid and neglected in post-Soviet states, are on the front lines of the fight against COVID-19 - and increasingly at the fore of civic activism against state repression. They’ve staged pickets, joined street protests, and launched campaigns, themselves coming under immense pressure from authorities.

In Belarus, in particular, medical activism has become a hallmark of the ongoing anti-government demonstrations. Medical personnel were among the first to join the mass demonstrations after Alyaksandr Lukashenka claimed victory in a rigged election on 9 August, and they’ve been a fixture of the protest movement since. Already taxed by the government’s callous disregard for the severity of the pandemic, many medical workers began to mobilise after treating victims of brutal police crackdowns on peaceful protesters. Doctors, nurses and medical students have been manhandled, arrested and assigned administrative penalties for protesting. Around 25 doctors have been jailed with administrative arrests, two are facing criminal charges. Some 20 medics have been fired for political reasons, and nearly 180 fined, according to activists.

Most recently, Belarusian doctors rallied in support of aesthesiologist Artsiom Sarokin. He was arrested after refuting government claims that 31-year-old opposition protester Raman Bandarenka, who died after being detained by police, had suffered from alcohol poisoning. Medical personnel at the Minsk Emergency Hospital, where Bandarenka had been treated, lined up as if they were protesters being arrested, holding signs that read “zero ppm”. The video went viral, and “zero ppm” has become a slogan, with journalists, students and activists replicating the protest.

“Medics are a striking example of social solidarity,” says Andrey Tkachov, leader of the Belarusian Medical Solidarity Fund, which was set up to help persecuted Belarusian doctors. The activist, who also coordinated the hugely successful ByCovid19 initiative to cope with the pandemic, says the coronavirus crisis was instrumental in forging what he calls a “new mutual solidarity” between medical workers and society.

“When doctors started to appeal for help, they saw who responded: it was not the government, it was society,” Tkachov said.

In a wave of solidarity never seen in the authoritarian country before, citizens donated some 300,000 euros to ByCovid19, which was used to purchase some 450,000 pieces of PPE and 1,500 pieces of medical equipment.

“For the first time, medics saw that society is on their side,” says fellow activist and ByCovid19 coordinator Andrej Stryzhak. “Now they are on the side of society too. They are the leading group refusing to just stand by,” he emphasises. “They have no fears, especially after fighting COVID for several months.”

More than 4,400 doctors have signed an open letter calling for an end to police violence, new presidential elections, the release of political prisoners and the reinstatement of workers dismissed for political reasons.

Meanwhile, the White Coats Telegram channel serves as a primary exchange platform for the new medical activists, monitoring arrests, dismissals, court sentences and other abuses of medical staff. The channel was hacked recently, and its administrator was arrested and faces criminal charges. After migrating to a new channel, the channel again has over 51,000 subscribers. On another website, medics have teamed up with legal and IT experts to process data and provide independent information on COVID-19 for citizens and medical professionals.

“Where else do you see doctors beaten up and jailed in the midst of an epidemiological crisis?” asks Alexander Apeikin, an initiator of the Medical Solidarity Fund. “Medical professionals are a systematic necessity for all of us. Now they need systematic assistance.”

“Everything is much worse now [than before the disputed elections] for physicians and people who want to help them,” says Andrey Tkachov, director of the solidarity fund. Like most Belarusian activists, he now lives abroad, as fundraising channels inside the country have been shut down and any form of civic activism is harshly repressed. Undeterred, the solidarity fund is organising support for the families of arrested medical personnel and advising medical students dismissed from their universities for joining protests. They also collected more than 31,000 euros in several weeks.

In neighbouring Russia, while medical workers are not driving broad, cross-sector solidarity as in Belarus, they are speaking out in unprecedented ways. The appalling situation in the country’s hospitals battling the COVID-19 crisis has been enough to provoke new forms of activism in the medical community.

“It was a journey into hell,” says Anastasia Vasilyeva, a prominent face of medical activism in Russia, in a new video about a recent hospital tour. The young ophthalmologist set up the Doctors’ Alliance, an independent trade union, in 2018 after treating opposition activist Alexey Navalny for an eye injury. Since the pandemic first hit Russia in the spring, she has been driving tirelessly up and down the country, delivering respirators, masks and other protective gear to desperate medical staff in dilapidated hospitals.

Videos on Vasilyeva’s YouTube channel, where she discusses official COVID data, empty pharmacies and appeals by frazzled hospital staff, also show her and her team being denied entry to hospitals by hospital management or police, harassed or sometimes even detained. Those Russian medical professionals who draw attention to grave deficiencies in the healthcare system or stand up for persecuted colleagues quickly come under pressure themselves.

The second wave of the coronavirus has been raging across Russia since the late summer. With official numbers, some 29,000 daily registered infections, still going up, most experts think the real rate is much higher. Mortality rates are now rising more steeply than in other countries, while public health measures remain minimal and economic support is nearly non-existent.

Above all, the latest wave has spread to Russia’s regions, revealing deep structural deficits in the country’s health system. After years of chronic neglect and drastic cutbacks, the sector is woefully under-equipped and nearing collapse. For several weeks, independent media have reported horror stories of shortages of doctors and medical staff, ambulances waiting for long hours, sometimes days, outside hospitals, clinics refusing to accept new patients, corpses piled on floors and overcrowded morgues.

In the Arkhangelsk region, a video published by the Alliance of Doctors revealed that patients even went on hunger strike after the ward ran out of probes for COVID tests. “Probably the worst hospital I have ever seen,” Vasilyeva commented after a visit.

The catastrophic conditions are taking their toll on medical staff. A “Memory List”, published online by an independent group of doctors, names more than 900 medical professionals who have died throughout Russia during the pandemic.

And of those who survive, ever more are on sick leave or have resigned in despair.

Morale is further drained by medical workers not receiving additional payments promised by president Putin in the early days of the pandemic. In protests organised by the “Deistvie” (Action) union, an independent initiative set up in 2012, medical workers staged pickets in several Russian cities, showing up with hand-made signs demanding authorities “Pay for Covid”.

Meanwhile, protests continue across Belarus in support of Artsiom Sarokin and other doctors and medical staff who have been arrested. “People are with doctors, and doctors with the people,” end many messages on the White Coats Telegram channel. In Russia, the new motto of medical activism coined by the Russian Doctors’ Alliance is “Our strength lies in unity.”