Medical Crisis Looms in Ex-Soviet States : Shortages: The Red Cross warns that without increased supplies of even the most basic drugs, thousands could die.

MOSCOW — Tens of thousands of people in the former Soviet Union could die needlessly in the coming months, victims of the shortage of medicine that has worsened even more dramatically since the country fell apart, Red Cross officials here warn.

Concerned that donors have been distracted from the region’s needs by the wounded in the crumbling Yugoslav federation and famine in Africa, they issued a new appeal this weekend for donations and cautioned the world that although dire predictions of hunger and civil war in the old Soviet Union have been exaggerated, very real suffering is on the rise.

“We see a tremendous deterioration in the medical area,” said Stephen Richards, head of the Moscow delegation of the International Federation of Red Cross and Red Crescent Societies. “And we believe it will continue.

“They’re running out of basic lifesaving drugs like insulin; they’re not able to do necessary surgery if they don’t have the supplies,” he said. “There were stockpiles that were available, and now those stockpiles are being exhausted and there’s nothing on the shelves.”

Richards acknowledged that donor interest also may have dropped off because of skepticism stemming from extreme predictions of famine and unrest that never came to pass.

“This is not a Third World country,” he stressed. “Food is not a problem. Medicine is a problem.”

Red Cross doctors who have been touring the former Soviet Union to determine the extent of shortages have been appalled, Richards said, by the lack of such necessities as insulin, antibiotics and heart medicines.

The Soviet Union had a medicine shortage for years, first because of the sorry state of its own pharmaceutical industry and then because the East European countries that had been supplying many of its drugs began to demand hard currency for them in place of the old barter or ruble deals.

The collapse of the Soviet Union drastically worsened the medicine shortage in a similar way: Most of the region’s fledgling countries have almost no pharmaceutical industries of their own, and they are now forced to pay hard currency, which they lack, for medicine even from other former Soviet republics.

Dr. Yuri Zapadalov, a physician and an official in the Russian Red Cross, noted that the medicine shortage has also gotten significantly worse in Russia and elsewhere because cash-strapped governments have even fallen down in the funding of hospitals in rubles.

The budget shortfalls have left state-run health systems helpless, with no payments to be expected from medical insurance--still a novel concept here--and only small pockets of private medicine.

“The only answer is a change in the medical system,” Zapadalov said. “But that will take time.”

Zapadalov has seen reports of hospitals receiving only half the supply of insulin they order, he said, and a hospital in the northern city of Arkhangelsk reported that newborn babies there died for lack of infant formula.

“Their only hope for medicine and drugs is humanitarian supplies,” Richards said.

The Red Cross Federation had already launched a campaign to raise more than $40 million in additional medical funding for the former Soviet Union this year, in part to support a visiting nurses program that serves about 500,000 elderly people. In total, the Red Cross has already provided more than $70 million in drugs and hospital supplies.

But “as of today, our funds to purchase new medicines are exhausted,” Richards said.

He noted that other areas in which the Red Cross specializes are also getting worse here, particularly the problem of refugees across the former Soviet Union, now estimated by the Red Cross to number more than 1 million.