Surviving 'Europe's Last Dictator' in Belarus

The cease-fire agreed at talks brokered by Belarussian President Alexander Lukashenko between Moscow and Kiev may not have held, but the president has enjoyed something of an image makeover since his Russian and Ukrainian counterparts met in Minsk for a scheduled gathering of the Russian-led Customs Union in August.

The peace deal in Minsk was doomed from the outset, but Western countries saw a new side to the Belarussian president. Lukashenko remained impartial and optimistic while news of Russian troop incursions into Ukraine emerged. He now acts as a confidant to his Ukrainian counterpart, Petro Poroshenko, and on Oct. 9 was given the unenviable task of notifying Russian President Vladimir Putin that the Ukrainian president would not attend the CIS Heads of State Council meeting in Minsk.

Lukashenko seems rejuvenated by Russian violence and Ukrainian frustration. He is less stern and more genial. It is almost impossible to believe that he once bellowed, "It is better to be a dictator than be gay!" at Germany's foreign minister, during a turgid exchange about his own erratic behavior.

With his bristly mustache and paternal propensity for peculiar stories, this sullen, impenetrable homophobe has the ear of Poroshenko, the European Union and the Organization for Security and Cooperation in Europe. For those who remember Lukashenko's defense of former Yugoslavian President Slobodan Milosevic, Lukashenko's rehabilitation seems very strange indeed.

Ryhor Astapenia, an analyst at the Ostrogorski Center think tank, has raised the question of whether former U.S. President George W. Bush administration's lasting characterization of Lukashenko as "Europe's last dictator" is still accurate. Many journalists have catalogued his regime's human rights abuses, but in order to decide whether Lukashenko deserves this title, we must examine whether life has improved for Belarussian citizens during his two decades at the helm of Europe's pariah state.

The most reliable litmus test of Lukashenko's governance is how his government has affected public health standards in the country.

Lukashenko often refers to himself as "batka" — an affectionate term for father — which alludes to his role as creator of the modern nation. In real terms, Lukashenko has earned this title — by significantly improving both the maternal and infant mortality rate.

"At population level, the big gains have been in mother and child health," said Erica Richardson, a doctor and technical officer at the European Observatory on Health Systems and Policies, based at the London School of Hygiene and Tropical Medicine. "Infant mortality in Belarus has fallen from 14.4 per 100,000 live births in 1995, to just 3.9 in 2012."

Other former Soviet republics have also enjoyed improvements in their infant mortality rates, but not to the same extent. The Belarussian average of 3.9 deaths per 100,000 live births is not only significantly better than Ukrainian and Russian figures — which are 9.2 and 8.9 deaths, respectively — but better even than the average in the United States. "Europe's last dictatorship" has safer hospitals for mothers and infants than the U.S.

When it comes to maternal mortality rates, Belarussian achievements have been impressive. Russia's average of 74 deaths per 100,000 births in 1990 had fallen to 24 by 2013. Ukraine's figure has dropped from 49 to 23. Lithuania's average has fallen from 34 to 11. By the same ratio, Belarussian hospitals recorded only one maternal mortality per 100,000 live births last year, compared with 37 in 1990.

Such a low figure could indicate a small anomaly, but even if we take into account the four maternal mortalities recorded by Belarus in 2010, Lukashenko is giving women a quality of care comparable to that offered in the EU.

Belarus was hit hard by the collapse of communism, but did not endure shock therapy or the economic turmoil of 1990s Russia. People live longer in Belarus than in other former Soviet republics.

"As in Russia and Ukraine, there were fluctuations in life expectancy throughout the 1990s, particularly for men, but the fluctuations [in Belarus] were not as dramatic as in neighboring Russia or Ukraine," explained Richardson from the European Observatory on Health Systems and Policies.

These figures might help to partly explain Lukashenko's political longevity. A section of society in Belarus trades freedom of expression for reasonably regular pension payments. They tolerate Lukashenko's propensity to harass and torture his opponents in exchange for services such as health care. Nobody can blame them. National life expectancy stands at 72.2 years — far from EU standards, but high when compared with other former Soviet states.

Despite these encouraging figures, hidden in the high life expectancy is an appalling disparity. Women live to the age of 76.6, but men on average die at 66.6. In deserted villages, unemployment and isolation strand a generation of men in misery. Alarmingly, the Belarussian male suicide rate has not changed since 1991, and alcohol is fueling the phenomenon. According to the World Health Organization's 2014 Global Status Report on Alcohol and Health, men from Belarus are the heaviest drinkers in the world.

As Lukashenko's government licenses businesses and profits directly from alcohol sales, the death of a lost generation to alcohol abuse marks a growth industry for Lukashenko. Remarkably, he attracts praise for tackling alcohol abuse in the WHO's 2014 Global Status Report, which cites Belarus as an example of "leadership and commitment to reducing harmful use of alcohol." In fact, Lukashenko is just micromanaging a situation of his own creation. As the same report finds, 29.8 percent of men above the age of 15 who drink in Belarus suffer from an alcohol-use disorder, and 19.6 percent are alcohol-dependent.

Pregnant mothers may face fewer risks under Alexander Lukashenko, and babies may be more likely to survive childhood. Yet this process is cruel and gravely dystopian, if, under "Europe's last dictator" each male child is destined to face an intolerable life and inordinate risk of avoidable death. Life has improved for some in Lukashenko's Belarus, but not for all.