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Special Report: Report FIFA Tournament 2018 UnitedHealthcare Global1 2018 Soccer/Football Tournament - Russia

Russia will be hosting one of the biggest and most anticipated tournaments across the world from 14 June – 15 July 2018. With the finals expected to take place in at the Luzhniki , the tournament will be played in 12 venues across 11 cities in the Western part of Russia.

This report provides intelligence on the overall healthcare environment and security concerns in Russia along with hospital referrals in each of the host cities, and logistical information on the various higher-level-of-care medical destinations considered by UnitedHealthcare Global during a medical evacuation.

Venues and Cities: • Yekaterinburg Arena, Ekaterinburg • Stadium, Saint Petersburg • , Kaliningrad • , Volgograd • , Rostov-on-Don • Fisht , • , Moscow • Otkritie Stadium, Moscow • Stadium, Nizhny Novgorod • , Saransk • Arena, Kazan • Samara Arena, Samara

MEDIAL RISK RATING

Health Intelligence Overall Medical Risk 4

Quality of Care Summary Disease Risks 3 Historically, the healthcare system and the overall condition of Quality of Care Risks medical facilities in Russia have been below international standards. 3 The quality of medical services countrywide varies significantly Remoteness Risks 4 depending on the region. Generally, larger cities such as Moscow and Saint Petersburg are better served compared to rural areas and Cultural Challenge Risks 5 have medical facilities that provide adequate care, and are accustomed to providing services to globally mobile patients. UnitedHealthcare Global advises against elective hospitalization in Russia.

Special Report: 2018 Soccer/Football Tournament – Russia 2

Language Proficiency Medical Intelligence Only a small percentage of Russian health care workers speak English; travelers have reported difficulties communicating medical problems General Health and Medical Assistance to Russian physicians, nurses, and hospital supporting staff. Given the from Russia expected influx of travelers attending the tournament, language courses will be provided at the designated hospitals along with the support of Call 8 ~ 10.1.410.453.6330 (can be dialed collect) reportedly 15,000 volunteers including interpreters. The level of fluency Fax 00.1.763.367.4063 speaking English is expected to vary drastically. Email [email protected] Diseases and Health Risks Available 24/7 Russia, particularly in remote areas, carries several health risks for foreign visitors, including diseases spread by ticks and other insects. Alcohol related incidents such as road traffic injuries, and second hand smoke Local Medical Emergency Services are also health risks for visitors. Food and water also present risks for Ambulance and Medical emergency services: 03 or 112 travelers, as tap water even in the major cities of Russia is not considered Fire: 01 or 112 safe for consumption. General food and water precautions should be observed when traveling to Russia. Police: 02 or 112

Immunizations and Preventative Treatments Ground Ambulance and Emergency Rescue For recommended and required vaccinations as well as preventative Services treatment for travel to Russia, visit the US Centers for Disease Control and Prevention. Access to ground ambulance through the public Russia EMS will be available in all the host cities for the tournament. Medical posts Hospital Care with ground ambulances and medical personnel will be set up near each designated sporting venue. Outside of major cities and travel destinations where quality private outpatient and inpatient medical facilities are available, state-run Ambulances can be dispatched by dialing 03. Travelers should hospitals are in most instances, the best and only options for the be advised that dispatchers and ambulance staff will probably provision of emergency medical care and for stabilization purposes. only speak Russian. During the tournament, English speaking Private facilities are generally not equipped to deal with the most serious volunteers will be available for over-the-phone interpretation. The medical conditions (e.g. trauma cases) and will refer patients to public public ambulance will transfer the patient directly to the most institutions. It is important to note that the physical appearance of the adequate facility to treat or stabilize their particular symptoms. medical infrastructure, level of hygiene, accommodations, and hospitality services at some facilities may be below one’s expectations, especially The levels of care: for globally mobile populations. In addition, patients may find the quality and availability of nursing support to be below one’s expectations and it Resuscitation ambulances -- can be dispatched to respond to is important to remember that the training, and the role and duties carried cardiac arrest cases and other critical situations. out by nursing support are different than those in other countries; and Cardiology ambulances -- may be dispatched to respond to patients- especially those hospitalized, may be approached for additional, potential cardiac emergencies. although unofficial, requests for payments to provide such services. Basic emergency medical service ambulances -- are the most In preparation for the event, 3500 physicians will be mobilized at the common type of emergency care offered in Russia. medical facilities and the various outpatient medical posts near the stadium venues. Ground ambulances and paramedics will also be on standby near the . Medications Patients presenting to hospitals for care, especially public facilities, should The Russian pharmaceutical market is not very reliable and travelers expect to show their hard-copy passport prior to entry. You may be and foreign visitors should take special care to ensure that they have an asked by security officers stationed inside the hospital doors to yield your adequate supply of prescription medications before going to Russia. passport during your time in the facility. Travelers should be aware that counterfeit drugs as well as questionable medications imported from the Far East and Eastern Europe are prevalent UnitedHealthcare Global may recommend medical evacuation for serious in Russia. medical conditions and emergencies requiring invasive procedures, serious surgical intervention or prolonged hospitalization. Russia’s larger cities have reputable pharmacies that should be able to provide most international medications.It is recommended for travelers to Non-Urgent Care carry all medications in their carry-on luggage if possible - if not, include in their carry-on luggage at least enough supply to cover any unscheduled Whenever possible, it is recommended to seek non-urgent care at the delays in travel and for the first week at their destination. To help with designated private facilities where available. Alternatively, house-call customs inspections, carry all medications in their original labeled physician service can be coordinated to the member’s hotel. Medical containers, carry their original, written prescriptions and, in a separate units will also be accessible near the various stadiums for the provision place, write down the name (including the generic name), strength and of first aid for minor illnesses and injuries. prescribed dosage with their doctor's name and contact information. Special Report: 2018 Soccer/Football Tournament – Russia 3

Medical Evacuation/ Repatriation Sochi: 3 hrs 45 mins nonstop using Learjet 60 Volgograd: 3 hrs 50 mins nonstop using Learjet 60 From Western Russia, medical evacuations can be coordinated by Samara: 4 hrs 15 mins nonstop using Learjet 60 commercial flight or air ambulance, depending on the patient’s medical Saransk: 3 hrs 50 mins nonstop using Learjet 60 condition. The typical evacuation destinations are Western Europe; Nizhny Novgorod: 3 hrs 40 mins nonstop using Learjet 60 Helsinki, ; or Istanbul, . Ekaterinburg: 4 hrs 55 mins with zero or one stop using Learjet 60 Rostov on Don: 3 hrs 30 mins nonstop using Learjet 60 Following an emergency medical evacuation, and upon stabilization, Kazan: 4 hrs 05 mins nonstop using Learjet 60 UnitedHealthcare Global can assist with the medical repatriation back Kaliningrad: 1 hr 50 mins nonstop using Learjet 60 home, to the patient’s work-site, or to the point of origin. Commercial Evacuation or Repatriation In the event of an emergency medical evacuation, UnitedHealthcare Global will always advise transfer to the location and facility that is best UnitedHealthcare Global will evaluate each patient’s medical condition, suited to handle the patient’s particular situation. In cases requiring in collaboration with the treating physician, and may determine immediate treatment, this evacuation destination may not be in the the evacuation can be performed via commercial flight. A medical patient’s home country, and instead may be the closest UnitedHealthcare repatriation to the member’s country of residence or home country Global Center of Excellence hospital that can appropriately manage the will also be considered when medically fit. A medical repatriation by patient’s condition. commercial flight may be necessary, especially for patients that require long term care. When medically necessary, a nurse or a physician Air Ambulance escort for medical care during commercial travel will be coordinated to accompany the patient. UnitedHealthcare Global upholds stringent selection criteria when selection air ambulance partners. The air ambulance crew is composed From the various cities, medical transport by commercial flight will of two aero-medically qualified clinicians, as well as two pilots. The be coordinated to the nearest higher level of care destination, while medical equipment & drugs available during the flight, the medical taking into account the availability of convenient flights, flight time, protocols and the medical staff as well as the airplane, the flight crew and availability of visa, and the most suitable destination for the treatment the plane maintenance are reviewed periodically and are consistent with or reassessment of the patient’s specific condition. Commercial flights the patient care needs. Upon arrival UnitedHealthcare Global will arrange are readily available from Moscow, the county’s main commercial flight admission to an approved UnitedHealthcare Global Center of Excellence hub, to Western Europe, Finland, and Turkey. During the tournament, facility and coordinate hotel accommodations for family members and direct flights may be available from the secondary cities to international travel companions. evacuation destinations.

Sample Flight Times by Air Ambulance to Istanbul, Turkey from: Wheelchair assistance is available for patients with mobility problems. Moscow: 2 hrs 50 mins nonstop using Learjet 45 UnitedHealthcare Global can coordinate all flight arrangements and Saint Petersburg: 3 hrs nonstop using Learjet 45 pre-payments, if applicable. UnitedHealthcare Global can also arrange Sochi: 1 hr 30 mins nonstop using Learjet 45 for the traveler to be seen on an outpatient basis at a UnitedHealthcare Volgograd: 2 hrs 20 mins nonstop using Learjet 45 Global Center of Excellence facility, as well as providing convenient Samara: 3 hrs 10 mins nonstop using Learjet 45 hotel accommodations. Saransk: 3 hrs 10 mins nonstop using Learjet 45 Nizhny Novgorod: 3 hrs 16 mins nonstop using Learjet 45 Sample Flight Times by commercial airline from Moscow to: Yekaterinburg: 4 hrs 15 mins with one stop using Learjet 45 New York: 9 hrs 55 minutes direct flight available daily and operated Rostov on Don: 1 hr 55 mins nonstop using Learjet 45 by or 12 hrs 10 mins with 1 connection in Kazan: 3 hrs 15 mins nonstop using Learjet 45 Frankfurt available daily, operated by Lufthansa Kaliningrad: 2 hrs 20 mins nonstop using Learjet 45 Washington: 10 hrs 20 mins direct flight available daily, operated by Aeroflot Sample Flight Times by Air Ambulance to Helsinki, Finland from: : 11 hrs 5 mins with 1 connection in Frankfurt, operated Moscow: 1 hr 27 mins nonstop using Cessna Citation Sovereign by Lufthansa Saint Petersburg: 40 mins nonstop using Cessna Citation Sovereign Frankfurt: 3 hrs 20 mins Aeroflot Daily Sochi: 2 hr 51 mins nonstop using Cessna Citation Sovereign Volgograd: 2 hrs 26 mins nonstop using Cessna Citation Sovereign Sample Flight Times by commercial airline to Moscow from: Samara: 2 hrs 20 mins nonstop using Cessna Citation Sovereign Saint Petersburg: 1 hr 15 mins daily flights available Aeroflot Saransk: 1 hr 59 mins nonstop using Cessna Citation Sovereign Sochi: 2 hr 30 mins daily flights available Aeroflot Nizhny Novgorod: 1 hr 44 mins nonstop using Cessna Citation Sovereign Volgograd: 1 hrs 45 mins daily flights available Aeroflot Yekaterinburg: 2 hrs 49 mins nonstop using Cessna Citation Sovereign Samara: 1 hr 45 mins daily flights available Aeroflot Rostov on Don: 2 hrs 24 mins nonstop using Cessna Citation Sovereign Saransk: 1 hr 35 mins daily flights available Aeroflot Kazan: 2 hrs 08 mins nonstop using Cessna Citation Sovereign Nizhny Novgorod: 40 mins daily flights available Aeroflot Kaliningrad: 1 hr 07 mins nonstop using Cessna Citation Sovereign Yekaterinburg : 2 hrs 25 mins daily flights available Aeroflot Rostov on Don: 1 hr 55 mins daily flights available Aeroflot Sample Flight Times by Air Ambulance to Frankfurt, from: Kazan: 1 hr 30 mins daily flights available Aeroflot Moscow: 3 hrs 15 mins nonstop using Learjet 60 Kaliningrad: 1 hr 50 mins daily flights available Aeroflot Saint Petersburg: 4 hrs 15 nonstop using Learjet 60 Special Report: 2018 Soccer/Football Tournament – Russia 4

Designated Medical Facilities

MOSCOW Russia situations near the venues. 125047 The soccer (football) matches in Moscow will Saint Petersburg State Budgetary International Phone +7 495 995 0033 be held in Luzhniki Stadium and Otkritie Healthcare Institution (Санкт-Петербургское Local Phone 495 995 0033 Arena ( Stadium). The closest государственное бюджетное учреждение www.medicina.ru designated medical facilities to the venues, as здравоохранения) Geo-coordinates 55.773579 37.59449 part of the tournament preparation program City Emergency Medical Care Station - Facility Description: Private, Joint Commission for emergencies, are respectively the state- (Городская служба скорой медицинской International (JCI) accredited facility is one of the run hospitals City Clinical Hospital № 1. NI помощи) Pirogov and Botkin Hospital. Private medical best in Moscow offering comprehensive range u.l Small Garden 1/25 facilities in Moscow accustomed to the needs of diagnostic services including CT scan and MRI, as Saint Petersburg, 191023 foreign travelers are also listed for non-emergent well as a wide range of in-and-outpatient services International Phone +7 812 595 80 58 situations. The state hospitals are easier to including invasive cardiology. English is spoken by Emergency Number +7 812 571 45 04 access and the better options for emergent some staff but fluency may vary. Centrally located Local Phone 812 246 60 58 situations near the venues. and is approximately 8 km from Luzhniki Stadium http://03spb.ru City Clinical Hospital № 1. NI Pirogov and approximately 12 km from Spartak stadium. Geo-coordinates 59.935946, 30.339111 (Городская клиническая больница № 1 им. Outpatient Care: Dedicated outpatient clinic. Open Facility Description: Public, multi-specialty Н.И. Пирогова) Monday through Friday, 8am to 9pm, Saturday, facility with 24/7 emergency and ambulance Leninsky Prospect 10 9am to 7pm, and Sunday, 9am to 3pm. English is services. Designated emergency hospital as part Moscow spoken by some staff but fluency may vary. of the tournament preparation program. Located Moscow City approximately 10.5 km from Russia European Medical Center (EMC) Saint Petersburg. Postal Code 344010 5/1 Spiridonievsky Pereulok International Phone +7 499 236 6069 Near Mayakovskaya Station American Medical Clinic Local Phone 499 236 6069 Moscow (Американская Медицинская Клиника) Website http://gkb1.ru Moscow City Geo-coordinates 55.720872 37.598373 78 Moika Embankment Russia Saint Petersburg Facility Description: Public, multi-specialty 123104 Saint Petersburg hospital specializing in emergency medicine, International Phone +7 495 933 66 55 Russia trauma, cardiologic and neurologic cases. Over Local Phone 495 933 66 55 190000 1400-bed capacity. Closest to the Luzhniki www.emcmos.ru International Phone +7 812 740 2090 Stadium, approximately 7 km. Geo-coordinates 55.762043 37.593223 Local Phone 0812 740 2090 Facility Description: Private, multi-specialty facility www.amclinic.ru Botkin Hospital with emergency services available 24/7. Offers Geo-coordinates 59.93036 30.304757 2nd Botkinskiy Proezd 5 inpatient and outpatient services supported Moscow Facility Description: Private, multi-specialty by advanced diagnostic equipment such as facility with emergency and ambulance services Moscow City CT scan. English-speaking staff is available. Russia available 24/7. Equipped with advanced medical EMC has five other clinics in Moscow and has technologies. English speaking staff available. 125284 experience treating expatriates. The above facility International Phone +7 499 490 0303 Located approximately 9 km from Saint- is in Spiridonievsky Pereulok and is located Petersburg stadium. Local Phone 0499 490 0303 approximately 6 km from Luzhniki Stadium and 14 www.botkinmoscow.ru km from Spartak stadium. Outpatient Care: Outpatient services are available Geo-coordinates 55.781392 37.554721 on a walk-in basis. 24/7 clinic. Outpatient Care: Open Monday through Friday, Facility Description: Tertiary, public care 8am to 9pm and on Saturday, 9am to 2pm. House MEDSI - St. Petersburg (Former MEDEM) facility with emergency services available call service and English speaking staff available. 24/7. Specializes in trauma and neurological ulitsa Marata 6 and cardiovascular cases. Equipped with SAINT PETERSBURG Saint Petersburg advanced diagnostic technologies such as CT Saint Petersburg The soccer (football) matches in Saint Petersburg and MRI scans. Close to the Spartak Stadium, Russia will be held at the Krestovsky Stadium. The approximately 9 km. 191025 closest designated medical facility to the venue, International Phone +7 812 643 5195 Outpatient Care: Open Monday through Friday, as part of the tournament preparation program Local Phone 812 643 5195 8am to 7:30pm. for emergencies, is Saint Petersburg State www.medem.ru Budgetary Healthcare Institution City Emergency Geo-coordinates 59.93045 30.35532 JSC Medicina (клиника медицина) Medical Care Station: Private medical facilities Facility Description: Private, multi-specialty facility Second Tverskoy-Yamskoy pereulok, 10 in Saint Petersburg accustomed to the needs of with 24/7 emergency services supported by Near Mayakovski foreign travelers are also listed for non-emergent advanced diagnostic equipment. English speaking Moscow situations. The state hospitals are easier to staff available. Located approximately 10 km from Moscow City access and the better options for emergent Special Report: 2018 Soccer/Football Tournament – Russia 5

Saint Petersburg stadium. and the Sochi City Hospital No. 4 and Trauma Russia Outpatient Care: Offers 24-hour doctor availability Center is an alternate option for emergencies 620102 with house calls service. closer to Sochi city center. International Phone +7 343 351 1697 Local Phone 343 351 1697 Sochi City Hospital No. 4 and Trauma Center www.okb1.ru SAMARA (Городская больница № 4 и Geo-coordinates 56.810414 60.560912 The soccer (football) matches in Samara will травматологический центр) be held at the Samara Arena. The closest Dagomsysskaya Ulitsa, 42 - ул. Дагомысская, 42 Facility Description: Largest hospital in the Ural designated medical facility to the venue, as Central District (Tsentralny Rayon) - Mountain Region and is a regional referral center. part of the tournament preparation program Центральный район Offers in- and outpatient services. Equipped with for emergencies, is Samara Regional Clinic Sochi advanced medical technologies such as CT and Hospital V.D. Seredavina. The Samara City Krasnodar MRI scans. Located approximately 3 km or 12 N.I. Pirogov Clinical Hospital №1 is an alternate Russia minutes from Ekaterinburg Arena. option for emergencies closer to the city center. International Phone +7 8622 61 44 31 Local Phone 8622 61 44 31 KALININGRAD Samara City N.I. Pirogov Clinical Hospital №1 www.gb4sochi.org The soccer (football) matches in Kaliningrad (Городская больница № 1 им. Н. И. Пирогова) Geo-coordinates 43.595051 39.737861 will be held at the Kaliningrad Stadium. The 80 Polevaya Street ул. Полевая, 80 Samara Facility Description: Located in Sochi City is closest designated medical facility to the venue, Samara approximately 17 miles from the Coastal Cluster as part of the tournament preparation program Russia in Adler. Hospital of first choice for any injuries for emergencies, is the Regional Center for 443096 or illnesses occurring in Sochi City or in nearby Medical Prevention and Rehabilitation. This International Phone +7 846 207 2235 Adler at the site of Coastal Cluster venues. facility offers inpatient and outpatient services. Local Phone 0846 207 2235 Transportation to the facility will be by ground Regional Center for Medical Prevention http://en.samara-pirogova.ru/ ambulance provided by the Olympic Medical and Rehabilitation (Центр медицинской Geo-coordinates 53.20402 50.12901 Services, by private ambulance or by helicopter if a профилактики и реабилитации patient requires transfer from the Mountain Cluster. Facility Description: Public, tertiary care facility Калининградской области) ul.Litovsky val, 64-A ул.Литовский вал, 64-А with emergency services available 24/7. Large Adler State Regional Hospital No. 4 ("Adler facility with over 1000-bed capacity. Equipped with Kaliningrad Clinic") (Адлер ГБУЗ Краевая больница №4) Kaliningrad advanced medical technologies. Specializes in Kirov Street, 50 - ул. Кирова, 50 (Sochi) orthopedic and neurosurgical conditions. Located Russia Adler District - Адлерский район (Сочи) 23600 approximately 14 km (30 mins) from Samara Sochi stadium. International Phone +7 401 246 7912 Krasnodar Local Phone 0401 246 7912 Russia http://cmp39.ru/ Samara Regional Clinic Hospital V.D. International Phone +7 8 862 240 05 29 Geo-coordinates 54.70827 20.537495 Seredavina (Самарская областная Local Phone 08 862 240 05 29 клиническая больница имени В. www.sochigb6.mctweb.ru Facility Description: Specializes in Sports Д. Середавина) 159 tashkent Street Geo-coordinates 43.429868, 39.928562 Medicine and Rehab. No ER. Located ул.Ташкентская, 159, approximately 4 km from Kaliningrad Stadium. Samara Facility Description: 345 bed facility. Not to be Samara confused with the Sochi State Clinical Hospital KAZAN No. 4 & Trauma Center in Sochi City. Located Russia The soccer (football) matches in Kazan will in the town of Adler nearest to the site of the 443095 be held at the Kazan Arena. The closest Olympic Coastal Cluster. 24/7 emergency room. International Phone +7 846 956 1260 designated medical facility to the venue, as Designated facility for cardiac services and Local Phone 846 956 1260 part of the tournament preparation program for interventions and surgery. First choice for medical http://sokb.ru/ emergencies, is the Republic Clinical Hospital emergencies in Adler. Geo-coordinates 53.25986 50.24474 #1. Medel is a private outpatient facility that offers Facility Description: Public, tertiary care facility EKATERINBURG general medicine and specialist consultation services. with 24/7 emergency services. Designated The soccer (football) matches in Ekaterinburg emergency hospital as part of the tournament will be held at the Ekaterinburg Arena. The Republic Clinical Hospital #1 preparation program. Located approximately closest designated medical facility to the venue, (ГУЗ Республиканская клиническая больница) 2.9 km from the Samara Arena. as part of the tournament preparation program 138, Orenburgskiy trakt Оренбургский тракт, 138 SOCHI for emergencies, is the Sverdlovsk Regional Clinical Hospital No.1. This facility offers Kazan The soccer (football) games in Sochi will be held inpatient and outpatient services. Tatarstan at the located in city of Russia Adler. The closest designated medical facility to Sverdlovsk Regional Clinical Hospital No. 1 420064 the venue, as part of the tournament preparation (Свердловская областная клиническая International Phone +7 843 231 20 90 program for emergencies, is the Adler State больница №1) Local Phone 843 231 20 90 185 Volgogradskaya Street Regional Hospital No. 4. For traveller in Sochi, http://en.rkbrt.ru/ Ekaterinburg Medline Clinic is recommended for general Geo-coordinates 55.730604 49.18698 Sverdlovsk outpatient care via house call physician services, Special Report: 2018 Soccer/Football Tournament – Russia 6

Facility Description: Multi-specialty hospital Russia NIZHNY NOVGOROD located the South East region of the city. Regarded 400138 The soccer (football) matches in Nizhny as one of the best options for comprehensive International Phone +7 8442 58 1661 Novgorod will be held at the Nizhny Novgorod medical care in Kazan. Hospital has few English Local Phone 08442 58 1661 Stadium. The closest designated medical speaking Physicians and 24/7 emergency room. http://kb25.ru/en/ facility to the venue, as part of the tournament ______Geo-coordinate 48.75992 44.515109 preparation program for emergencies, is the Medel (Многопрофильная Клиника МЕДЕЛ) Facility Description: Public, multi-specialty Regional Clinical Hospital N.A. Semashko. (ГУЗ Республиканская клиническая больница) hospital with emergency services available 17, Adoratskogo str. 24/7. Largest emergency hospital in the city of Regional Clinical Hospital N.A. Semashko Kazan Volgograd with over 800 bed capacity. Specializes (Нижегородская областная клиническая 420126 in trauma, burn and cardiovascular cases. Located больница им.Семашко) Ulitsa Rodionova, 190 International Phone +7 843 520 20 20 approximately 7 km from Volgograd Arena. Local Phone 843 520 20 20 Nizhny Novgorod http://www.medel.ru NIZHNY NOVGOROD 603093 Geo-coordinates 55.830123, 49.144052 International Phone +7 831 432 87 23 The soccer (football) matches in Nizhny Local Phone 831 432 87 23 Facility Description: Private outpatient clinic Novgorod will be held at the Nizhny Novgorod http://www.semashko.nnov.ru located near the Kazan Arena offering general Stadium. The closest designated medical Geo-coordinates 56.310195, 44.077876 medicine and specialist consultation. Open facility to the venue, as part of the tournament Monday-Friday, 8am to 8pm, Saturday 9am to preparation program for emergencies, is the Facility Description: This is a public multi-specialty 5pm. Located 2.8 km from Kazan Arena. Regional Clinical Hospital N.A. Semashko. hospital offering 24/7 emergency services.

SARANSK Regional Clinical Hospital N.A. Semashko (Нижегородская областная клиническая The soccer (football) matches in Saransk will больница им.Семашко) be held at the Mordovia Arena. The closest Ulitsa Rodionova, 190 designated medical facility to the venue, as Nizhny Novgorod part of the tournament preparation program 603093 for emergencies, is the Mordovia Republican International Phone +7 831 432 87 23 Clinical Hospital. Local Phone 831 432 87 23 Mordovia Republican Clinical Hospital http://www.semashko.nnov.ru (Мордовская республиканская клиническая Geo-coordinates 56.310195, 44.077876 больница) Facility Description: This is a public multi-specialty Pobedy Str., 14/5, hospital offering 24/7 emergency services. The Saransk hospital has both medical and surgical capabilities. Mordovia Medical specialties available include neurology, Russia traumatology, general surgery and cardiology. This 430013 is a designated emergency hospital as part of the International Phone +7 8342 76 0097 tournament preparation program. Local Phone 8342 76 0097 http://mrkb.saransk.ru/ ROSTOV ON DON Geo-coordinates 54.207284 45.114217 The soccer (football) matches in Rostov on Don Facility Description: Multi-specialty hospital will be held at the Rostov Arena. The closest with 24/7 emergency services. Specializes designated medical facility to the venue, as in cardiovascular and trauma cases. Located part of the tournament preparation program for approximately 8 km from Mordovia Arena. emergencies, is the Rostov Regional Clinical Hospital. VOLGOGRAD Rostov Regional Clinical Hospital (РОСТОВСКАЯ The soccer (football) games in Volgograd will ОБЛАСТНАЯ КЛИНИЧЕСКАЯ БОЛЬНИЦА) be held at the Volgograd Arena. The closest Western residential area, st. Blessed, 170 designated medical facility to the venue, as Rostov-na-Donu part of the tournament preparation program 344015 for emergencies, is the Mordovia Republican International Phone +7 863 224 79 58 Clinical Hospital. Local Phone 863 224 79 58 City Clinical Emergency Hospital No 25 http://rocb.ru (Городская клиническая больница скорой Geo-coordinates 47.223399, 39.617945 медицинской помощи № 25) Facility Description: Regional referral hospital Zemlyachki Street, 74, with acute surgical capabilities. 24/7 emergency Dzerzhinsky district services. Designated emergency hospital as part Volgograd of the tournament preparation program. Volgograd Special Report: 2018 Soccer/Football Tournament – Russia 7

Security Concerns Crime Crime – Moscow and Saint Petersburg Crime, particularly in the form of petty theft, is the security concern most Individuals traveling to Moscow should exercise caution around the Red likely to affect travelers to Russia. Petty thieves are especially active in Square, the Izmailovsky Market and in stations, as petty crowded areas, such as transportation hubs, tourist attractions and restau- thieves are particularly active in those locations. Additionally, travelers rants. There is a high rate of passport theft in particular. It is also common should avoid the areas outside central Moscow at night to the extent for such criminals to operate in groups of women, teenagers or children possible, as the suburbs areas are less safe than the city center during posing as beggars. Additionally, there have been reports of criminals pos- non-daylight hours. Travelers to Saint Petersburg should avoid the Admiral- ing as police officers and then robbing unsuspecting foreigners. Criminals ty, Frunze, Kirov, Kronstady and Moscow City districts to the extent possible, have also targeted parked vehicles for theft of its contents. as reports indicate that these districts have a high incidence of crime. Pickpockets are also prevalent on Saint Petersburg's main street Nevsky While violent crimes -- including muggings and assaults -- take place in Prospekt. Travelers should avoid traveling at night to the extent possible as Russian cities on occasion, they are less likely to affect foreigners than res- the majority of crimes take place between 2200 and 0300 local time. idents. Such crimes include armed robbery and physical assault. Reports also indicate that criminals may drug travelers’ drinks at bars and nightclubs before physically assaulting them or robbing them. In order to reduce the Terrorism risk of becoming victims of crime, travelers should undertake basic security Terrorism is an ongoing concern in Russia. While the threat is greatest in precautions, including securing valuables and not traveling alone at night. the North Caucuses region -- where a low-level Islamic insurgency has been Criminals will also target foreigners due to perceived affluence, and travel- ongoing since the Second Chechen War (1999-2009) -- Islamic militants ers should therefore avoid ostentatious displays of wealth. have carried out attacks in large urban centers, including cities where tournament matches will take place. Previous attacks in large cities -- such Financial fraud is also a significant concern throughout Russia. ATM tam- as Moscow and Saint Petersburg -- have often targeted transportation hubs. pering, credit card fraud and currency exchange scams have targeted trav- For example, in April 2017 a radicalized Kyrgyz-born Russian citizen deto- elers in the past, and individuals operating to Russia should only exchange nated an explosive device on the , killing 16 people currency at official exchange booths (located in airports, banks and hotels), and injuring another 64. Unconfirmed reports indicated that the attacker should keep their credit cards within sight during all purchases and should only use ATMs located inside banks. Higher-Crime Places in Organized crime groups are present throughout Russia, and these groups Moscow have been known to extort foreign businesspeople in the past; however, this is more of a concern for long-term residents rather than short-term travelers. Organized crime groups have also been responsible for acts of violence in large cities -- including Moscow and Saint Petersburg -- but these incidents rarely target travelers. There have been reports in the past of organized criminals conducting kidnappings for financial, political or other reasons; however, such incidents rarely target foreign travelers and do not occur often.

Ethnically motivated attacks and other hate crimes pose a security concern for travelers throughout Russia, as well. Such attacks can range from verbal harassment to physical assault, which has resulted in death in the past. Travelers operating to Saint Petersburg should be aware that the city typical- ly records some of the highest numbers of hate crimes involving violence Higher-. While homosexuality is not illegal in Russia, a loosely interpreted Districts in law does prohibit the dissemination of homosexual propaganda among Saint Petersburg minors. Authorities have been known to use this law as justification for harassing members of the LGBT community.

Russian hooliganism during the upcoming world soccer tournament matches is a concern. On past occasions, Russian hooligan groups have been involved in clashes with other hooligan groups and with security forces. Reports emerged in 2017 that some Russian hooligan groups planned to explicitly target England supporters at the tournament, calling the tourna- ment “a festival of violence.” While passersby may not be explicitly targeted initially, the clashes pose a significant collateral risk to travelers. Never- theless, the increased security measures that will be in place during the tournament (see Security Measures) along with an ongoing crackdown on soccer hooligans by Russian authorities reduce the risk of major incidents of hooliganism. Special Report: 2018 Soccer/Football Tournament – Russia 8

was acting on behalf of either the Islamic State (IS) or al-Qaeda. In the past, assumption that they are being monitored and should refrain from political terrorists groups have also targeted transportation hubs in Moscow and discussions while in Russia to avoid unwanted attention from authorities. Volgograd, including airports in the capital. Travelers should also ensure that their electronic devices do not contain any sensitive information prior to arriving in Russia. While Russian authorities have stated that reducing the risk of terrorism during the upcoming competition is their major priority, the threat of Anti-Western Sentiment terrorism in all host cities during the tournament remains elevated, as Relations between the West and Russia are tense for various reasons, in- militants often seek to target high-profile events to attract attention to their cluding the crisis in eastern , the subsequent U.S. and EU sanctions cause. Terrorist groups -- including IS -- have already issued explicit threats on Russia, Russia’s involvement in Syria and Russia’s involvement in U.S. to target the tournament. politics. The deterioration in relations has resulted in increased anti-West- ern sentiment. U.S. nationals have primarily felt the effects of the current Russian authorities regularly receive anonymous bomb threats targeting tensions in their encounters with Russian federal authorities. Such senti- various facilities such as airports and shopping centers across the country, ment may also take the form of vandalism or other symbolic acts against including in Moscow, Saint Petersburg and Yekaterinburg. The Russian Western businesses. To date, there have been no reported attacks against government has increased the sentencing penalties for such threats in an Western individuals, and there is no indication that the current situation has effort to deter these actions; however, reports indicate that false threats increased the chances of Westerners suffering physical harm in Russia due continue to occur. Local law enforcement personnel typically evacuates the to their nationality. Nevertheless, actions targeting Western nationals cannot targeted site(s) upon receiving a threat, which could cause delays or disrup- be entirely ruled out. tions for travelers. Stadiums where tournament matches are taking place are potential targets for these actions. Travelers should follow authorities’ instructions and take such threats seriously due to the previously mentioned Security Measures terrorism-related developments. During the tournament, the Russian government has indicated that it will deploy an increased number of security personnel as well as surveillance Demonstrations cameras to areas where fans are likely to congregate -- including stadiums, hotels, transportation hubs and match viewing venues. Media reports indi- Demonstrations take place on occasion throughout Russia, particularly cate that this will include approximately 14,500 private security company in larger cities, such as Moscow and Saint Petersburg. Most demonstra- employees, and authorities also intend to deploy drones to monitor the tions remain peaceful, but the rallies sometimes disrupt traffic and public behavior of fans and combat hooliganism. Units equipped for radiation transportation. Russian authorities have placed restrictions on demonstra- detection will be present at matches to identify explosives designed to tions, subjecting any protests taking place between 25 May-25 July to the disperse radioactive material. Special “tourist police” forces are also being approval of local authorities. These local officials will be able to set the time established. Officers in these forces will speak multiple languages -- such as and place of any protests that are permitted to occur, and it is unlikely that English, French, Spanish or Chinese -- to help assist visitors; however, there they will approve large demonstrations in the geographic vicinity of tourna- are concerns that the size of these forces will be small due to a lack ment matches. On the one hand, this will likely limit the number of protests, of bilingual officers, potentially limiting their utility. but it also makes it more likely that any demonstrations that do occur will turn violent, as security forces typically used force to disperse unauthorized Authorities will restrict traffic and public events -- including demonstrations gatherings. Travelers should avoid all political demonstrations due to the and protests -- around the stadiums where matches will take place, and risk of violence. security services are conducting background checks on all volunteers for the games. National Guard units are also deploying to provide security to Corruption bodies of water near the venues, and Russian military aircraft and surface- Corruption is a major concern throughout Russia. Short-term travelers to-air missiles will be deployed near stadiums to prevent attacks utilizing to the country are most likely to encounter corruption when dealing with hijacked aircraft. Security forces continue to conduct counterterrorism drills police officers or other security personnel, who may attempt to solicit bribes in preparation for the tournament, and Russian security services maintain from foreigners for supposed infractions. Authorities may also harass cooperation with regional and Western European governments despite foreign visitors, especially ethnic minorities and those with nontraditional ongoing international disputes. sexual orientations. If stopped, travelers should ask for the officer’s name and badge number and should make every reasonable effort to resist pay- Authorities will require all tournament attendees to possess both a ticket ing any bribes; however, if travelers are forced to pay a bribe, they should and a fan ID in order to enter any of the host stadiums for a match. Foreign- report all incidents of misconduct to their nearest embassy or consulate. ers with a fan ID will also be permitted to enter Russia without a visa and will be allowed to stay in the country for the duration of the tournament as Espionage Crime well as up to 10 days before the start of the tournament and up to 10 days after the end of the tournament. Nearly all foreigners visiting the host cities Internal security services may monitor travelers upon arrival, including between 25 May and 25 July are required to register at their place of stay in their hotel rooms, and travelers have reporting having their personal with Russia’s Ministry of Interior within 24 hours of arriving at that location. belongings in hotels rooms searched in the past. Travelers should be circumspect when transmitting sensitive information via phone, internet or other methods, as the government frequently conducts espionage against citizens and foreigners alike via communications systems. Authorities have the ability to monitor all internet usage, emails, phone calls (both land and cellular), text messages and faxes that take place in the country and store this information for up to three years. Travelers should operate under the Special Report: 2018 Soccer/Football Tournament – Russia 9

Airports Transportation

All host cities are equipped with at least one airport available for servicing Despite the availability of numerous modes of transportation, secure trans- passengers during the tournament, and authorities have stated that an portation is recommended for all ground travel within Russia due to the increased number of flights will be available between these cities through- threats of petty crime and terrorism associated with public transportation. out the tournament. However, eight airports -- Sochi International Airport Most major cities have extensive public transportation systems that often (URSS/AER), Krasnodar International Airport (URKK/KRR), Anapa Inter- include a metro (subway), , minibuses, and in some cities, local national Airport (URKA/AAQ), Koltsovo Airport (USSS/SVX), Kurumoch commuter trains. Visitors to Russia who possess both a match ticket and International Airport (UWWW/KUF), Strigino Airport (UWGG/GOJ), Platov a fan ID will be able to utilize special inter-city trains for free; however, they International Airport (URRP/ROV) and Airport (URKG/GDZ) -- must register ahead of time, and only trains set to operate for their match in the vicinity of host cities are currently operated by companies that the will be free. Host cities will provide free public transportation on match days. U.S. sanctions, and travelers attempting to travel to those airports may have Additional public transportation routes will operate throughout these cities difficulty finding an international carrier operating to those facilities. Travel- during the tournament as well, with many of the routes connecting passen- ers may encounter corruption issues (see Security Concerns) when dealing gers to stadiums, airports and major public transportation centers within with airport employees. There have been reports in the past of customs each city. Travelers should exercise caution if utilizing public transportation and immigration personnel requesting bribes from passengers, as well as due to the prevalence of criminal activity and the threat of terrorism (see incidents of theft by airport security personnel. Security Concerns).

Moscow -- the host city that is expected to receive the largest number of While taxis are widely available, travelers should only use official taxis that visitors during the tournament -- has three major international airports: they have called in advance to reduce the risk of becoming victims of theft, Domodedovo International Airport (UUDD/DME), Sheremetyevo Internation- extortion, assault, robbery and kidnapping. Even with official taxis, travelers al Airport (UUEE/SVO) and Vnukovo International Airport (UUWW/VKO). may still encounter language barriers, and drivers may not always use me- Domodedovo International Airport is located approximately 40 km (25 mi) ters. Travelers should always agree on the fare before accepting a ride, and south of the city center, and the journey into the city takes approximately travelers should be aware that resisting payment after the trip, or attempting 1-1.5 hours by car. Sheremetyevo International Airport is located approxi- to renegotiate the fare, will increase to the probability of an escalation in mately 28 km (17 mi) north of the city, and the journey takes approximately security threats. Travelers should never share a cab with a stranger, as this 1 hour by car. Vnukovo International Airport is located 28 km (17 mi) west poses significant security concerns as well. of the city, and the journey takes approximately 1 hour by car. Trains, city buses, minibuses, taxis and rental cars are available for transportation Travelers should avoid self-driving in Russia due to generally poor road between each of these airports and Moscow. conditions, the dangerous driving habits of locals and to avoid contact with traffic police officers, who are often corrupt. Additionally, traffic will be (ULLI/LED) services Saint Petersburg, where the second restricted in and around stadiums on match days (see Security Measures), largest number of matches will take place, including one semifinal and the likely making self-driving more complicated and inconvenient. third-place match. The airport is located approximately 20 km (12 mi) south of , and the journey takes approximately 30-40 minutes by car. Buses, taxis and rental cars are available for transportation from the airport into the city.

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