Dmitry Aleshkovsky helps carry a donated cabinet into the neglected hospital in the onetime farming village of Itomlya, 160 miles northwest of Moscow. Volunteers organized by Aleshkovsky are trying to keep the hospital going. (Will Englund/WASHINGTON POST)

A country doctor, a tiny, dilapidated village hospital, an indifferent health bureaucracy — and now, coming to the rescue, volunteers from distant Moscow, bringing furniture, equipment, money and, maybe most important, good cheer.

In the background, though, is the parliament — weighing a law to bring any volunteer activity under the purview of the state, on the theory that people who organize themselves to do good work are a threat to the state’s power.

The past year or so has seen an upwelling of a trend unprecedented in Russia — people getting together on their own to help others in need. Personal initiative, always suspect here, is suddenly taking off. Drivers deliver medicine to shut-ins. Women cook meals for hospitals. Volunteers use rubles and hammers to renovate shelters for battered women, teenage orphans and abandoned pets.

And here in Itomlya, a decaying farm village a five-hour drive west of Moscow, a group of young men led by Dmitry Aleshkovsky, a former news photographer, is trying to help save a 15-bed hospital.

“If I can help, it will show people they can help, too — that it’s time to stop sitting around and doing nothing,” he said. “I put my little brick in the wall.”

Dr. Sergei Vishnyakov, 55, has run the 15-bed hospital in the village of Itomlya ever since he was assigned there by Soviet health authorities in 1981. (Will Englund/WASHINGTON POST)

The rapid emergence of volunteer efforts, fueled in large part by social media, coincides with the eruption of public political protest — and that’s not by happenstance. There is an overlap between the political opposition and those who have become fed up with a corrupt government that delivers little and who have decided to take matters into their own hands.

Legislation to regulate volunteers has been introduced in the State Duma, or lower house of parliament, by President Vladimir Putin’s United Russia party. Backers say it will ensure that volunteer activity conforms to the government’s priorities and doesn’t conflict with Kremlin policy.

Officials aren’t the only ones hostile to volunteerism. Russia’s Soviet past, when the government controlled all aspects of life, has left it with a population that is accustomed to the idea that the government should provide for its citizens and that is suspicious of volunteer organizations. A 2012 poll found that more than half the population disapproves of them, said Boris Dubin, a sociologist with the Levada Center in Moscow.

The legislation reflects “an absolute lack of understanding of the whole nature of the social phenomenon,” said Yevgeny Grekov, who helps run a drivers group called Volunteers on Wheels. It’s a Facebook community where people with needs and drivers who want to help can find one another.

“They want volunteers to be walking in columns and support the authorities,” Grekov said. “But programs such as ours have no lists. If you want to help, well, help.”

The drivers help all kinds of people. Say a group has gathered toys and equipment for an orphanage but has no transportation. Volunteers deliver the items.

Periodically, someone will drive a doctor to Kaluga, three hours south of Moscow, to see a patient who requires a specialist’s attention. A babushka has to come to Moscow for surgery: They’ll pick her up at the airport or train station. Actors need scenery transported for a charity performance.

“This is our theory of small deeds,” Grekov said. “I’m really in love with this project. It’s pure human energy.”

A volunteer group called Tugeza, which is an approximation in Russian of the English word “together,” has grown in two years to include 3,000 members on Facebook. Oksana Prikhodko first got involved in volunteer work with cystic fibrosis patients, because her daughter has the disease. She found she liked helping people so much that she has moved on to other causes.

She has worked on a support group for a teenage shelter in Pskov, nearly 500 miles from Moscow. And, most Friday evenings, she gets together with a dozen or so other women and cooks hearty meals for a children’s hospital — which Volunteers on Wheels deliver.

“We’re people who love cooking,” she said. “We want to do this. So we do — together.”

There’s a tension, though, that won’t go away. “Why should we do the state’s job for it?” Prikhodko asked. “On the other hand, why should our children suffer? It’s a constant debate, and we’re always on the edge.”

‘A light in the darkness’

Aleshkovsky, the former news photographer, heard about the hospital in Itomlya from friends of friends. The Health Ministry plans to downgrade it to a recovery center, where no treatment could be offered. The hospital serves a district of 112 villages, or about 3,000 residents. The next-nearest hospital is 30 miles away, in the city of Rzhev. A bus goes there — on Saturdays and Sundays.

Sergei Vishnyakov, 55, has been the sole doctor in Itomlya since 1981, when he was assigned there fresh out of medical school. Although the hospital has an annual budget of about $25,000, which includes his salary, Vishnyakov has come to love his work. He knows all the families in Itomlya and supplements his pay with home-grown potatoes, pickles and about 20 chickens.

The hospital was set up in Soviet times to serve the huge collective farm that included Itomlya and the surrounding district. Workers grew flax here, but the farm has closed, the fields now full of saplings. Most of the men who haven’t taken up illegal logging have drifted to Moscow in search of work.

Mechanical accidents used to be a major contributor to Vishnyakov’s workload. Now it’s alcoholism and the infirmities of age.

“This hospital is like a light in the darkness for us,” said Alexandra Tikhomirova, 72, who had been admitted with dizziness three days earlier and was staying on in a cramped ward because a recent snowfall had made it too hard for her to return home.

“I can’t leave my patients,” Vishnyakov said. “I know all of them. They’re like my family.”

Aleshkovsky, 27, arrived leading a group of volunteers who brought a vanload of donated furniture from Moscow.

“Thank God we now have such young people in Russia,” the doctor said. “I think they will be able to stir the society and make the authorities listen to them.”

A deep lack of trust

The authorities have been clear about their hostility toward volunteer work. In 2010, after deep cuts in the forest service, volunteers tried to help put out peat fires that sent choking smoke throughout much of European Russia. Police stopped them, some volunteers reported on social media, demanding bribes to let them through.

A group called Liza Alert was organized to conduct volunteer searches for missing people when it became clear that the police weren’t interested in doing so. After more than a year of trying, the group’s leaders have won grudging indifference from the police, and sometimes cooperation, said Irina Vorobieva, one of the organizers, a change from the outright interference they faced at first.

This month, in the town of Domodedovo, just outside Moscow, police raided a group house for homeless people that had been set up by worshipers at St. Damian’s church in Moscow. “We’re not going to have you in our community,” project leader Emil Sosinsky said he was told by one of the officers.

Residents, who must work as construction laborers or floor-washers, contribute money toward the house’s upkeep. Sosinsky said he thinks authorities police are trying to build a case to charge him with running an illegal business. Homeless people, he said, make a tempting target for a crackdown.

Volunteer organizers said most of the resistance they encounter from officials is more subtle than that, in the form of bureaucratic delays or simple lack of cooperation. But it’s impossible to quantify. For one thing, many volunteer groups, like Grekov’s, make a point of not formally organizing so they can avoid legal complications. That makes it less likely that they would report obstructionism — even if there were some person or agency to report it to.

Aleshkovsky, who has been helping half a dozen other worthy causes through a Web site he set up, said it’s likely the Duma will pass the law on volunteers. So he has been lobbying to water down some of its harshest features. That leaves him open to criticism from the political opposition, which is against the bill.

“I cannot be choosing sides,” he said. “I will sit down with the devil to keep this hospital. Look, we’re in the abyss. But to get out, we’ll have to build a staircase. Protesting against Putin is not enough. People should do something, not just against Putin, but for themselves.”

Grekov, of the drivers group, said Russia suffers from a lack of trust among its people. It can’t have a real civil society without such trust, he said, and it can’t have true democracy without civil society.

He described his program as a model of civic behavior that he hopes will be instructive.

“It is sad for us, because we know we could be a thousand times better than we are,” he said. “But we are better than we were yesterday. The speed is slow.”

Lally reported from Moscow.