SCIENTIFIC - MEDICINE

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80-00809A000600120017-0
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 12
• Document Creation Date: December 22, 2016
• Document Release Date: May 19, 2011
• Sequence Number: 17
• Publication Date: December 4, 1956
• Content Type: REPORT

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Uchebnik dl a meditsinskikh sester
Textbook for Nurses/, M. S. Ikhteyman,
1949, Leningrad, Pages 346-354
FUNDAMENTALS OF SOVIET PUBLIC HEALTH
Article 122 of the Constitution guarantees governmental protection of
the interests of mothers and children by placing at the disposal of
pregnant woman sick leave with the retention of maintenance, a network of
maternity homes, creches, and kindergartens, consultation offices, dairy
kitchens, and also material aid to mothers with many children. Thanks
to this, the Soviet woman has obtained the possibility of combining pro-
ductive work with the fulfillment of maternal duties.
the expense of the state, gratis medical aid to the workers, and the
placing at their disposal of a broad network of health resorts."
fundamental law of the country, the protection of the health of the
population is accomplished and conducted at the expense of the state.
Article 120 of the Constitution of the USSR reads: "Citizens of
the USSR have the right to material provision for old age, and also in
the case of disease and loss of work capacity. This right is provided
by a wide development of social insurance for workers and employees at
Article 119 of the Constitution guarantees to citizens of the USSR
the right to rest; its significance for the stren3thening of health is
evident. This righ is -nsured by the establishment of annual vacations
with the retention of work pay, the placing at the disposal of the workers
a wide network of sanatoria, homes of rest, etc.
Public health in the USSR is one of the most important areas of
socialist building. The organs of public health in their pra:tical
work are directed by the positions set forth in the program of the All-
Union Cosmiunist Party (Bolsheviks) adopted at the Eighth Congress of the
Party in 1919.
"At the basis of its activity in the area of the protection of public
health the Party places, first of all, the conduct of wide sanitizing and
sanitary measures having the object of preventing the development of
diseases. In accordance with this the Party sets as its proximate tasks:
"(1) the decisive conduct of wide sanitary measures in the interests
of the workers, i.e.: (a) sanitisation of settled places (the protection
of the soil, water, and air); (b) the setting up of public nutrition on
scientific-hygienic principles; (c) the organization of measures prevent-
ing the draelopesent and spread of infectious diseases; (d) the creation
of sanitary legislation;
"(2) the struggle against social diseases (tuberculosis, venereal
disease, alcoholisa, etc);
"(3) the provision of generally accessible, gratis, and competent
therapeutic and medicinal aid."
THE BASES AND ORGANIZATION OF SOVIET PUBLIC HEALTH
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sanitary education, besides the communication of fundamental information
pertaining to hygiene, is the inculcation of hygienic habits among the
population. It is necessary to strive for conditions whereby people
will not begin to eat without washing their hands preliminarily, will not
drink raw water from a suspected water source in the field, in spite of
thirst, etc.
All medical workers are obliged to participate in sanitary-educational
The forms of sanitary-educational work are diverse. In it, depending
upon the situation, are applied both the spoken-word (lecture, report,
conversation, evening of questions and answers), and printed sanitary
propaganda (pamphlet, leaflet, newspaper, box of questions and blackboard
of answers), and graphic agitation (displays, show cases, the use of
the theater and movies).
The independent activity of the pope ation is manifested in various
forms. Attached to hospitals, dispensaries, schools; creches, and others
ar active group is organized which aids in improving the work of these
institutions. From the active group are put forward public sanitary
inspectors and sanitary representatives who are selected by the collect-
ives of the collective farms, institutions, house managements, trade
unions, and Red Cross organizations. They see to the cleanliness of
courts, dwellings, dining rooms, wells, baths, toilets, immediately
communicate to the area physician concerning those individuals suspected
of infection with acute diseases and in general aid in conducting pre-
ventitive measures against infectious diseases.
The voluntary Red Cross and Red Crescent Societies render great aid.
In the collective farms and state farms, on enterprises and homes, they
organize sanitary posts which work under the direction of medical workers.
These same voluntary societies prepare thousands of nurses and sanitary
teams, organize GSO ("Ready for Sanitary Defense") circles and for young
school children BGSO ("Be Prepared for Sanitary Defense") circles. The
public health section of the local soviet consisting of the deputies of the
soviet and medical workers, is the organiser and director of this entire
lower public-health group. It observes the work of the medical insti-
tutions and authorizes fundamental tasks of public health (in the rayon,
city, oblast).
At the present time bed aid is rendered in a network of hospital
institutions which are available in our country both in cities and in
the village.
Article 507
The secondary medical personnel of hospitals includes the senior nurse,
hostess nurse, ward muses; operating room attendants, diet nurses, et al.
To what has been said in the division "Care" concerning the peculiarities
of the work of the nurse 'lrtieles 402, 403, 406, 440) we shall add little
here. The nurse is the closest assistant of the physician. In carrying
out the Stalinist. concern with regard to the individual person:, the nurses
often have shown an example of heroism and exceptional selflessness on
the field of battle and in the hospital. Alleviating the suffering of
the wounded with her attentive care, her cordiality and sympathetic word,
the nurse can win the complete confidence of the patient who will be
related to her, both as to a kindred person and as to a sister. However,
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they should not indulge the capricious demands of pati~-rts? but rather
should courteously but firmly decline them. The patients wish to hear
that their position is not dangerous; knowing this, the nurse should
suggest to the patients that they do everything which is necessary for
the most rapid recovery. In the presence of the patients she should not
complain of any defects in the hospital life and .situation, since this
acts depressingly on the patients. Cleanly and neatly clothed, she should
always retain an affable appearance, of whatever sort may be her personal
experiences, in order that her external appearance may act soothingly on
the patients. if, besides a knowledge of her job and skilful hands, the
tact ant t.^...iling of the na#.''sarv#.a.
nurse knows how to .i_cii:ruiiu.:d ta~.~ .~.~.," t?h?_ ?--~-----o __ __._ _ _ _
then she readily wins common sympathy, and her word becomes law for the
patients.
Article 08
The patient, being admitted to the hospital, first of all is received
by the casualty ward where he is examined by the duty physician. Here
it is determined to which division he is to be sent. In the casualty
ward the patient is subjected to sanitary treatment and his clothing is
sent to a disinfection chamber. In the ward the interne fills out the
history of the disease. The nurses should see to the observation of the
routine of the day (the approximate routine in hospitals is as follows:
at 0700 hrs -- the measurement of temperature, cleaning of the room, the
toilet of the patient; 0900 hrs -- the morning breakfast; from 1000 to
1300 hrs -- rounds of the physicians and carrying out of procedures; from
1300 to 1400 hrs - dinner; from 1400 to 1600 hrs - rest; 1600 hrs -
evening tea; from 1600 to 1800 hrs - measurement of temperature, carrying
out of procedures and prescriptions; at 2000 hrs - supper; and 2200 hrs
-- sleep).
Article 509
Out-patient aid is rendered to the population fundamentally by poly-
clinics (calculated to serve more than 50 thousand people) and ambulatoria
(serving 7 to 10 thousand people). Besides them-the institutions of out-
patient aid include dispensaries, malaria stations, dental and other
specialized ambulatoris, trachoma and other points; at enterprises --
health points and medical assistant medical points, closed factory-plant
polyclinics and ambulatoria.
Out-patient aid is set up on the area principle. The rayon of activity
of the polyclinic or ambulatorium is divided into areas; the population of
each area is served by a definite area physician-therapist not only in the
ambulatorium, but also at home (the physician takes up a part of his
working day with ambulatorium patients and in the remaining hours visits
patients at home). In the presence of such a system of serving the
patient, independently of whether or not he comes to the polyclinic or
summons the physician at hams, is always treated by one and the same
physician and the physician can study his patients well, can familiarize
himself with the conditions of their work and life, and can become the
actual organizer of sanitisation of that area in which he works.
In agreement with the latest indications of the Ministry of Public
Health USSR, polyclinics, ambulatoria, and hospitals are organizationally
united in order better and more full, i.v a*z=va %o r~%r~%i Lice
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The entire medical personnel of the ambulatorium, polyclinic, and
the hospital, together with the active group, is involved in sanitary
prophylactic work at the area (preventitive inoculations, detection of
bacillus carriers -- Article 249 -- and their treatment, sanitary-
educational work, et al). All this work is conducted according to a
concrete plan which is compiled by the physician depending on morbidity
in the rayon, on the sanitary state of the objectives (schools, enter--
prises, public places, etc), the time of year, etc. Depending on the
active group, the area physician and the nurse conduct a struggle for
cleanliness, and also inspection or the sanitary state or aweiiings,
courts, and other measures. In the presence of each outbreak of acutely
infectious diseases it is necessary to conduct daily house-to-house
rounds of the area for the detection and timely hospitalization of
patients, for the inspection of the sanitary state of the dwellings,
the conduct of sanitary treatment of the individuals surrounding the
patient, and of their belongings.
Article 510
Before the Great October Revolution dispensaries were enumerated
in units; at the present time the number of tuberculosis, dermo-venerologi-
cal, psychoneurological, oncological (for the struggle against cancer)
and trachoma dispensaries in the USSR. exceeds 3,000. The dispensary tries
to detect patients in the earliest possible period of the disease, when
the patient, still not considering himself sick, does not turn to medical
aid. The early detection of patients is achieved by periodical medical
examinations of various groups of the population (school children,
juvenile workers, youths undergoing premilitary training, workers of
dining halls, bath-house attendants, et al). Having detected and taken
into account the patient, the dispensary does not limit itself to the
rendering of medical aid; it does not let a patient out of its field of
vision until the most final treatment and remembers the patient whose
treatment is not completed, when he should appear for repetition of the
treatment, for repeated investigation, etc. The matter of detecting
patients is alleviated by obligatory notification concerning each case of
disease (tuberculosis, syphilis, trachoma, cancer) which is sent to the
appropriate dispensary by the physicians of the polyclinics and ambulat-
oria. With the aid of the "patron" nurses the dispensary e-azsines the
families of those who have been sick and individuals who have been in
close contact with the patient (e.g., those who live with his in one
room) and detects the individual from wk'om the patient was infected (the
source of infection), conducting a compulsory treatment of those who
refuse treatment. Having familiarised itself with the conditions of work
and life of the patient, the dispensary, besides specialized therapeutic
ai.d, can send the patient to a sanatorium, woodland school, sanitizatioc
area, attach him to a dietic dining hail, obtain by petition through the
rayon soviet supplementary living area, obtain from the administration of
the enterprises transfer of the patient to lighter work, etc. It is
important that the "patron" nnraw by demonstration instruct the patient
how to sanitise the dwelling and general conditions of his life. The
dispensary conducts wide sanitary-educational work, directing attention
to measures of prophylaxis (details in Part II).
Article 511
Health point.(at industrial enterprises, in transport, attached to
machine-tractor stations) conduct observation for the sanitary state of
the enterprise and its living institutions (dining, shower rooms, toilets,
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etc), render first aid in the presence of traumata and acute diseases,
select those needing sanatorium treatment, dietic feeding, etc. For
rendering preliminary first aid in the absence of medical personnel
there should be individuals in each shop who have mastered the methods
of rendering first aid. Such persons may be members of sanitary posts,
members of the Red Gross and Red Crescent Societies, those who have
passed the norms of the GSO, and other specially instructed individuals
from the younger technical personnel. Upon the rendering of first aid,
the health point sewndn the casualty to a therapeutic institution. The
workers of particularly dangerous occupations are subjected to periodical
medical examinations, and, if it is necessary, a petition is presented
concerning transfer to other work or concerning application for special
treatment. In the presence of an increase in the number of traumata,
in the presence of an increase in the number of cases of temporary
inability to work, the heal?h point, jointly with the polyclinic and the
administration, compiles a plan of measures pertaining to the lowering
of morbidity and traumatism. In enterprises where there is no special
industrial-sanitary physician, the health point observes the state of
the ventilation, illumination, the state of the protective devices, etc.
Leaning on the active group, the health point conducts antiepidemic
measures (preventitive inoculations and others)'and sanitary-educational
work.
Article 512
In the USSR sanitary affairs are conducted by the State sanitary
inspectorate of the USSR, included in the composition of the Ministry of
Public Health USSR. In accordance with .he administrative construction
of the USSR, there are republican, c5last, and kray sections of the
Gossaninspeltsii state sanitary inspectorate, and in the rayonal center
-- the rayonal gossaninspector State sanitary inspector. The sphere of
authority of the Gossaninapelctsii includes the sanitary inspection and
control for the fulfillment of the existing sanitary norms and rules (they
are discussed in the "Bygienen division), the working out of new general-
obligatory sanitary normatives, control for the work of the sanitary
service of all departments, sanitary protection of t.re frontw.ars of the
USSR. The following divisions of the sanitary inspectorate are distin-
guished: (1) dwelling-communal, (2) food, (3) industrial-sanitary, (4)
sehoo'. The jurisdiction of the diwl-communal sanitation division
includes the communal cleaning of cities, the sanitary protection of the
sources of water supply with the establishment of zones (Article 346) of
sanitary protection of the water lines, laboratory control for the
quality of water, observation for the cleaning up of sewage, control for
the fulfillment of sanitary norms of dwelling, school, and public con-
struction, for the work of the communal institutions (water lines, sewage
works, baths, laundries, hairdressers), and their aaniwary .tenarca.
The jurisdiction of the food sanitation division includes places of
the production, sale, and use of food products with observation for the
quality of the latter and the prevention of food poisoning. Found under
its control is the activity of the sanitary inspectorates which are
attached to the ministries of food industry.
The :t_
LriBi-Oat.a Ma'y ....,.. =~. =-r-------
The yr,Qys e
of enterprises for observation of the established norms and decrees in
relation to ventilation, illumdnation, the struggle against dust,
against increased moisture, temperature, noise, and other unhealtlp
production work conditions, for the timely issue to the workers of working
clothes and special protective devices.
-6-
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Falling under the supervision of the school-sanitary inspe,:torate
are children's therapestt:!c-educational therapeutic-prophylactic insti-
tutions (schools, kindergartens, children's therapeutic-prophylactic
ambulatoria, etc).
There are rayonal or interrayonal (one for several rayons) sanitary-
epidemiological stations to ensure sanitary-epidemiological work. Each
of them includes a sanitary-bacteriological laboratory (for the production
of AAn iit.Ary nnri }~a ::
rater ..l -.n..~....1 ..ly eat
-G-v....r. 'u.ayy {Yqb f, O uilifiLUQ;-.c~n point KJ.Zn
disinfection installations, an inoculation point
a milk-control
,
station, and a sanitary education point with a mobile sanitary-educational
display
.
Article 513
For the antiepidemic organization, see the division "Infectious
Diseases," Article 131, and further in Part II on the measures pertaining
to the struggle against infectious diseases and the successes achieved.
Special antiepidemic work (vaccination against smallpox, typhoid
fever, dysentery, diphtheria, measles, sometimes also typhus
the
,
detection and treatment of bacillus carriers and others) is conducted and"
planned in the ministries of public health by the antiepidemic adminis-
trations and the divisions in the kray and oblast public health divisions
(in the rayon by the rayon epidemiologists). In a rural medical area
this work is organized by the area physician With the aid of the sanitary
medical assistant, the smallpox inoculators, and the disinfectoos. For
the struggle against malaria ;.here are malaria stations, malaria points,
and others; for the struggle against other infections a special network
is created: Pasteur stations for the struggle against rabies; brucellosis
stations, et al. (see Part II).
The importance of the house-to-house rounds of dwelling buildings
which are being conducted by the secondary medical personnel and the
sanitary active group when infectious diseases appear was discussed above.
Article 514
In the prerevolutionary period Russia was distinguished by the
high. mortality of breast-fed- (up to one year of age) infants. (Of 100
babies' who were born in 1916,-22 died in the very first year of life in
Moscow, and 28 in Petrograd which exceeded by a factor of 3 the mortality
of'breast-fed children in Norway). This is explained by the severe
living conditions of the workers and peasants in tsarist Russia. Old
midwives, the chief advisers of inexperienced mothers, often did not
kuuw that early feeding of the children with porridge was harmful.
Children were also born weak on account of the fact that pregnant women
continued to perform heavy labor in enterprises right up to the inception
of birth, and after birth under the conditions of that time were not
able to be freed from work to !Need the children. In -.hose cases in
which the father left the pregnant women to the mercy of fate, the
"illegitimate"child, abandoned by the mother, was received by a fotndling
home where the mortality as a consequence of the poor care reached 90%.
ifter the
.a.ar~a e-??-l, myolIILi~ the 30vieL
war potter conducted
a series of measures which led to the sharp lowering of the infantile
mortality.
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measures ensuring to the woman full-value fulfillment of her most
important function of maternity, the possibility of the normal rearing
of children, and creating for her the best conditions for participation
in the productive and public life of the country.
Article 122 of the Stalinist Constitution puts at the disposal of
the woman equal rights with men in work, in remuneration for work, and
by Soviet legislation pertaining to the work of pregnant women, social
insurance, obligatory leave of absence for mothers of 35 days before
birth and 42 days after birth.
infancy the decree of the government of 27 June 1936 concerning the for-
bidding of abortions and the intensification of material and legal aid
to mothers has great significance. Subsequent concern of the Soviet
power concerning mothers and children is reflected in the Decree of 8
July 1944 concerning the increase of the exemption from taxes for
pregnant women and mothers, extending the network of institutions for
the protection of maternity and infancy, and the introduction of'the
honorary title of "Mother Heroine," the order of "Maternal Glory," and
the medal "Medal of Maternity."
While in prerevolutionary Russia there were enumerated. no more than
40 institutions of the consultation room type, which besides were of a
semiphilanthropic character, in the USSR a mighty network of institutions
for protection of maternity and infancy, embracing the entire population,
has been created. The fundamental institutions are: (1) women's
consultation rooms with "patron" care of pregnant women and women. in
childbirth, (2) children's consultation rooms with the "patron" care of
children (when they are present a dairy kitchen is also organized), (3)
maternity institutions of various types (obstetrical point, collective
farm maternity home, maternity home, maternity division of a general
hospital). Here too must be included creches of various types, houses
of rest of mother and child, and others.
The woman's consultation room works according to the dispensary
method (Article 510). It conducts active observction of the pregnant
woman, familiarizes-her with the hygiene of pregnancy (Part II, Article
457), prepares her for the duties of a mother, instructing her in the
care of the breast-fed child. On the very first visit of the pregnant
woman the obstetrician, therapist, venerologist, and dentist investigate
her; the data of their examination are put on a special list; here too
are recorded the results of an investigation of the blood by the Wasser-
mann reaction and an analysis of the urine. Subsequently the pregnant
woman visits the consuiteLiv6 ruca no less than once a month.
Achieved thanks to this is the possibility of detecting cases of
abnormally proceeding pregnancy, latent syphilis, and kidney diseases,
which detection is important for the prevention of complications in
birth (Part II, Article 473). All such cases are taken into account.
When necessary, the consultation room sends the patient for treatment
to the corresponding polyclinic or dispensary which, besides treatment,
ahop1A aege~rriine tr the line of shit" ~-edue t ,cn ,~ work --1.'~:~. :~.
the population the task of the consultation roams. With the aid of lec-
tures, conversations, reports, the consultation room tries to attract
to itself all those pregnant woman who live in the rayon, and, in parti_M+lar,
to explain the detrimental effect of abortion on the health of ir..sa.
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home with an accompanying chart on which is noted all that merits the
attention on the part of the physician of the maternity home.
Mothers, particularly solitary mothers left by their husbands in the
period of pregnancy, need legal protection, which is provided by having
avai3 able in the consultation room a social-legal office It aids the
woman to obtain aid according to the number of children she has, exacts
xlimnny_ nht.r,inx_ it it. is oaf-AsItArv hwr t-rsrsfer to ether werk, puts
at her disposal leave of absence or aids. Thanks to such aid, a mother
even in the presence of severe family and living conditions does not feel
alone, begins to be accustomed to the child, and abandons the thought
The social-legal offices in their work lean on "patronft care? How-
ever, women are also given "patron" care upon medical indications. The
obstetrician-gynecologist working in the consultation room selects
such women (in the first place those suffering with habitual abortion
or to whom the production of an abortion has been refused, primiparae,
single women, et al. "Patron" nurses verify whether the woman is ful-
filling the prescription of the physician, aid her to master sanitary-
hygienic habits, instruct her in the care of children
Article 516
For the struggle against abortions, Soviet law forbids abortions,
since abortion causes harm to a healthy woman.
Liable to criminal prosecution for abortion is not only the physician
or other person who has conducted the abortion, but also that person
who led the woman to commit artificial interruption of pregnancy. Only
in those cases in which the prolongation of pregnancy to the normal period
threatens the life or threatens severe loss of health to the pregnant
woman, or in th" presence of a severe disease transmittable by heredity,
is artificial interruption of pregnancy permitted in the hospital and
maternity home situation (this is abortion upon medical indications), but
only when this necessity has been established as valid by a special
commission. For a pregnant woman to whom the commission has refused
abortion, and also for women who have appeared for establishing the fact
of pregnan , and subsequently have ceased to visit the consultation room,
the last /he consultation roof should establish observation for the
prevention of secret abortions.
Article 517
With respect to maternity homes and maternity divisions of hos-
pitals at the present time maternity aid in the large cities of our
country embraces 100% of births. Loh woman newly arriving at the
maternity home passes through a pre-review room or "filter" where she
is subjected to questioning and superiioial inspection; hence she is
sent to the review ward of the normal division. (In the presence of a
temperature above 37.5? C and in the presence of any infection the woman
is sent to a doubtful or septic division). (Sepsis is general infection
of the organism (see Part II, Article 244).) In the review ward an
external investigation and sanitary treatment is conducted and then the
woman is transferred to a prenatal ward where she is left until the
birth goes from the maternity ward to the postnatal ward ordinarily for
8 days before discharge (in the case of complications in the postnatal
period or in the presence of acute disease of the child the discharge is
delayed). With the object of protecting now mothers against infection,
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visiting them in the maternity home is not permitted.
Article 518
The children's consultation room represents a dispensary for children
of breast-fed or early infpntile age. Into its tasks enter: (1) obser-
vation for the development of the child up to 3 years of age, (2) the
prescr;rtio of the correct feeding (breast feeding is propagandized),
(3) inculcation of the mothers with hygienic habits via sanitary-educational
care and feeding of the child, lectures pertaining to care with practical
drills) and the struggle against prejudices (fear of fresh air, etc),
(4) the supply from the dairy kitchen which-is attached to the consulta-
tion room of milk mixtures, sterilized milk, ate, (5) the rendering of
therapeutic aid to children up to 3 years of age by physician-specialists
for all diseases, the production of preventitivv inoculations against
smallpox, diphtheria, and measles. The childrenta consultation room,
having obtained from the maternity home information concerning the
newborn, sends a "patron" nurse to the latter. She not only teaches the
mother care for the child, but also tries to aid her in the solution of
material conditions of life problems. The "patron" nurse should strive
that in the first 3 months of the life of the child the mother should
bring it to the consultation room no less than twice a month; after 6
months once a month; and after a year once in 2 months.
If the mother on account of disease cannot breast-feed, then the
child is supplied with human breast ilk from the collection of breast
milk available at the consultation point which is drawn off from women
having excess milk not needed for their own child. The rayon attached
to the consultation room is divided into individual areas, and each area
is serviced by an individual physician and one or 2 "patron" nurses.
Thus both at home and at the ambulatorium the child up to 3 years of age
is treated by one and the same physician.
Article 519
In the construction of consultation rooms, it is necessary to
reason out measures for protecting children against accidental infection
with infectious diseases from sick children. The con">>>trtion room has
separate rooms with individual entrances for thL re__r_ion r healthy
and sick children. Near the entrance to the consultation room there is
a "filter" where the nurse on duty inspects the c:arna.L integument and
pharynx of the child, measures the temperature, and only after this admits
it into the common waiting room. See Part II, Article 134, on the
construction of boxes 5666-
Weakened children, premature children, twins, and groups of children
particularly threatened as regards summer diarrhea are i.akeu into special
consideration and are all the time under the observation of a "patron"
nurse and the area physician.
In the social-legal office (see above) the lawyer also conducts a
struggle against neglect of children of an early age.
Article 520
Lenin early noted that "the building of a socialist economy can be
further advanced when millions and millions of women will take part in
it." But in order for woman to enter into production, she must know that
there are well organised creches for her children. It is clear from what
has been said, that creches are not narrowly a medical, but a social
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institution, giving the possibility to mothers of participating in the
common life of the country. Creches serve for the common rearing of
children up to 3 years of age.
In collective farms, besides permanent creches, summer seasonal
creches are also organised at the time of field work from the beginning
of sowing to the and of harvesting. In order to provide timely feeding
by the breast, nursing mothers are united in brigades and they are
allowed to work close toths collective farm.
Rayonal creches (at the place of residence) and creches in the
presence of production are distinguished. Besides day creches, there
exist 24-hour creches where the child remains for 6 days when the
mother has night work and only on the seventh (day of rest) day does
the mother take it home. Children in creches are distributed according
to age groups with 20 people in each, and each group is attended by one
nurse and dry nurse. In creches, besides- the reception room, children's
rooms (according to the number of group), rooms for play, bedrooms,
pottery rooms, and lavatories, there should be an isolation-hospital
ward, where children who have become sick are placed until their admiss-
ion to a hospital, or until their recovery.
Soviet law provides the mother with the possibility of breast-feeding
the child for the course of 6 months; for this purpose she is freed
from work a half-hour every 3-1/3 hours. The significance of periodic
weighing of the chile is discussed in Part II in the division "Children's
Diseases."
Article 521
Placed in the infant home aa-e children who do not have parents.
The number of these homes is diminishing in connection with the develop-
ment of the "patronat" which consists in that the organs of the Ministry
of Public Health give up orphans for a definite fee to a family for
rearing under the control of the consultation room. This is accomplished
by the "patron" nurses.
The therapeutic-prophylactic serving of children from 3 to 14 years
in age is accomplished by children's hospitals, children's ambulatoria,
children's divisions of general polyclinics, summer health schools,
children's sanatoria, et al.
Article 522
The of :w,natvo medicine embraced only an insignificant
part of the territory of tsarist Rustia, and the rural population, par-
ticularly of the national outlying districts, was poorly served by medical
aid. If the semstvo physician was alone in his efforts to improve the
hygienic living conditions of the poor ignorant peasantry, under the
conditions of the Soviet country the rural public organizations can render
support to the medical workers in the sanitisation of the village. The
successes of the building of Soviet medicine in the village are explained
to a considerable extent by this.
Included in the composition of the village medical section and sub-
ordinated to the rpon public health division are the hospitals and
ambulatoria, and also the medical assistant, medical assistant-obstetrical,
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and the obstetrical points, the collective farm maternity homes, the creches,
the points for the struggle against malaria, trachoma, etc. In those
collective farms where there are no other medical institutions collective
farm nurse medical, points of the Red Cross are organized at the expense
of the collective farms. The collective farm Red Cross nurse detects
febrile patients, sends them to the hospital, organizes a Red Cross active
group, and, upon the pres-ription of a physician, carries out the simplest
therapeutic measures (the application of cups, injections, the treatment
of scabietic patients, etc). Besides work in the area hospital, the
physician controls the work of all institutions in the area, riding out
on established days to the medical assistant and obstetrical points. There
he receives patients selected in advance by the medical assistant, and
with the participation of the sanitary active group conducts measures
pertaining to the line of sanitary-prophylactic and sanitary-educational
work.
]Medical assistant and medical assistant obstetrical points, besides
therapeutic aid, conduct preventitive inoculations, conduct antimalarial
measures, follow the sanitary state of sources of-the water supply, schools,
creches, stores, dairy farms, hostels, and others, direct the work of the
active group and conduct sanitary-educational work (conversations, displays,
etc).
Obstetrical aid at the area level is rendered in the section hospital
predominantly in the presence of pathological births. Normal births are
conducted under the observation of an obstetrician, chiefly in collective--
farm maternity homes which are equipped with 2 to 3 beds and maintained
at the expense of the collective farms, and also by the obstetrician at
the home of the mother.
The "patronage" of pregnant women and children of a breast-fed age
has most important significance in the struggle for lowering the mortality
and morbidity of mothers and children. "Patronage,'l besides by the special
"patron" nurse, is conducted by the other workers of the medical area.
Article 523
In contrast to recent achievements on the public health front, in pre-
revolutionary Russia more than one-fourth of-all children died in the
first year of life, and epidemics of cholera, ..yphoid, and ethers often
use. At the present time the mortality of the population in the USSR
has decreased 564 in comparison with 1913, while infantile mortality
has decreased almost twice as much. We are on the road to the liquidation
of the most dangerous epidemic diseases; for example 'for a long time
there has been no cholera in the country (since 19245, only isolated cases
of smallpox (of foreign origin) are encountered. And since in the Soviet
Union the birth rate is being maintained at a high level, the natural
accretion Oaw lase t__ l a i o in thC Z... ISSR its con~i derahl e.
i+vy`u-a.ev+v.a .
The organs of Soviet Public Health in the future should also strive
towardc the uninterrupted movement of their work in order in agreement
with the directions of comrade Stalin "to develop a new generation of
workers, healthy and full of the Joy of living, capable of raising the
might of the Soviet country to due height, and of protecting itself
against encroachments on the part of enemies."
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