U.S.S.R. SCIENTIFIC/POLITICAL MEDICINE AND HEALTH IN THE SOVIET UNION. IV. EFFECT ON HEALTH OF THE SOVIET MEDICAL SYSTEM
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Information
U.S.S.R.
Scientific/Political
Medicine and Health in the Soviet Union.
N. Effect on health of the Soviet medical system
1. Compared with Europe, the general state of health of the population is bad.
Very little interest is taken in people who are too old to work, and there is
nothing cheaper in the Soviet Union than the human life. But the medical
profession is not responsible for the unsatisfactory health situation which exists
particularly where children are concerned. Many factors 9
play a part; bad
monotonous food, harsh climatic conditions, bad living conditions, lack of
hygiene, and excessive physical demands. The death of the weak or old, or of
persons who are unfit for work, is regarded as a kindness and not a tragedy in
the majority of families, whose financial burden thus becomes lighter. The
only advantage arising out of this situation is that the natural selection and
rejection of the unfit exists to a much higher de-rce than it does among
Europeans. This process of the
survival of the fittest produces a hard tough
race possessed of immense powers of resistance. The people know nothing more
than the primitive struggl for existence, to wwhic__ they have grown accustomed
and are in consequence, just as hard with themselves as they arc with each other.
They arc so far unaffected b7 western civilisation, and like th,: young soldiers
who are comparatively a;rell fed, clothed and housed, are una sumi '
From the biological standpoint, it is clear that their s ecdn~ in the extreme.
concentration, to work is much inferior to that of the peoples of the western world of
strong competition. It is understandable that this also has its offcct on
health in the Soviet Union. Prisoners of course, are in a worse plight, because
they are worked to the point of physical exhaustion.
2. The number of pathological births is much lower the
n it is in highly
civilised countri:;s, because the Slav woman has a greater ability to bear
children. There are comparatively few surgically, assisted births, and the use
of injections for stopping labour pains is rare. Against this, there is a high
proportion of cases of inflammatory illness caused by gynaecological inflamation
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after birth. This is partly due to the lack of hygiene, but more so to the
fact that normal life bet,veen men and women has long ceased, and they live in a
much more primitive gray than is the custom, or even possible, in Europe. The
number of extra-uterus pregnancies is consequently high, and compared with
European hospitals, a surprising number of women suffering from internal
hemorrhage enter hospital for operations.iE The primary cause is the chronic
inflammatory process, but whether this is a natural or unnatural process is another
question. It cannot be said that any joy is attached to the birth of children,
and very few large families are to be seen among the younger generation. Neither
the health authorities nor the doctors have boon able to alter this. It is too
much to expect of a woman who is forced to do the same work as a man to look
after a home and bring up a family at the same time. Large families which exist
appear to belong to the older generation. Children are looked upon as a burden,
because both parents arc forced to go out to work, and unless they are lucky ,
enough to have an aged ,:grandmother to look after them, parents have to leave the
children to fend for themselves. The wonderful homes for children which are shown
to foreign visitors to the Soviet Union only exist in or near the large towns.
The size of the country places the main body of the population out of reach of
children's and babies' homes. A high proportion of the manually employed women
are not suited to have children, in spite of their great powers of resistance.
The majority of them appear to be physically exhausted by the time they roach the
age 25-30, when they are about 15 years older in appearance. The only women
who can care for themselves properly are those living in or on the peripheries of
the large towns. It is understandable that the number of abortions is not
inconsiderable, although they are illegal and the penalties are heavy. Doctors
carry out abortions because of the financial advantages, the average charge being
between 200 and 250 Roubles, payable in cash in advance. It is difficult for
the people to rake this sum together, but they manage it somehow, and about a
dozen cases attended Dr. Hoffmann's hospital every week for treatment after having
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a miscarriages.mm Abortions seldom lead to criminal procoedi
IF
~lly lo.LUIM a in s exceed deaths b
Y Y otwocmillionuevery yew' in in ares which
Soviet Union are not correct. the
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against the do r,,.,, " se ere is no prosecutor available.
g
public has no interest in such cases, but only in those with a strong
flavour.
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3. Small children of school age are in much greater danger from the health
point of view than are similarly aged European children. They are fed and cared
for by an aged female, and when the family is not lucky enough to possess such
a person, the children are loft to the care of older children, and simply grow
up on the streets. Pooding is consequently bad and irregular, and is done by anyone
who happens to be at home. No control is exorcised over the uostic,
q _n of diet,
and the children's tooth are bad, in many cases being already spoiled in the gums.
They got their second sets of tooth much later in life than do the children ih
Europe. The "English disease" is Widespread, and in the last year or two has been
treated with vitamin D and codlivcr oil, both of w;~hich have boon made available b
the goverrmont. y
The number of gland diseases and exudative dia, esA,is very
high, but cases of children outgrow their strength are not as prevalent as
they are in Europe. Because the children seldom have the opportunity of mixing
with adults, their standard of intcllia;,: ~ g
~ ,1c., is lo-iv. There is a great shortage
of doctors who specialize in children's diseases, and in any case, the effect
of their efforts is small because it is purp;,sel,esti for them to order that the
children should be fed better. The food is not there. In some areas a litre
of milk costs about 4 Rcublc;s, which means that the monthly -,,ilk bill of a
family with two children would be around 240 Roubles.
',s this rules out a proper
supply of milk, the children are under average weight, and are pale, when
compared with European children. Nevertheless, the death rate among
young
children is not high, and with the exception of the usual children's mild
complaints there appears to be very little infectious disease, or latent infectious
disease caused by abnormal reaction of the; lymph systom.m The way Soviet
children are reared is tragic; when parents themselves have not been properly
brought up they cannot know y
possibly know how to bring up children in the right way.
The result is that the doctor who is treating children is faced with insoluble
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r_~ku. u d Positive ability to resist diseases,
which has boon practically lost in Europe.
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The
eneral
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difficulties. With all the good will in the world, he cannot b
e expected to
educate the mother in the
proper care of her offspring if there are no beds for
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thorn, and the means to koep them clean are lacking.
Doctors become resigned,
order something or another, and go their way. There are cases where the
make a special effort in their primitive parents
y, but when this happens, the doctor
p agrainst a lack of cooperation caused by an unreasoning partiality.
In spite of all these drawbacks, there is a positives
side, and that is, the strength
and toughness of the childr`on's organisms which allow them to put up groat to the difficult climatic conditions and the ~ p g at resistance
effects of their social surroundings.
4. Children live under those conditions until they reach school leaving and food is definitely bad and insufficient, ago,
The number of hungry children is
high, and consequently, so is the number of young criminals. Doctors
little to hel can do
p, and even in country areas, hunger drives the children to steal.
When they are caught, they appear before juvenile courts which invariably sentence
them to a spell in a youth camp, whore they are better off than the w
These critical social conditions are rathe y ere at homa.x
r outside the sec,?e of what is intended to
be a paper dealing directly with the medical OR of
the health situation, but they
have to be included hero because they help to give some idea of the difficulties the
health service is up against. A regular health control is enforced in the schools,
but is confined to finding out if anything is wrong, and what it is.
to give relief because the moans for doing It is not able
~ s~,-. are not mudo available to it. The
youth newspaper "Komsomolskaja Pravda" last year claimed that the youth org
is fighting against the anisatic.n
the bad social and moral conditions of family life, as wall as
against the unbelievably bad living conditions.
Reproaches were levelled against
the health services and doctors, who wore accused of havin? failed in their The correctness c duty.
of this attitude is questionable, but in improvement in the health
situation affecting children is hardly likely under the existing rc ime.
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them tearfully complained that if they were sent home Some of
have to start stealing again if they would only
"Oro not in favour of Children homy wished to remain alive.
another mouth to f, t ad to them because it meant
food and anothbr body to o Clotho.
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situation is -;worsened by an attitude of -rind -which is incomprehensible to the
European. On tho basis of th,: comr_lunist thesis about the right of self-
determination, the people, and also youth from
an immature ago, enjoy a c~ t
-r din
freedom of choice -,when they are notntally equipped to Hake such a choice. For
example, a child has the right to object to any measures which its parents impose
for its own good. The chip'- can also r.-fuse
::,cdical treatment when it (?.oos not
like it. In the event of a divorce, and there are largo numbers daily, a child of 7
has the right to decide with which parent it will liv,;. It is not uncommon for
children aged 12 and upwards to be taken away from, sch:cl and put to work for a
period. In one large area, when the winter s.-ias starting and the crops ;-Toro still
out in the fields, all schools were closed and children over the ago of 12 were sent t.
the KolKhosyx to T c
gather in the harvest. They wore lodged in barns, boys and girls
slept together, there were no proper f.;eding b , arrange
m,,nts and the children had to
Wear their own clothing. The results of all this were indescribable, and the
maj:~rity wont down ill ':with the intense cold, and a -wave of influenza broke out.
5. The health situation so far as adults are concerned is not quite so bad
because they .ro better cryualified to take; care of themsclves. The State health
cr-anisation in one s one form cr _un, thor, is available more or less ;vcr.ywhere, but
because there is a justifiable lack of confidence in it adults seek medical
treatment privately as for as they can. Their eve.rridin consideration is to
avoid work -which requires greet physical effort' and this is readily y understandable
in the case of rro2en, who have c u-~,l rights gand therefore have to do the same
manual work as non. To avoid work therefore, their only course is to be declared
unfit by a doctor, and this happens time and time again, thus opening wide e. the -,ay
to bribery and corruption. The mis;;
enj of the people has also caused thorn to sock
solace in drugs, a mania for ;which is strongly developed in the adults.
respect there is net a great deal of difference bet-,weon an excessive use In this
and the taking g of hashish of alcohol,
aor opium. That is important however, is that in recent
years, women have started to drink
large quantities of vodka, must hich mshave
a bad
effect on What family life there; is, as Wo
11 as on the children, and the next
generation. The fi,;ht -which communist youth w wages against alcohol seems to have
little effect, and the State authorities are equally unsuccessful, both against
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drink and drugs. Opium is prepared in a very primitive fashion. ,y
ma Pop
head is slit open, and the juice is injected into the body. The seeds of the
poppy arc boiled, and the resultant strong concentration is drunk. The result
is a state of intense excitement fcllowcd by coma. ?lack tea also is drunk in this
concentrated form (50 or. tea to on:; cup of -eater) and brings on euphoric and
exitationsstadium, which in the most serif us farms causes the sufferer to run
amok. The consequent progressive cakness of the complaint leads to continuous
relapses. The damage to health is widesproad and irreversible. There are a
number of other illnesses and complaints for which the Soviet authorities have not
found an answer, and are not likely to do so in the future. To those belong:
(a)
Deficiency illness caused by the monotonous food; witaminosen?'
Scurvy, rickets, beri-beri, pellagra or rough skin). Those complaints
can only be overcome with natural and decent feeding which is beyond the
powers of the Soviet Union. The only food available in near sufficient
quantities is all of a meal basis, and fresh foodstuffs are in very
short supply. The substitution of vitamin preparations for fresh fare
is now in hand, but is net yet .Lvailable in sufficient quantities.
Also, as every doctor knows, vitamin preparations are never a complete
substitute for the real t' ing.
(b) Yellow jaundice. Neither in the camps, nor among the civilian
population are they able to ccmplotoly overcome the constant wave of
jaundice.
(c) High blood pressure (genuine hypertonie). The grounds for this
complaint have to be sought in the lack of variety in the food, in
the restless and nervous way of life, in the excessive use of alcohol and
nicotine, both by males and females, in an increasing degree, as Jell
as in the abnormal climatic demands. A largo proportion of disability,
even among the comparatively young, is due to this complaint, which is
also responsible for a large number of deaths. The high blood pressure
can be traced back to the central nerve system, and to a great extent
terminates in the sloop therapeutics explained in PAVLOV's doctrine.
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b. The number of abnormal
psychr.legical reactions are necessarily
h
g
er
than in trope. If the assumption that hysteria in a
pathological form brings
on ego6entrism is acceptable, then the way in Y hick the people react must also be
described as hysterical, a condition for which the social surroundings must carr
the blar.2e. Y
To 'uhat extent the ondu~len -which has developed through many generations
is responsible, in which case the effect of narcotics has played a not inconsiderable
part, remains an open qu::stion. Psychological complaints are a daily occurrence
which cannot be mastered with the facilities available, because the root cause of
the complaints cannot be ov,rcomo. Nevurtholoss, the number of cases of
insanity do not appear to be greater than they are in E-erope. These medical
considerations may help to explain why the Soviet people may not be trusted. They
react completely differ 1 Brent/to the people of the western world, and just
attitude to their doctors suggests, have no fooling of honesty or sincerity. Because
the egocentrism is just as strongly developed as the ondogun and oxogen factors
already described, all the counter measures taken by the medical authorities are
useless.
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