SANITATION

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80-00809A000600200255-8
• Release Decision: RIPPUB
• Original Classification: R
• Document Page Count: 6
• Document Creation Date: December 22, 2016
• Document Release Date: June 29, 2011
• Sequence Number: 255
• Publication Date: August 27, 1948
• Content Type: REPORT

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I
COUNTRY USSR
CENTRAL INTELLIGENCE AGENCY
INFORMA-AW RT
PLAC
ACQUIRED USSR
DATE OF
ION Jerry, 1948
DATE DISTR. 23 august 19' 8
NO. OF PAGES 6
NO. OF ENCLS.
IUSTED BROW)
SUPPLEMENT TO
REPORT NO.
THIS IS UNEVALUATED INFORMATION FOR THE RESEARCH
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w m.ee~etrrs a .rt?wrr ? u rr?trerear tawri n ra
gyp wnro row wroaun USE OF TRAINED INTELLGENCE ANALYSTS
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A, _.y,gr,.MOr.;K fi[:fMBtiMMm:M7MG7:
No 1, 1948? (Translation
SOURCE Russian pericdiaal,
ep.cifically regueste
PUBL?TM mH IN TUGA LAST D1IRIi t LD WAR II
(From a dissertation in ooepetition for the degree of
Candidate of lbdioal Scienee)
By S. Z. Topeh5 an
Hon P!g'e Of RSFSH
Tula Oblast was am of the fret districts liberated by the Soviet A^ny from
the am= invader.. Dining the ahert aeaspation of the ablest by the enemy, so
snob d~amege was done that rauonatruotion hoe required, and still requires, maew
ncntha.
The d dome by the invaders, the almost camolete curtailment of work in
the field dt praventive medicine ad oommity sanitation in the oblaet (outside
of the of of Tale), the thesat at epidesios qt esanthematcus and abdominal
to , tn~.a a aid other high] contagiam diseases, the spread of skin-
plpe+aiitio and vwttr4 diseases aaasg the poputatiae, and likewise ver infutlsa
aid to emaustton of the inhabitants due to malnutrition and privations, have
be . f 'e the pablio health authorities the urgent problem of -'.staring the
Imo .
entire ptvnrtivs,aedioias netaarl~ of the district in the shortest possible tiara
To soles this pprobl.a, the public health authorities had to onroome coraiderable
difficulties in discovering maw to eradicate the consequences of the occupation
in he sbarteat possible tine.
Invesblgctione of sanitation oca3itians and public health of TuleOOblst in
the years preceding NoNld War II will serge to throe! sass light upon
qmmsee of the oonupstiom and the work of the public health authorities in
carracttrg this.
Daring the 30 years of Soviet rule, great progress was made in impa'eving
sanitstlas
eeoanaay, the ~ rim This wea -the result of the cessful in the security and cultural level of tie ban~+,~
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and also the adoption of a eyeten of measures in the field of public hea~.th.
The birth rate in Tula Obiaet before the war was high, and, in 1939, it was
close to the average for the Federation.
On the eve of World 14!r U, the mortality Of. the urban and rural population
was 39 percent lover than before the Revolution. Infant mortality to Tu;.a Oblast
before World war II was lower than the average for the ROM, and 41 percent lover
than in 1910-1913.
Epidemic morbidity fluctuated from year to year before the war within wide
limits depending on its various causes. Compered with the pre-Revolutionary period,
a significant downward trend was noticed in a majority of the epidemic diseases.
Thus, for example, smallpox and relapsing typhus Were completely eradicated; in-
stances of abdominal and exenthematoas typhus were reduced to one-fifth, and were
recorded as single incidences; the morbidity of scarlet fever, diphtheria, and
whooping cough decreased. The control of epidemic diseases is characterized by
high hospitalized incidences: abdominal typhus, 98.6 percent; scarlet fever; 95.4
percent; diphtheria, 85.4 percent; dysentery, 71.6 percent.
Basic measures to cope with epidemid diseases were carried out intensely in
Tula Oblast, and in hospitalization and inoculations Tula Oblast even exceeded the
average Indices for the AS1SR. In general, enormous progress was made in the public
health oars in the oblast in 25 years of Soviet rule. Along with a 12 percent ie-
crease to population, the number of hospitals increased 2.7 times; hospital beds,
3.7 times; dispensary polyclinics, 4.3 times; surgical and eurgioal-obAtetrical
canters, more than 19 times; doctors, 3.8 times; and doctor's assistants and mid-
wives, almost 7 times.
The invaders entered Tula Oblast early in October 19h'. In October and Novem-
ber, almost all. regions were completely occupied. At the and of October 1941, the
Germans reached Tula, the city famous for gunsmiths and partridge-makers. At the
and of December 1941, almost the entire Oblast bad been obliterated.
The majority of the ri,,raa-e were under occupation 50-60 days. Ealuga was
occupied for 79 days. The siege of Tula Lasted 55 days. But even is this compara-
tively short time the iiv.-Aere succeeded in ia.llioting tremendous damage upon the
sanitation facilities in the oblast.
Serious damage was done to the water economy, which woke reflected in sanita-
tion conditions. As a result of She destruction by 'he coo"vying Oermana, the
sources of 'star supply, water works, artesian wells, tzeehines, pumps, reservoirs,
*to., were rained. According to incomplete data, 35 percent of the water pipes
and 25 percent of the a.testen wells in Tula Oblast we-e destroyed or damaged;
soma of the derrick and framework wells were damaged.
The entire network of i iraity hoses, saaatoria, public nurseries, and esni-
tation-spidemlologioal etatione was completely destroyed or damaged; the hocpitaL
ne9w+ork was 92.4 percent destroyed; the network of polyclinics and dispensaries,
90 pereeat; health stations were destroyed almost completel,-. In those places where
hospitals and other medical establishments escaped complete destruction, their
property end equipment were for the most part plundered by the Oerman soldiers.
The medical estabiiehmeate of Tula suffered considerably luiiag the siege; 5
hospitals, 5 polyel_aioe for adults, 2 r'.ildrsn's polyclinic., 5 children's consul-
tation center,, 12 public nurseries, and 2 sanatoria were damaged.
The regions of the rodmoekovgyy Coal Basin suffered morn tba.r the others. Thus,
In the Shehlkin Rayon a new 40-bed hospital with all its equipment was burned; in
oostomarov a ;O-bed hospital and a hospital for contagious diseases were 85 percent
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persa ;
thsrs Were % militar7 persomry:l. In spite of the sericas character of the wounds,
11
the mo
t
6
b
.
s
c
and woo-d'd iche.'t entered the ha,pital, there were 442 atulte and 97 children, A
preppaadsse00e of the wounded eel sick was !from the a1ei3iea population (83 i
ma
Semauhko directly from the front line and, also after Qeawcan aircraft raids on the
eilay, and Were them transflesred to the base hospital. if the total
num&- of
i
k
her 1947.) 428 persons died in eU.Ls, inoluditag 21 ohildten under one year of age.
Amaag the dead, more than one-third Had of war wounds.
The woupdad cams to the ewrpicai. department, of thw: Field It-44-1 i
m
m
o m
ne
t sa r the 35-bed 9hvarte-bed Hos-pensary
pital, a 15-bed maternity homey and a die hletely; the 30itd
burued therapeutic unit of the taraty HoapitaT.. was doa r it"co
rest ems and a taropre~. The Volokhcv Hospital, a
polyclinic were ccoairierably damaged. Aflia nurseries at many
pits and mines tare destroyed or burned.
lbdiaal establishments worked UM&r difficult eoacLitione during the severe and
anxious days of the siege and cccnpati+m. Wounded ware brought directly from the
front Lim to the hospitals of Toearkvr Rayon, It wan necessary to receive them,
give them first aid, food them, and ev,iouate them fart'*nr. Hospitals wore converted
into unusual evacuation points. Ns bwdred and f "rounded were treated at the
Bogaroditak City Hospital every der.
Daring the aiegc of Tula, under ocnditiona of continuous raids by enen(y air-
craft and artillery baebardment, PolyoiLnio No 3, the kkepital imeni Semashko, the
aurgioal department of the district somatic hospital, th> dispensary of the optical
hospital, and the central maternity hone continued operwcionc without interruption,
although- no more than 4L' doctors (aut ar 279) and 250 average medical workers (out
of 1,175) remained in the city.
According to Incomplete data, drug the 2 months of siege (November and Docem
a
e
s
nd
pvw"c
nurseries were destroyed. In the mines, tan health atatimm sere destroyed, aim .7
mod, together
gethe
V a ai.. h- Ir
i dl - CJiia- rh
i
tubercular and venereal centers, a 25-bed maternity` tome, a children's Consultation
center,, 4 public nurseries, and 3 children's nurseriee were 4550 percent destroyed;
and in Cgarev, a dispensary building, a children's oonoultat4em
e
t
r
r
a
4. perasnt) nee act hih.
y
Daring the stage of Tu7r., no lace than 130 of the a Ivilien population were
k47364, and about 600 wars wounded.
Sanitation problems for lbe civilian population or :aa Oblast did not end with
the liberation from occupation. Since it was very clan to the front during all of
1942 it for thegrs star part of 1943 (until Angnst-September), the territory of
the ob~ae% with ills mines' "'amiss, towns, and villages, oontimaed to be subjected
the desire to paroduoe an oxploaiai led to their being !,,lured, The children suffered
its thb ...e Vkov Bispensar7s 22 tr"re ohl3dzren under 14.
In the Ealega Hospital (September 1S#43) several wards ca-e filled almost ex-
Aumsivw,4 with brie under 14 years of age with amputated upT'r on laawr linbs. It
Leese aaEre viotriaa or alae explos:uns and blasts. althamh ire eMteiw~,.A4a,.I-A
Tn This, for the 4-month period after the lifting at the b ockads (Jarraary-
Apri] 1942), 328 civil an wanaded were hasaitaliwd) dnr3nT 1942 and for 9 months of
1949, 90 wonodad entered the Baago'oditek Hospital of Town av RC =l 18 victims of
air raids entered the Twerkov Hapitel in 1942, and 26 during 9 months of 1943.
Q9i1dren under 14 years of up farmed a considerable put of those with war
%wade. Its somber reached 70 percent in the Tale Optical lospitalj out of 24 vlotiaa
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the greatest number of wands in the eyes and wristu.
Mortality from war wounds among the civilian population depended, naturally,
on the site of the wounds. The highest mortality rate was among those with body
wounds, the majority of which were abdominal wounds pith internal co plications.
The experience of pact were demonstrates that epidemic diseases constitute
the greatest danger for the army and the civilian population. During World liar I,
and especially in the period of the civil war, an epidemic of essnthsreatoua typhus
assumed terrible proportions. Therefore, the first objective of the public health
authorities, in the liberated areas was the control of exanthematous typhus cases,
a great number of which wore noted in marry rayons in the very first days after 1ib?.
oration. Together with this it was necessary to take preventive measures against
abdominal typhus, dysentery, and other acute gastrointestinal diseases, the danger
of which would arise after the malting of the anew in spring and summer, after -
decomposition of corpses and garbage bad set in, and after pollution of the eoiurcos
of water supply by melted anon and ground water had began.
Epidsniologioal work, naturally, could not be carried out apart from the entire
restoration work. From the very first days, the building, repair, and the adapta-
tion was begun of accommodations for hospitals,, dispensaries, consultation centers,
public nurseries, eanitat!on-epidemiological stations, baths, delousing centers,.
and barber shape; sources of water supply were repaired and cleaned; fuel was
procured for baths and disinfection stations; sanitation facilities were put into
working order; sanitation order was established ?.n communal dwellings, homes, .and
in populated places; medical establishments were supplied with hardware, dry goodep
and medinal equipment. At the Game time, inoculations against smalllpox, abdominal
typhus, dysentery, and diphtheria were given.
Among the epidemiolOgical reasures, house-to-house surveys brought oonsid-
cowe ed bp- this means. The r dical workers began these surveys immediately after
the espulsion of the invaders. In Tavarov Rayon in January 1942, 112 persons ill
with high temperatures and 3,712 with rashes were discovered by house calls ntule by
The high morbidity of exanthsmatous typhus in 1942 shah how great were the
effects of the occupation in the first months after liberation. As a result of the
measures taken, the morbidity of exanthemataus typhus in 1943 dropped almost to one-
fift9 as compared to 1942. The greatest meter of incidences of disease occurred
in the raycew along the front. The morbidity of abdominal typhus and dyseotory was
loser then in 1939, and nothing threatening Eras this direction wee noted either in
1942 or 1943. In the first months after liberation, an increase was observed in
tularemia incidences, which was connected with the pollution of wells 17 the: bodies
of rodents.
The restoration of the network of medical establishments and execution of epi-
deminloginl measures by local organs alone was impossible. The party, the government,
and the lsepiela Gmtsseriat of Health of the RSF3R came to the aid of +.''a liberated
rayons, Including Tula Oblast.
By the and of the first quarter of 1942, 77 hospitals in the oblast had already
been rswtaaed. These hospitals had 4,685 beds, including 2,216 for infectious cases.
This naaebsr assured proper hospitalisation, with normal bed turnover, for victims of
exanthssetous typhus.
The scatter of sanitary facilities for the population wat, considerably worse.
After the expulsion of the invaders, only 59 baths were recovered. By the and or the
Mat gwrter of 1942, there were no more than 355 baths in the .blast including
those restored, which was inadequate for the sanitary needs of the populations. The
network of baths and disinfecting stations was gradua:.ly reetared and increased with
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great diffioultioe. On 1 July 1943,. a Plan for the building of very, simple .bat1-
(1,759) had been 73 percent completed. By this time, 1,301, public bathe were
ftnnaticeing, and, in addition, there were 211 individual bathe. The building of
disinfecting and delousing stations lagged behind, and the corresponding plan had
been only 35.1 percent completed by the same time.
llanitatice.eduoatian played an important role in the system of epidemiological
measnrea. h#lsouseions an diaeaae prevention were held at meetings, gatherings, mine,
and before the showing of motion pioturee.
The misfcrtu.es of war meet inevitably be reflected in the birth rate and in
the total and infant mortality, the level of which changed from the prewar figures.
This ocatisuad during 1942 end for a part of 1943, after which sanitation conditions
were bettered; its subsequent years the mortality fell balm the prewar level.
Deterioration of sanitation conditions was especially noted in the towns and
bell " which ~ moot from the occupation and military operations. To these Mast.
The rood of the population of the occupied re glows for medical aid was an great
that in a number of places (VoVrhov, Shobekin, Tovakov, and other rayons) the
acceptance of patients in the local medical eatabliebmento began on the very day after
the e ; re. Because of destruction of, or damage to, regular IntAct, llings were temporarily converted to medical establishments.
Softest, sedltoal personnel were the most important need. Coooperatively few
doetars (abort 30) and average medical workers romained at their poets durir3 the
oscupation, and even fewer continued their work under the Germane. At the beginning
of 1941, ,hare were 818 doctors in tks obiaet. After the liberation? there were aome-
what more than 90 doctors in the dblaest, including 63 in Tua.
With each mouth, the member of medical personnel increased due to the acquisition
of ycoag doctors, as well an doctors sent by the People's Commissariat of hhaith from
other ohiastso of the total number of doctors who arrived in theod.ast, 44 asrcent
wars young doctors who graduated in 1942 and W.
for the aqtr al of exenthametoea typhus and other epidemic diseases, and also
for the iwposeiont of tin general sanitation conditions in the ablest, the staffs
of natation dgotars and epidemiologists were strengthened. The mmeber of aenitation
doetars-epecialiets by the beginning of 1943 had even increased beyond the prewar
period.
The network of hospitals,, In prtioular that of the infectious disease hospitals,
was rapidly resound. This was digitated by the nea?seity for the complete hospiiali-
satlan at victims of exantbamatous typhus. On 1 April, 77 hospitals ver, already.
fumetsoniug In the liberated regions (excluding Tula); an 1 July, 91 hospitals. The
n er of beds increased from 1,200 to 3,900 during the first * months of 1942. In a
year end a bale after liberation, the bed network had been 80 percent restored, and
the "Manes of hospital beds for the population (exclusive of maternity ham--) ex-
ceeded the prow level.
MR accordance with the problems facing the public health authorities in the-first
period after libaat-Lc:a, the ailobient of beds wasoha>aeds the nweber of bede for in-
fectic" osaes?was.3mrealad (acne than doubled), an well as the ariw of therapeutic
and gesi's1 beds and beds for neuul'cpath1o oases; she maecnr of surgical -.beds was not
w:tLs`t~ ember of maternity and obildreaea bade was reduced. ;'
tar asawdrk of dispensaries and polyolinios was restcxe . o a considerable dabev e
(85 peroent)a an 1 Jolly 1943 130 diepeasarise and polyclinics wore in operst.ion as
cv
,Mond to 29 on 1 Jaoary W. By this time there was not a single rayon without
a mw:,wl dispensary, and in a aaober of rayon there were aevsral dieponeari* s.
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Great work was accomplished by the public health nuthoritios in the Wet". of
lth centers
d 73 he
l
a
an
restoring the health centers. By 1 January 1943, 30 medica
ware already in operation. The restored health centers twre.comparatively bettor
staffed with medical personnel than before the wear.
The development of the network of establishments for the aceommdatior. )f
worn and children proceeded at the same tempo as the restoration of polyclinics
and dispensaries. On 1 January 1943, 27 consultation centers in urban aettle*ierrts
(as against 42 before the war) were in operation. In the city, 21 consultation
canters accepting children had increased to 24. The zone system for serving children
by means of urban consultation centers was completely restored, and all zones were
staffed with doctors and nurses.
By the beginning of 1943, the network of permanent public nurseries included
61 establishments in the city and 68 In the country, as against 95 in the city and
the same r in the co~qq on 1 Jan ry 194,1. The number of seasonal public
aatr oriea increased considerably in comparison with the prewar period. Children's
dining rooms were organised, serving 6,000 children, 90 percent of whom were children
of soldiers. The work of serving children in the toms and rayons was conducted by
city and rayon pediatricians, of whom there were 43 in the oblaet, molding seven
in Tula.
The aanitatiozeepidemiologioal organization was expanded and became stronger
during the war; the member of establishments increased, as weU as the }emeber Of
medical personnel employed in these setablisbsents,.
Tams, the problem facing the public health authorities, namely, assurance to
the population or the Oblast of naeaesary medical-sanitation aid, had already )ern
solved to a considerable da ee one year after the expulsion of the inv'adirn.
This was accomplished despite the fact that the majority or hospitals, dispen-
saries, and other medical facilities ware deetraped, and work was bogrn in the in-
tact dwellings, public buildings, and other temporary quarters. At the same time,
work progressed on the repair of the surviving buildings. Tumbro,m difficulties
such as shortage of lusher, roofing iron, glass, transportation, and manpower had to
be surnounted.In order to carry out this work.
In the process of the reconstruction of hospitals under wartime conditions, with
the lack of 1tal, food, supplies, and medical equipment, the incidences renuuring
bed care naturally could not be the same as they acre bef a the war. The number of
dos of bed cars decreased oeneidera'q in the city (from 293 days in 1940 to 245
and to a lcseer degree in the country (eeen+eopording figures: 221 and 214).
1942)
i
,
n
The turnover of bids in urban settlements dvareaead from 23.6 In 1940 to 17.4 in 1942.
The amber of patients admitted to each bed decreased partly because of an increase
in the time spent by a patient An bed from 12.4 days in 1940 to 14 days in 1942, which
is explained by the more serious condition of the patient.
Such were the first steps of the public health workers healing ' the wounds in-
flicted upon Tray Oblast. They worked diligently and by wines to be dam toward the atta..asent ad prewar level1 Amery ,(lees than 2 percent for the
bed swy, 8 Mesa for medical parscaosl, ate.).
The first y~esa~rc of the Firs Ter Plan since the war has brought the radical workers
of Tula lust their first successes: the passer level for beds in hospitals was ex-
seeded by 2 perasnti. the masher of diapensa yrpolyolinicel establlishments, by 30 per
centl the :wber of accommodations in public mn-series, by 2 percent; medical per-
sonnel, by 15 rvereerm.
As we have shown, many medical establishments still housed in temporary quarters
and equipment of hospitals plundered by the Fascists have ei'iboted the quality of medi-
cal treatment. The struggle for the improvement of medical-sanitation aid to the pop-
alation is the most important probLam of the pn.blic health vathositiee and medical
workers of Tula Oblast.
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