SCIENTIFIC - MEDICAL, PUBLIC HEALTH DEVELOPMENT

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80-00809A000700210113-8
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 9
• Document Creation Date: December 14, 2016
• Document Release Date: January 10, 2002
• Sequence Number: 113
• Publication Date: March 6, 1953
• Content Type: REPORT

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MAR 1952 "- "
CLASSIFICATAECONFIDENTIAL
ITX INFORMATION
CENTRAL INTELLIGENCE AGENCY
INFORMATION FROM
FOREIGN DOCUMENTS OR RADIO BROADCASTS
COUNTRY USSR
PUBLISHED Semiweekly newspaper
WHERE
PUBLISHED Moscow
DATE
PUBLISHED
LANGUAGE
Scientific - Medical, public health development
4 Nov 1952
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DATE OF
25X1A
INFORMATION 1952
DATE DIST. t. Mar
NO. OF PAGES 9
SUPPLEMENT TO
REPORT NO.
THIS IS UNEVALUATED INFORMATION
Meditsinskiy Rabotnik, No 89, (1105) 1952.
USSR PUBLIC HEALTH MEASURES
UNAER FIFTH FIVE-YEAR PLAN 1951 1955)
Ye. Smirnov
Minister of Public Health USSR
"Economic decisions of the 19th Congress of the VKP(b), and Stalin's work,
Economic Problems of Socialism in the USSR," open lofty prospects for the
further development of socialist economy and culture.
The basic economic law of socialism, plainly and scientifically formu-
lated by Stalin, was expressed clearly in the directives of the session per-
taining to the Fifth Five-Year Plan. Essentially, this law consists of providing
maximum satisfaction of the continually growing material and rultural needs of
the entire society via uninterrupted increase and improvement of pro?ducticn on
the basis of superior technology.
At the 19th Party Congress, G. M. Malenkov stated, on t*half of the Central
Committee: "In the future, our party will also devote untiring attention to
the maximum satisfaction of the continually increasing needs ofLhe Soviet people,
because the welfare of the Soviet citizen and the well-being of the Soviet people
constitute the highest law of our party."
There has been a sharp increase in the netGo*-r: of sanitation-antiepidemic
institutions,. these institutions are better equipped with therapeutic and diag-
nostic apparatus, institutions of higher medical education are larger, and the
number of medical personnel, especially the number of doctors, has increased
greatly.
The number of hospital beds increased 25.2 percent during the Fourth Five?
Year Plan alone. In the Lithuanian SSR, the number of hospital beds increased
57 percent, in the Latvian SSR 39 percent, and the Moldavian SSR 46 percent.
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At present, there are 5,585 sanitation-epidemiological stations in the
country. No city or reyon is without a sanitation-epidemiological station.
During the Fourth Five-Year Plan, the number of X-ray machines in munic-
ipal therapeutic-prophylactic installations increased 2.5-fold. In rural instal-
lations, X-ray machines increased by the factor of 5.5.
Now, 83 percent more medical installations have clinicodiagnostic labora-
tories. The number of physiotherapeutic treatment rooms has doubled, showing
a 7.5-fold increase in rural areas.
During the postwar Five-Year Plan, 104,000 doctors and 254,000 medical
workers with specialized intermediate -level training were trained. At present,
nearly 300,000 doctors and 900,000 fel'dshers, nurses, and other personnel
of an intermediate level of training are working in metropolitan and rural
therapeutic installations.
No other country in the world has as large a cadre of physicians as the
Soviet Union. Each year, the institutes of higher medical education of the
USSR take in students and turn out physicians in numbers three to four times
greater than the US.
The USSR, especially in postwar years, has attained important achievements
in the development of rural public health, and in therapeutic-prophylactic, and
sanitation-antiepidemic services to kolkhoz laborers.
At present, no rural rayon of the Scriet Union is without doctors or with-
out the services of doctors.
In 1950, 30.9 percent of the rayons had 15 doctors or more; 22.5 percent
had. 11-15 doctors; 36.1 percent had 6-10 doctors; 9.2 percent had 3-5 doctors;
and 1.3 percent of the rayons had 1-2 doctors. Thus, 90 percent of rural
rayons had six or more doctors.
More than 8o percent of the rural rayons provide not only general medical
aid, but specialized medical aid in the fields of surgery, obstetrics and gyne-
cology, pediatrics, therapy, and other specialties.
It may be noted that in the US 40 million people, or nearly one fourth of
the population, are deprived of the means to pay the necessary fees enabling
them to receive the simplest type of medical aid in rural areas. As was stated
in a 1952 issue of the Journal of the American Medical Association, there are
no public health organs in the areas inhabited by these 40 million people.
After World War II, the USSP government issued a series of important de-
crees aimed at sharply increasing the quality of medical service to the popu-
lation. With the aim of bringing nearer to the population a competent and ef-
ficient medical service, a program of basic unification of hospitals with poly-
clinics, was carrie-' out, providing all conditions favorable to enlarging the
practical exr>erience of therapeutic personnel, and thereby also raising the
quality of prophylactic and therapeutic work.
For improving the direction of medical-prophylactic installations of pub-
lic health organs, the posts of chief specialists for internal diseases, surgery,
obstetrics, and childhood (detstvo) were introduced.
Every year the state allocates large funds for the purpose of training
physician-specialists for rural ?cherapeutie-prophylactic installations, permit-
ting expansion of the system of advancement and specialization of doctors.
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in the postwar years, production of medicines, medical apparatus, and in-
struments increased sharply.
The mortality rate has decreased as a result of raising the material and
cultural level of the population and improvement ct medical service. During
the Piet 3 years, the net increase in poptlation was 9.5 million.
In the postwar years, a sharp (greater than ten-fold) reduction in the
incidence of malaria was achieved. There is every cause to believe that in
the next year or two, the incidence of malaria. in the Soviet Union will be
reduced to zero. Relapsing fever has been eradicated throughout the USSR, and
in many rayons and oblasts there are virtually no cases of typhus. The rate
of incidence of other nosological forms is also decreasing.
Considering the aid preferred by party .nd Soviet organs, it is the medical
workers' duty to insure furLher improvement and development of the public
health service of the population.
The party announced the following tasks:
To expand, over a 5-year period, the network of hospitals, dispensaries,
lying-in homes, sanatoria, rest homes, nurseries, and kindergartens; to in-
crease the number of hospital beds by not lese than 20 percent (including a
10-percent increase in the Lithuanian SSR, 30 percent in the Latvian SSR, and
30 percent in the Estonian SSR); increase the capacity of sanatoria 15 percent,
the capacity of rest homes 30 percent, and the capacity of nurseries 40 percent.
To ensure the utm,:st degree of equipment of hospitals, dispensaries, and
sanatoria with the latest medical facilities, and ensure improvement of the
cultural level of their work.
To increase the number of doctors, over the 5-year period, by not less than
25 percent, and further develop methods for the advanced training of physicians.
To direct the efforts of medical scientific workers toward solving the
most important problems of public health, focusing particular attention on the
problsma of prophylaxis, to ensure the quickest utilization advances of medical
science by medical practice.
To increase production of drugs, medical equipment, and instruments, by
1955, to two and one half times the 1950 level, paying particular attention to
expansion of production of the newest drugs and other effective therapeutic-
prophylactic agents, and also expansion of production of modern diagnostic and
therapeutic medical equipment.
The Soviet public health system has all the resources and facilitiea for
creditably fulfilling the tasks of protesting the health of the people, as
established by the 19th Party Congress. The Soviet public health system has
at its disposal a ramified network of therapeutic-prophylactic and sinitation-
antiepidemic institutions, scientific research institutions and universities,.
with excellent physician, fel'dsher, and nurse personnel, to whom nay task
may be entrusted for solution.
The very great potential of the Soviet public health system is engaged in
further reducing disease and in reducing the death rates of the general popu-
lation and of children. This potential must be utilized to the fullest extent.
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CONFI rIAL
A further increase in the quality of medical service to the population
enables earlier discovery of illnesses, at a stage when they still have a
functional character and when correct therapeutic methods can forestall their
further development into the organic stage. Such an approach requires that
physicians have much more extensive clinical knowledge and that the directors
of l.sbl:: health organs and installations devote increased attention to the
dispensary-polyclinical aspect of their work.
Organizational measures which have been 2ompleted already have had a deci-
sive effect on the quality of prophylaxis and therapy. The mortality rate has
decreased twofold since the prewar year 1940.
Analysis of prophylaxio and therapy statistics shows that 1951 qualitative
indexes were considerably higher for municipal hospitals of the Ukrainian SSR,
than for the Azerbaydzhan, Georgian, and Uzbek SSRs, where the work of some
municipal hospitals can be greatly improved.
The material means of the public health system of the Ukrainian SSR in no
way differ from that of the aforementioned other republics, neither in the num-
ber of therapeutic-prophylactic and sanitation-antiepidemic institutions nor
in the number of physicians. On the contrary, there is a higher ratio of phy-
sicians per population in the Azerbaydzhan, Georgian, and Uzbek SSRs, than in
the Ukrainian SSR. This emphasizes the fact that in the struggle to improve
the qualitative indexes of the therapeutic-prophylactic service of the popu-
lation, the number of physicians, institutions, and beds are not the only factors,
and that an important role is played by the quality of work, primarily the
clinical training of physicians. knowledge, and extensive application of modern
methods of diagnosis, prcNnylaxis, and therapy.
The primary task is the following: to achieve unification of hospital
and polyclinic t.stallation, available resources should be completely utiliz.;d,
more daring should be exercised in streamlining therapeutic-prophylactic insti-
tutions, aiming at mutual utilization of building facilities, and new construc-
tion speeded up in accordance with the people's economic plan. This practice
is being put to use successfully in several Ukrainian cities; particularly in
Kiev. Public health organs must rely oa active aid given by local soviets in
this very important mv.tter.
Second, the attention of the directors of public health organs and instal-
lations and that of chief specialists must be focused on raising the quality of
the dispensary-polyyclinical division of work, on utmost consolidation of public
health service given to the population within districts, and on the problems of
educating the clinical thinking of district physicians.
The importance of individual prophylaxic in further reducing the death rate
and disease morbidity should no longer be underestimated. At the moment of its
onset, an illness has a functional character; quantitative changes occur in the
limits of physiological norms, as was initially described by Pavlov. The basic
task of workers of scientific-practical medical institutions is to learn to dis-
tinguish these functional disorders, to perfect methods of research, and to pre-
vent the further development of the affliction.
District doctors and dispensary-polyclinic: divisions of hospitals have an
important role in this matter. Directors of public health organs and instal-
lations should, therefore, devote the necessASy attention to district doctors,
to their development in practical work, to their education, and also to control
of their activity.
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CONFIDENTIAL
Thirdly, the task consists of systematically strengthening medical districts,
expanding the district network, and aiming to have the work of the district phy-
sician conform to established norms. The annual increase in the number of listed
positions of staff doctors should be reviewed for this purpose, and those posi-
tions which keep a physician from doing a physician's work must be cut down.
Material and infant welfare is a subject of special interest of the govern-
went.
Maternal and infant mortality is decreasing in the Soviet Union from year
to year. Significant advances have been achieved in this field. Infant morta-
lity in the USSR has decreased twofold since 1940.
However, these results could be improved with the elimination of serious
defects connected with the inadequate clinical training of district physicians,
and with undervaluatic:i of the work of district physicians, pediatricians, and
obstetricians-gynecologists in the matter of early detection of the pathological
course of a pregnancy is well as in early detection of diseases in children.
The chief causes of death in children up to one year old are: pneumonia
(approximately 50 percent of all deaths), diseases of the newborn, and gastro-
intestinal disorders. Modern Soviet medicine has powerful means at its dis-
posal for combating the mortality from these diseases. The means of combating
these diseases must be correct and timely in their application, i.e., they
must be applicable in its early stages, within the first few days of the illness.
It is impossible to count on success in overcoming maternal and infant
mortality without /irst7 sharply increasing the clinical knowledge of district
physicians, pediatricians, and obstetricians-gynecologists. The proper con-
ditions favorable for such an increase may be created only in unified insti-
tutions. In unified institutions, the physician is able both to work in the
hospital (statsicnar) and also work either in the district, or do consulta-
tive work in addition to that. Under this arrangement, there is syetematic
control over the work of district physicians, and they may receive daily aid
from the chief physician, from department heads, and from chief specialists.
Improving the quality of execution of all matters pertaining to maternal
and infant welfare means solving a task of state significance, which inevitably
has a positive effect on protection of the health of the total adult population
as well. It is Pavlov's teaching that any illness which is contracted, espe-
cially in childhood, leaves a trace in the organism, and makes the organism
more vulnerable, even if the illness was not accompanied by complications.
Therefore, in the end result, improving prophylaxis of children's diseases,
also enables solution of the problems of protecting the health of the adult
population.
The USSR was the first country in history to organize rural public health
service which offers qualified medical service in the basic medical specialties.
In rural areas, unification of hospitals with polyclinics is particularly
beneficial to enlargement of the clinical training, and to the consolidation
of rural physicians. The time has lo.ig passed when peasants, as a rule, jour-
neyed to the city for medical aid. Now, virtually everywhere, there are spe-
cialized medical, facilities in rayon centers for serving the rural population.
Measures such as establishing hospitals in rayon centers, with staffs of spe-
cialists including surgeons, therapists, obstetricians, pediatricians, roent-
genologists and phthisiologists, and in many places, specialists in even
narrower fields, have been particularly effective in approximating a IIfulil7
qualified medical service for kolkho workers.
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'tt may be said without exaggeration that a radical gaalitative change has
taken place in the composition of rural medical personnel. The initial special-
ization of cadres of physicians conducted by the Soviet public health organs
on the bases of large local hospitals, advancement of the knowledge of special-
ists in institutes, the daily, meticulous instruction of physicians by the
chief specialists of oblasts, krays and republics, and especially, the awakening
of the physicians, desire to improve their clinical training, and their resolute,
independent daily, studies have had a beneficial effect on the quality of the
medical service given to the population.
Medical culture is improving steadily in many hospitals of rural rayons.
It is significant that physicians of rural hospitals now figure in many pub-
licized events, and that not infrequently they show good examples of creative
mastery of the advances of Soviet science.
The psychprophylactic method of obstetric anesthesia which now is used
extensively was first tested in practice in the rural rayon of Krasnodarsk,
Kbar,kov Oblast.
A group of workers of the Makarov rural hospital, Kiev Oblast, in striving
to improve medical culture, exhibited commendable init.tstive in the practical
application of the principles of Pavlov's teachin,,on the therapeutic-prophy-
lactic method. Thus, the progressive teaching of Pavlov already has been
employed as the methodological basis for the therapeutic-prophylactic work
of many medical institutions. The Ministry of Public Health RSFSR recently
held a republic-level conference for the purpose of exchanging experiences in
the reorganization of therapeutic and prophylactic: activity on the basis of the
physiological teachings of I. P. Pa'Tlov. This conference was bald at Vinogradov,
Moscow Oblast, which is where physicians of a rayon hospital first transformed
Pavlov's physiological teaching into practice in the RSFSR and graphically
demonstrated that the experience of innovators is growing to be massive.
The physicians of Chuanov Rayon, Zhitomir Oblast, greatly aided kolkhoz
production through active and efficient dispensary treatment of kolkhoz members,
thoroughly checking the health of all of the agricultural population, and pro-
viding differentiated, effective -therapy through the services of the specialists
of rayon and district hospitals. Illnesses among kolkhoz members decreased
sharply following the introduction of the dispensary method of treatment in
Churinov Rayon. 'Thus, the creative work of medical personnel enabled the people,
the party, and the state to solve problems of the peoples economy suc.essfully.
As a result, the authority of medical workers has grown immeasurably in the eyes
of the population, and their role as active participants in the building of
Communism in the USSR has increased.
Henceforth, even greater persistence must be exercised in carrying out the
designated measures and in generalizing and popularizing the foremost achievements.
In 1951, there were nearly twice as many physicians working in rural areas
as in 1945. This included an especially sharp increase in the number of phy-
sician-specialists in rayon centers. This expanded the range of specialized
medical treatment, which is reflected in the increased occupancy of hospital
beds in rural therapeutic-prophylactic institutions. Coneeqtmen?t1y, fatalities
in rural hospitals have been decreasing from year to year, and continue to
decrease.
However, the executive committees of the soviets of worker., deputies of
some oblasts and rayons, which are concerned with total public hee1,z., -u ,.iui
creating the appropriate conditions, have not devoted sufficient attention to
this problem. To a large degree, thin is precisely the cauee of L::e great
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turnover in personnel and understaffing of rayon hospitals with physicians.
This situation is characteristic for the oblasts of the Kazakh and Turkmen SSRS.
In the Kazakh SSR, there are no surgeons in 33 percent of the rayons, no ob-
stetricians-gynecologists in 25 percent of the rayons, and no pediatricians in
23 percent of the rayons. -i the Turkmen SSR, 51+ percent of the rayons have no
surgeons, 1+5 percent of the rayons have no obstetricians-gynecologists, and 58
percent of the rayons have no pediatricians.
The task, then, consists of ecntinuing to consolidate rural rayon hospitals
with dispensaries, and liquidating the inattention of divisional organs of pub-
lic health and of workers of the executive committee= of soviets of workers dep-
uties, as far as rural public health needs and the needs of rural physicians are
concerned. Within the next 3 years, it is essential that there be at least six
to ten physicians in each rural rayon.
In addition to raising public health practice to the level of the advances
of clinical medicine, further raising the quality of therapeutic-prophylactic
service of the poi:.:.ation also requires extensive development of scientific re-
search work based on the Pavlovian phsyiological doctrine applied to actual
problems presented by the demands of public health practice.
The party, the government, and Stalin are devoting a great deal of atten-
tion to the development of scientific research in the field of medicine.
Soviet public health has at its disposal 255 scientific research insti-
tutes, which are occupied with scientific research in the field of medicine.
Many problems of diagnosis; prophylaxis, and, consequently also therapy,
still have not been solved. This impairs success in combating mortality and
reducing incidence of diseases. The scientific research institutes of the
public health system, and especially of the Academy of Medical Sciences, must
focus especial attention, and concentrate m_,cimum scientific resources on the
solution of the tasks of specific prophylaxis of diseases such as influenza,
whooping cough, scarlet fever and measles, which cannot be overcome successfully
without solution of the problems of specific immunoprophylaxis. Mauy USSR
scientists have been working in these fields of study for a long time, and have
had some success. It is essential that they be extended every aid in the solu-
ticz of important tasks.
Public health practice is deficient in the consolidation and extension of
scientific research in the fields of prophylaxis and therapy of cardiovascular
diseases and rheumatism, and in the prophylaxis and therapy of neoplasms. These
are the most serious diseases, and result in the highest percentage of morun~y.
Henceforward, it will be impossible to tolerate the condition in which, in many
institutes of the Academy of Medical Sciences, the problems of rheumatism, neu-
roses, gastritis, and angina were not studied at all, and the study of cardio-
vascular diseases was evidently neglected.
Special scientific reseaazh institutions of a clinical and theoretical
nature have been established in the USSR, which are conducting manifold studies
on the problem of cancer. Methods of detecting precarcerous illnesses already
have been incorporated into public health prsrflce. In many cases, these methods
permit warning of the development of malignant neoplasms.
In many instances, early diagnosis and therapy of cancerous illnesses is
very difficult, and solution of these tasks is to be sought not only in perfecting
clinical methods of diagnosis and therapy, but also in the development of sero-
logi,:al and immunobiological methods of die gnosis and prophylaxis of cancer.
There is ground for -predicting that by proceeding in this direction, substantial
successes may be achieved in the fight against cancer in the near future.
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In conformance with the directives of the 19th FPrty Congress, during
1951 - 1955, 135,000 physician-specialists will receive advanced training and
will specialize by taking various courses at institutes for advancement and
specialization. This undertaking should be organized so that the studies of
the physicians will meet requirements, arm medical cadres with durable knowledge,
and broaden their clinical horizon.
The production enterprises of the Ministry of Public Health USSR have a
great role in the struggle for attaining a higher level of medical service for
the population, and in combating the death rate and disease morbidity. Iii 1952,
medical production subordinated to the USSR was seven times that of 1940; and
in 1955, production will exceed the 1940 level by the factor of 13.5. The pro-
duction of antibiotics and other highly effective chemicopharmaceutical prepara-
tions is receiving special attention.
This year saw the appearance of an entire series of highly effective thera-
peutic and prophylactic drugs. Among these, the new antituberculosis drug
phthivacide deserves particular attention. Its therapeutic effectiveness is no
less than that of streptomycin, and it has several very important advantages
over streptomycin: it is not toxic, does not evoke secondary effects, and is
simple to administer (in powder or tablet form).
Of even greater significance is the new antibiotic albomycin, which has
proved effective in treating pneumonia and septic diseases of young children;
also, synthomycin has been shown to be effective in the treatment of many
diseases, viz. dysentery, early stages of brucellosis, etc.
Synthetic drugs, such as methyltestocterone, testosterone propionate and
acetate, progesterone and pregnin are being used extensively in medical prac-
tice. Along with their customary use as the must effective agents for the
treatment of hormonal disturbances of the male and female organisms, these drugs
are employed successfully in the treatment of several forms of cancer, and
also in the treatment of blood circulation disturbances, tumerous diseases, and
other illnesses.
The new drug pachyc rpine ;pakhikarpin) is very effective in the treatment
of endartritis obliterans, muscular dystrophy, and affections of the vegetative
nervous ganglia. This drug also is valuable for its capacity to accelerate
obstetric activity. Other new medicines deserving special attention are the
sedative promedol, which has many advantages over morphine; and tiphen, which
acts against spasms of the blood vessels of internal organs, especially the
vessels of the heart. The drug trimetin has been found to be effective in the
treatment of minor forms of epilepsy, especially in children. Diplatsin is
very important in surgery, especially for relaxing the musculature during
surgery.
Dicumarin has gr-' blood anticoagulating characteristics, and is very im-
portant in the prophyaxis and therapy of thrombosis, enbolisms, and myocardic
infarct.
In 1955, the manufacture of medical, surgical, and traumatological ffirst
aid and prosthetic] equipment will be between two and three times greater than
in 1950. This permits greater stocking of therapeutic-prophylactic institutions
with modern diagnostic and therapeutic equipment. One of the important tasks
of medical production is to exert the utmost effort to increase the quality of
products, and t., improve apparatuses and instruments. The great and serious
deficiencies in this field must be eliminated.
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Under the directives of the 19th Party Congress, protection of workers in
production enterprises will be further improved.
A great deal of attention is being devoted to the problems of improving
working conditions and living conditions of laborers, as is clearly seen in
the construction of new and the reconstruction of old production enterprises,
as well as in the construction of dwellings and cultural establishments. All
this is done for the purpose of creating the conditions most favorable to the
physical and spiritual development of the Soviet people.
The transformation-of-nature program permits millions of hectares of land
to be carved out of the elements, protects agriculture against the -pernicious
influence of dry periods and droughts, changFs the climate and the flora and
fauna of a great territory of the Soviet Union, imt+roves the environment of
the Soviet people, and eliminates many factors which have a deleterious in-
fluence on the health of the population.
The extensive prophylactic measures which have been developed in the
USSR have an integral effect on building the Soviet society and state. With
the aim of maintaining hygienic, conditions as far as the purity of air and
water are concerned, the USSR withholds approval of projects and does not
give permission for the activation of new enterprises. e7.cntric stations,
thermal electric centers, and divisional shops and aggregates unless appropriate
purification facilities have been provided.
In the USSR, a large army of state sanitation inspection and sanitation-
antiepidemic service workers, invested by the Soviet government with great
authority (prava), stands guard over the enforcement of legislation which pro-
vides measures for the purification of air, soil, and water in order to create
and maintain sanitary conditions.
However, the work,pf these organs contains great deficiencies. State in-
spectors of sanitation and sanitation physicians frequently show liberality
with respect to negligent agricultural division heads who are violating sani-
tation legislation and are not providing protection of workers in production
enterprises. Liberalism and tolerance have been noted on the part of sanita-
tion division workers, viz., in the production enterprises of the Magnitogorsk
Combine, the Ural Machine Factory (Urnlmashzavod), etc.
It is essential that the liberal attitude t,ward persons who permit them-
selves to violate the Soviet sanitation laws be categorically terminated.
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