1. BLACK MARKET MEDICAL ACTIVITY 2. ADMISSION TO MEDICAL FACILITIES 3. ATTITUDES AND POSITION OF MEDICAL DOCTORS

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80-00810A001400430007-2
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 4
• Document Creation Date: December 14, 2016
• Document Release Date: August 10, 2001
• Sequence Number: 7
• Publication Date: July 10, 1953
• Content Type: REPORT

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CENTRAL INTELLIGENCE AGENCY
INFORMATION REPORT
SECRET'
SECURITY INFORMATION
PLACE ACQUIRED
This Document contains information affecting the Na-
tional Defense of the United States, within the mean-
ing of Title 18, Sections 793 and 794, of the U.S. Code, as
amended. Its transmission or revelation of its contents
to or receipt by an unauthorized person is prohibited
by law. The reproduction of this form is prohibited.
DATE DISTR.
io July 1953
NO. OF PAGES
4
REQUIREMENT NO.
25X1A
1. There was no extensive "after-hours" black market in medical services in
Eherson, USSR. Private practice by physicians was not legal. Dentists, on the
other hand, could carry on a private practice after their regular state duties
had been met, and no punishment would be imposed. This was probably because
the authorities recognized a. need for dental care among the population,
whereas they did not recognize any need for "after-hours" medical attention.
a. Occasionally,. arrangements would be made by a patient with a physician for
an illegal abortion or for treatment of gonorrhea. These arrangements were
made between the individual concerned and a friend who was a physician or
who knew a physician. No such clandestine treatment could be arranged for
treating syphilis, since concealing the latter disease was regarded as,an
enormous crime,
b. For those few people who could not afford to take time from their daily
work to wait-at the polyclinics for medical care, arrangements could be
made with some physician who was a personal acquaintance. The doctor would
then be given money for his services; or, perhaps more frequently, the
patient could reciprocate by doing some favor for the physician.
.2. .There was very little black marketing in prescriptions. Occasionally, spurious
prescriptions
...,.prepared; but this was probably something done on an
individual basis rather than as an actual black market activity. I recall that
private citizens were forbidden to use sex gland preparations designed to restore
or increase virility. One such preparation, "bobrovaya struya" (an extract of
beaver glands), was popularly believed to be an aphrodisiac, and there was a
black market in'prescriptions for it, because use of aphrodisiacs was frowned
upon by the State.
STATE ` ARMY i'
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AIR 1# J FBI J IAEC
(Notef Washington DlstributAp~I~~@i CIA-RDP80-00810
1, Black Market Medical Activity
2. Admission to Medical Facilities
3. Attitudes and Position of Medical
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25X1A
Signatures on drug prescriptions were normally examined by the
druggist, so that he could',assure himself that the prescriptions
were genuine. The druggist usually knew all doctors in the city.
It was possible, however, to have a prescription filled in cities
other than the one in which the 14spu phys'ioian. ' lived.', Thus,
the druggist could not be expected to know all the signatures he
examined. Although I do not recall the form employed for'k.wr,ting
prescriptions, I do know that the prescription blank was made up
according to a definite pattern. These blanks were prepared for
the use of physicians at the respective medical offices, e.g., the
polyclinic, dispensary, or hospital. The prescription always bore
the day, month, and year of its writing, according to this form:
19 53; that is, the first two and last two digits of the year were
asp ated by a line above which was written the day of the month and
below which, in Roman numerals, was written the month of the year.
The symbol 19 4 53 means, therefore, 20 February 1953. Important
physicians soma imes had their own prescription blanks prepared on
which were listed their names and titles. It occasionally happened
that prescription blanks became scarce and then the physicians at
the medical installation concerned would simply use a blank piece
of paper on which to write out the neosesa;y prescription. This
blank paper had to bear the date, written in the fashion indicated
above, and the physician's name. Prescriptions could not be
refilled.
To get into a factory dispensary, the so-called "Zdra unkt", nothing
was"required of the factory worker by way of documentation. To enter
an ambulatoriya, or small village dispensary, the patient had to
show,a "spravka emesta raboty" (a note from his place of work,
-e.g., a kolkhoz) or a "trudovra knizhka" (a worker's book). When
the small village "ambulatoriya" referred a patient to a "polikiinika"
~polyolinic, or out-patient clinic) the patient had to present a
napravleniye" (referral slip). When entering ,a city polyclinic, the
patient showed the "epravka smesta raboty", or the "trudovaya
knishka" only on the-first occasion he appeared for consultationj'at
that time the patient received,a number by which he identified him-
self on future visits.
To get into a hospital, a patient had to carry a "napravleniye" from
a polyclinic doctor, or, in oases of emergency such as street
accidents, he had to be.consigned to the hospital by the attending
ambulanoe physician. No passport or other.-personal identification
papers were requested from patients at any of these installations.
No observation of physicians, simply because they were physicians, was
carried on to my knowledge. The average .citizen paid no special
attention to the movements of doctors, nor did citizens or state
security police ever pay undue notice to whomever the doctors visited.
However, doctors were"no different from other citizens when it came
to being scrutinized by security officers. Records on those whom
physicians saw outside of their professional contacts were not.
maintained. Records on the outcome of a physician's professional
oases were available only to the physician and his superiors.
Mon-professional medical personnel were poorly paid compared to.
regular physicians.
It was rare that homes or other buildings were inspected by sanitation
workers. It occurred no more than once a year. These personnel
carried no identification and apparently were never requested to show
identification papers. The sanitation workers in Kherson uOually did
no cleaning or extermination, but instead called the attention of
the building occupants to any sanitation problems; they gave no
cleaning material or exterminating powder to the occupants whom they
ordered to clean up the.premises.
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.A physician who had made an incorrect diagnosis which had received
official notice was required to explain his error to a'Party
Committee made up of a clinic director, several physicians, and
assistant medical personnel. These committee members might give
the.off ending doctor a reprimand, or hand him over to a public
prosecutor for trial on various appropriate charges.
10. Whenever a worker reported to his foremah that he was sick the
foreman was obliged to send the worker to the dispensary ( Zdravpunkt")
of the enterprise. The staff of the dispensary decided whether the
man was actually ill. Body temperature above normal was sr:; y ...,::
symptom used by the doctor in deciding whether an individual was sick.
There was a list of illnesses` which disqualified a,worker from
normal activity and which permitted him to remain away from work. I
do not recall the illnesses set down in this list, which was known as
.the "bolnichny'y, list" .
11.. Sickness from food served in plants or government mess halls was rare,
because such official eating establishments were kept fairly clean.
Butybeoause of low pay, the workers ate very poorly at home, and this
caused considerable intestinal disorders not attributable to factory
or institution food. If sickness did develop as a result of
.ti it al feeding, an,, investigation was launched. Responsibility
might be shared by both the establishment's director and its
physician, or by either one of these people, as the men most answerable.
for carelessness of their subordinates.
12. It was not possible to guess the political loyalty of doctors as a
group. They were no different from the res#:_6t'the population; some
were-fanatic Communists; others, disinterested. The idea that it
would be easier to induce a doctor to cooperate in resistance, in
preference to a man of other skill or professional training, Is false.
I believe it would be dangerous for anyone to approach a doctor to ask
him to betray his rulers; the doctor would report the suggestion to the
authorities even if he'were susceptible to the suggestion of betrayal,
because he would fear that the person making the suggestion was a
provocateur. A village doctor might be more susceptible than?a city
physician, because it was generally true that village dwellers saw
more clearly than their city counterparts that the Communists were
destroying Russia.. I do not believe that there existed in. the USSR
any relation between one's extent of training and attitude toward
Communism. Hence, the medical assistant's (felds.her's) attitude
towards the Government was not substantially different r4 that of
the physician.
13. I believe that physicians as a group were more friendly to the
people than other public officials. I did not notice that they were
more independent than others. I know of no cases where doctors were
punished for not conforming or for not being strict enough. It was
always possible that anyone in the USSR, including the doctors,
could be police agents.
1L-...1: believe the lack of defectors among doctors is based on the fact
that they hesitate to leave their families or their steady-payig' abs.~'
and that they wait in the hope that better times will come. Only
the man who has no ties, i.e., no relatives and no position, will
risk defection.
15. There were four reasons for the lack of defectors, apart from possible
`loyalty to Russia:,
a. People dl not want to~.abandon thiif?fa M , including their
relatives. Those le ,t,behind would suffer.
ILLEGIB
b. People did not nave any ea wnat rortune awaited them outside
of Soviet territory. Western propaganda either did not reach
them or was unconvincing.
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c. Defectors who were caught could expect no mercy.
d. If a defection succeeded, and a subsequent war between the USSR
and the sheltering country broke out, the people felt that the"
Soviet Union would demand return of the defector to the'USSR as
A condition for peace. The people had no confidence that the
sheltering country could or would protect them from Soviet
vengeance.
.16. Assignment of doctors to rural posts was not a disciplinary action.
Usually, young doctors were so assigned, and many requested such
assignments. ;t would be a mistake to believe that rural physicians
were ipso facto discontented.
-17. 1 estimate that 30% of Soviet physicians were Jews. These people
could rise to any post. In 1952 I had no idea that anti-Semitism
existed, and I recall that, in 1945, many Polish Jews who were
refugees in the USSR elected to remain in the USSR, believing it to
be the land where they would be protected.
18. All nationalities were encouraged to study medicine. I believe that
the people in the USSR paid little or no attention to nationality as
a basis for privilege. A physician of any extraction could work
anywhere in-the USSR, even in the Kremlin.
.19. Auxiliary medical personnel received low salaries, usually between
600 and 800 rubles per month;; the USSR had adequate auxiliary medical
service manpower. I believe these people enjoyed reasonable prestige
and pride in their jobs.
20. A professional Soviet bacteriologist had the same standing as a
physician. He was not regarded as a technician, or as someone of
lesser calibre than the physician.
21. Some etoxnatologists in the USSR had the same professional training and,
competency as a physician. There were some dental technicians who
were referred to as stomatologiste,even though they did not possess
the eduovbional background. Some of these technicians had the same
competency as the genuine stomatologists. Members of the dental
profession were able to make their own reputation based on skill and
service.
22. It was forbidden to employ gold in tooth repair. Silver was not used,
but a silver-lead alloy was sometimes employed. Stainless steel and,
occasionally, porcelain, were used for dental prostheses. (Peasants
usually preferred extraction to repair.)
23. Drugs most likely to be available on the black market were penicillin
from West Germany and chemical contraceptives which were not made in
the USSR. Contraceptive condoms were sold in the USSR, at 30 kopeks
each; but they were not a black market item.
24. Penicillin was the most valued drug. I never saw streptomycin in the
USSR. I never heard of any demand for gramicidin S on the black market.
25. A diabetic in the USSR got his insulin injection-at a dispensary.
He could not administer it to himself.
26. Morphine addiction. cases did exist in the USSR but I do not believe
they were frequent. There was probably some illicit trade in dope, but
I never saw any concrete examples. Excessive alcoholic indulgences,-not
,drug addiction, was. the common dope mechanism. I believe that
physicians were included,in,the number of people who drank excessively.
In this regard I would e'xpl'ain that intellectually honest_.physieians
could not endure Communism and would, therefore,'Aake rip the bulk'of
"alcoholics" among ,physicians.
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