HEALTH PROTECTION IN THE SOVIET UNION

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80T00246A001600750002-0
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 33
• Document Creation Date: December 21, 2016
• Document Release Date: February 7, 2008
• Sequence Number: 2
• Content Type: OPEN SOURCE

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HEALTH PROTECTION
IN THE
SOVIET UNION
FOREIGN LANGUAGES PUBLISHING HOUSE
Moscow 1956
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This is a lecture prepared for physicians
and public health administrators by the Cen-
tral Institute of Advanced Medical Training
of the U.S.S.R. Ministry of Public Health. It
is translated from the pamphlet published by
the Medical Publishing House in Moscow.
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State Character, Unity and Planning of
Soviet Public Health Service . . . . .
11
Free Qualified Medical Aid for All . . . .
32
Soviet Public Health and Medical Science
36
Prophylaxis-Prevention of Disease . .
40
Public and Health Service . . . . . . .
52
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Soviet public health service is a, new, high
form of health protection, born after the Great
October Socialist Revolution and perfected in
the process of socialist construction. Guided
by the Communist Party and the Soviet Gov-
ernment, it is an important branch of socialist
construction and an integral part of socialist
culture.
Socialist culture has developed by critically
assimilating all that is valuable in the cultural
heritage of the past.
V. I. Lenin wrote:
"Proletarian culture must be the result of
a natural development of the stores of
knowledge which mankind has accumulated
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under the yoke of capitalist society, landlord
society, bureaucratic society."
Soviet culture is popular in character. It be-
longs to the people and is creatively developed
by millions of workers.
The same feature applies also to public
health protection. In the Soviet Union qualified
medical aid is free and available to all.
The Soviet doctor is a servant of the people;
he shares their interests and represents and
promotes socialist culture-the culture of the
working class.
Another feature of Soviet culture is its multi-
national character.
Writing on the interrelations of proletarian
and national culture, J. V. Stalin said:
"Proletarian in content, national in form-
such is, the universal culture towards which
socialism is proceeding. Proletarian culture
does not abolish national culture, it gives it
content. On the other hand, national culture
does not abolish proletarian culture, it gives it
form."
The building of socialist society and culture
means eliminating the economic and cultural
backwardness of formerly oppressed peoples
and the development by various socialist na-
tions of their own culture-national in form
and socialist in content.
Forty-eight nationalities of the U.S.S.R.
have created their own written language since
the October Revolution. Illiteracy has been
stamped out in all the union and autonomous
republics, and school children are now taught
in their own language. Now the national re-
publics train their own cadres for economy and
culture. All this represents the supreme
achievement of socialist construction.
The working class and its Party have al-
ways been guided by the principle of racial and
national equality and friendship among the
peoples. The leading role in the mutual enrich-
ment of the culture of national republics is
played by the culture of the Russian socialist
nation.
The socialist public health system takes into
account the national peculiarities of each re-
public.
Yet another characteristic feature of Soviet
culture is its socialist humanism.
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The Soviet doctor is wholeheartedly devoted
to the task of enhancing the well-being of his
people.
And the working people, in their turn, are
deeply grateful to the doctor who looks after
their health and upholds the standard of social-
ist humanism.
STATE CHARACTER, UNITY AND PLANNING
OF SOVIET PUBLIC HEALTH SERVICE
In its essence, tasks and functions the Soviet
Socialist State radically differs from all the
other types of state that preceded it. In the
same way its public health service differs from
all previous health services.
The. main forms of this system were laid
down explicitly in the programme adopted at
the Eighth Congress of the Communist Party
in 1919:
"As the basis for its !activity in the sphere of
protecting the people's health, the Russian
Communist Party considers as a prime duty
the carrying out of extensive health-building
and sanitary measures with the object of pre-
venting the incidence of disease.
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"Accordingly, the RCP makes it its imme-
diate task:
"1) To carry through resolutely extensive
sanitary measures in the interests of the work-
ing people, such as: a) improvement of health
conditions in populated places (protection of
soil, water and air from pollution), b) organ-
ization of public catering on a scientific and
hygienic basis, c) launching of measures to
prevent the outbreak and spread of infectious
diseases, d) creating a code of health legis-
lation.
"2) To combat social diseases-tuberculo-
sis, venereal diseases, alcoholism, etc.
"3) To make qualified medical and pharma-
ceutical services eviailable to all free of
charge."
These progressive trends in health protec-
tion are laid down in the Constitution of the
U.S.S.R. Article 120 says:
"Citizens of the U.S.S.R. have the right to
maintenance in old gage and also in case of
sickness or disability.
"This right is ensured by the extensive de-
velopment of social insurance of industrial,
office, and professional workers at state ex-
pense, free medical service for the working
people, and the provision of a wide network
of health resorts for the use of the working
people."
The Great October Socialist Revolution put
an end to, exploitation of man by man and en-
sured conditions necessary for the all-round
physical and spiritual development of the So-
viet working people.
Protection of people's health was proclaimed
the basic concern and duty of the Soviet
State, which is vitally interested in, promot-
ing people's health, prolonging their lives and
improving their well-being.
"In a socialist country the health of the
workers and peasants is the primary concern
of the state," M. I. Kalinin said.
Here is how N. A. Semashko, first People's
Commissar of Public Health, characterized the
Soviet public health system:
"The working people in the U.S.S.R. are
not the `objects' of the concern of other classes.
They are the `subjects,' the creators of their
own history. Herein lies the radical and fun-
damental distinction between the Soviet public
health system and the systems in pre-revolu-
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tionary Russia and in capitalist countries.
Herein lies the significance of the nationaliza-
tion of the medical services in our country."
In capitalist countries the state, as a rule,
plays a rather limited role in the health ser-
vices. Budget appropriations for health are
meagre and medical aid is generally in the
hands of private practitioners.
An example is the public health system in
the United States where, in addition to the
Federal Department of Health, mainly respon-
sible for hygiene and administration, there are
autonomous health departments in the states
which are not accountable to the Department
of Health. The public health services are not
unified under one department, there is no
single code of health legislation, land medical
aid, like in practically all the capitalist coun-
tries, is on a purely commercial basis.
Sanitation and hygiene in capitalist coun-
tries are developed only in so far as they are
in the interests of the bourgeoisie. It is no
secret that the health of the U.S. population
and the country's medical service have reached
an extremely low level. In. 1951, Pre-
sident Truman said that more than one mil-
lion Americans died from chronic diseases in
1950, and that mortality from heart ailments
in that same year was 20 per cent greater than
in 1940. To most of the population medical
treatment is a luxury they can ill afford.
The successes of the Soviet health service
have their origin in the socialist economy to
which such phenomena as anarchy in produc-
tion, crises and unemployment are utterly
alien. In the U.S.S.R. labour is a matter
of pride, enthusiasm and valour. The free
creative labour of the Soviet people is an
inexhaustible source of their well-being and
health.
Under socialism each new step in the devel-
opment of the country's productive forces, end
the consolidation of its material and technical
base means fuller, all-round satisfaction
of personal needs, and the growth of the
well-being and cultural level of the working
people.
The Soviet State, exercising economic, or-
ganizational, cultural and educational func-
tions, co-ordinates and directs public health
work. The U.S.S.R. Constitution proclaims the
right of every citizen to free medical aid, and
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ensures this right by the extensive development
of medical services at state expense.
Soviet public health plays an important part
in raising labour productivity and promoting
hygiene in industry and agriculture. At the
same time widespread measures are taken to
improve living conditions and here, too, the
Soviet health services are a factor of major
significance.
These measures include housing and munic-
ipal development on an unparalleled scale
and the improvement of amenities in populat-
ed places. The huge state appropriations for
social insurance benefits, pensions, cost-free
or port-free accommodation at sanatoria, holi-
day homes and children's establishments, aid
to mothers of large families and unmarried
mothers, free medical aid, and other measures
aimed at improving the well-being of the
working people, have 'had a beneficial effect on
the health of Soviet citizens.
In 1954 alone the state spent 146,000 mil-
lion rubles on allowances and other social be-
nefits.
For the first time in history, society-free of
exploitation of man by man-is putting all its
efforts into harmoniously developing man's
personality, physical and moral strength and
capacity, and into bringing up a healthy gener-
ation. This problem is being solved with the
direct and active participation of the Soviet
health services.
Wide prophylactic measures, mass physical
culture, qualified medical aid, application of
the latest curative and prophylactic meas-
ures-all this has made for considerable reduc=
tions in sickness incidence and mortality. In
1953 the number of deaths registered was one-
third of the 1913 figure. In pre-revolutionary
Russia the death rate was double that of Brit-
ain and the United States and almost double
that of France. Today, death incidence in the
U.S.S.R. is lower than in any of these coun-
tries. The Soviet public health services, how-
ever, have made it their task not only to reduce
sickness incidence but to eliminate completely
a number of diseases with the aid of the ad-
vianced methods worked out by Soviet medical
science. Major success has already been
achieved in this respect. An end has been put
to such dangerous diseases as plague, chol-
era, smallpox, and recurrent typhoid fever.
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There are no longer any epidemics of typhus
and the time is close at hand when malaria,
venereal and other diseases will be a thing of
the past. Malaria incidence in 1953 was 34
times less than in 1948. In the towns, deaths
from tuberculosis dropped two and a half
times, and the number of new tubercular cases
18.5 per cent in the same period. Effective pro-
phylactic measures are being outlined to
stamp out various infectious diseases.
Soviet scientists are now working on a prob-
lem whose solution had always seemed unat-
tainable-the problem of senility; how to pro-
long human life.
Sanitary and prophylactic measures are
carried out not only by the public health ser-
vices, but by industrial, public and trade-union
organizations as well.
All the medical establishments, scientific re-
search centres, medical schools and colleges,
pharmacies and factories manufacturing med-
ical equipment are owned and financed by
the state.
The Soviet budget covers all public health
expenditure. In 1940 this amounted to 11,200
million rubles; in 1953 it was almost 2.5 times
more and totalled 27,200 million rubles. More-
over, another 22,700 million rubles were spent
on health protection from state social insur-
ance budget funds.
On July 11, 1918, V. I. Lenin signed the
historic decree establishing the People's Com-
missariat of Public Health. The decree stipu-
lated:
"1. The Commissariat of Public Health will
be established for the purpose of unifying med-
ical and sanitary work in the R.S.F.S.R. and
will direct all the medical and sanitary ser-
vices in the country.
"2. All the files and funds of the Council of
Medical Collegia will be handed over to the
People's Commissariat of Public Health.
"3. The People's Commissariat of Public
Health will unify the activities of the medical
services of all the commissariats and control
their work pending full unification."
This decree placed all the medical and sani-
tary services, hitherto operated by various de-
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partments, establishments, organizations and
individuals, under the Commissariat's control
and on the state budget list.
The People's Commissariat of Public Health
set out to create a comprehensive system of
control over local public health services and
launched on the solution of the most urgent
problems (elimination of infectious diseases
and sanitary consequences of war) and mod-
ernization of medical- and sanitary institu-
tions.
It took resolute measures to strengthen the
public health departments of the local Soviets
of Workers', Soldiers' and Peasants' Deputies.
Health work was directed on the principle of
centralism, which is based on centralized di-
rection and broad initiative of the local medic-
al workers.
"It is necessary to stress the unique chiarac-
ter of the unification of medical institutions
under one single body," N. A. Semashko re-
called. "Our task was not simply to order uni-
fication (although the decree of the Council of
People's Commissars authorized us to do so),
but to show that unification of medical ser-
vices would benefit the people. Even the army
medical corps-an independent organization,
though extremely weak at that time-was
placed under the People's Commissariat of
Public Health, for it could better serve the Red
Army with such ia relatively strong organiza-
tion backing it."
To, enlist the co-operation of the public, the
Commissariat created an advisory body, the
Central Medical and Sanitary Council, with
members from workers' organizations. An-
other body, the Scientific Medical Council, was
set up to unify scientists. This council, headed
by the eminent scientist, Professor L. A. Tiara-
sevich, was entrusted with scientific and prac-
tical problems.
The Soviet Government promulgated a se-
ries of decrees aimed at further unification of
the administration and working methods of
the medical and sanitary institutions. Among
these were the decrees on health insurance
(December 22, 1917), nationalization of phar-
macies sand medical property (1918), mother
and child care (January 31, 1918) and
compulsory smallpox vaccination (April 10,
1919).
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Having successfully checked epidemics, the
Soviet public health services began a resolute
struggle against the pernicious heritage of the
past-tuberculosis, venereal and other diseases.
Again and again in the years that followed,
the public health services reorganized their
activity, striving by every possible means to
carry out the urgent tasks that arose in the
various ?stages of socialist construction. Uni-
fication of the medical services and the con-
struction of new hospitals, clinics and other
medical institutions considerably widened the
public health network. By 1928 the number of
hospital beds had increased by 70,000, rural
medical circuits by almost 100 per cent, and
doctors by 43,000, as compared with prerev-
olutionary times.
Many new-type institutions were established,
among them mother and child centres, tuber-
culosis and venerealogical dispensaries, con-
sultation centres, and night sanatoria.
The number of scientific research centres
grew, too. In 1930 the medical departments at
various universities, originally under the
People's Commissariat of Education, were
turned over to the People's Commissariat of
Public Health and reorganized as medical col-
leges. This led to improvement of tuition
methods and an increase in the number of
students. Teachers at these colleges were given
practical training in hospitals, polyclinics and
dispensaries.
The establishment of union republics was
followed by the formation of republican peo-
ple's commissariats of public health. In 1936
the Soviet Government set up the, U.S.S.R.
People's Commissariat of Public Health
(predecessor of the present Ministry of Public
Health) to co-ordinate and methodically direct
their activities.
The public health system underwent con-
stant changes to meet current exigencies, im-
proving with each phase of the development of
the Socialist State.
The Ministry of Communications, the Min-
istry of Defence and the Ministry of Internal
Affairs established their own medical and san-
itary services for the better care of their per-
sonnel, while the Ministry of Food Production,
the Ministry of Trade and other Ministries set
up sanitary inspection services. This did not
violate the principle of unity governing Soviet
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public health, since over-all direction and con-
trol remained in the hands of the U.S.S.R.
Ministry of Public Health.
Local public health services are directed by
the U.S.S.R. Ministry of Public Health
through the Republican Ministries. The local
Soviets of. Working People's Deputies have
their own public health departments in various
territories, regions, towns and districts. In most
republics .they are headed by deputies of the
local Soviets, who are accountable not only
to the higher authorities, but to their electors
as well.
The state character of Soviet public health
ensures application of the latest methods by
all medical institutions..
New advanced methods are popularized
by the medical press, scientific associations
and congresses. There are more than 40 mass-
circulation medical journals in the Soviet
Union, published in the Russian and other
languages.
Soviet doctors closely follow the advanced
experiences of the medical world, and take
an active part in international congresses
and conferences. The accomplishments of So-
viet and world medical science are widely
publicized and made use of.
The tremendous advantages of state or-
ganization and unification of working methods
in public health have been conclusively proved
by the complete elimination of malaria as
a widespread disease in various republics,
regions and districts. This has been made
possible by the co-operation of various
state organizations and wide application
of comprehensive preventive and curative
methods.
The state character, unity and planning of
the Soviet public health system have had an
especially beneficent influence on the medical
servicing of women and children who enjoy
particular attention in the Soviet Union.
Article 122 of the Soviet Constitution says:
"Women in the U.S.S.R. are accorded equal
rights with men in all spheres of economic,
government, cultural, political and other public
activity.
"The possibility of exercising these rights
is ensured by women being accorded an
equal right with men to work, payment for
work, rest and leisure, social insurance and
24
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education, and by state protection of the in-
terests of mother and child, state aid to
mothers of large families and unmarried
mothers, maternity leave with full pay, ahd
the provision of a wide network of maternity
homes, nurseries and kindergartens."
Half of the specialists graduating from
Soviet universities and institutes, and more
than half of all the doctors, are women. There
are more than 1,000,000 women, including
220,000 doctors, employed by Soviet medical
institutions. Many women are in charge of
university chairs and medical research cen-
tres.
Mothers enjoy special attention. The Soviet
Government has exalted the dignity and
honour of the Soviet mother by creating the
honourable title of Mother Heroine and insti-
tuting the Order of Motherhood Glory and
the Motherhood Medal.
More than 4,500,000 mothers have been dec-
orated with the Order of Motherhood Glory
and the Motherhood Medal for bringing up
five or more children. The title of Mother He-
roine has been conferred on more than 44,000
women who have given birth to and raised
ten or more children.
Mother and child care in the U.S.S.R. is a
state function. It is secured by special legisla-
tion and a wide network of medical and pro-
phylactic institutions.
Pregnant women are kept under observa-
tion by consultation centres that give them all
the necessary medical aid before and after
confinement and teach them child care and
hygiene.
Women working in factories or offices are
granted an extended leave (56 days before,
and 56 days after, childbirth). with full pay.
After the birth of a child they receive a sum
of money covering the cost of a layette. Fur-
thermore, they are entitled to time off from
work every three and a half hours to nurse
the baby.
Women collective farmers, too, enjoy privi-
leges. The Rules of the Agricultural Artel
-provide that they shall be granted a month's
leave before and another after confinement.
Maternity homes and maternity wards in
hospitals ensure all the necessary aid to ex-
pectant mothers not only, in the towns, but
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in the rural areas, too. Infants are kept under
observation by consultation centres and may
be reared in creches until they are three years
old. In the rural areas there are seasonal and
field creches in summer.
Children of pre-school age (from three to
seven years of age) attend kindergartens
which, like creches, are set up at factories and
plants, offices and residential blocks.
The state pays particular attention to the
health of school children. Proper sanitary
regime, physical culture, large-scale sani-
tary measures and systematic medical check-
ups help to ensure a healthy rising genera-
tion.
*
Planning of the national economy is one of
of the most important features of the eco-
nomic and organizational function of the So-
viet State.
Article 11 of the U.S.S.R. Constitution
says: "The economic life of the U.S.S.R. is
determined and directed by the state national-
economic plan, with the aim of increasing the
public wealth, of steadily raising the mate-
rial and cultural standards of the working
people, of consolidating the independence of
the U.S.S.R. and strengthening its defensive
capacity."
The national economic plan of the U.S.S.R.
covers all the branches of the economy and
culture: industry, agriculture, municipal and
housing economy, public health, education,
science and art. The public health develop-
ment plan is thus a component part of the na-
tional plan.
Apart from the national health plan there
are plans for each branch, department and
district, which take into consideration the
basic demographic and sickness indices. Here
particular attention is paid to medical ser-
vices in industry and the industrial centres,
new towns, machine-and-tractor stations, and
in the areas where virgin and fallow lands
are now being cultivated. This is in line with
4 the principle of rational differentiation in the
activities of public health services.
The need for it in the existing, and espe-
cially the newly created, medical institutions,
arose in the very first phase of Soviet public
health development.
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Planned public health made it possible to
expand the network of medical institutions
in places where they were inadequate, such
as the Sverdlovsk, Chelyabinsk, Molotov and
other industrial regions in the Urals, Siberia
end the Far East. They now have a sufficient
number of doctors, well-equipped hospitals and
other medical and prophylactic institutions.
The number of hospital beds in these regions
increased by 21,000 in the period of the first
post-war five-year plan.
Planned organization of the public health
services has largely done away with the
sharp distinction between town and country
on health matters. Specialized medical aid is
now available in 98.3 per cent of all the rural
district centres.
The policy of the Communist Party on the
national question is reflected also in public
health planning. The situation in the medical
services has changed radically in all the na-
tional . republics.
The number of hospitals in the Tajik S.S.R.
increased 75.4 times between 1917 and 1941,
in the Kirghiz S.S.R. 29.5 times, and in the
Turkmenian and Armenian" Soviet Socialist
Republics, 25 times. Soviet Azerbaijan has
8.5 times more medical and sanitary institu-
tions than Turkey and 23 times more than
Iran.
The national republics and outlying regions
of the U.S.S.R. have medical services which
are coming up with those in the central areas
of the European part of the country.
The Soviet health service is comprehensive
in character. As already mentioned, its main
tasks of protecting people's health are tackled
not only by the relevant organization, but
also by various other departments whose
plans provide for medical and sanitary meas-
ures.
Constant control and check-ups are abso-
lutely essential for successful implementation
of the measures provided for by the plan.
The development of the public health service
in the Soviet Union is a graphic example of
the advantages of unified direction and plan-
ning.
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FREE QUALIFIED MEDICAL AID FOR ALL
Soviet working people are assured free
qualified medical aid.
The introduction of free medical aid, how-
ever, did not mean thawtremendouse of
all. To make it so required
fort: the creation of a network of specialized
medical institutions and the training
adequate number of doctors and intermediate
medical personnel. The first step in this di-
rection was large-scale construction of med-
1941 the num-
ical ear t from 1917 to colleges.
In the the 25 25
ye
ber of hospitas in in towns increased the national r p blicsfold,
and even more
There were only 15 medical colleges in
Russia in 1913, with 1,500 doctors a after
ing annually. Within the first few years the
the Great October
colleges Socialist
medical vdepartments
number of by 16. At-present there are 84 such
increased by raduat-
institutes and the number of doctors There were
ing each year averages
only 20,000 doctors in pre-revolutionary Rus-
sia. In 1953 there were 277,000 doctors and
19,000 dentists. The increase has been espe-
cially sharp in the union republics, most of
them backward border regions under the tsar-
ist regime. For instance, before the Revolu-
tion there was only one doctor for 31,000 in-
habitants in Uzbekistan, now there is one for
895. In Azerbaijan there is a doctor for every
490 people and in Georgia for every 373.
Almost every union republic has its own
medical schools and colleges, in which stu-
dents are taught in their own language. Con-
sequently, all these republics have their own
physicians and intermediate medical person-
nel who speak the language, know the life
and customs of their patients, and ably carry
on health education among their people. In
Armenia, for example, native doctors consti-
tute 92 per cent of the total, in Georgia 82
and in Lithuania 61. There are also consider-
ably more doctors now in Siberia and in the
remote northern districts where previously
medical circuits were hundreds of miles apart.
No small role in public health is played by
the intermediate medical personnel-the phy-
sician's assistants, midwives and nurses-
whose number in 1917 totalled only 50,000.
33
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Nowadays the annual enrolment in medical
schools is 60,000, and there are already
900,000 physicians' assistants, midwives and
nurses in the Soviet Union.
The demand for qualified medical aid grows
along with the development of culture and
improvement of living standards. Only highly
qualified health services can satisfy the work-
ing people. Personnel for these services are
trained by the departments of Soviet medical
institutes dealing with curative cs and stoma-
tology. hygiene, pediatr
tology. The medical course has been extended
to six years, and in the sixth year the future
physicians enter clinics and hospitals for spe-
cialization purposes. specialists
On their graduation the young etc.) are
(surgeons, therapeutists, pediatrists,
sent by the U.S.S.R. Ministry of Public Health
to the places where they study annually
More than 16,000 physicians
at the ii institutes established for special and
advanced training. Scientific research centres
and the larger regional and city hospitals
There
possess facilities for advanced training.
are specialized courses for the intermediate
personnel, too.
The recent amalgamation of polyclinics,
clinics, consultation centres, dispensaries and
hospitals into single institutions under one
management has enabled dispensary doctors
to improve their qualifications.
A doctor working in a polyclinic can now
keep his patients under observation both during
the initial stages of their illness and while they
are in hospital, and can consult with eminent
specialists who formerly worked only in clinics.
Since district hospitals in the countryside
were reorganized as specialized institutions
the overwhelming majority of rural districts
now have their own specialists.
Another step towards better organization of
specialized medical aid is the institution by
the republican health ministries and regional
health departments of the office of chief spe-
cialist.
Scientific medical societies, physicians' Con-
gresses and conferences, and medical journals
do much to help the doctors to better their
qualification and augment their theoretical
knowledge.
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SOVIET PUBLIC HEALTH
AND MEDICAL SCIENCE
Socialist construction is inseparably linked
with the development of science and its
achievements.
"Previously, the human brain and human
genius created only to give some the benefits
of technique and culture and to deprive others
of the most essential things-education and
development. Now, all the wonders of tech-
nique, all the gains of culture will become the
property of all, and henceforth the human
brain and human genius will never be turned
into a means of oppression, into a weapon of
exploitation." So spoke V. I. Lenin, the found-
er of the Soviet State. This prophecy has
come true.
Soviet public health service is developing
successfully because it makes wide use of the
achievements of Soviet and world science.
There were few medical research centres in
pre-revolutionary Russia, scientific research
being done almost exclusively by the medical
departments of the universities and their
clinics. Today the Soviet Union has 84 medi-
cal institutes, and 259 medical research cen-
tres staffed by more than 15,000 scientific
workers. Instructors at the medical colleges
include 2,500 Doctors of Science and about
6,000 Candidates of Science.
Many hospitals in towns (Tula, Kalinin,
Penza, Sverdlovsk, Torzhok, etc.), and even
in the countryside, are headed by Doctors and
Candidates of Science.
Research work is done not only by scientif-
ic workers, but also by thousands of general
practitioners, scores of whom have been
awarded a government prize for their outstand-
ing accomplishments.
More than one-third of all the articles in So-
viet medical journals are written by general
practitioners and public health administra-
tors.
The co-ordinating centre of medical science
is the Academy of Medical Science of the
U.S.S.R. under the Ministry of Public Health.
It has more than 30 scientific research insti-
tutes, including physiology, biology, therapy,
surgery, pediatrics, public hygiene, labour
hygiene, organization of public health, and
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medical history. Among the academicians are
such prominent scientistsBas N. N. Anichkov,
Bykov, L. A. Orbeli,
Y. N. PavlovskY, K.
A. I. Abrikosov, A. D. Speransky, K. 1. Skrya-
bin, A. N. Bakulev and V. P. Filatov.
The activities of the medical research insti-
tutes are directed by the Scientific Council
of the Ministry of Public Health, whose mem-
bers include some of the Academy of most
Med-
ical scientists, and by
ed
Science. They determine what problems
these institutes and scientists shall work
upon.
It is on this basis that the state scientific
Ministry implementa-
research plan is worked the out. Its
tion is controlled by y
Health which is informed of the work under-
taken by each scientific institution and gives
all necessary assistance to scientists. in ris
precludes the possibility of duplication
search work and raises its efficiency.
Such method of planning enables scientists
the
to concentrate their efforts on solving hose
most urgent problems, particularly
e
whose solution will reduce sicknss incidencand
and mortality-such as the prevention
care of influenza, malignant growths, car-
diovascular diseases, etc.
Often scientists, and even scientific research
institutes, join forces on some urgent problem.
For instance, working on the problem of
hypertonia, the Institute of Therapy of the
Academy of Medical Science has enlisted the
co-operation of more than 100 specialists
from scientific research institutes all over the
country for the joint study of the etiology and
treatment of this disease.
Scientific achievements and discoveries are
immediately introduced into practice. New
methods of prophylaxis, diagnosis and treat-
ment are brought to the notice of medical and
prophylactic institutions through letters, in-
structions and the press.
Nation-wide, republican and local con-
gresses of medical specialists are held regu-
larly. The Academy of Medical Science of the
U.S.S.R. and the scientific councils of the re-
search institutes hold their sessions in various
towns with local practitioners taking part.
Soviet medical science is developing on the
basis of a free exchange of opinion and con-
structive discussion-a system that is widely
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applied by all medical research institutes and
societies.
Recent discussions~ral cardhad
problems, in which gen practitioners
widely participated, defined the targets of
scientific research in the sphere of preve =active
and curative treatment, reinforced practice
with advanced theoa'y, and ensured further
successful development of Soviet medical sci-
ence and public health.
PROPHYLAXIS-PREVENTION
OF DISEASE
The Soviet health service is based on the
principle of prophylaxis, i.e., its aim is not
merely to cure disease but to prevent it.
"We should not regard prophylaxis as an
ordinary preventive measure undertaken by
Soviet medical institutions," N. A. Semashko
said. "It is much more than that; it is to
solic-
expression of the Soviet State's deep
itude for people's health."
The Soviet State has created all the condi-
tions necessary for successful prophylactic
work.
In capitalist countries prophylactic measures
aimed at improving people's working and
living conditions are strictly limited in volume
and character and are implemented only to the
extent that they serve the interests of the
ruling classes.
"The root difference between So=viet medicine
and medicine in the capitalist countries," wrote
Z. P. Solovyov, one of the organizers of the
Soviet public health system, "lies in, the fact
that the latter cannot ? practise prophylaxis
without endangering the very foundations of
capitalism,, and for that reason its activities
are confined to so-called general measures and
limited individual charity."
And further: "The transfer of state power
into the hands of the working people, establish-
ment of the Soviet governmental system and
the development of a comprehensive medical
system have created the necessary premises
for organizing prophylaxis."
In the Soviet Union, where the aim of
socialist production is fully to satisfy the
growing material and cultural demands of
society, the enhancement of people's health and
the creation of healthy working and living con-
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ditions constitute one of the most important
state tasks.
It is to this end, too, that the ctandesrand-
public
mass measures of all the
union organizations are directed.
The principle of preventive medicine is
reflected in the Marxist-Leninist theory that
the living conditions of the working people
depend on the mode of production, in the scien-
tific and materialist conception of the organ-
ism's interactions with its environment, and
in the decisive significance of social conditions
for the protection of health and the elimination
of sources of disease.
Reactionary scientists deny that external,
end particularly social, conditions exert deci-
sive influence on the development of the orga-
nism and on people's health. They claim that
man's health is influenced by his physique and
heredity. They do this in an attempt to relieve
the capitalist class of the responsibility for
high sickness incidence end mortality among
the working people.
It was the progressive representatives of
Russian medicine who first proved
M. Sechenov,
tific basis of prophylaxis.
father of Russian physiology, wrote as far back
as 1861 that "the organism is inconceivable
without the environment which sustains it.
Hence, the scientific definition of the organism
must include the environment which influences
it, for without it the existence of the organism
is impossible." '
One of the first Russian clinicians, S. P. Bot-
kin, repeatedly pointed out that the cause of
sickness lay in poor living conditions. "The
concept of sickness is inseparably linked with
its cause which is always, and exclusively,
conditioned by the environment that affects the
afflicted organism either directly or indirectly,"
he said. "It is the organism's reaction to ma-
lignant action, to the influence that the envi-
ronment exerts on it, that constitutes the es-
sence of the disease."
The materialistic understanding of the role
which improvement of living conditions plays
in preventive medicine was also recognized
by another outstanding Russian clinician,
A. A. Ostroumov. "The aim of clinical re-
search," he said, "is to study the conditions of
the environment in which the human organism
exists, the conditions in which it adapts itself
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to the environment, and the causes of disorder.
The subject of clinical study is an ailing man
whose normal life has been disrupted by the
conditions of his environment."
And how true is the prophecy made by the
medic Pirogov: "The
famous Russian surgeon
future belongs to p
Eminent Russian scientists repeatedly
stressed the importance of hygiene in preven-
tive medicine. M. Y. Mudrov, father of the
Russian school of therapy, as. far back as the
first half of the 19th century considered that the
primlary duty of a doctor was to keep healthy
people under observation, since this would
permit early diagnosis and prevent disease.
"To take care of healthy people, safeguard
them from sickness, hereditary or otherwise,
and prescribe to them the regime they must
follow is the duty of every honest doctor," he
wrote. "This saves a lot of trouble, for it is
easier to prevent disease than cure it, and
preventing disease is the doctor's first, duty."
The eminent Russian therapeutist G. A. Za-
kharyin wrote: "The more qualified a medical
practitioner is, the more clearly he perceives
the power of hygiene and the relative weakness
of treatment, therapy. It is well known that
hygiene can prevent even the most dangerous
and widespread diseases against which therapy
is helpless. Therapy is successful only if one
observes hygiene. We might add that, while
therapy is valuable in individual cases, it
becomes less important as the number of cases
increases. It is only hygiene that can fight
victoriously against disease."
Research work by Russian sanitary statis-
ticians and hygienists reveals that it is social
conditions that influence people's health. They
have proved conclusively that the struggle for
man's health can be successful only if his
environment-i.e., his working and living
conditions-is improved.
I. P. Pavlov's study of conditioned reflexes
enriched our concept of the organism's inter-
action with its environment, and showed how
environment influences the organism. The
great physiologist's study of man's first and
second signalling systems strengthened the
possibility of "educating" the organism and
influencing it in the right direction for prophy-
lactic purposes. Pavlov particularly stressed
the tremendous importance of etiology and
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pathogeny for prophylaxis. "Indeed, do not the
causes of the disease," he wrote, "usually
creep into the organism where they begin to
act long before the patient becomes the subject
of medical attention? Knowledge of these
causes is, naturally, of extreme importance for
medicine. In the first place, only when we know
the cause, can we effectively struggle against
it, and in the second place, what is still more
important, prevent its action, its penetration
into the organism. Only knowledge oft present-day
causes of diseases will turn the p es y
medicine into the medicine of the future, i.e.,
hygiene in the broad sense of the word."
It is along this path that Soviet medicine is
advancing.
Inheriting all that was progressive in Rus-
sian and world medical science, Soviet doctors
not only formulated the preventive trend in
socialist public health, but also put it into
practice.
The successes of socialist construction and
the accomplishments of Soviet medical science
have been the factors making for the enrich-
ment and perfection of prophylaxis. It is
the basis upon which the work of our public
health bodies and medical personnel proceeds.
Protection of people's health- is primarily
effected through the implementation of exten-
sive sanitary measures, and is secured by state
legislation on the improvement of health con-
ditions in populated places (protection of soil,
water and air from pollution).
V. I. Lenin prophesied that under socialism
technical progress "will make working condi-
tions more hygienic, free millions of workers
from smoke, dust and dirt, and speed up the
transformation of filthy workshops into clean,
bright laboratories worthy of man." This
prophecy is becoming e reality.
Public health bodies participate in and
control the construction and reconstruction of
cities, industrial centres, factories, plants and
public enterprises.
The standards of hygienic working and
living conditions are worked out by Soviet
medical institutions, laboratories and epidemi-
ological stations which see to it that they are
strictly adhered to.
The struggle against the outbreak and
spread of contagious diseases is waged. by
powerful epidemiological services which have
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their own network of sanitary and bacterio-
logical institutes and laboratories.
Epidemiological stations, equipped with all
the necessary apparatus and well stocked with
disinfectants, serums and vaccines, function
in every town and district.
Soviet medical and prophylactic institutions
take an active part in the prevention and
elimination of infectious diseases. Hundreds of
millions of rubles are spent annually on
vaccinations and inoculation against small-
pox, diphtheria, tuberculosis and other dis-
eases.
Of vast prophylactic value is the network of
health resorts, sanatoria, night sanatoria and
holiday homes set up during the Soviet rule.
They annually accommodate nearly 5,000,000
people. is a
The synthesis of cure iand prophylaxis h is a
special feature of Soviet public
principle of preventive medicine is embodied
in the dispensary methods of work of Soviet
medical and prophylactic institutions.
This is how N. A. Semashko characterized
the dispensary methods of work: perfect
"The Soviet dispensary (1) ensures p
diagnosis and highly-qualified specialized
medical aid; (2) mobilizes society to combat
diseases; (3) implements measures aimed at
improving the working and living conditions
of the population; (4) propagates hygienic
knowledge among the population; (5) pre-
scribes the use of subsidiary establishments
(dietary dining-rooms, night and day siana-
toria, children's recreation grounds) ; and,
finally, (6) organizes further treatment (at
clinics, sanatoria or health resorts), if it is
found necessary.
"The dispensaries use active methods: they
are not satisfied with treating only those who
apply for medical aid. They seek out ailing
people and take measures to cure them in the
initial stage of the disease and to eliminate
sources of tuberculosis."
The dispensary methods applied by the
medical and prophylactic institutions have
improved along with the development of Soviet
public health. One of them is to take under
dispensary observation certain groups of
healthy people (on the production-and-age
principle) and of ailing people (on the noso-
logical principle).
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The dispensaries have played a decisive role
in combating the so-called social diseases
(tuberculosis, venereal diseases and alcohol-
ism) -the pernicious heritage of the past.
The first tuberculosis dispensary was opened
in Moscow in 1918 and the first venerealogical
dispensary in 1921. This was followed by the
establishment of a nation-wide network of dis-
pensaries with their own dietary dining-rooms,
night sanatoria, children's day sanatoria,
recreation grounds, etc.
There are also oncological, psychoneurologi-
cal, physical culture and other dispensaries as
well as a growing network of women's and
children's consultation centres which also ap-
ply dispensary methods. Dispensaries look
after babies from the moment of their birth,
children of pre-school age, school children,
youths, expectant mothers, etc. In the industries
this job is done by medical and sanitary sec-
tions, polyclinics and first-aid stations.
Dispensary methods are being increasingly
applied by the medical and prophylactic insti-
suffer-
tutions. Circuit doctors look after people e-
ing from cardiovascular ises, hyper and
rheumatism, ulcers, dysentery, malaria
other chronic diseases. Dispensary methods are
now being increasingly applied in the coun-
tryside.
The new phase in the development of prophy-
laxis is linked with the amalgamation of
polyclinics and hospitals. Dispensary methods
are now being used by clinicians and have
thus become the leading method of work in all
the medical and prophylactic institutions.
The solicitude of the Communist Party and
the Soviet Government for the improvement of
public health was vividly reflected in the
directives adopted by the 20th Congress of the
Party on the Sixth Five-Year Plan (1956-60):.
The Congress stressed the need for more ex-
tensive prophylaxis and, a higher standard of
medical service.
The Soviet Union has set itself the gigantic
task-never before attempted in human history
-of achieving 'a level of nourishment based
on physiological standards which scientists
consider necessary for the harmonious a.11-
round development of a healthy man.,
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PUBLIC AND HEALTH SERVICES
There is no sphere of socialist construction
that does not reflect the magnitude of people's
creative power, the development of which is
ensured by the Soviet State and social system,
the most democratic in the world.
Soviet public organizations and working
people have played an extremely active role in
every phase of public health construction.
Their volunteer services are an integral part
of the public health system. On their part,
health authorities and institutions maintain
the closest links with the people. All this makes
Soviet public health genuinely popular in
.character.
No medical organization could have success-
fully tackled the job of protecting and improv-
ing people's health and preventing diseases
without the support of public organizations and
the population.
"We have a `magic means'. of enlarging
our state apparatus tenfold at once, at one
stroke, a means which no capitalist state ever
possessed nor could possess," V. I. Lenin said.
"This magic means is to draw the working
people, to draw the poor, into the daily work
of state administration."
During the Civil War and foreign inter-
vention, workers, peasants and Red Army men
helped the public health services to check the
typhus epidemic. In 1920, in response to a call
from V. I. Lenin, our country launched a drive
for cleanliness and against filth-the source of
epidemics and disease. The nation-wide meas-
ures included the "Struggle-for-Cleanliness
Week," "Bath-and-Laundry Week," cleaning
up of yards, houses and dormitories, and
mass disinfection. Permanent volunteer health
stations, sanitary commissions and first-aid
stations were established in the industries,
houses, schools and in the army.
Then came peace and the rehabilitation of
the national economy, and it was in this period
that the factories and work places formed
public health aid groups, set up social insur-
ance councils under, the factory committees,
and elected insurance delegates. Commissions
entrusted with improving working and living
conditions and with advising the population on
social aid were established at hospitals, poly-
clinics, dispensaries and consultation centres.
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Volunteer services were also organized in
the countryside. Rural health agents, first-aid
stations and sanitary commissions rendered
valuable assistance to theedi a l personnel
.
Somewhat later there appear ization in
the volunteer health l gahealth agents new andr sanif
an institute of Pubic
stations.
These health volunteers played an exceP-
tional role during the Second World Wahealth
considerable assistance tot Cross and Red
services, was given by Red gave first-aid
Crescent organizations. They eo le,
instruction to more than 23,000,000 ppet
trained 60,000 public health inspectors
of
up 250,000 sanitary stations. art of
thousands of Red Cross members took cphealth
the anti-epidemic drives of the p
services, looking after the sanitary conditions yards in the industries, sresidenal blocks e-toouse health a n~Pect on
carrying out hou
and seeking out the sick. s gave invaluable
Red Cross sanitary eamitals in receiving
assistance to clearing P
the wounded from hospital trains and in seeing
to. the needs of the wounded.
It was on the initiative of the Red Cross
that collective farms set up medical stations
which conducted ;anti-epidemic and sanitary
education work under the guidance of medical
personnel.
After the war the population joined actively
in restoring the medical establishments which
the fascist aggressors had destroyed. Twelve
thousand collective farmers in Zhitomir
Region, the Ukraine, set the example by work-
ing on Sundays to repair the medical insti-
tutions in their area. This example was fol-
lowed by collective farmers throughout. the
country.
There are many types of volunteer health
organizations and methods of work, and they
have changed and improved with each phase
of public health development:
Public participation in health work is now
organized along definite lines. The Soviets of
Working People's Deputies have permanent
public health commissions (formerly public
health sections) whose members are drawn
from among Deputies of the Soviets, medical
personnel and other workers. These commis-
sions look after health conditions, control the
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activities of medical institutions, deal with
population's complaints and help to eliminate
shortcomings in the public health system.
An exceptionally active role in public health
is played by trade unions. The social insurance
councils of the factory committees and the
insurance delegates supervise the work of
medical and prophylactic institutions, help to
improve the medical treatment of workers and
their families and see to it that the sick observe
the regime prescribed by doctors.
Implementing the decision of the U.S.S.R.
Ministry of Public Health and the All-Union
Central Council of Trade Unions, the hospitals,
dispen-
polyclinics, maternity homes, creches,
saries and other medical and prophylactic
institutions have organized Councils of Assist-
ance. Their members are Communist Party
,and trade-union representatives, medical work-
ers of the institution concerned, workers and
employees of the factories, plants other
establishments serviced by the institution, and
representatives of the residential blocks in the
institution's district, the permanent public
health commission of the Soviet of Working
People's Deputies, and the Red Cross Society.
The Council of Assistance is headed by the
director of the medical institution.
The Council members work out measures
aimed at improving medical and prophylactic
services, reducing sickness incidence and
preventing diseases, organize sanitary educa-
tional work and carry out sanitary and anti-
epidemic measures. The Council sees to it that
the medical institution is kept in repair, well
equipped and supplied, and deals also with
complaints concerning the public health ser-
vices.
In orphanages there are guardianship coun-
cils which supervise activities, look after the
children's education and find suitable homes
for them in workers' families.
Public health agents at the medical and
prophylactic institutions and epidemiological
stations in towns and in the countryside con-
stitute the biggest of the voluntary groups.
They have well proved their worth in practical
work. They assist the circuit doctors of town
and rural hospitals, physicians at factories and
other industrial enterprises, and epidemiolo-
gists, and also look after sanitary conditions.
These agents are elected by the local com-
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mittees of various enterprises, by collective
farms and by local Red Cross organizations,
from among their most active social workers.
The basic voluntary public health organi-
zations are the sanitary posts set up in factory
workshops and other enterprises, in schools,
universities and colleges, at state and collec-
tive farms, and machine-and-tractor stations.
These posts are serviced by members of the
Red Cross and Crescent Society and other
social workers. They give valuable assistance
to medical personnel in prophylaxis and
sanitary education, and look after sanitary
conditions at the workshops, residential blocks
and dormitories.
They are particularly active in the country-
side where they carry out house-to-house
inspection, superintend the work of children's
establishments, see to it that wells and other
sources of water are kept free of infection, and
look after hygiene in field work.
Red Cross Society sanitary teams are
attached to medical and prophylactic institu-
tions and help them in their health-building
work,
The work done by the permanent commis-
sions of the Soviets of Working People's
Deputies, the Red Cross and Red Crescent
Societies, social insurance councils and in-
surance delegates, councils of assistance and
guardianship councils, public health agents
and members of the sanitary posts is a major
factor in the success of Soviet public health in
prophylaxis, in developing medical services
and improving the health of the people.
Improvement of city and rural medical
services, of prophylaxis and sanitation is
inconceivable without the active participation
of the population and of public organizations
in health work. The health services must rely
on the everyday assistance of voluntary work-
ers whose strength and potentialities are in-
exhaustible.
The membership of the Red Cross and Red
Crescent Societies alone exceeds 17,500,000
Soviet citizens who assist the health services
in carrying out prophylactic measures and
propagating hygiene.
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The main task of those leading the public
health service is to make proper use of the
creative potentialities of the voluntary health
workers, and it is their duty to train and
educate such workers.
The education of voluntary health workers
is the duty of all medical workers, Red
edu-
medical rocs
and Red Crescent organizations,
cational institutes and of the medical workers'
trade union, but it is, first and foremost, the
job of therapeutists, pediatrists, gynaecolog-
ists, doctors practising in workshops, sanita-
rian, and epidemiologists who, serving t ne
industrial workers and the p pulation
tain close contact with them.
The public health authorities and institutions
co-operate with the permanent health com-
missions of the local Soviets, and strive with
their assistance and to
sanitary measuresnw thin
prophylactic
their district or town.
They enlist the help of Red Cross members
in carrying out mass measures aimed at rais-
ing the level of sanitary services andv m rov-
ing hygienic conditions in towns,
settlements, residential blocks and dormitories,
industries and schools, as well as at collective
farms, machine-and-tractor stations, dairy
farms, and in agricultural work.
Sanitary education plays an extremely
important role in the improvement of hygiene,
the elimination of the remnants of the past and
the betterment of living conditions. It is used
to interest the populiation in health protection
work. Help given to the public health author-
ities and institutions by voluntary workers is
a necessary condition and guarantee of the
successful protection of the health of Soviet
people, the builders of communist society.
Approved For Release 2008/02/11: CIA-RDP80T00246AO01600750002-0
 Approved For Release 2008/02/11: CIA-RDP80T00246A001600750002-0
OCHOBEIbIE IiPHHIJHIIbI
COBETCKOrO 3.E PABOOXPAHEHH51
Printed in the Union of Soviet Socialist Republics
Approved For Release 2008/02/11: CIA-RDP80T00246A001600750002-0