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Document Number (FOIA) /ESDN (CREST): 
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Document Creation Date: 
November 4, 2016
Document Release Date: 
December 1, 2011
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Publication Date: 
August 31, 1982
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(h)(1) Declassified in Part - Sanitized Copy Approved for Release 2011/12/01: NSA-RDP96XO079OR000100010049-4 Directorate of Intelligence _Seeret- 5 AUG 1982 ~ ~? ?;~,1~~ 7 t' i ~_? ~. ?. y .' _ . `~~.~'l1 ~' . "~- _.:~. I~}~af?~~; j ?.' f" . ~ r%..: T . ~'~.t 4i Declassified in Part - Sanitized Copy Approved for Release 2011/12/01 (b)(3) Declassified in Part - Sanitized Copy Approved for Release 2011/12/01: NSA-RDP96XO079OR000100010049-4 Direct- -te of Intelligence (b)(1) (b)(3) USSR Monthly Review July-August 1982 (b)(1) (b)(3) (b)(1) (b)(3) ,swrer SOV i!R 82-007X August 1982 Declassified in Part - Sanitized Copy Approved for Release 2011/12/01: NSA-RDP96XO079OR000100010049-4 Declassified in Part - Sanitized Copy Approved for Release 2011/12/01 NSA-RD P96XO0790R000100010049-4 (b)(1) (b)(3) Soviet VIP Health Care The death in January 1982 of 79-year-old Mikhail Suslov, leading ideologue of the Communist Party of the Soviet Union (CPSU), underscored the mortality of the aging Soviet leadership. Several of these men, including Brezhnev, have been afflicted with life- threatening illnesses, and the preservation of their lives and health is due largely to a special subsection of the USSR Ministry of Health called the Fourth Main Administration. This health-care organization has sustained, beyond what might have been expected, the longevity in office of the current leaders. Al- though it may have given the Western world the security of dealing with men whose past behavior and ideas are well known, it has also helped saddle the Soviet Union with a moribund Politburo, whose full members, at an average age of 70, seem ill equipped to handle the kind of political and diplomatic changes that confront the nation. The Fourth Main Administration Background. Shortly after the Soviet Government moved to Moscow from Petrograd (now Leningrad) in 1918, the Kremlin Medical-Sanitary Administration was established; it later became a part of the CPSU Central Committee and was renamed the Medical Department of the Affairs Administration. During the 1920s and 1930s this department developed a network of hospitals, outpatient clinics, sanatoriums, and pharmacies established especially to serve party and state officials. Just before World War II, the Ministry of Health established the Fourth Main Administration (Fourth MA) to assume responsibility for these special health-care facilities and for VIP treatment. The CPSU Medical Department was rele- gated to basically administrative functions. Scope of the System. The Fourth MA is responsible for serving the medical needs of: ? Senior Soviet leaders and their immediate families. ? Other high-level CPSU officials. ? Senior officers of the Committee for State Security (KGB). (b)(1) (b)(3) 33 r (b)(1) (b)(3) ? Prominent public figures and other officials down to the republic ministr level. (b)(1) ? Foreign dignitaries (b)(3) The care that each patient receives is governed by rigid rules. These include guidelines for the assign- ment of physicians: ? Every top Soviet official is assigned a permanent, personal physician (usually of his choice). ? Middle?,cvel, but still senior, government and party officials and their families are under the care of a junior physician supervised by a higher level consultant. ? Further down the hierarchy, several officials and their famili ies may be under the care of a(b)(1) lb)(3) The VIP health network is extensive: every major Soviet city has at least one clinic for the exclusive use of VIPs. Numerous facilities dot the Baltic and Black Sea coasts.(b)(1) (b)(3) Administration Director Chazov. Since 1976 the di- rector of the Fourth MA has been cardiologist Yev- geniy Ivanovich Chazov. He heads the Kremlin Poly- clinic and is personal physician to General Secretary Brezhnev. Chazov is also a consultant on health problems of other Kremlin leaders. His duties'include: ? Making house and office calls on Soviet leaders. ? Writing medical reports and findings on VIPs. ? Arranging for the transfer of patients to Fourth MA facilities. ? Arranging staff consultations with outside medical specialists on difficult VIP cases. ? Keeping the leaders informed of the medical prog- ress of their ailing peers.-- Chazov's status was publicly acknowledged in July 1978, when Brezhnev awarded him the Order of Lenin, a Hammer and Sickle Gold Medal, and the Declassified in Part - Sanitized Copy Approved for Release 2011/12/01 NSA-RDP96X00790R000100010049-4 (b)(1) Declassified in Part - Sanitized Copy Approved for Release 2011/12/01: NSA-RDP96X00790R000100010049-4 (b)(1) (b)(3) (b)(1) (b)(3) (b)(1) (b)(3) title Hero of Socialist Labor during a nationally televised ceremony. Chazov was made a full member of the CPSU Central Committee in May 1982.n ? Ready access to scarce medications ? Excellent prophylactic care. ? Best equipped and most modern facilities. Advantages to Elite The system of preferential health care affords sub- stantial advantages to the Soviet elite, including: problems are encountered Limitations Political Considerations. Doctors on Fourth MA hospital staffs obtain their positions not only because of skill but also because of political or personal connections. Such nonmedical considerations have usually ruled out Jews, Armenians, or others consid- ered politically unreliable, even though qualified pro- fessionally. Thus, VIP facilities may not always pos- sess the best staff doctors. Prominent outside specialists are called in whenever serious medical Separation From Research. Because of the adminis- trative and physical separation of medical research facilities from medical institutes, VIP and other phy- sicians are often unaware of new medical discoveries, while researchers are frequently out of touch with the Retarded Professional Development. Because of the limited patient admission policies of VIP facilities and consequent light workload, staff physicians get less day-to-day work experience than their counterparts in the public health system. In addition, because VIP doctors and nurses often perform daily services that are beneath the level of their professional abilities, the sharpen ng of their medical skills is further impeded. needs of practicing doctors those doctors. Conservative Approach Physicians treating VIPs are reluctant to take chances. They still remember the arrest in January 1953 of Kremlin doctors (most with Jewish names) for allegedly plotting to murder senior party and military personnel. Only the death of then-CPSU General Secretary Josif Stalin forestalled the execution of Surgeons know that they and their procedures will be investigated should a patient die while undergoing surgery. A physician involved in two such deaths is barred from ~ur h r participation in the work of the Fourth MA.I (b)(1) (b)(3) Using outside consultants on as many as 80 percent of all cases, Fourth MA doctors have sought to minimize improper treatment and career risk. If the patient being treated is important enough, (b)(1) Western equipment and pharmaceuticals are ob- (b)(3) tained, and foreign doctors are brow ht in to consult on or even to conduct treatment (b)(1) (b)(3) Major VIP Health Facilities Central Clinical Hospital. The Central Clinical Hos- pital is variously referred to as the Kremlin Hospital, the Kuntsevo Hospital, or the Zagorodnaya Hospital. It has all the facilities of a general hospital, and it is apparently limited to VIP patients. Treatment ranges from outpatient care to intensive care for the seriously ill who r uire extensive hospitalization or major surgery. (b)(1) (b)(3) Kremlin Polyclinic. The Kremlin Polyclinic, a branch of the Central Clinical Hospital, is a system of physically separate clinics and hospitals. The head- quarters, which is the building generally referred to when discussing the Kremlin Polyclinic, is especially well equipped for resuscitate to am generally treated on an outpatient basis (b)(1) (b)(3) M. V. Lomonosov Central Polyclinic. The Lomonosov Central Polyclinic is sometimes referred to as the Medical Directorate in Lenin Hills, the New Central Clinical Hospital, or the Leadership Hospital The polyclinic has both inpatient and outpatient facilities; VIP patients with both serious and minor illnesses arc admitted to the hospital section of the polyclinic. (b)(1) Little information is available on the polyclinic's (b)(3) facilities, b' elieved to be among the best in Moscow(b)(1) (b)(3) Barvikha and Other VIP Sanatoriums. Barvikha and other special sanatoriums are exclusive facilities for the treatment of VIPs. In addition to receiving medi- cal care, officials can rest and have mud baths, (b)(1) (b)(3) 34 Declassified in Part - Sanitized Copy Approved for Release 2011/12/01 : NSA-RDP96X00790R000100010049-4 Declassified in Part - Sanitized Copy Approved for Release 2011/12/01: NSA-RDP96X00790R000100010049-4 massages, and heat treatments. They can also enjoy recreational activities, film showings, and luxuries unavailable to the public. No surgery is performed. Unusual Treatment In addition to the several major medical facilities, other units exist for the treatment of special VIP medical problems: Emergencies. Emergency treatment for high-level of- ficials taken ill inside the Moscow Kremlin is avail- able in the Kremlin First Aid Unit, also called the Inside Polyclinic. Physicians specializing in reanima- tion and pulmonary resuscitation are on 24-hour dut3 in a special room maintained solely for General Secretary Brezhnev Alcoholism. The V. P. Serbskiy Psychiatric Institute in Moscow has an unnumbered, unnamed section devoted to the care of VIP alcoholics Psychiatry. The V. M. Bakhterev Psyehoneurological Institute in Leningrad has treated VIP patients with psychiatric problems. Officials seeking psychiatric help usually turn to private practitioners, however, because they are afraid that if they go to a hospital, they will be removed from their posts. Faith Healing. The most unusual health care service available to Soviet VIPs is provided by a 33-year-old "Assyrian" faith healer (a native of the Georgian SSR) named Yevgeniya (Dzhuna) Davitashvili. Ru- mors abound concerning the healing abilities of this woman, and despite increasing official unease, her (b)(1) (b)(3) a.s,~.nro (b)(1) (b)(3) clientele continues to grow; it may even have include General Secretary Brezhnev and former Health Mi ister Boris Petrovskiy. In the land of scientific socia ism, medical mysticism apparently remains as deer rooted as it was 66 years ago when Ras utin influ- enced another group of Russian leaders (b)(1) (b)(3) (b)(1) (b)(3) (b)(1) (b)(3) Declassified in Part - Sanitized Copy Approved for Release 2011/12/01: NSA-RDP96X00790R000100010049-4