USSR MONTHLY REVIEW

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): NSA-RDP96X00790R000100010049-4
• Release Decision: RIPPUB
• Original Classification: K
• Document Page Count: 5
• Document Creation Date: November 4, 2016
• Document Release Date: December 1, 2011
• Sequence Number: 49
• Publication Date: August 31, 1982
• Content Type: REPORT

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Directorate of
Intelligence
_Seeret-
5 AUG 1982
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Direct- -te of
Intelligence
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USSR Monthly Review
July-August 1982
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,swrer
SOV i!R 82-007X
August 1982
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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).
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r
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? 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)
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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)
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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
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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)
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Using outside specialists.as 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)
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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
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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)
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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)
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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,
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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
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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
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