Ice-hole fishing and reindeer hunting are the main coping mechanisms. Reindeer provide food for many in the farthest reaches of Siberia. And with hunger and cold comes disease. Tuberculosis, venereal disease and other, more common ailments have increased infant mortality, and anemia among nursing mothers is climbing. In some areas, melted ice is the only source of drinking water, leading to a surge of digestive disorders.
Sewage systems are also poor and easily stopped up during the winter.
The result is raw waste frozen into surrounding permafrost, leading to even more health and sanitation problems. As the situation deteriorates, hospitals have little remaining medical supplies and equipment to respond. Bankrupt with little or no assistance, some hospitals have been forced to wash bandages for reuse. Often associated with the brutality of its Gulags and its inhospitable isolation, Siberia is a land of frozen tundra, an endless, icy wilderness where temperatures drop to 65 degrees below zero for weeks on end. Before the Soviets lured them here, not many besides the indigenous people, a few fur trappers and some miners braved this alien landscape.