A MEDICAL REVIEW OF SOVIET RUSSIA: V.--THE MEDICAL PROFESSION, SOVIET SCIENCE, AND SOVIET SANITATION
Authors: W. H. Gantt
Journal: BMJ (1927)

IT will be initeresting to the physicianws1 of other coun1tries to kniow of the personal life and work of thieir colleagues in the U.S.S.R. (Union of Socialistic Soviet RepuIbliCs).Before descIribiniig th1eir present conditionl I shall give a brief leview of their life duin-ing the past decade.After 1914 there was a gradual decline in tlhe stanidard of living in, Russia.By 1917 deprivations had become chronic.Then the exhaustion of two revolutions, blockade, famine, and diseaso precipitated wholesale misery, from which Russia is just beginniing to recover.What corre- sponded to the worst period in the rest of Europe was only the prelude to the Russiani experiences.It is important to remember lnot only tho intenisity of this suffering, but its duratioii; A barefooted, tattered Russian physician said to mlie in 1922, onl receiving an Eniglish newspaper, " It lhas been so long since I have even heard of anything civilized it seems like lhearing from another world."Another doctor said lhe was so accustomed to going all day without anythinig to eat that ho never felt hungry (in 1924) wheni he missed a meal.In Russia as early as 1916 there were four iieatless days a week, anid sugar lhad enitirely dis- appear e1d in miianiy districts.Salaries had been raised 20 per cent., but the cost of living had doubled or trebled.' Dur ing t1le grIeat ar tlher e wer e fewer Russian doctors but mouc Russiani wounded tllan in other counLtries.Wihen -fighting with Ge-rmany ceased tlle Russian plhysiciani was mobilized into wnhatever army was occu-pyinig his section of the country-wh-lietlier white, red, or allied.This Civil war and proletarian revo1ution, which lasted withi some intermissions unitil 1922, left the populationi without medical assistanice, and counttry medical cliniies were closed and disorganized.The declared piurpose of thle secon(d rovolution was socialism through the elevation of the proletariani, and the destruction of the social superstructure.It brought disaster to all.tlose who live'd on a highler level, and lowered the stanidard of life to that of tlle peasant.tThe doctoir's positioln was more hazardous than the peasant's, as shown by his higher deatlh rate.When fightinig was over alnd Comiluniistic rations were abandonedl (end of 1921) the physicians returned to their former positions, often without remuneration.'The official salaries were too little to live on, and were often paid soveral monitlhs late, and thle population had no moniey to pay for private practice.If any valuables had been retained, tlhey weye sold for food.Well known professors and cliinicians became destitute, and in 1918-20 many physicians entered thle lhospitals witlh hunger oedema, and death from starvationi became frequent.Though the official.rationoften did not suffico for onie person, it had to be divided among the family, anid a medical practitioner, in order to sustaini himself, hadi to hold several appoint- menits, hurry-ing.fromnone to the otlher oni foot throuigh the snow, goinlg several miles to get a pound of bread.tAt one time it was the duty of a physician to work in at Previous papers on medical and scientific work in Soviet Russia