Russia - Public Health
( Originally Published Early 1900's )
BEFORE going to Russia I was warned by people I met in Scandinavia and Finland that disease of every sort and kind was raging in both Petrograd and Moscow ; that it was sheer madness on my part to go into the country without previously being inoculated against half-a-dozen diseases. As it turned out I was not inoculated and am thankful to say T left Russia quite healthy, and during my month's stay was not attacked by any of the prevailing diseases.
There is no doubt at that many thousands of people have suffered, and many thousands have died of typhus, spotted typhus and diphtheria. It is also true that many thousands more will die this spring when the thaw lets loose the accumulated mass of refuse and dirt which has been collected in Frozen heaps in the backyards and other parts of the big cities. It needs to be pointed out that, most, of the big houses in Moscow are central heated, and thus water-pipes and sanitary arrangements are kept going during the winter months. But the past winter has seen such an absence of fuel of every sort that the pipes in most of the big houses have been completely frozen during almost the whole of the winter —and as many of these large residences are now inhabited by three or four families where formerly there was only one, it can easily be imagined what a desperate plight people find themselves in with the sanitary arrangements out of order, and with no means of removing refuse. The consequence was that the backyards become heaps of refuse which froze where they lay.
It was fear of the consequences of what the thaw would entail which compelled the Moscow Soviet to issue the order that every citizen should, when the thaw came, take his or her part in the removal of this accumulated rubbish.
There are tens of thousands of other houses in which there is precious little sanitary accommodation at any time. As a matter of fact, the great mass of Russians do not under-stand how to use sanitary conveniences : many have never seen a water closet or even earth closets, and as in many parts of France, the very crudest arrangements are considered sufficient. In Russia sanitary conveniences are even more crude than in the working class districts of France ; consequently when there is a shortage of fuel, shortage of food, coupled with the usual very low sanitary standard of life, it is only to be expected that epidemics arising from filth should be the order of the day. In addition there was very little soap to be obtained owing to the absence of fats. am told, but have no authority except hearsay for the statement, that Russians as a rule do not care to wash themselves too often, but whether this be so or not, during my short stay washing would have been impossible for me had I not, carried my own soap. As typhus is a disease which is carried by lice, it is easy to understand how everything conspired to produce the sort of epidemic which has been running through the country for a considerable time.
In an interview with the Commissar of Public Health—N. A. Seniashko--he informed me that in Moscow during the time of my visit things were much easier with regard to aII diseases; that in Moscow and Petrograd the number of affected persons was down to 5,000 ; that there was a daily average for both towns together of 200 cases and this was steadily falling. Both the Commissar and his assistants were confident that with the necessary disinfectants and n united effort on the part of the people, it would he possible to get through the spring without a very large increase on these figures. But he pointed out that the springtime, even under the Czardom was always a had time for epidemics, especially dysentery amongst children ; he was very hopeful however that under the Soviets a very much reduced death rate would obtain than under the rule of the Czars.
Semashko went on to describe how in the provinces the business of Public Health was being organised. He asked us to understand that there had been very little local life in the villages ; people were not allowed to interfere too much in the local government of Russia : consequently the Revolutionary Government was not only obliged to set up administrative machinery but, was also obliged to supply the necessary men and women for carryinging on the work. He expected Lo be able to establish Public Health Committees in every village, township and city throughout, Russia. On these he was going to secure a majority of women as members because he was convinced that in Russia it was women who must first be taught the value of keeping their own bodies and the bodies of their children clean. It was a tremendous task which he had under-taken and he was glad to have this responsible work entrusted to him, but it; would tax all the resources, not merely of himself but of thousands 4 efficient workers throughout, the country, before the masses of people realized the value and necessity of bathing and cleanliness generally. At present owing to the blockade and war it was impossible for the Government to supply the necessary means for securing baths or even a decent supply of water in some places, and there was certainly little or no soap for anybody.
We come right up against, the blockade here, because it was not, merely a question of the things have mentioned, but disinfectant.s and medicines of all kinds had been cut oft, so that his department worked wit h its hands tied behind it. For all this, very much had been done and very much more would be done within the next few months. They proposed to establish Publie Health Week during which, right throughout the country. public meetings and lectures would be held and the people encouraged to use the means at, their command, small as these may be, for the purpose of building up the health of the people.
He was careful to point out that the Russian Government was very anxious indeed to preserve the life of children. There are child welfare exhibitions in some towns. I went round one in Moscow with two fellow journalists : the exhibition was quite as good as anything I have seen in England and from an visit any intelligent mother could learn what there is to learn about childbirth and the proper treatment of babies.
In connection with this department there are big stores, where the clothing and special food necessary for a child are supplied free. This sort of thing does not yet apply everywhere, but Semashko hopes very soon to have a child-welfare exhibition in every centre, not on a large scale hut big enough to teach the things needed to be known about children.
It will be a mistake, however, to imagine that plague and pestilence is necessarily associated with the Bolsheviks. This Public Health Commissar is deliberately of opinion that the epidemics which have affected Moscow and Petrograd are directly attributable to the war and especially to the Red Army's having come into contact with the armies of Denikin and Koltchak. The authorities in Moscow consider that while the Red Army has been marching from victory to victory, they have had working side by side with them an army of devoted men and women, a sort of army of health whose business it is to fight disease. It is the Communists who make up this army : their work in times of epidemic is to bury those who die of disease, disinfect clothes and dwellings and generally take the lead wherever danger is involved. It is on record that when the Red troops took the town of Nicopol they found 9,000 persons sick with typhus ; dozens of dead were lying in the streets, in the cemeteries masses of human corpses were being eaten by dogs. They appealed to Moscow for help. Remember all this happened under the Denikin and Koltehak régimes. It is also stated that right throughout the Kazan region unheard of suffering was being endured. At Omsk 20,000 persons were discovered affected by spotted typhus : over 400 dead bodies were found unburied. It was expected that cholera would break out at Kharkoff.
The Communists took this situation in hand and first of all organised drastic measures to keep the Red Army free from disease. A new scheme drafted by the Public Health Depart-ment in co-operation with Lenin, was put into operation. Each regiment was called upon to elect a private who, with a doctor and the colonel, was held responsible for the good health of the regiment. All the sanitary arrangements were in their charge and they were made responsible for the proper cleanliness of billets and camps. A public health order of the day was issued as follows : " To be dirty is a crime against the revolution." Arrangements were made for special isolation stations capable of dealing with about 80,000 cases every day and providing beds for 5,000 patients. I repeat this all happened in districts recaptured from the reactionists who were responsible for the terrible conditions with which the Bolsheviks were called upon to deal.
These theoretical Bolsheviks have also been practical enough to set up travelling baths which go round with their trains. No one, in certain parts of Russia is allowed to enter a train without first taking a bath. They have also made arrangements by which over a hundred thousand men of the Red Army are able to get a bath each day. The soldiers are given, not one set of clothing, but several, in order that clothing may be frequently cleansed. The result of all this is that to a very large extent the Red Army may be considered an army of health; whereas the Denikin and KoItchak armies by spreading disease may be called the armies of death. The task of t he Red Army was to clear away disease brought into existence by the sheer neglect of the leaders of the counter revolution.
A Research Department under the supervision of Professor Lazareff, who has a big staff of men and women experts under him, is in working order studying how to prevent and deal with disease. They have also been devising means for overcoming the effects of the devilish invention used by the Allies and the White Army against the Bolsheviks, an invention which blinds the soldiers in trenches These Russian specialists consider that they have now devised means by which this weapon is now quite ineffective.
In a thousand and one ways, health, services are being set up, but the one cry from everybody—specialists, doctors and nurses—was : " Throw down the blockade ; let us have the means for alleviating suffering ; let us have the means for preventing disease. It is impossible to establish effective public health administration unless we have these means : we can only get them from outside." Again and again protests were uttered against the infamy of the Allies, and especially against the International Red Cross, for its failure to send into Russia the means for dealing with the wounded and those stricken with disease. It was pointed out that the Denikin and Koltchack armies were always well supplied ; that again and again the Bolsheviks had occupied a village or a town only to find all the medical stores burnt up, and I was asked : " By what sort of right did the international Red Cross, that gathers money from all sorts and conditions of people, defend the policy of assisting one side only in a great struggle like that through which Russia was passing? " It was also stated that in many places doctors were not allowed to remain to treat either the wounded or those suffering from disease, but that, often they were carried off by the White Armies at the point of the bayonet.
Semashko and his friends have no fear of tomorrow if only they are allowed their chance, but as with everything else in Russia, the future depends on peace. Given peace, this work of reorganising the civilian life of the people will be taken in hand, and there is no reason at all why Russia, should not become one of the healthiest of the nations of Europe.
With regard to housing : that is a problem in Russia as everywhere else. The wretched working class dwellings of the great towns are themselves a standing example of the disgraceful manner in which the Czarist Government neglected the life of the people. Almost under the walls of the Kremlin and within sight of the most magnificent cathedral in Moscow there are slum districts, the like of which I should think could scarcely be found anywhere else in the world—except in the very worst quarters of industrial towns. Many of these have been destroyed since the revolution, having been pulled down and the wood used as fuel. Semashko hopes that these will never be rebuilt. He hopes that great areas of the cities will he cleared, for good and for all, and that an altogether new housing scheme will be adopted. This is, however, for the future : the whole work of his department, as far as efficiency and effectiveness is concerned, repeat, depends on peace. There can be no labour or material available for housing until the Red Armies become Labour Armies.
In spite of living in the midst of war, pestilence and famine, these Russian Bolshevists, theorists and dreamers as they are called, are proving they know how to organise and that with idealisms they also carry a complete knowledge of all that is needed not merely to govern but to administer the social life of a great nation by the co-operative of the whole body of citizens.