Francoise Thom

The Gorbachev Phenomenon

It is known that some newborns are not registered until such time as they seem likely to survive. According to official figures, in 1987 12,000 stillborn babies were registered in the USSR (5,615 in France). Infant mortality among premature births (4.5 per cent of premature births, compared to 5 per cent in France) is over 20 per cent.65 Of all children born 5 per cent have serious genetic deformities;66 2.5 million suffer from spasticity as a result of birth trauma and 8 per cent of children born in Moscow are oligophrenic (mentally retarded). The number of children suffering from diabetes, hypertension and hormonal imbalances is increasing alarmingly. More than 53 per cent of Soviet schoolchildren have health problems (poor eyesight, digestive disorders and neurological troubles). It is reported that 80 per cent of childhood ailments are caused by contaminated water.

Adults are no better off. Fatalities from cardiovascular disease are nearly twice those in the developed countries. Since the mid 1970s there has been an upsurge among adults of various childhood illnesses (measles, scarlet fever, whooping cough), which often take very grave forms in adults. Digestive disorders, hepatitis, and diphtheria are 'causing a lot of problems'; 1.5 million people suffer each year from digestive ailments. From 1965 to 1985, lung cancer claimed one million, the number having doubled over one period of ten years. Soviet health officials have recently declared that AIDS will become a major problem in the USSR.

Added to these are various regional diseases. According to a Georgian physician, hepatitis B 'has nearly assumed the dimensions of a national problem'. In May 1988 a typhus epidemic swept through Georgia. Malaria is widespread and there have even been recorded cases of cholera. In Moldavia 13 per cent of the population carry the hepatitis B virus—giving a national average of 3.8 per cent, around 10 million people. Each year 33,000 children die in Uzbekistan, mostly from contaminated water. In Kazakhstan 60,000 cases of tuberculosis have been counted. In Turkmenistan 12 per cent of young men are declared physically unfit for military service. Only 40 per cent of conscripts from Kirghizia are judged physically sound by the army—this in a country in which very few young men are exempt from military service. In Karakalpakia life expectancy is around 40 years. In some areas of Uzbekistan 'mortality among newborns is over 50 per cent. In the Alat region it is 53.4 per cent, in Guijduvan 72.8 per cent.' What is the reason for the physical decay of the population, shown in official figures certainly well below the true ones? Experience of the grim ordeal of any encounter with Soviet medicine casts some doubt on the cynical explanation offered by Health Minister Yevgeny Chazov that 'free medical care leads people to neglect their health', echoing Pravda's comment that people in the United States enjoy better health because medicine there is expensive. Various related factors probably account for the decline in health standards in the USSR.

The alcohol problem illustrates the workings of the 'boomerang effect' perfectly. Until recently the sale of vodka was highly advantageous to the regime. In the absence of consumer goods, sales of alcohol circulated money, guaranteed massive revenue to the State and anaesthetised the population. But now the stage has been reached where the evils are outweighing the advantages. The regime is suffering enormous losses in man-hours because of alcoholism. Not only must alcoholics have medical care, but the State is being left to look after an increasing number of deformed children born to alcoholics. Compensation must be given to the victims of road and work accidents caused by the effects of alcohol. Last, but not least, production suffers considerably on account of workers' hangovers. All this led to the present regime's severe criticism of Brezhnev's policies: 'Previous policies were designed to encourage drunkenness among the people, to prevent them reflecting on their lives or worrying about politics.' Over the 11th 5-year plan (1981-5), taxes on alcohol brought the state 169 billion roubles (compared to 67 billion over the 8th 5-year Plan).

In the USSR drinking begins early in life. Commenting on teenage alcoholism, Literaturnaya Gazeta has written that 'This anomaly has almost become the norm'. According to official figures, over 90 per cent of alcoholics began drinking before the age of 15, a third before the age of 10 and 90 per cent were hardened drinkers by the age of 19. In the Soviet Union there are 4.5 million alcoholics registered by the police or the health services. This figure is probably a pale reflection of the true one. A samizdat article distributed just before the introduction of Gorbachev's anti-alcohol campaign suggested a figure of 40 million. Women make up 12 to 15 per cent of alcoholics.

The drug problem is being raised more and more often. To go by official statistics, in 1987 50,000 addicts were in clinics in the USSR. That compares favourably to Western countries, but the increase in drug addiction is disturbing. Each year, 3,000 addicts and 120-130,000 drug-abusers are sent to detoxification centres. Drugs are spreading through the schools. In one year in Georgia alone drug trafficking brought in a profit of 36.5 million roubles. A campaign against drug addiction was launched in August 1987 in Moscow; anti-drug legislation was introduced in Tadzhikstan in that same year. Also in 1987, 26,000 people were sentenced for drug-dealing. Recent articles, particularly in the military press, show that the amount of smoking in the USSR is beginning to worry the authorities. There are 70 million smokers in the Soviet Union and 17 per cent of young people begin smoking around the age of 8 or 9; by the time they reach secondary school, 80 per cent are smokers. Over 430 billion cigarettes are sold each year. From 1970 to 1986, tobacco consumption increased by 23 per cent. Another disquieting factor is the Soviet diet, too high in sugar and fat, which contributes to the high rate of cardiovascular disease. Furthermore, many basic foods are unfit for consumption: in the Ukraine, for instance, 'fresh' cream must always be boiled to prevent food poisoning. Now, under perestroika, sausage, when available, turns green in the light. Lack of fresh fruit and vegetables causes serious deficiencies of between 20-60 per cent of essential vitamins.' Misuse of fertiliser and pesticides renders many products toxic. Cases of fatal nitrate poisoning among children were recently reported.

How is Soviet medicine coping with this disaster? Public health receives 4 per cent of the national budget.