The Work of the Public Health Authorities in Soviet Russia

The Communist Review, June 1923, Vol. 4, No. 2.

N. A. Semashko

Extract from speech of Comrade N. A. Semashko, Commissar for Health of the R.S.F.S.R., at a conference of the Workers’ International Russian Relief at Berlin.

THE tasks of the Commissariat for Public Health have been extraordinarily heavy and full of responsibilities, but, in spite of all, we have succeeded in the main in overcoming the plagues and epidemics which had their cause in the famine, although in the Ukraine and in some of the eastern districts dysentery, typhus, cholera and small-pox are again breaking out.

But in every respect the worst consequences of the famine are to be seen in their effect on child life. In the cases of these plagues the organism of children has to put up a much greater power of resistance to enable it to recover than is the case with adults.

Russia has always had the sad notoriety of possessing the highest rate of infant mortality in the world. The death-rate in the case of young children is as high as 25 per cent. In consequence of the famine, this rose to 32 per cent. In the course of 1922, thanks to the energetic efforts of the Soviet Government and workers’ and foreign organisations, we were able to reduce it to 20 per cent. Since the war, and especially as a result of the famine, a serious diminution in the population of Soviet Russia has occurred, though this, is not the same in all districts. In Siberia it is much smaller than in European parts, largely due to the fact that in the latter there is a great shortage of food and suitable dwelling places, conditions which afford a fruitful soil for epidemics.

In our work for the public health we have to distinguish between two different categories of diseases—the plagues on the one hand, and social diseases on the other. Among the latter category we find two which have always reacted in a frightful way on public health—consumption and venereal disease. Unfortunately, the limited means at our disposal do not allow the majority of cases of the social diseases to be properly treated in sanatoria, so travelling dispensaries have been formed as the most ready makeshift. These travelling dispensaries do not wait until the sick come to them, but carry help and medical aid right into the factories themselves, seeking in every case to arrange for such a type of employment as will enable the disease to be successfully overcome. The travelling dispensaries, and also all other units of the Commissariat for public health, work in closest touch with the different workers’ organisations.

In addition to the dispensaries, every effort is being made to provide a sufficiency of sanatoria for sufferers, especially for sick children, who are also being housed in forest schools and similar institutions. In order to bring this work to completion, a large-scale campaign has been undertaken. A special propaganda week for the struggle against tuberculosis and prostitution has already been carried through, with special emphasis on the question of additional relief for unemployed women.

A further field of work is mother and child protection. For this purpose advisory centres have been opened in every large town and district, which do not, however, limit their activities to giving advice to mothers and expectant mothers, but carry through practical work in this field. Special homes for mothers with babies, and lying-in homes have been set up in all districts. In proportion to the enormous mass of population, what has. already been achieved only reaches relatively modest proportions.

In this connection one thing especially must be borne in mind. Formerly nothing whatever had been done in Russia in this direction, and the Soviet Government has had to break entirely new ground. To the Soviet Government belongs the credit for these important social innovations.

Child welfare is not by any means limited to babies and young children, but attention is also paid to the welfare of older children and the youth. All these activities find their best support through the planned work of the committees for dealing with the consequences of the famine, on all such committees both working women and youth having representation.

In the case of the youth special attention is paid to physical culture as a basis for proper mental and moral development. Monthly courses are given in every centre at which chosen workers from every factory and large undertaking attend. In this way general instructors in physical culture for the masses are provided. There are also more advanced courses covering a period of three years, which fits special youth instructors to take over educational work of greater responsibility.

In view of our tremendous needs in both a bodily and mental respect, what we have already been able to achieve may appear insignificant, but a good beginning has been made in face of great difficulty. War and famine have enormously increased the number of unprovided children. There are in Russia to-day about two million children for whose care and education nobody is responsible unless this is undertaken by the social organs of the State. Of these two million children about 1,300,000 have already been accomodated in homes. A further point that must be borne in mind, is that the majority of these children, due to the severity of famine conditions and the hardships they have suffered, are not only bodily, but also mentally, often abnormal.

What then, in view of these conditions in our country, can the Workers’ International Russian Relief do to most suitably aid the work of the Health Department of the Soviet Government? One special activity presents itself at once. The Commissariat of Public Health is engaged in the preparation of small travelling dispensaries for service among the rural population. These dispensaries are being prepared abroad for introduction into Russia as complete units of medical aid, fitted up with the most important medicines for fighting plague and social diseases. This is especially a task in which the W.I.R.R. can share by materially supporting the supply of these travelling dispensaries. Anything that can be done to provide the dispensaries, sanatoriums and children’s homes with the necessary material, faced and clothing, will be a material help for Russia of the first importance.

With reference to the change over from pure famine relief work to productive economic relief, the Workers’ International Russian Relief can be of special service with regard to our work in the Crimea. The Crimea is the most healthy region of Russia, to which sick people go when convalescent. The People’s Commissariat of Health yearly sends many thousands of consumptive workers to this region, because in its balmy climate they can find the best relief, and stand the best chance of recovery. Many sanatoriums and dispensaries have been set up in this area for the benefit of the sick workers of Russia, and not only that, but to enable partially recovered workers to remain longer in the Crimea until their health is once again established. We have set up farms, vineyards and similar undertakings in which these workers can be employed with profit to themselves and the Republic,

All comrades must realise that it is in raising the public health, lies the best basis for a sound rebuilding of Russian economic life. The rebuilding of Russia cannot be carried through by a sick nation, by broad masses whose hygiene, physique and sanitary requirements are not well developed. In the great and heavy work of rebuilding Russia, the health standard of the Russian masses is of the very first importance. It is to be hoped that the comrades who are creating and supporting the International Workers’ Relief for Russia may bear these truths continually in mind so that we may go forward to a practical realisation of Socialism based on sound minds in healthy bodies.

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We are looking for his books to share with all:

The care of health in Soviet Russia , N. A Semashko( Book )
published in English1920

Health protection in the U.S.S.R,  N. A Semashko( Book )
published in English 1934 

The right to rest and leisure, N. A Semashko( Book )
published in English 1937 

Public health in the U.S.S.R,  N. A Semashko( Book )
published in English1946