Five years’ work of the People’s Commissariat for Health.

‘The Fifth Anniversary of the Narkomsdrav’ by S. Turki from International Press Correspondence. Vol. 3 No. 56. August 16, 1923.

In May and June of this year there were several medical congresses in Moscow: for bacteriology, epidemiology, for combatting tuberculosis and venereal diseases, for the protection of motherhood and infancy. The programs of these congresses, as well as the reports and addresses given by Russian and foreign participators, all bore a strictly scientific character. The representatives of the working class attending these congresses were given the opportunity of following the proceedings and forming an idea of the significance of the progress of medical science for the protection of public health; this is a feature imparting to the congresses held in Moscow a character entirely different to that of similar meetings in other countries. The combination of science and labor with the aim of realizing the ideas of social hygiene and social medicine gave the congresses their distinguished character. The fundamental purpose of the “Narkomsdrav”, which is to induce the broad masses of the people to take active part in the work of protecting the public health, that is, to realize in actual life the principle that “the health of the toilers is the concern of the toilers themselves”, has thus found concrete expression in actual contact between science and labor.

The material basis for the realization of this principle was created by the October revolution, for this created the necessity of replacing the chaotic lack of organization prevailing in matters of public health under the Czarist regime by the concentration of work in this sphere, in the interests of the protection of the working people, in the hands of a single People’s Commissariat.

On July 21, 1916, the “Narkomsdrav” undertook the care of public health. Since then the” Narkomsdrav” has been endeavoring, despite all material and financial obstacles arising from epidemics, civil wars, famines, blockade etc., to introduce all the new methods of protecting public health which are characteristic of the Russia of the workers and peasants.

In a capitalist social order the methods of prevention, of prophylaxis, in combatting disease, are only accessible to the ruling classes. Statistical investigations have amply demonstrated the fact that in the case of epidemics by far the greatest number of victims belong to the working class.

To prevent disease, that is, to provide the best possible sanitary conditions for the masses of the people (proper housing, workers’ protection, hygienic working conditions, etc.), to apply prophylactic methods for the benefit of the broad masses of the population–this is the fundamental watchword of Soviet medical endeavor. The worker is not to be cured for the purpose of making him capable of being further exploited by capitalism, but such conditions of life are to be provided for him, such conditions of work, food, and rest, that the organism of the worker is given the best protection against the danger of disease. The utilization of all scientific knowledge, of all climatic and physiatric methods of treatment, among the broad masses of the people–this is the leading thought actuating the whole activity of the “Narkomsdrav”. Medical assistance is becoming more and more available to the whole population of the R.S.F.S.R. In the year 1918, 30.154.693 persons received medical aid; in the year 1921, 64,598,747. The number of medical districts and sanitary stations superintended by medical officers (exclusive of the railway medical districts), was 2,486 in the year 1918 and 2989 in 1921. The number of medical institutions in 1919 was 1470, with 119,580 beds; by the year 1921 there were already 2443 medical institutions with 156,882 beds. Special attention has also been devoted during this time to giving the broad masses of the population the opportunity to benefit by visits to watering places. The number of patients who could be accommodated in health resorts amounted to 48,435 in the 1920, 66,516 in 1921. In 1918 the number of beds available in health resorts was 1840, in 1921 it was 29,790.

The first prerequisite for the application of the principle upon which the whole activity of the “Narkomsdrav” is based, has naturally involved special measures for the protection of motherhood, of infants and of growing children. From the moment of procreation the idea of the protection of the child’s health must be kept in the foreground. The labor code of the Soviet republics ordains special measures for the protection of expectant mothers (liberation from work for two months before and two months after confinement; privileges with regard to housing accommodation; homes for the mothers and children). A healthy mother is the best security for the health of the children; healthy children are a security for the health of the population. The constant increase in the number of institutions for maternity protection is one success gained for public health by the activity of the “Narkomsdrav”.

This fundamental task in the sphere of prophylactic measures does not prevent the People’s Commissariat for Health from mobilizing numerous forces against the epidemics prevalent at the present time–spotted fever, intermittent fever and cholera–and from attaining considerable success here also. As a statistical proof of this fact it suffices to give the comparative numbers of those attacked by spotted and intermittent fever. In January, 1922, 653,537 persons were taken ill with intermittent fever. In the year 1923, 119,321 persons contracted intermittent fever during the same period. During the same times 124,717 persons were attacked by spotted fever in the year 1923, as compared with 764,262 in 1922.

A most important auxiliary in the protection of public health, and in inducing the broad masses of the people actively to participate in this work, is sanitary propaganda, enlightenment with respect to hygienic questions.

The diffusion of knowledge in this direction is the task of a special department of the “Narkomsdrav”. The Czarist regime endeavored to suppress any such measures. It is the principle of the “Narkomsdrav “, in educating the broad masses of the people to self-help, to learn itself, and then to act on its knowledge.

The struggle against the social diseases (tuberculosis, venereal diseases, prostitution, alcoholism) is being conducted on the broadest possible scale. The main cause of the social diseases lies in the exploitation of human beings by other human beings. Capitalism, anxious to protect its own interests, has never gone thoroughly into the question of combatting the social diseases. These diseases, bearing within them the danger of degeneration of the human race, have been combatted under capitalism by half measures only. Soviet medical science places the struggle against the social diseases on the broad basis of protection of labor (shorter working hours, combatting of unemployment, provision of proper housing), and of extensive prophylactic measures.

In the course of the past five years all the necessary conditions for the unhindered execution of the “Narkomsdrav’s” program have by no means existed. The interventions on the part of the Entente, the civil war, the famine, the various epidemics, all these have obliged the People’s Commissariat for Health to send its best working forces from one front to another; the blockade made the import of the most necessary remedies into Russia impossible.

With the transition to the New Economic Policy the Narkomsdrav” had to restrict general free medical treatment, and to reconstruct a number of institutions in accordance with the new conditions. But although it proved necessary to limit, to some extent, the work done, the fundamental program was by no means lost sight of. The material possibilities for the realization of the tasks of the “Narkomsdrav” increase proportionately to the restoration of the productive forces of Russia, and to the economic reconstruction of the country.

Medicine, as practised by Pasteur and Virchow, has after its emancipation from the spell of metaphysics, developed from its original empiricism to a strictly scientific experimental branch of knowledge. But its further evolution, the utilization of all the knowledge gained to combat disease, meets an insuperable barrier in the capitalist social order. In investigating the causes of disease, scientific medicine was bound to observe the extreme and decisive significance of social conditions in the spread of mass diseases. But the progress of medical science in the capitalist state was halted before the ideas of social hygiene, of social pathology, of social medicine. It is only a workers’ state which can create a material basis for the realization of these ideas. The first five years of the activity of the “Narkomsdrav” have been the first phase in the history of the protection of the health of the people, the first steps on the road to the utilization of scientific knowledge on a comprehensive social basis.

International Press Correspondence, widely known as”Inprecorr” was published by the Executive Committee of the Communist International (ECCI) regularly in German and English, occasionally in many other languages, beginning in 1921 and lasting in English until 1938. Inprecorr’s role was to supply translated articles to the English-speaking press of the International from the Comintern’s different sections, as well as news and statements from the ECCI. Many ‘Daily Worker’ and ‘Communist’ articles originated in Inprecorr, and it also published articles by American comrades for use in other countries. It was published at least weekly, and often thrice weekly. Inprecorr is an invaluable English-language source on the history of the Communist International and its sections.

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