#21 - RW 271
RFE/RL (Un)Civil Societies
Vol. 4, No. 21, 27 August 2003
"RFE/RL (Un)Civil Societies" is prepared by Catherine Fitzpatrick on the basis of reports by RFE/RL broadcast services and other sources.
ONLY 20 PERCENT OF RUSSIANS HEALTHY; 60 PERCENT OF CHILDREN SICK.

Russians are constantly subjected to media reports of scary health statistics -- surely enough to have a negative effect on their mental as well as physical health. "Only about 20 percent of the population is healthy," Health Minister Yurii Sevchenko said, "Rossiiskaya gazeta" and other media reported on 8 August. It was a typically blanket statement, long on shock value and short on specifics or breakdowns by region. Citing poor lifestyle habits, Sevchenko said, "the main culprits in Russia's health crisis are nicotine and alcohol." He also blamed foreign tobacco companies, breweries, and fast-food franchises for worsening the already grim picture, which has led to a decrease in life expectancy and a decline in population. The message was clear -- Russians shape up, and foreigners watch out.

While populations are generally aging and declining across Europe, the sickening and dying process provokes nowhere near the angst it does as in Russia, where population drops have been more precipitous. Russians often speak in despair of the depletion of the "genafund," or genetic pool as they dub their nation's stock, and its loss has a psychological and political as much as a demographic dimension. The shortfall is also a catalyst for health campaigns, such as those recently launched with a new organization, the National Health League.

The Russian population has reportedly already dipped from the 145 million at the last census in 2002, to over 144 million. To be sure, the birthrate has nudged up a bit to 9.8 births per 1,000 last year from 9.1 the year before, but it is still not at the replacement rate, that is, not exceeding the death rate, and the population is expected to decline. Male life expectancy stands at 58 years, 10 years less than it was a decade ago; female life expectancy is 72, with the discrepancy between the two among the widest in the world, Russian demographers say.

Although adults face their own crisis, the statistics reported about children are even more unsettling. Every few weeks, some health official is sure to deliver some bad news to journalists, who then wheel out the stories of drug-addicted schoolchildren, and then forget about the topic while they focus on the latest political assassination or terrorist bombing. The number of healthy children in Russia over the past 10 years dropped from 45.5 percent to 33.9 percent, and the number of disabled children doubled, according to the epidemiology section of the Health Ministry, RosBalt reported on 6 August -- surely cause for national alarm.

Curiously, in the Health Ministry's announcement this time, despite past lurid media accounts, childhood illness wasn't blamed on alcoholic parents creating substandard health environments, or increasing drug abuse, or sexually transmitted diseases among young teenagers, or even smoking and fast food but surprisingly, on an increase in the school workload and an ensuing greater amount of time without fresh air and exercise. A whopping "up to 75 percent of children" were said to be suffering from high blood pressure and related conditions, a statement that was difficult to assess, since such a high number of children truly suffering from serious hypertonia would have led to greater numbers of deaths.

In another worrisome report, about one-third of Russia's children have been discovered to be born out of wedlock, the government minister overseeing nationalities policy, Vladimir Zorin, told a news conference on 7 August, citing information gathered from the 2002 census, which asked new questions about ethnicity, marital status, and other personal data. Zorin did not specifically link the illegitimate birthrate with poverty, but as in other countries where the connection has already been well-established, the issue will be one to watch when the government publishes further census studies in December. This will create a clearer picture of the Russian family, pravda.ru reported 7 August.

Few Russians question such alarming pronouncements, usually delivered in terse lectures from public officials and covered in short wire-service reports. They are already steeped in a culture of acute anxiety about the next generation. Indeed, the topics of the paucity of babies in Russia and the plight of the young are themselves a kind of metaphor for all the angst that post-Soviet citizens feel about the traumatic upheavals of market reforms, the ruble devaluation, job loss, dislocation, and war. It is difficult under these conditions to sort out what "sick" really means, and what to do about it at a practical level, given certain cultural norms.

Long before reforms, Westerners were bewildered when they saw Russian grannies wheeling babies wrapped in multiple layers like little mummies even in springtime, or when Russian friends told them with alarm that their merely colicky infants were destined to a life of horrible disability. Russian parents seem to hold the necks of their newborns far longer than Westerners, for example, do not like to let babies practice sitting up for fear they will damage their spine, and generally avoid letting their young explorers touch the ground. Prospective foreign parents seeking to adopt from Russia have found a perplexing phenomenon, where on the one hand, many babies have been labeled disabled for no apparent reason, often under catch-all terms not used in the West (such as "oligophrenia") or, conversely, have not had even simple interventions to prevent lifelong disabilities. In Russia, excessive anxiety about children appears side-by-side with woeful neglect.

When some Russian reporters use the word "congenital" about children's sicknesses as if to signify something permanent such as "birth defect," they surely must be exaggerated. While individual studies on different diseases have been done here and there, i.e. the affect of Chornobyl on children's thyroid cancer, comprehensive, detailed studies on the real health state of Russian children if done, are not widely published or examined in depth by the media. The preferred mode for addressing the topic is the panic bulletins of the type of "60 percent born ill" (in fact, the number is closer to 66 percent if the Health Ministry's statistics are taken at face value.)

Sickness at birth can mean mild conditions like a cold or jaundice -- conditions not considered terribly serious in the West, where they rapidly resolve in a few days with good health care. Or it could mean perinatal heart conditions easily fixed by medication and operations not so readily available in Russia. When doctors make the claims of "60 percent" (contrasting with the 80 percent of the entire population said to be sick), journalists don't seem to ask what they mean -- they take it on faith, and never wonder why other countries do not periodically produce such formulations.

Judging from reports on various Russian websites that have sprung up to meet the demand for health information, anxious parents frequently try to decipher complicated diagnoses attached to their infants at birth -- indeed, some students of the Russian infant-care system have concluded that babies are declared sick until proven healthy, and all possible conditions ruled out. Quite often, inquiring parents who take home babies they thought were healthy later learn of traumas during the birthing process, unspecified "damage to the central nervous system," labor complications, and poor Apgar scores (i.e. on color, breathing, vision, etc.) indicating that "sickness at birth" could be preventable.

Carelessness and unsanitary conditions in the delivery room seem to echo a negligence about safety in other areas of life. The UN's Children's Fund (UNICEF) has reported, for example, that children suffer many more preventable accidents in Eastern Europe and the former Soviet Union than in other developed areas of the world. Safety measures like seatbelts, bicycle helmets, or waiting a half hour after eating before swimming are not practiced. In fact, ignorance is not the only issue, as resistance to such notions of public safety is often explained by equal and opposite ardently held beliefs -- that a seatbelt will prevent someone from getting out of car safely in an accident, that a bicycle helmet will block peripheral vision, that a child on the beach must immediately bathe or face heat prostration.

Improvements in public education and public confidence in a reformed health-care system may enable people to keep their children healthier, but in Russia, with many different climates and cultural practices, as well as the separate problems of a crumbling public education system, it will be difficult to standardize and disseminate the message. Whether the numbers given out by health ministers are exaggerated or do not reflect only serious diseases, the fact is Russian parents perceive their children as chronically ill and behave accordingly.

CDI Russia Weekly #271 ~ Contents