N.I. Bukharin and E. Preobrazhensky: The ABC of Communism
Under capitalism the workers have always been compelled to live in unclean quarters of the towns, where epidemic disease is rife. It was only owing to the dread that they themselves would suffer from these epidemics, that the capitalists introduced certain measures to improve the sanitation of the areas in which their wage-slaves dwelt. As early as 1784 the British parliament manifested its liberal sentiments and began to concern itself about the workers. The reason for this activity was the report of a special parliamentary committee which had ascertained that a terrible epidemic of typhus had originated in the factories. Capitalism was only interested in the protection of public health in so far as this was necessary for its own safety.
As an outcome of the imperialist war, the condition of the great masses of the workers has changed considerably for the worse. The general circumstances, hunger, cold, etc., have given rise to devastating epidemics, causing widespread mortality, to successive outbreaks of cholera, typhus, and a new disease known as Spanish influenza. The last-named illness manifestly had a close connexion with the war. People’s constitutions, exhausted and shattered, had no power to resist the germs of this disease. Everywhere the mortality was unprecedentedly high, so that the epidemic had a truly catastrophic character.
The war left another legacy, an extraordinary diffusion of venereal diseases, and notably of syphilis. Vast numbers of the soldiers became infected with this disease, and then, returning home, introduced it into their villages.
Never have venereal diseases been so widespread as they are to-day.
All these evils make it essential that we should be specially active on behalf of the protection of public health. Of course, in addition to the measures specifically classed under the head of hygiene, there are many other ways of carrying on the campaign against disease. For example, the solution of the housing problem is of immense importance. With the improvement of the workers’ dwellings, numerous foci of epidemic illness will be destroyed. No less important is labour protection. Everyone will understand how much depends upon the food supply, upon the nutritive circumstances of the population.
But attention to these matters will not relieve us from the necessity of undertaking special hygienic measures, which must be applied on the grand scale.
To-day, when we are in a very bad position as regards the most elementary requisites for a healthy life, we must grasp at every available means of assistance in our struggle with the evil. Hence arises the urgent need for a special department of social work, the urgent need for measures for the protection of public health.
Capitalist society had at its disposal a capitalistically organised system of medical work. Private hospitals and lunatic asylums, private health resorts, sanatoria, hydropathics, chemists’ shops, electrotherapeutic, radiotherapeutic, and various other curative institutions, were organised on a profit-making basis. The major proportion of these comprised places for the cure of obesity, gout, and other aristocratic complaints. They were, that is to say, intended for the cure of diseases peculiar to the dominant classes of capitalist society. Workers could not visit the fashionable health resorts, nor were there any working-class invalids in the sanatoria.
The business of the retail chemists was in like manner pursued as a source of profit. Economically considered all these establishments were on precisely the same footing as any other profit-making enterprise.
It was therefore necessary to transform them from instruments for filling capitalists’ purses into instruments for the service of the workers. The first step in this direction was the nationalisation of all such enterprises.
The great prevalence of epidemic diseases and the need for prompt measures to prevent their spread led to the consideration of the possibility of a purposive, organised, and extensive campaign in this direction. Since the number of available workers was comparatively small, the urgent need for their scheduling and mobilisation in this campaign against epidemics became immediately and spontaneously apparent.
Thanks to these measures, thanks to the full utilisation of practically all the available medical strength from the most distinguished professors down to the first-year students and the surgeons’ assistants, it proved possible to get the better of the menacing epidemics — cholera and typhus.
Labour duty for medical workers has, however, a greater significance than that merely of “fireman’s work.” In association with the nationalisation of all curative enterprises, it is one of the germs of the organised social sanitation and social hygiene of the future.
Our work is rendered extremely difficult owing to the terrible dearth of many of the most ordinary essentials (proper food for use in the hospitals, drugs and instruments, etc.). In so far as the Communist Party is able to intervene actively in public health work, there are three main provinces for such activity.
The first essential is the resolute enforcement of broadly conceived sanitary measures. Attention must be given to the sanitary condition of all places of public resort. Many epidemics arise from the contamination of the water supply, from badly kept street gullies and storm-water pipes, middens and manure heaps, cesspools, closets, and so forth. The protection of earth, air, and water is the first requisite for public health. To the same category of measures belongs the organisation of communal kitchens and of the food supply generally upon a scientific and hygienic foundation. Owing to the scarcity of provisions, this task has hitherto been extremely difficult to fulfil; but it is already within our competence to ensure that the food shall be hygienically prepared in the communal kitchens, the children’s kitchens, the hospitals, and all other public institutions. It is further necessary to organise measures to prevent the spread of epidemic diseases of a contagious character. This will be secured by the sanitary inspection of institutions, private houses, and schools; by the filtration of water, by the organisation of depots for the provision of boiled water, by disinfection, by the obligatory sterilisation of wearing apparel, etc.
The second essential is that there should be a carefully planned campaign against the so-called social diseases, that is to say against those diseases which affect masses of people and are brought about by social causes. Three diseases, above all, come within this category. First, tuberculosis, which is dependent upon bad working conditions. Secondly, venereal disease, whose present wide diffusion is mainly the outcome of the war. Thirdly, alcoholism: this partly arises from brutalisation, depression, and sordid surroundings; and it is partly due to parasitic degeneration. These diseases do not merely concern the adults who, suffer from them; they exercise a disastrous influence upon the offspring. Humanity is gravely endangered by these influences, and above all because to-day their evil effects are exceptionally great owing to the prevalent condition of exhaustion.
Thirdly and lastly, it is of the utmost importance that the whole population should be able to secure gratuitous medical advice and treatment. Our main difficulty at present is due to the absolute lack of drugs. This dearth is not so much the result of the disorganisation of production in Russia as the result of the blockade. The “humane” Allies hope to crush us, not only by cutting us off from access to raw materials and fuel, not only by the “bony hand of hunger,” but also by epidemic disease. This brings us back to our general struggle with world imperialism.
SEMASHKO, The Elements of Soviet Medical Science. LINDEMANN, The Struggle with Typhus. — Symposium: A Year’s Work of the Commissariat for Public Hygiene.