Red Medicine: Socialized Health in Soviet Russia

Agricultural Conditions

THE gigantic attem to socialize agriculture, as industry had already been socialized, has been referred to, but further details are needed to enable one to compare the position of the peasant worker with that of the industrial worker.

Russia has still predominantly a rural population; nearly four fifths of its people live outside of towns. At least 6o per cent of all the farming in Russia is now undertaken on collective lines, an extraordinary change from the system of small individual farms which existed everywhere in the nation a few years ago. The socialized farms are of two kinds: the State farm, or sovkhoz, run by officials of one of the State trusts, in which the workers earn wages just like factory workers; and the collective farm, or kolkhoz, which is cooperative in character, with the individual usually retaining ownership of certain tools, domestic animals, gardens, etc., and sharing profits in proportion to the service given by him.

The State farms, now numbering more than 5,000 have been formed, to a great extent, out of land formerly uncultivated or from confiscated great estates. As highly mechanized as the most advanced American farms, they function incidentally as demonstration farms, while producing livestock and most of the grain exported by Russia.

There are various types of collective farms; but broadly they all represent partial departures from complete Marxian socialism, under which all private property in the means of production would be eliminated. While neither the peasants nor the collectives actually own the land being cultivated, it has, so to speak, been granted them for purposes of production.

This collectivization and socialization of farms has revolutionized the lives of some sixteen million peasant families. Unhappily it has led to the elimination by persecution of many of the richer peasants (kulaks, who were accused of oppressing by usury), and their skill and knowledge have been lost. Furthermore, the rapid change has meant that many villages at which the collective and State farms are situated have now too many laborers. These surplus workers are swelling the already great migration from the country to the towns, where we were repeatedly informed there was no unemployment, for the rapid increase of industries meant a demand for both skilled and unskilled operatives. The incursion was therefore regarded with complacency. Since our visit this view has been revised in official circles, and recently (February and March, 1933) drastic efforts have been made to stop the influx of rural population into such cities as Moscow,

Leningrad, and Kharkov, and to refuse urban passports (allowing continued stay in cities) to all who had no work.

Thus there has been a temporary approach of the Russian towards the western position in respect of employment. It is urged, however, that this is merely a passing problem of adjustment. Furthermore, it is unemployment associated with inadequate necessaries and comforts of life, instead of their glut, which is the marked feature of unemployment in western countries.

The success of the rural revolution would have been greater had it not been for the immense difficulties in transport, either by road or railway. This, in towns, has meant undernourishment of workers, and for the peasants it brings impoverishment in all other respects.

Stalin's dictum was that towards the end of the Five Year Plan, which was scheduled for October 1, 1928, to October 1, 1933, "collectivization of land must in essence be established." Maurice Hindus in Red Bread(New York, J. Cape and H. Smith, 1931) says that this, if accomplished, will constitute "the most colossal revolution the world has ever seen," in the securing of which "terror and agony, power and grandeur" have been commingled. Hindus summarized the further changes in the Russian village as including not only collapse of the village and disappearance of the individual ownership of land, but also the rise of rural. townships, the growing sophistication of peasant women, and the collapse of religion.

Many discrepant statements have been made as to the success of the Five Year Plan in industry. In fact, its measure of success as a whole was so great as to lead to the decision to reduce the period to 4% years, ending at the end of 1932. On the factory side it has undoubtedly accomplished a large share, perhaps most, of the work planned, there having been increased production in nearly every branch of work. This has been accomplished notwithstanding precipitate action, a magnitude of scheming for which technical advice and materials were often lacking, and much incompetent work by unskilled artisans. Slower progress would probably have been safer and less wasteful of effort and materials.

On the subject of unemployment there are divergent statements. In every city visited by us we were assured that there was no unemployment, for it had been completely "liquidated." There was an inadequate supply of factory workers, and no reduction of the high Russian birth rate was desiredexcept temporarily, because of housing difficultiesin view of the almost unlimited possibilities of expansion of industry. Due to the inadequate supply of satisfactory factory labor, work is provided in so far as practicable, even for the relatively incompetent.

On this point Sidney Webb writes (Current History, January, 1933)

Practically all the 8,000 or 10,000 managers of State works of different kinds are striving desperately to enroll additional men. Even for unskilled laborers, raw peasant youths from the villages, the demand cannot be fully satisfied. Of skilled mechanics there is such a constant dearth that managers have been seeking to "steal" them from other works by offering all sorts of inducements, until the practice had to be forbidden.

There was and is much unemployment among the disfranchised classes (priests, merchants, traders, kulaks, and others accused of exploiting labor). The total number of the disfranchised adults has been estimated as high as four millions, but probably it is nearer one million.

During the winter, 1932-1933, the disequilibrium between industrial and agricultural accomplishments became more evident. However, the Kremlin has found great encouragement in the spring sowing (1933) in the Ukraine and the North Caucasus, which showed very remarkable gains as compared with last year. The peasant forms "the keystone of the Russian arch," and his passive resistance to change has been almost invincible. Gigantic food factories run by officials of the State were to replace small farms and holdings; but the attems to do this, and to transfer the millions of displaced peasants to these food factories and to send others to the timber forests of the north had at first only partial success. Consequently, in 1931, Communist policy had to be largely modified, and some individual buying and selling permitted.

As to the situation during the winter, October, 1932, to March, 1933, statements differ both in regard to the industrial and agricultural situation, which are necessarily entangled one with the other. In January, 1933, the usually very great mobility of workers from one workplace to another had greatly increased, workers seeking better conditions of work and food, while deliveries of food were inadequate; and some action was already being taken to withdraw rations from those who abandoned their work.

This excessive mobility has always been a feature in Russia. Workers, both rural and urban, change their jobs to an extent which is inimical to efficiency. In traveling down the Volga in August, 1932, we were amazed and distressed by the crowds, far beyond the accommodation of the steamer, who attempted to get on board, often loaded by bundles which appeared to contain all their possessions. At every great railway station we saw great crowds waiting hour after hour for trains and camping out in and around the station; and on the Volga steamer it was difficult to walk because of the crowds camped out on its decks. This "excessive turnover" of labor must connote some loss of working time, as well as dissatisfied flitting from job to job. On the other hand, this is cited by some observers as an evidence of the personal freedom of the worker.

The London Times (December 2, 1932) quotes a warning stated to have been issued by the Soviet State Planning Commission that one of the most important problems of 1933 will be "the struggle to distribute surplus labor."

However, the statement that many factories cannot work at full capacity, owing to lack of materials and fuel, appears to point to the conclusion that, given improved transport arrangements and given more skilled management and better discipline in industries, and given time to convert unskilled laborers into artisans, the present evils are likely to be overcome. Meanwhile, factory employment is reduced and workers are being displaced. This increases the difficulty of supporting the superfluous people in cities; and a system of "domestic passports" has been introduced, under which every individual is "required to demonstrate his right to live in his present community.(Professor Edgar S. Furniss in Current History, March, 1933) All not engaged in work which the Government approves can be expelled from the city or village.

In many parts of Russia, particularly in the Ukraine, in the North Caucasus, and in the Lower Volga, it is officially stated that there has been serious failure to carry out the rural program of collectivization. Stalin has stated that this may be ascribed to undue satisfaction with the fact that a majority of the peasants had entered into the collective farms, and subsequent neglect to supervise their work. In the words of Walter Duranty, the very competent Moscow correspondent of the New York Times (February 28, 1933), "one thing is certain, that during the last two years, farming efficiency and results have progressively degenerated throughout the three regions mentioned." Much land has been allowed to become foul and overrun with weeds, sowings have . been scanty, and many peasants are "literally lying down on the job." "Merciless steps are being taken," and it may be assumed with considerable probability that this final "struggle to win the Russian peasants to Bolshevism" . will be successful. Military discipline is being established at each State farm, and it appears likely that the severe punishment accorded to slackers and discontented ones will overcome all open opposition to the new policy. Duranty's report in April, 1933, tells of the unusually heavy spring sowing which we have already mentioned.

Financial difficulties cloud the present position in two directions. Russia must sell oil, ore, grain, and lumber to enable her to buy the needed machinery and equipment for her factories, much of which she cannot as yet produce herself. The fall in prices for Russian exports means, for instance, that the cost of the tractors bought abroad by Russia on three years' credit had increased in 1929 to such an extent that to repay the loan meant three times the amount in bushels of grain it meant when the contract was made.(William C. White, North American Review, September, 1930.) The lapse of many countries from the gold standard and the progressive increase of trade barriers in the shape of tariffs throughout the world have intensified Russia's difficulties, while at the same time other countries suffer severely from the same policy.

The preceding somewhat gloomy review of Soviet Russia's position on its agricultural side does not necessarily or even probably mean that the Communist policy on which its leaders have embarked will be shipwrecked. Far from this, much of it must remain, and the lessons for capitalist countries are fairly obvious. It is necessary, however, in considering medicohygienic activities in Russia that this background of economic revolution should be remembered, if we are to realize their full importance.

It is sometimes asserted that Russia's policy can only succeed if other countries cease to be capitalistic, and a short comment on this contention may be added here.

Is World Socialism Necessary for Russia's Success?

Lenin considered that socialism in the sense of communism must be international in order to succeed; and as already stated (see page 97) this was consistent with the formerly persistent Communist propaganda in foreign countries. But irrespective of world socialism, Russia if she emerges entirely or partially successful from her present difficulties is in a different position from capitalist countries. We do not refer to the alleged wiping out of all her foreign and national obligations and to the confiscation of private property in the means of production, to this extent abolishing heavy overhead expenses which in other countries must be met. The point now indicated is that Russia is yet to a great extent a backward country with an immense population, still living, in respect of comforts and amenities and even of so-called necessities, in circumstances greatly inferior to the circumstances of western peoples.

Other European countries are weighed down by debts, the payments on which swallow up a very large share of total earnings and make them unable to buy from each other, while their powers of production have greatly increased. We see, alike in Europe and in America, in this year 1933, excessive production, diminished consumion, lowered prices, lowered' wages, and unemployment on a vast scale.

In Soviet Russia, on the other hand, supply does not keep up with demand, notwithstanding Russia's phenomenal increase in industrialization. In other countries there is starvation in the midst of overabundance; in Russia, owing to her inadequate training in industry, her lightning changes in policy, and especially owing to her selfsustained policy, there is, notwithstanding continuous increase in output, underproduction relative to demand, and inefficient distribution of what is produced. And yet the Russians claim, and it seems to be generally believed, that there are greater potentialities of steady elevation of the standard of living, owing to unlimited natural resources, than in any western country, not even exceing America. In the statement of this claim, the present low standard of living in Russia must be borne in mind. Other countries need not lay undue stress on future competition of Russia, given equitable conditions of trading, for it will probably be many years before Russia overcomes her handicap and approaches the level of western Europe or of America.