Russia

The Russian Federation is largest country in the world, and has a population of 142,400,000 (2006), with 421 doctors and 821 nurses per 100,000 people. It has its origins, historically, in the Russian Empire which lasted until 1917 when it was replaced by a series of republics which joined to form the Union of Soviet Socialist Republics—the Russian Soviet Federated Socialist Republic being the largest constituent member. In 1991 the members of the Soviet Union split to form fifteen different countries, with Russia being the largest country to emerge.

Traditionally, herbal cures were used by the Russians to treat many ailments. For many problems often drastic surgery was used to cut away infected areas. However health care was fairly primitive until the eighteenth century when German surgical procedures had a large impact on Russian health care. There were also large numbers of British and French doctors who moved to Russia where they treated wealthy Russians. [Page 1503]It was not long before lucrative private practices were being operated by Russian and foreign doctors in most cities in Russia, although the main Russian medical facilities of the Russian School of Therapeutics in Moscow were destroyed in 1812. They were rebuilt soon afterwards but with the focus moving to St. Petersburg, the Imperial family and others at court quickly attracted more foreign medical professionals, with local medical schools resulting in many thousands of doctors being trained. The Botkin family became court physicians, with Sergei Botkin being appointed as court physician to Tsars Alexander II and Alexander III. His son, Dr. Eugene Botkin, was physician to Tsar Nicholas II and was killed with the imperial family in 1918.

By the time of the Russian Revolution, most of the doctors in Russia were Russians, with Boris Paster-nak's novel Dr. Zhivago (1957) encapsulating some of the problems that doctors faced during the Revolution and the subsequent Civil War. During that period many medical professionals fled the country, and during the late 1920s there were major problems trying to get the health services together again. The Russian Pharmacological Association was established in 1928. The purges of the 1930s led to many doctors being deported or killed, and the hospitals were grossly understaffed at the start of World War II. Under the rule of Josef Stalin there was a quantitative expansion of the health services with the aim of providing free, qualified medical practitioners to care for all the people in the country, even though the service lagged a little in the countryside. In 1948 Stalin mentioned the “Doctors’ Plot” by which several Jewish doctors were alleged to have plotted to poison the Soviet leader-ship—this was later found to have been untrue.

The restructuring of the Soviet medical services started in 1944 with the formation of the Russian Academy of Medical Sciences. This was followed by the creation of many medical societies. These included the Federation of Anaesthesiologists and Reanimatologists (founded in 1991 from the All-Union Society of Anaesthesiologists, founded in 1959); the National Immunological Society (founded in 1983); the National Opthamological Society; the National Pharmaceutical Society; the National Scientific Medical Society of Endocrinologists; the National Scientific Medical Society of Forensic Medical Officers; the National Scientific Medical Society of Hygienists; the National Scientific Medical Society of Infectionists; the National Scientific Medical Society of Nephrologists (founded in 1969); the National Scientific Medical Society of Obstetricians and Gynecologists; the National Scientific Medical Society of Pediatricians; the National Scientific Medical Society of Physicians-Analysts; the National Scientific Medical Society of Roentgenologists and Radiologists; the National Scientific Medical Society of Surgeons; the National Scientific Medical Society of Toxicologists; the Russian Gastroenterological Association (founded in 1995); the Russian Neurosurgical Association; the Russian Oncological Society (founded in 1954); the Russian Society of Medical Genetics (founded in 1993); and the Society of Cardiology (founded in 1958). The Russian Medical Association currently has 262,000 members.

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