The Appalling State Of Russian Hospitals

Pittsburgh Oral Surgeon Robert M.

Hall was delighted by the invitation to visit Soviet hospitals. Like many Ameri cans, he figured that Russia's scientific skills in space and nuclear weaponry must reflect a similar competence in medicine. He was anxious to learn what ever he could.

Fortnight ago Dr. Hall returned from his two-week tour in Leningrad and Moscow as a guest of the Soviet Min istry of Health. He was disappointed.

"I learned nothing," he said. "There is no area of equipment or research or in strumentation that comes close to that in the United States. I saw no hospital or institute as well equipped as any hos pital or institute in the U.S."

Astounding Pace. During his visit Dr.

Hall observed 15 operations and "was appalled by the primitive conditions."

At Moscow's Institute of Reconstructive Surgery, widely regarded as one of Russia's best, he was ushered into a small operating room without proper aseptic precautions. Two "quite serious" cancer operations were under way, and Hall counted 43 persons clustered around. Some were perched on stepladders, others moved from one operation to the other, "stirring up dust and substantially increasing the dangers of infection." In a delicate nose restoration, a crude, oversized needle "fit only for abdominal surgery" was used. An effort to rebuild a face involved an old-fashioned technique that required transplanting flesh tunneled from the patient's arm. "In the U.S.," said Dr. Hall, "the surgeon would have used free grafts and implant materials."

Everywhere he went, the visitor smelled ether, a sure sign of outdated anesthesia techniques. Disposable products such as linens and syringes were unknown, though they are in wide use in the U.S. "Diagnostic work is primitive," said Hall. "Xray equipment is antiquated. Blood-chemistry analysis is inefficient." The leisurely, informal pace was astounding. At a 500-bed hospital, ten to 15 operations a day are normal in Russia--compared with 35 to 50 in the U.S. At Moscow's Neurosurgical Institute, the entire staff turned out to hear Dr. Hall lecture on the air-powered drills and bone saws he has developed. "Who was looking after the patients I don't know," he says. Leningrad's Neurosurgical Institute was closed during his visit because the doctors were on vacation. "An emergency case," he reported, "would simply be treated by less qualified personnel."

Best Billing. As far as he could determine, Russian researchers seem to go out of their way not to learn from the rest of the world; they doggedly carry on experiments already completed elsewhere. Spillover from space research has played a key role in the growth of American medical instrumentation, but Dr. Hall could detect no such beneficial results in the U.S.S.R. Electronic devices are so scarce, he said, that they are "virtually unavailable. Medical technology, as we know it, is nonexistent."

There are, to be sure, some compensating factors. The modern drugs and vaccines familiar in the U.S. are also used by the Soviets, and no available statistics suggest that their death rate is unusually high. Though their hospitals may be hampered by a lack of technology, patient care does not suffer as much as it might. There is none of the doctor-nurse shortage that now plagues the U.S. Nonetheless, Dr. Hall had reason to be distressed, for what he had been shown was billed as the best that Soviet medicine had to offer.

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