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Workers' Bodies in the Workers' State: Prophylaxis and the Construction of Soviet Citizenship
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Workers' Bodies in the Workers' State: Prophylaxis and the Construction of Soviet Citizenship Tricia Starks In 1918, as waves of disease buffeted the young state and civil war threatened to tear it apart, the People's Commissariat of Health, Narkomzdrav, set out to address the dire state of popular health in Russia. N. A. Semashko, long-time revolutionary and Bolshevik, took charge of the Commissariat and the arduous task of providing centralized, universal, prophylactic care to an already ill population in a state unable to supply even the most basic resources and services . While civil war ended and war communism relented, the people of Narkomzdrav got no respite and instead were told to soldier on with limited funds. Faced with a lack of facilities and personnel, it is not surprising that much of the work of Narkomzdrav during this period emphasized worker responsibility for health and illness prevention rather than expensive treatments.I Worker self-control was the foundation of Narkomzdrav programs since large numbers of facilities and institutions could not be funded. Propaganda -the cheapest of methods- spread the preventative message of prophylaxis , and in the 1920s Narkomzdrav-sponsored propaganda was omnipresent . Over 13 million examples of health-themed literature came out in brochures, magazine articles, leaflets, posters, and stories between 1919 and 1927. Narkomzdrav officials led the charge, bu t other "hygienists" from the Party, Komsomol, Zhenotdel, and p ublic added their voices in a general call for a new, rationalized, balanced life. Museums, plays, and movies all trumpeted the new Soviet man's healthful lifestyle. New institutions such as the consultation, the dispensary, the sanatorium, and the house of leisure emerged in limited numbers and integrated treatment and instruction urging I For histories of the foundational period of Soviet health, see Henry Sigerist, Medicine nnd Henlth in the Soviet Union (New York: The Citadel Press, 1947); Mark G. Field, Soviet Socinlized Medicine (New York: Free Press, 1967); Michael Kaser, Henlth Cnre in the Soviet Union nnd Enstern Europe (Boulder, CO: Westview Press, 1976); Nancy Mandelker Frieden, Russinn Physicinns in nn Ern ofReform nnd Revolution, 1856- 1905 (Princeton, NJ: Princeton University Press, 1981); John F. Hutchinson, Politics nnd Public Henlth in Revolutionnry Russin, 1890- 1918 (Baltimore: Johns Hopkins University Press, 1990); and Susan Gross Solomon and John F. Hutchinson, eds., Henlth nnd Socieh} in Revolutionnry Russin (Bloomington: Indiana University Press, 1990). The Making of Russian History: Society, Culture, and the Politics of Modern Russia. Essays in Honor of Allan K. Wildman. John W. Stein berg and Rex A. Wade, eds. Bloomington, IN: Siavica Publishers, 2009, 109- 27. 110 T RICIA STARKS citizens to take hold of their health and pursue a life infused with hygienic , concepts of balance and reason.While their exact prescriptions differed, hygienists displayed a remarkable unanimity regarding the meaning of health arguing, that health was integral to Soviet citizenship and membership in the body politic3 Hygienists' pamphlets and programs continually underscored that personal health was an issue both public and political as a balanced life and clean person could increase individual mental acuity, encourage political orthodoxy, and bring on modernity. Building upon classical concepts of hygiene and rationality as the basis of good health, Soviet hygienists argued that ordered lives necessarily produced healthy bodies and strong sta tes. In their quest to create utopia, hygienists fought what they considered holdovers of capitalism's disorder and tsarism's infection; they redefined these problems in the language of their profession- disease, infection, disorder, and dirt. Hygienists' political inclinations bled into their discussions of purely medical conditions, thus, dirt was not an absolute but a defined object whose presence signified disorder. As anthropologist Mary Douglas noted in her study of ritual pollution, dirt often exists only "in the eye of the beholder."4 Even as real problems of sanitation plagued cities unable to provide running water, sewage service, or heat, in the eyes of Soviet hygienists, ethical and political implications hung as dirt upon the people whom they were to heal and teach. This equation of dirt with ethical and political problems was echoed in prescriptions for change. Highly influenced by pre-Revolutionary medical authorities and European philosophical movements, Soviet hygienists equated citizens' behavior and cleanliness with the state's stability5 They argued that citizens who kept clean and balanced lives formed the foundation of a strong and productive state by decreasing costs for care, increasing worker productivity , and providing examples to others6 In close approximation of the model Norbert Elias put forward in The Civilizing Process...