The Body Politic: Propaganda, Hygiene and the Revolutionary State (review)

This book has many positive features. Starks succinctly, but thoroughly, adumbrates the utopian—almost millenarian—obsession of Soviet élites with public and private hygiene during the NEP or New Economic Policy (1921–1928), the period of relative calm between the civil war that felled more than World War I and the forced industrialization and collectivization of the late 1920s that, coupled with the purges, unleashed famine, diseases, and the deaths of millions. The title implies a review of hygiene throughout the USSR, but this Herculean task is wisely superseded by focus on Moscow with references to Petrograd and Ukraine.

Chapter 1 insightfully links Lenin's political purges to his crusade for physical cleanliness. Five succeeding chapters plumb regulations, pronouncements and propaganda exhorting citizens to live healthfully and productively at work, at home, publicly, and interpersonally and to raise progeny benefiting the Soviet Union—and sketch citizens' responses to these edicts. Stark's variegated sources include laws; proclamations, especially those of Health Commissar Semashko; plays, films, fiction; accounts of mock trials; memoirs; and posters. The last, contrasting proper and improper life styles—a methodology which Starks' aptly notes resembled icons—contribute enormously. Her depiction of new public health institutions—sanatoria and vacation spas (established in houses and dachas sequestered from dispossessed élites and middle classes), clinics and hostels for TB sufferers (some for night use in the open air) and visiting nurses and consultations—is interesting. Starks concedes, however, that while these measures helped improve hygiene or at least people's attitudes toward more orderly living, visiting nurses and consultations could be intrusive. Additionally, health officials often were condescending to women. Very welcome is Starks's acknowledgment that the Soviet hygiene movement was not sui generis. She provides context by citing historical precedents, both Russian and foreign, and by comparing developments in the USSR with similar ones abroad in the 1920s. The book is enlivened by amazingly contemporary Soviet hygiene slogans: diatribes against smoking as a cause of cancer and prenatal problems; pressures for pregnant women to refrain from spirits, eat healthfully, and nurse their infants; promotion of abstemious diet and exercise; and campaigns for youth to "just say no" to drugs and sex.

The study is not without flaws, however. One is Starks's allegation that the 1917 revolutions were caused by Russia's economic and political disintegration during World War I. This cliché contradicts publications by Peter Gatrell, other economists, and my In Health and In Sickness which document increased industrial (including pharmaceutical) production and adequate food output in selected agricultural zones in 1916 and F. A. Gaida's analysis of how liberals and radicals in the State Duma undermined the Tsarist regime.

More significant are two major disconnects with reality. First, Starks sidesteps the issue of whether items required for hygiene were available. Admittedly, the term "Propaganda" in the title suggests concentration on the subjunctive—on the Soviet government's proposals to improve hygiene for, as Starks sensibly notes, extant data do not permit us to quantify the results of the hygiene campaign. Nevertheless, she attempts to link the campaign to outcomes by proffering statistics on the use of health institutions and TB cure rates. Yet, although she quotes Soviet health specialists' laments about lack of soap and mentions filthy toilets, unhygienic communal eateries, and lack of water in crowded dwellings, she does not explore how these deficiencies curtailed the hygiene campaign or whether other necessities—disinfectants, antiseptics, and insecticides—were sufficiently produced or imported.

A second disquieting feature of this study is that the Muscovites highlighted rarely get sick. Indisputably, health is more than absence of illness; it includes good hygiene. But the reverse is not true; good hygiene does not insure health. Good hygiene can lessen certain infectious diseases but cannot prevent others or chronic medical problems. Starks mentions TB of the lungs, scabies, rickets, and venereal diseases but avers that Soviet officials were able to...