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  • Lives in the BalanceWeak and Disabled Prisoners and the Biopolitics of the Gulag
  • Dan Healey (bio)

Did the Gulag have a biopolitics? The linked concepts of “biopower” and “biopolitics” were sketched by Michel Foucault and have been taken up by historians of medicine and the body examining diverse historical contexts.1 It may sound counterintuitive to suggest that the Soviet forced-labor camp system operated policies (a “biopolitics”) to manage the quality and character of life at the level of the individual and at the collective level of the populations housed in the camp. The scale of mortality in the camps was extraordinary, apparently belying any official concern about prisoner health. Despite a lack of agreement over the precise numbers of prisoners lost to malnutrition, exhaustion through labor, disease, and violence, the death toll in the camps was very high, especially during the World War II and famine years.2 Nevertheless, medical facilities existed in the Gulag to monitor and ostensibly to improve the physical condition of prisoners, and the work of these institutions was framed by regulations and norms that merit systematic scrutiny. Declassification and scholarly publication of Gulag administrative archives have given us a previously inaccessible view of [End Page 527] what camp administrators said and did, and a majority of scholars now accept these documents as a flawed but credible record of Gulag practices (including those of concealment and dissimulation).3 Careful reading from a critical perspective can help us assess what these bosses and the doctors who worked for them thought they were doing with prisoner labor. Understanding the history of medicine in the camps begins with a close examination of official rationales and actions.4

Simply put, histories of the Gulag have failed to analyze the camps’ significant medical infrastructure that from the early 1930s was subordinated to the Unified State Political Administration/People’s Commissariat of Internal Affairs/Ministry of Internal Affairs (OGPU–NKVD–MVD). The Gulag’s Sanitation Department (Sanitarnoe otdelenie GULAG NKVD SSSR), or Sanotdel, served both the system’s prisoner and free employee populations.5 Although never as well resourced as civilian medical services, its representatives and facilities were ubiquitous within the camp system. Archival records suggest the scale of activity of this “embedded” medical service, a dedicated (vedomstvennaia) service similar to “medico-sanitary” services operating in the People’s Commissariats of War, the Navy, and Railroads. The Sanotdel’s central Moscow apparatus was run by a physician who directed a cadre of doctors and lay bureaucrats acting as medical inspectors, sanitation specialists, and statisticians; on the eve of World War II, they constituted 8.6 percent of central Gulag personnel.6 By 1939, the Gulag Sanotdel network in the camps counted 1,171 infirmaries, clinics, and [End Page 528] hospitals with 39,839 beds. During World War II, it expanded to 165,000 beds, and by 1953, on the eve of Stalin’s death and the subsequent release of millions of prisoners, the Gulag medical service had 111,612 beds at its disposal.7 In 1938, it employed 1,830 qualified doctors, of whom perhaps one-third were prisoners; at the same time, 7,556 nurses and paramedics worked in the system, and a large proportion of these were prisoners, too.8 As the camp system expanded, the system’s appetite for medical professionals grew inexorably. Prisoner-physicians were plucked from transports and put to work as medics, thereby avoiding life-exhausting “general labor” in the Gulag’s mines and forests; such was the demand that prisoner-medics were (from 1939, at least) allowed to use their professional skills more often than engineers or other skilled technicians.9 They were supervised locally by “freely hired” doctors and medical bureaucrats who were Sanotdel employees. There were lower-level “free” employees, too. From 1938 on, Gulag representatives recruited newly qualified doctors, nurses, paramedics (feld´shera), dentists, and pharmacists directly from the graduate assignment commissions of medical institutes and training colleges.10 Many prisoners were trained as paramedics and nurses in the Gulag’s in-house courses, which varied in quality and geographic distribution.11 Prisoners taught themselves medical basics and forged careers in the camp infirmaries.12 The medical service was...


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pp. 527-556
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