Vodka Politics (69 page)

Birth Dearth

The disturbing upshot in mortality is only one-half of the Russian cross; the other is the dramatic collapse in the birth rate. Amid the crisis of economic demodernization, Russian women suddenly stopped having kids.

Demographers like Dr. Feshbach speak in terms of a country’s “total fertility rate” (TFR) or how many births a typical woman has during her lifetime. To maintain a stable population, the TFR must stay around the replacement rate of 2.15 children per woman: one to replace the mother, one for the father, and the additional 0.15 covering those who do not reproduce (either due to choice,
infertility, or premature death). In the Soviet era, Russia’s TFR hovered around 2.0 before jumping temporarily with the liberalization and anti-alcohol campaign of the Gorbachev era. In 1987 the TFR was 2.23 kids per mother. Within eleven years it had fallen to a shocking 1.23—well below the replacement rate. As Feshbach explained to
60 Minutes
, this constitutes the lowest birthrate of any country in the world, the consequence being that, by the late 1990s, more than a million more Russians died every year than were born.
²⁹

To find out why, Fenton and Feshbach called on Stanley J. Tillinghast, an American cardiologist and director of a healthcare-reform program in Russia. He explained: “Their outlook for the future is very poor, which is part of the reason the birthrate is so low.” Turning toward the camera he explained how many of his Russian colleagues had children of the same age: all born during the early days of Gorbachev’s
perestroika
a decade earlier. “They were the children of hope: they were born during the early stage when people were still very optimistic.”

“And she’s had no children since then?” Fenton concludes, rather than questions.

“And she’s had none since then, correct.”
³⁰

Russia’s dilapidated healthcare system has implications for fertility as well as mortality: according to the World Health Organization, even as recently as 2005 a Russian’s risk of death in childbirth was over six times higher than for women in Germany or Switzerland.

Increasingly, couples that want to have children simply cannot: fifteen to twenty percent of all Russian families experience infertility, which is often the result of syphilis or other untreated sexually transmitted diseases. Russian men, hobbled by disease and alcoholism, are also becoming impotent at an alarming rate.
³¹

Women can also be rendered barren through botched or repeated abortions. The “abortion culture” that so shocked American President Ronald Reagan back in the 1980s was borne of the lack of reliable contraceptives. Soviet birth control pills had such high levels of hormones that they occasionally caused cardiac arrest. Consequently, Soviet women turned to abortions as a form of contraception, with the number of abortions routinely outnumbering live births even in the best of times. Dr. Archil Khomassuridze was the physician tasked with filing Soviet fertility and abortion data with the World Health Organization in Geneva. In the late 1980s, the WHO mainframe consistently rejected his reports, programmed as it was not to believe that any woman could undergo more than twenty abortions in a lifetime.

In Khomassuridze’s Georgian homeland, as in Russia, this trend intensified in the post-Soviet period, when some
two-thirds
of all pregnancies ended in abortion. Yet as he told Pulitzer Prize–winning journalist Laurie Garrett, rather than
scorn these women, Khomassuridze felt only sympathy for their plight. They had to live not only with deep financial difficulty but also with “abusive, often drunken men. Not only was sex often involuntary for the women,” they told him, “it was rarely pleasurable even when mutually consenting.”
³²

Back during the Soviet Union’s epic struggle against fascism in World War II, more than twenty million young Russian men bid a tearful farewell to their loved ones and left for the front lines, never to return. Consequently, at the same time that returning American soldiers contributed to a postwar “baby boom” in the late 1940s, postwar Russia experienced a “baby bust”: eligible men were few and far between, vastly outnumbered by legions of forlorn widows. A half-century later, the birth-dearth dynamic has returned, though on a smaller scale. With alcohol-related mortality rendering the working-age, childrearing-age Russian man an “endangered species,” Russian women have even complained: “there simply aren’t any men!”
³³
The number of marriages has fallen accordingly. The obvious conclusion is borne out by Russian studies: the absence of a loving partner is the most powerful factor in the decision to not have children.
³⁴

As if the lack of suitable husbands and the increasing possibility that some sort of (often drunken) tragedy will claim one or both parents before they are able to reproduce weren’t daunting enough, divorce discouraged even more women from having children. Of every one hundred marriages in Russia, fifty-eight end in divorce. I’ll leave you to guess the most frequently stated reason for separation.
³⁵

Domestic violence also reached astronomic figures: in the Yeltsin years, between twelve and sixteen thousand Russian women were killed annually by their spouses, with another fifty thousand suffering severe injuries—a rate ten times higher than in the United States. Across Russia’s eleven time zones, there were only six domestic violence shelters. “If the country had a functioning network of battered women’s shelters,” wrote professor Judyth Twigg, “it would be filled with victims of domestic violence perpetrated by drunken boyfriends and husbands. Yet vodka remains cheaper than milk, supported by a state that relies on almost $500 million in annual revenues from alcohol duties.”
³⁶

The American audience of
60 Minutes
learned that the crisis of the Russian family did not end with divorce—as the tragical history tour rolled into a typical orphanage. There, they were introduced to the ever-growing number of children whose parents had either fallen victim to the mortality calamity or were cast off by their parents as too great a burden. Today, the rate of child abandonment in Russia is the highest in the world: over one hundred thousand children have been cast off every year since 1996. One of every thirty-eight children does not live with his or her parents, and one in seventy is sent to Russia’s orphanages, where children are isolated from their community and—in another enduring legacy of the Soviet era—are tainted socially as undesirable and unworthy. In cases where
the state deems an adult unfit to parent and places the child in orphan care, alcoholism is again by far the most frequently stated reason.
³⁷
The dramatic increase in the orphan population since the 1990s and dwindling numbers of school-age children have led to the sad trend of repurposing many of Russia’s elementary schools as orphanages. As my wife and I learned firsthand, working with the city orphanage in Podolsk south of Moscow (just blocks from the apartment where vodka historian Vilyam Pokhlebkin was brutally murdered), this retrofitting includes slapping steel bars on the windows and erecting tall concrete walls in order to isolate the orphanage grounds, indicative of the social stigma that Russia’s growing army of orphans are forced to endure. According to the government’s own estimates, thirty percent of institutionalized orphans will end up as alcoholics, and forty percent will end up in prison. With limited education or vocational opportunities, upon “graduating” from state custody—usually at the age of sixteen or seventeen—most are unable to live on their own and wind up on the streets, where they join the one to four
million
other homeless children in Russia.
³⁸

In her best-selling exposé
Betrayal of Trust: The Collapse of Global Public Health
, Laurie Garrett interviews some of Russia’s “lost generation” in orphanages and shelters across the former USSR. One pattern clearly emerges from the stories: parental alcoholism leading to child abuse and abandonment. She recounts the story of the emotionless, eleven-year-old Vanya whom she found in a Moscow homeless shelter. When Vanya was just nine, his drunken father began to regularly thrash his wife and son. Vanya’s mother “drowned her sorrows in moonshine purchased at local kiosks. The bad booze drove her insane, and escalated the violence in the household.” After the nightly domestic bloodletting, Vanya and his mother packed their bags and left for the Belorussky station. Just as a train was pulling away from the platform, Vanya’s mother dropped her son’s hand and jumped aboard, never looking back.

“I lost her at the railway station,” Vanya morosely recalled. The entire following year—his tenth—was spent wandering the streets, begging for food, and sleeping in a telephone booth before he eventually fell into a small children’s shelter reliant on charitable donations. Sapar Kulyanov, the shelter’s director, tells of “an avalanche” of abandoned and abused children since the collapse of communism, with upwards of ninety percent coming from homes torn apart by drug and alcohol abuse.
³⁹

If that wasn’t enough, the prospects are if anything even more bleak for children born with physical or mental disabilities. Cast off by their parents, Russia’s most vulnerable citizens suffer systemic ostracism, neglect, and abuse. In what one Russian disability advocate calls an “undeclared war,” those with mental and physical limitations are denied even the most basic social, educational, and medical services.
⁴⁰
The alcoholization of society borne of vodka politics is making
things worse here too: a recent epidemiological investigation into the health of orphans in Murmansk diagnosed fifty-eight percent of the babies with damage to the brain and central nervous system associated with Fetal Alcohol Syndrome.
⁴¹
All told, only
one in four
Russian babies is born healthy. Russia’s chief pediatrician, Aleksandr Baranov, estimates that perhaps only five to ten percent of all Russian children have a clean bill of health. Meanwhile, seventy percent of the teens of the 1990s—the post Soviet generation expected to transform Russia into a vibrant and prosperous economy—suffer chronic diseases.
⁴²

Meanwhile, during their televised orphanage tour, excursion guide Murray Feshbach continued to rattle off one disturbing statistic after another to his accidental tourist. For instance, in the worst areas of industrial pollution, upwards of forty percent of children are born with mental impairments.

“That is devastating!” exclaims a flabbergasted Fenton. “That’s a
huge
number.”

“It’s awful,” admits Feshbach. “It’s much worse than what I even knew. And I must say I’ve been prepared for many awful things… but not that figure.”
⁴³

Russians born in the late 1980s and 1990s are saddled with enormous expectations in the new millennium: charged with transforming Russia into a robust market economy while reclaiming its past political and military glory. Yet this generation is not only far smaller (by half) than previous generations; it is also far sicker. The Russian armed forces rely on a system of obligatory conscription beginning at age eighteen. So in 2002, to get a feel for the incoming recruits, the Kremlin commissioned a detailed health survey of children from age zero through seventeen—everyone born since Gorbachev came to power in 1985. The results of this Child Health Census—intended only for President Vladimir Putin and his cabinet but obtained by (you guessed it) Murray Feshbach—painted a shocking picture of demodernization’s toll on Russia’s children. Compared with the children surveyed only a decade earlier, the rate of mental disorders had doubled; instances of muscular-skeletal illnesses and cerebral palsy tripled; and the rate of both cancers and tuberculosis among children had quadrupled. When it came to vodka, the rate of alcoholism among Russian children—not kids having a drink occasionally or even regularly, but clinical alcoholism—was increasing by 33 percent
per year
. Indeed, to the extent that vodka is one of the primary engines of Russia’s demographic nightmare, more recent statistics suggest that the average age when Russian boys become committed drinkers has dropped from sixteen to thirteen. The number of “tweens” aged ten to fourteen who regularly drink vodka is now over ten million.
⁴⁴

At some point statistics like these become almost impossible to comprehend. Could a global superpower truly fall so far, so fast? To be sure, the crisis caused by skyrocketing mortality and sudden infertility is multifaceted: an onslaught of diseases, depression, and societal self-destruction straining a social safety net already shredded by the hardships of “transition.” Yet from the kiosks to the
hospitals to the orphanages—every place that Fenton and Feshbach explored for
60 Minutes
—one could distinctly see the shadow of alcohol and the looming legacy of Russia’s autocratic vodka politics. Finally, at the end of their grueling expedition, like Dante and Virgil having weathered the nine circles of the
Inferno
only to ascend to purgatory, the American journalist and his chaperone take a moment to reflect.

“Is this a country that is dying?” Fenton asks.

“Yes.”

“It’s almost as if it is committing suicide.”

“Well, I think that’s one way of reading all the data.” Feshbach pauses for only a brief moment. “I don’t want to read it that way, but the answer is almost ‘yes.’ What I do in what I write and in working with my Russian colleagues is to alert people that this is a problem, and you’d better do something about it.”