When the Soviet Union collapsed in 1991 it left some twenty-five million ethnic Russians—many of whom had lived their entire lives in cosmopolitan cities like Odessa, Baku, or Almaty—beached in the so-called “near abroad”—the other newly independent post-Soviet republics. Some chose to “return” to a Russian homeland they had never visited and were often shocked at what they found. “They drink, as a norm,” marveled an ethnic Russian from Kyrgyzstan after settling in the Oryol region. “You can buy anything for a bottle, they don’t know any other price… here women living on their own, when they ask for help with the cattle or the allotment, they must have a bottle, nobody ever takes money… so you learn to make samogon.”62
Jarring experiences like this—even between members of the same ethnic group—suggest that ethnicity is not what causes social demodernization, but vodka: not just how much people drink, but the ways in which it has been entrenched into both people’s accepted day-to-day coping strategies and the economic life of the country itself.
In simplest terms: economic crisis plus vodka politics equals demodernization.
Demodernizing Values
Russia’s vodka-fueled demodernization also impacted its political prospects. Just as Hans Rosling has mapped the movement of nations toward the healthy-wealthy corner over the past two centuries, political sociologists have charted a similar evolution of cultural traits supportive of democracy and effective governance. For them, “modernization” is in the triumph of rationalism over tradition, secularism over religion, tolerance over xenophobia, gender equality over patriarchy, and liberalism, happiness, life satisfaction, individualism, and self-expression over basic survival needs. The relationship between economic modernization and the cultural changes that support democracy has proven quite robust, since it is not the elites, but the orientations of the citizenry that motivate them to push for liberty and effective governance. “Genuine democracy is not simply a machine that, once set up, will function effectively by itself,” concludes University of Michigan political scientist Ronald Inglehart. “It depends on the people.”63
Yet his own work, which tracks the global progress of such values, bodes poorly for Russia in the 1990s. Based on his exhaustive World Values Survey—conducted regularly by a network of social scientists in over eighty countries—Inglehart scores each country in terms of simple survival values versus modern self-expression values and traditional values versus modern secular/rational ones. Happily, from the 1980s through the 1990s every country surveyed improved on at least one of these dimensions, and most improved on both… except two. Russia and Belarus slid backwards: instead of becoming more secular and modern, they were becoming more religious and more traditional than under the Soviets. Russians were also becoming more suspicious, insular, distrustful, and dissatisfied: over half of Russian respondents said they were “not happy” or “not happy at all,” placing Russia among the world’s most miserable populations, while their trust in public institutions ranked as the world’s lowest. Findings like these suggest that the economic and health catastrophes of “transition” were accompanied by a cultural demodernization.64
For development sociologists, the conclusion is clear. Inglehart claims that “support for democracy is relatively weak in Russia—indeed, it is weaker than in almost any other country.” In some ways this is understandable, since the tumultuous 1990s led many to associate democracy with drunkenness, disorder, and economic insecurity.65 This societal weakening of pro-democratic values was just another impediment to meaningful political reform demanding more effective governance.
Demodernization, then, is a complex phenomenon encompassing political, economic, social, and cultural attributes—and vodka seems central to understanding it all. Post-communist transition, when mixed with the legacies of vodka politics, produced the thoroughly unprecedented demodernization of a global superpower. In turn, the economic, political, and even cultural consequences of this demodernization have bolstered the durability of Russian autocracy, making democratization far more difficult.
Certainly this was anything but an ordinary economic downturn.
21
The Russian Cross
The television news magazine 60 Minutes has been a weekly staple for generations of American TV viewers. Since 1968 its poignant brand of investigative journalism has made it the longest-running, highest-rated, and most successful show in television history.
In early 1996—just as Boris Yeltsin began his miraculous political resurrection—a most remarkable 60 Minutes investigation presented the true costs and human suffering of the post-Soviet “transition” to an otherwise disinterested American public. It painted an alarming picture: while Yeltsin battled to keep the communists from returning to power, “Russia,” it declared, “is confronting a humanitarian tragedy of immense proportions.”
Cut to CBS journalist Tom Fenton strolling through a snow-covered Moscow courtyard casually discussing Russia’s arduous transition to capitalism and democracy with an owlish man with a thick Brooklyn accent. While many Russia watchers were preoccupied with the economic side of demodernization—how many lost their jobs or how much production had contracted—this man was horrified by Russia’s deteriorating health statistics, which told of a wholesale social catastrophe that had accompanied Russia’s economic collapse. No one was better positioned to sound the alarm: Fenton’s interviewee was none other than Murray Feshbach—the same American demographer who had been publishing worrisome health statistics for decades. As we saw in chapter 16, it was Feshbach’s coauthored reports on infant mortality in the 1970s that suggested that the Soviet superpower was in dangerously frail health. And as we noted in chapter 18, it was Feshbach’s encyclopedic knowledge of the impairments to Russian health—alcohol foremost among them—that was consulted by journalists, academics, and policy makers alike. If his Cold War–era warnings were grim, his new reports about the collapse of Russian healthcare, its skyrocketing mortality, plummeting fertility, and shrinking, sickly population were downright apocalyptic.1
“Is there any parallel with this anywhere?” Fenton asks.
“No. Certainly not in any developed country.”
Like the Roman poet Virgil accompanying Dante Alighieri through the nine circles of hell in the Divine Comedy, Feshbach then guided the American journalist through the horrors of post-Soviet society: touring decrepit healthcare facilities, underfunded orphanages, polluted swimming holes, smog-filled cities, drug dens, vodka kiosks, and cigarette stores before winding up where Russians were arriving at an unprecedented rate: the cemetery. All the while, Feshbach spouted devastating statistics, explaining with his dark humor (no doubt a necessary defense against the depressing subject matter) how the decidedly unsexy issue of population health was quickly becoming a massive political challenge. “It puts in danger their economic and political reforms if everybody is dead. Of course, not everybody is dead, but their conditions are not very good,” Feshbach explained.2
Skeptics have challenged such dire assessments: Were things really that bad? How could the nation’s health really impact the future of Russian politics? And what role did vodka play in this?3
In 2006, academics Andrei Korotayev and Daria Khaltourina explained that the demographic crisis was generated by the “Russian cross.” They weren’t referring to the Russian Orthodox Church but rather to the dramatic upsurge in the Russian death rate in the 1990s just as the birth rate plummeted, statistics that formed the shape of a cross when plotted on a graph. With far more people dying than being born, the size of the Russian population has shrunken dramatically since the collapse of communism and will likely continue to do so.4
Certainly, some argue, other countries also have higher death rates than birth rates—and not just Russia’s neighbors in post-Soviet demodernization. The “graying” of Western Europe also has produced more deaths than births and a gradual population decline. But as figure 21.1 shows, when compared to wine-drinking Italy or the post-communist tribulations of
the beer-swilling Czechs, the suddenness of the change combined with the sheer scale of lives lost makes the Russian cross categorically unlike anything seen before. According to Russia’s state statistical agency, in the twenty years from 1992 to 2012 some 12.5 million more Russians were buried than were born.5 Outside of the horrors of total war, the only comparisons to such depopulation are the 1918 flu pandemic, China’s catastrophic Great Leap Forward, and the AIDS epidemic in sub-Saharan Africa.6 Yet since this devastation appears almost self-inflicted, Russia’s suffering has been passed over in relative silence.
Dead Drunk
What caused this horrific state of affairs? As it turns out, Khaltourina and Korotayev’s list of culprits is virtually identical to what Murray Feshbach explained to 60 Minutes a decade earlier, beginning with a disaster in healthcare. Amid the worst of the crisis in the mid-1990s, Feshbach took the American viewing audience into a typical Russian hospital, which was struggling just to operate as ever more government resources were siphoned off to pay for the war in Chechnya. Proceeding across crumbling floorboards down a dimly lit hallway, viewers saw discarded plastic water bottles reused as drip containers, rubber sheeting used as a mattress, a neonatal unit with only one respirator, and vital drugs in such short supply that patients are told to buy their own.
Figure 21.1 THE RUSSIAN CROSS: ANNUAL BIRTHS AND DEATHS IN THE RUSSIAN FEDERATION, ITALY AND THE CZECH REPUBLIC, 1970–2010. Sources: Goskomstat Rossii, http://www.gks.ru/dbscripts/Cbsd/DBInet.cgi?pl=2403012; Istat, http://demo.istat.it/index_e.html; Czech Statistical Office, http://www.czso.cz/eng/redakce.nsf/i/population/.
“We can’t believe what’s become of our country. It’s worse than the war,” said one elderly woman in the hospital ward, choking back tears. For the past eight months she had spent her entire pension on prescriptions that should have been covered under the universal healthcare bequeathed by the Soviets. “Under the communists we were alive,” she says, suggestive of demodernization’s undermining of political values. “Now we are dying with this kind of democracy.”
Over 75 percent of Russian patients have to resort to bribery, the 60 Minutes narrator explains.
“And they call this ‘free public health’”—Fenton sarcastically puts it to his host.
“Well, if you want to call it that, fine,” Feshbach shoots back. “I don’t.”7
A resource-starved healthcare system alone cannot explain the plummeting statistics. In fact, when compared to Brazil, India, and China (Russia’s other BRIC counterparts sharing a similar level of economic development), Russia not only spends more per capita on healthcare, but it also has more medical professionals. More doctors and more money translates into better health the world over—except in Russia, where life expectancy is still a decade less than models would predict based on healthcare availability and expenditure statistics. Russia’s nagging ailment isn’t so easily “cured,” at least in the epidemiological sense.8
Russia actually has many ailments beyond its alcoholic affliction. In the 1990s, AIDS entered the former Soviet bloc primarily through drug addicts sharing dirty needles. While an outmoded HIV-screening system has allowed the state to downplay the prevalence of the disease, international organizations warn of a potential AIDS disaster looming just below the surface. Beyond AIDS, there was an explosion in diseases that have been all but wiped out in the West: polio, measles, rubella, and one hundred fifty thousand new cases of tuberculosis annually—half of which are of a mutated TB strain that festers in Russia’s crowded prisons and is stubbornly resistant to all known treatments.9 Add to that the polluted drinking water that spreads bacterial dysentery, malaria, and diphtheria.
“This is a huge catalogue of horrors,” Fenton notes, as they continue to walk through the gently falling Moscow snow.
“I’m sorry,” Feshbach stops, as if to emphasize the point, “that’s why people thought that I spoke in hyperbole. That is, I couldn’t be right about all of this. But unfortunately I feel I am.”
Still, the single greatest cause of this dismal state of affairs is vodka. Soviet medical experts used to call alcohol “Disease #3,” as the third leading cause of death, behind only cancer and cardiovascular diseases. By the 1990s vodka had leapfrogged both, officially becoming “the main killer of Russians.” Alcohol-related mortality in Russia was the highest in the entire world.10
How could it come to this? Against images of staggering homeless drunks, vodka kiosks, and Yeltsin’s drunken Berlin embarrassment, Fenton narrates: “To quench its sorrows, the average Russian male now guzzles an incredible half-a-bottle of vodka per day. And remember, that’s the average.” That’s roughly 180 bottles of vodka per year.11 Stop for a minute—let that sink in.
With illicit samogon and third-shift vodka permeating the market, calculating alcohol consumption is a tricky matter. The best estimates are that in the 1990s Russians quaffed some fifteen to sixteen liters of pure alcohol annually—doubling the eight-liter maximum the World Health Organization deems safe. Making accommodations for nondrinkers (children and abstainers) and how much men drink relative to women, as well as their drink preference, these abstract numbers mean that the average drinking Russian man downs thirteen bottles of beer and more than two bottles of vodka every week—week in and week out.12
Not surprisingly, Russia is either at or near the top of every list of the world’s hardest-drinking nations, along with Ukraine, Moldova, the Baltic states, Hungary, and the Czech Republic. Yet even though all of these countries endured post-communist transitions, perhaps only Ukraine has had a collapse in public health indicators similar to that of Russia (see chapter 20). How are we to make sense of this?
The answer is that the destructiveness of alcohol depends not just on how much alcohol is consumed, but on what kind and how it is consumed. The Czechs, for instance, have long had a beer-drinking culture, with the average man downing only two-thirds of a bottle of spirits per week but sixteen beers and a bottle of wine. In wine-drinking Hungary, the average man quaffs the same two-thirds of a bottle of liquor along with eleven beers and two and a half bottles of wine per week. Each scenario describes a lot of heavy drinking, but the legacy of vodka politics reflected in Russians’ preference for potent, distilled liquors over milder, fermented beer or wine is the difference between a moderate social-health concern and a full-blown demographic crisis.13
Consider alcohol poisoning. Four hundred grams of pure ethyl alcohol is usually enough to kill you. If you’re a beer drinker, to get that much pure alcohol into your bloodstream, you’d have to down almost an entire keg in one sitting. In the United States, every year there are a few tragic cases—usually college students—who die in such a manner, but a beer drunk usually passes out clutching the toilet bowl long before he approaches a lethal dose. The same thing is true for wine drinkers, who tend to fall asleep well before downing a lethal five and a half bottles at once. Passing out is the body’s defense mechanism—shutting down before you completely poison yourself. Due to vodka’s higher potency, it takes only two half-liter bottles to deliver a lethal dose: an amount that can be more easily consumed before the body can shut itself down.14
“It’s not just that consumption is high, although it is,” Feshbach explained about Russia’s peculiar drinking culture. “It’s the way they consume. It’s chug-a-lug vodka drinking that starts at the office during the morning coffee break and goes right into the nighttime.”15 Until recently, instead of twist-off lids, vodka bottles in Russia came with tear-off caps that could not be resealed. Why would you want to put the lid back on? A “real man” would finish off the entire bottle rather than let it go to waste. Moreover, in contrast to the communal drinking culture of the imperial past, Russia’s modern, individualistic drinking culture means that Russians today often drink alone (and without proper nourishment), only compounding their health problems.16 A further complication, as we found in chapter 7, is the unique practice of zapoi: when an individual withdraws from social life—sometimes for days at a ti
me—to go on an alcohol-fueled bender. This binge drinking leads to higher rates of sudden heart failure from acute stress on cardiovascular muscles.17
This is to say nothing about the quality of vodka. With samogon moonshine and unregulated third-shift vodka making up more than half of the market, there was little quality control in the 1990s. To cut costs, some unscrupulous alcohol producers even cut their vodka with toxic technical, medical, or industrial alcohols to save a few rubles.18 Then come the alcohol surrogates: from antifreeze and break fluid to eau-de-cologne and cleaning compounds. Recent fieldwork suggests that one in twelve Russian men—some ten million people or more than the entire population of Hungary—regularly drinks potentially toxic medicinal or technical alcohols.19 Not surprisingly, those who turn to such alternatives tend to be desperate men from the poorest socioeconomic groups. Also unsurprisingly, the risk of death among those who regularly drink antifreeze and other toxins is six times higher than even clinical alcoholics and a full thirty times higher than men who don’t drink at all.20
In sum, the individualized culture of tossing back huge quantities of hard liquor—often of low quality or outright poisonous—has produced a level of alcohol poisonings in Russia that is up to 200 times higher than that in the United States, making vodka the single greatest contributor to Russia’s unparalleled health disaster. When Dr. Feshbach rather nonchalantly explained to the 60 Minutes audience that over forty-five thousand Russians died from alcohol poisoning in one year, this is how.21
Alcohol kills in other ways, too. Notably, deaths from liver cirrhosis and chronic liver disease have steadily increased since the collapse of communism, adding another sixteen deaths per one hundred thousand throughout the 1990s. Vodka also contributes to coronary heart diseases and strokes, harms that accumulate gradually over a long period.22 Indeed, more than half of the increase in male mortality is attributable to cardiovascular diseases in which alcohol and tobacco play a lethal role. As a consequence, in 1995 the rate of deaths from cardiovascular diseases in Russia was 1,310 per 100,000. In Spain, by contrast, it was only 268. Demographer Nicholas Eberstadt has translated these numbers with brutal clarity: “the world has never before seen anything like the epidemic of heart disease that rages in Russia today.”23
Vodka Politics_Alcohol, Autocracy, and the Secret History of the Russian State Page 47