Between 1956-1991, the national health problems continued. During the 1950s, tuberculosis, traumatism, occupational diseases and dysentery were the main concerns of the medical research work. In parallel, there were staff problems. The Faculty of Medicine of Tartu State University suffered the peak of repression in March 1950: 56 lecturers were repressed, hundreds of students were expelled, many were arrested. 12 of the 17 professors at the Tartu University were dismissed, replaced by those being loyal to the Communist Party. Thus, the quality of work at the University dropped.

Though during the political “thaw” in 1953 there were general improvements, the isolation from the West hampered scientific work and obtainment of the required equipment. Politically, a three-level hospital network had been created: Communist Party hospitals, central hospitals, and district hospitals, with significant differences in the provision of medications and equipment. Standing in the Communist Party was important; there was a shortage of certain groups of medications because prevailing demands by the war industry, which came first.

It should be noted that as a consequence of liberal Soviet alcohol policy, alcoholism became a health problem in Estonia. In 1982-1989 the consumption of alcohol per person in Estonia was 11.2 lit., in Finland it was 6.7 lit. per year. The drug addiction grew: 93 in 1980; 266 in 1991.

In summary, in 1991 there were 6527 doctors in Estonia, 13,215 mid-level medical workers, 17,620 hospital beds, but the life expectancy decreased; it is now 5.5 years shorter than for the Finns.

The following chapter is a thorough continuation of this basic summary of health concerns in the occupied Estonia

IV — Permanent Health Damage

The introductory paragraph:

“Massive terror and repressive measures were employed during the Soviet occupation in Estonia, including mass murders, arrests and deportations. The Soviet power injured and crippled a large number of people, causing a serious permanent trauma to their mental and physical health. About half of Estonia's population suffered because of direct or indirect repressive measures. Memories of violence and health injuries will be engraved in the collective memory and their results might last for generations.

This chapter of the White Book focuses on the results of the crimes against humanity committed in Estonia during the Soviet and so-called Stalinist repressions (1940-1941 and 1944-54). The treatment of the issues is victimological.”

Alongside the 1968 UN definition of crimes against the humanity, the comparable legal scope of crimes committed in Estonia is given in article 89 of the Penal Code of Estonia, defining it “...as systematic or large scale deprivation or restriction of human rights and liberties, instigated or directed by a state, organisation or group; or killing, torture, rape, causing damage to health, forced displacement, expulsion, subjection to prostitution, unfounded deprivation of liberty; or other abuse of civilians.”

This section deals mostly with crimes committed in Estonia during the Soviet occupations 1940-41 and 1944-54; treatment of issues is victimological and sovietological by the author, Dr. H. Noor, who himself spent 8 years in the GULAG.

Regarding the character of repressive acts committed in Estonia by the Soviets, the author states that “...because of their extent of severity, the repressive measures of this period can be compared to the Jewish holocaust, causing long term physical and/or mental disorders to nearly all of the survivors.” According to researchers, these psychological consequences are carried over to the children and grandchildren of the survivors. At least 30-60 % of the survivors still need care; 10-30 % need cure. Symptoms can be observed for 50 years.

Referring to the aims and means of the repressive measures, this article defines the repression as acts of violence, committed for political purposes by the occupational authority, prohibited by international law. The aims and of the Soviet repressive measures were to subdue, repress and/or destroy the active core of the population; to erase the national independence from the memory of the people. It is considered that the marks left by the psychological torture were often deeper than the bodily injuries.

A number of health disorders have been encountered, requiring cure, and caused by the repressive measures:
a) Starvation, nutritional marasmus, alimentary detropy, vitamins deficiencies, pellagra, scurvy;
b) Chronic pneumoconiosis — caused by the work in the mines;
c) Radiation disease with pneumoconiosis — caused by mining radioactive ore;
d) Infectious diseases, like lung and bone tuberculosis, typhus, and brucellosis;
e) Maltreatment syndromes — caused by exposure to cold and being left without food and potable water;
f) Bone fractures and other bodily injuries, received during torture, or as a result of working conditions;
g) Obliterating endarteritis, affecting lower limbs, resulting in amputation (happened frequently in Vorkuta).
This listing demonstrates inhuman suffering of great magnitude.

Damage to mental health was another result of repression. Mental trauma is a shock or tension caused by excessive negative experiences, damaging to the psyche, spirituality and mentality of a person. The mental trauma caused in Estonia belongs to the categories of extreme and disastrous. Trauma is described in three stages: a) shock, scare, fright that accompanied imprisonment and deportation; b) adapting to the situation, which could last for days or for years; c) resolution, release, regression. This final stage could last for the rest of one's life.

Another means of political repression was the internment to a closed mental hospital. One of the victims was President Konstantin Päts, interned in Russia for 15 years. On January 18th, 1956, he died in the Kalinin-Eurasevo mental hospital from pleurisy and infectious hepatitis.

(To be continued)

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