“After so many years as enemies,” he asked me, “is it possible that Americans will help us help our children survive?” The speaker was Boris N. Topornin, the late director of the prestigious Institute of State and Law of the Russian Academy of Sciences. We were in Atlanta, where I’d come to meet with this influential Russian lawyer.
Topornin had been teaching a course at the Emory Law School for a semester and would soon be returning to Moscow. Although I had met him on several occasions and knew how notable he was in Russia, I had never spoken to him about serious matters. That is, until we sat down to dinner that evening.
I had been working in Russia for nearly 20 years and witnessed firsthand the insidious and destructive effects of atheistic materialism on the national soul. And the worst of these nihilistic manifestations was its appalling abortion rate. I saw it as one of history’s greatest moral calamities—on a scale with Stalin’s butchery. Then, miraculously, glasnost came and, along with it, the changes that led to the end of the Soviet Union.
But the disappearance of Communism left a moral vacuum in which abortion on demand continued to thrive, even as Russia’s long-standing population decline approached catastrophic levels. Faced with a decreasing adult lifespan and births substantially below replacement levels, the newly elected Russian president, Vladimir Putin, in his first national address in 2001, told the Russian people that “the most acute problem facing Russia is its declining population.”
When I read the press coverage of Putin’s speech, a thought came to me: The time might be right for Russia—a people struggling to emerge from the valley of the culture of death—to lead the world toward a culture of life, with abortion as the test case. Was this just a pipe dream, or might it be a God-given impulse to one born in a free, democratic, and prosperous nation, blessed by a happy marriage and seven wonderfully different and interesting children? I hoped that the meeting with Topornin might help guide me.
“Would you, Boris, be willing to help me find out whether public health leaders in Russia would be willing to entertain the possibility of collaboration with Americans?” I asked him.
“Yes, of course,” he said. We spent the rest of the evening working out the strategy.
Our first step was for Topornin to form a committee of leading Russian doctors and public-health officials to identify the practical ways to stem the nation’s plummeting birth rate. While he was doing that, I began to assemble an ad hoc panel of Americans to evaluate proposals put forth by Topornin’s committee.
Less than two weeks after he returned to Moscow, he called to say that not only was his committee in place, but that the minister of health for the Russian Federation, Dr. Yuri Chevchenko, wanted to meet me.
“Ishould tell you, Tom,” Topornin said, “that our minister thinks your proposal is too good to be true.”
“When will he see us?” I asked.
“As soon as possible,” he said.
We met in the minister’s spacious office in the heart of Moscow. We were told that Dr. Chevchenko, a trim, well- spoken man in his early 50s with a dignified bearing, had left a meeting of the counsel of ministers presided over by his longtime friend, President Putin, to be with us. After a few pleasantries, he addressed me directly in Russian. “Mr. Murray, Academician Topornin has told me about your friendship for Russia and the contributions you have made—particularly during our perestroika period—to a better understanding between our two countries. I also understand that you are disappointed that more progress has not been made in building a new relationship between your country and mine to replace the bitterness of the Cold War years. I can tell you that our president believes that it is absolutely essential that we promote healthy births and discourage abortions.”
There was a pause, while the minister cocked his head slightly and smiled. “If your country can help us achieve this, it may soon be possible to hold a memorial service and bury the remains of the Cold War forever. May I ask why you are willing to do this?”
Here was an open invitation to speak my mind, from the highest-ranking public-health official in Russia. I had no intention of letting this opportunity escape me.
“Dr. Chevchenko,” I began, “I believe that the assault on pre-born life both in my country and yours is the most serious moral issue of our age. Although we in the West have benefited greatly in all spheres of life from the fruits of the so-called age of enlightenment, the resulting secularization of society has also helped to produce a culture infused with utilitarian materialism. This, in turn, has led to an abortion rate in the United States that now exceeds one million a year.”
“Do you believe something similar has happened here in Russia?” he asked.
“Yes, only much worse. In the West, and in my country in particular, a purely materialistic concept of human nature has always been restrained by the power of religious faith. Although the Bolsheviks were unable to destroy this restraint completely in Russia, they weakened it to a catastrophic degree. Much has been written since glasnost about the destructive effects of alcoholism, mental illness, divorce, suicide, and disease on your population. Although your government is committed to improving these causes of the problem, we believe that the best strategy in the long run is to substantially increase new births above replacement levels, and that will require a radical reduction in abortions.”
He nodded. “Academician Topornin has explained that you are a Roman Catholic. I believe your pope, John Paul II, has referred to abortion as part of a culture of death. I can see that you agree with this.”
“That’s correct,” I replied. “That’s why I’m here.”
There was a long silence. Had I been too blunt? Had I offended this important Russian official who, like his friend Vladimir Putin, had risen through the ranks of the failed Soviet system? When he finally spoke, his tone was somber but gentle.
“You may have heard that our president is a man of deep religious faith, even though it was often quite difficult to be a believer during the Soviet period. Nevertheless, as he explained to your President Bush, he has always kept a crucifix next to his heart that belonged to his mother and which he rescued from a fire when he was very young. I have told him about your proposal, and he has asked me to assure you that you will have the complete support of our government regarding this project. Academician Topornin has told me what has been accomplished so far. May I ask what funding is available?”
This was going well.
“My wife and I will contribute the money necessary to get the project started,” I said. “Once we’ve identified a public maternity hospital to serve as a pilot project, we’ll form a Russian-American partnership that will be funded equally by the Russian and American participants in the project.”
“It’s a good plan,” commented the minister, “and I have asked our distinguished director of the State and Law Institute to keep me informed about your progress.”
What I told the minister was true: The Bolsheviks had created a one-ideology state based on the philosophy of militant atheism that included virulent attacks on religion. Under Stalin, most of the churches in Russia were reduced to rubble or recommissioned for secular functions, and most priests were simply murdered, a practice that continued up until the Second World War. Premier Nikita Khrushchev also demolished thousands of Christian churches of all denominations across Russia.
This assault of militant atheism on religion was intended to sever all links between religion and a radically secular order in which people were reduced to instruments of production to be manipulated by the state. Inadequate living space and financial pressures on women to stay in the labor force led married couples to limit themselves to one child. Abortion was made available on demand and became the main birth-control technique, it was commonplace for a woman to endure a dozen aborted pregnancies before reaching menopause.
During the Gorbachev years, courageous men and women began battling the Soviet bureaucracy to improve their scandalously neglected health-care system, which had been starved of resources in favor of military expenditures, heavy industry, and large public-works projects. No sector had been hit harder than public maternity care, the only kind available to the vast majority of Russians. Change was in the air, and the Russian Orthodox Church was leading the way to a renaissance of the pre-revolution national ethos infused with a sense of God’s presence.
A month after my meeting in Moscow, I returned to Russia, this time accompanied by an American team that included the chairman of a children’s hospital, a pediatrician, an architect, and three highly educated women (including my wife, Ann). Our mission was to inspect a 220-bed Soviet-era maternity hospital that had been recommended by Topornin’s committee as a model for our project.
Located in Balashikha, a city of 163,000 and an hour’s drive east of the center of Moscow, the hospital serves a region about the size of Ohio. According to the report of Topornin’s committee, this was the best facility available to women in the entire area.
After a brief meeting with the governor and several representatives of his government—including his health minister—our delegation traveled by van to the maternity hospital. What we discovered left us stunned. Standing near a wooded area on a patch of ground overgrown with weeds, the building looked more like a factory than a hospital. Although we were told it had been built in the mid-1970s, the cement and paint covering its prefabricated concrete slabs were cracked and peeling.
Once we entered the building, we were struck by a pervasive grayness that conjured a morgue rather than a place for giving birth. The dimly lit hallways were dirty; the toilets were broken, the area around them reeking of urine;and the occasional elevator in the five-story building, which groaned and creaked when in use, could barely accommodate four people.
We soon discovered that the hospital was so lacking in basic supplies that syringes had to be reused on dozens of patients before being discarded. When we were ushered into one of two functioning delivery rooms, the three American women were shocked by what they saw. Along the walls of the cramped, grimy-looking room stood tables cluttered with medical instruments, wash basins with dripping faucets, and shabby-looking surgical gowns hanging from hooks.
In the center was a wooden, uncushioned chair with stirrups where women were placed and strapped down during the final stages of labor. Frankly, it looked like a torture chamber. As we were about to leave the delivery room, Ann whispered to me, “I would deliver my baby in the woods myself before I would give birth in this place.” I heard similar comments later that day from the other American women in our delegation.
Most chilling of all was the discovery that there was a thriving abortion clinic attached to the hospital. There were more abortions performed there than live births in the connecting hospital. When I asked Topornin how this could be possible in a country with a dying population, he explained that the abortion clinic was used by the doc tors to supplement their incomes, which was less than $100 a month. “So you see, Tom,” he remarked, his face filled with sadness, ”how serious is the moral sickness from which Russia is still suffering.”
Soon after our return to the United States, our panel reached three conclusions. First, as Dr. James Lustig, the pediatrician in our group, pointed out, since this was the best facility available in the region, it probably typified everything that was wrong with public maternity care in Russia. Consequently, it was ideal for building a program for systemic modernization of Russia’s entire maternity care system.
Second, although the building outside was a monstrosity from an aesthetic point of view, it was basically sturdy, and its plumbing and heating infrastructure was satisfactory. The architect on the committee, Byron West, believed that the interior could be renovated to include modern delivery suites, a nursery, and wards that would be a vast improvement over what existed. He also pointed out that there was an unused wing that could easily be converted into a badly needed antenatal clinic where women could be educated about such issues as diet, alcohol, and smoking during pregnancy and receive periodic health exams while pregnant.
Finally, we had been particularly impressed by the health minister for the region, Dr. Vladimir Semenov, and his chief deputy, Dr. Gayane Tamazyan, with whom we had held discussions following our visit to Balashikha. Both doctors exhibited a complete openness regarding the wide- ranging problems that plagued Russia’s dysfunctional maternity care system and left no doubt that they were eager to work with us in developing a strategy that could serve as a model for systemic reform nationwide.
The pace of events picked up rapidly. Early in 2002, Ann and I established the not-for-profit Future of Russia Foundation (FOR). A short time later, FOR retained as its medical director Dr. Al Brann, an internationally recognized leader in pediatrics and a tenured professor at the Emory University Medical School. About the same time, John Straub, a lawyer and CPA with a proven track record as a corporate CEO, accepted the position of president and director of our newly formed foundation. Dr. Brann and Straub were soon engaged in extensive discussions with Drs. Semenov and Tamazyan that led in July 2003 to the formal signing of a protocol between the health ministry of the Moscow region and FOR. Under the terms of the agreement, the health ministry agreed to fund extensive renovations in several areas of the hospital and to renovate the maternity wards commensurate with the needs and dignity of mothers, newborns, and visiting family members.
The ministry also agreed to select for special training in the United States a team of Russian doctors, nurses, and technicians to serve as the teaching staff at the Balashikha Hospital for providers throughout the area.
Finally, the ministry conferred on the Balashikha Hospital the status of a special health zone to speed up needed changes in treatment procedures, medical monitoring, and hospital management. Balashikha Hospital doctors, nurses, and technicians were assigned to serve as hospital director, deputy director, and other key positions, and the salary scale at the hospital was increased to a level commensurate with the responsibilities required by our protocol.
For its part, FOR agreed to fund the cost of converting an unused 5,000-square-foot first-floor wing of the hospital into an antenatal clinic; to furnish and equip the antenatal clinic; to provide the renovated birthing suites and nursery with state-of-the-art medical equipment; to develop and fund a program of education and training for the team of Russian doctors, nurses, and technicians selected by the region to serve as the teaching staff of the Balashikha Hospital, and to devise in cooperation with the health ministry a data-collection system needed to evaluate hospital performance and medical outcomes at the hospital, in accordance with generally accepted international standards.
The agreement was a great victory for life. And I can happily report that not only have both sides fulfilled their commitments, they have far exceeded them.
In the summer of 2004, the antenatal clinic, now the most modern in Russia, opened for business. Every week hundreds of women, either already pregnant or hoping to become so, are seen by a doctor for evaluation or enrolled in an educational program administered by the hospital staff. The clinic’s reputation has grown so fast that women living in Moscow itself are now coming to Balashikha for help. In the fall of 2004, Ann and I were deeply honored to have the antenatal clinic officially named after us.
And, as Dr. Tamazyan had promised, the abortion clinic has been shut down.
Our work has borne much fruit: In the past three years, the number of live births at Balashikha has nearly tripled. In addition, the education and training program for Russian providers is now fully established. During the past two years, a team of Russian medical workers has received extensive training at the Emory University Medical Center under the direction of Dr. Brann. He and his team have also spent several weeks at Balashikha conducting training sessions for the Russian group which, in turn, is now offering regular instruction and training at the hospital for providers throughout the region. More than 300 Russians have already received training under this program.
With the Balashikha project nearing completion, the government has established a new health-care district sur rounding and including Balashikha, with a population of 700,000 people, in which the measures developed at Balashikha will be extended to three district hospitals. We hope that the entire program will eventually be implemented throughout Russia.
The kernel of an idea that fell on fertile ground in Atlanta has been cultivated by contributions from many sources, including the $2.5 million from the Future of Russia Foundation as seed capital; $3 million for hospital renovation from the Moscow Oblast Ministry of Health at the direction of its popular and recently reelected governor, Boris Gromov; an equipment gift valued at about $2 million from the Elphin Society of the General Electric Company; a $500,000 global-development alliance grant from the United States Agency for International Development;substantial monetary contributions from the Rotary Clubs of Atlanta and Stowe, Vermont; and substantial private contributions from prominent people, including former Soviet president Mikhail Gorbachev and the internationally known aviation lawyer George Tompkins.
For Ann and me, being part of this project has been among the most rewarding experiences of our lives. Although we have contributed a substantial part of our life’s savings to the undertaking, we have been richly blessed in return. We recently visited the Balashikha Hospital with our children and their spouses. As we toured the hospital, we were overwhelmed by the transformation that has taken place. From the clean, well-furnished reception area, to the new and fully equipped antenatal clinic, to the beautifully designed and well-stocked nursery, to the state-of-the-art delivery suites where women can share the birthing experience with their spouses, Balashikha is now a place filled with a spirit of life and hope.
In the final analysis, it has been the Russians’ trust in us and their generous willingness to accept what we have been able to give that has been a wonderfully precious gift to us.
After our family returned from Moscow, my son confided in me that he and his siblings had discussed the fact that a large part of their inheritance went into the Balashikha project. “I just wanted you to know, Dad,” he told me, “that all of us now feel a part of this because some of our inheritance went into it. And we are grateful to Mom and you for helping us to understand what is really important in life.”
My cup runneth over.