relief from disease

The ARA Medical Division At Work

Hoover Institution Library & Archives

Content warning
Bread + Medicine: Saving Lives in a Time of Famine tells a story about the illnesses that arise when there is mass starvation. It includes depictions and discussions of human suffering, death, recovery, and aspects of medical practice in the 1920s.

Use of historic language
The names of places and things can change over the course of history. For this exhibition, the spellings and terminology in use during the early 1920s have been maintained as that is how they appear in the primary source documents on display. It is reflective of the culture and context in which the material was created.

SAVING LIVES

Preventive medicine was at the core of the ARA’s program, as few curative treatments were available in the 1920s and would not be until the discovery of antibiotics in the 1940s.

The initial focus of the ARA’s “sanitary offensive” was on providing clean water and improving standards of hygiene. In the summer of 1922 came a massive vaccination campaign that immunized some five million people against five infectious diseases.

The success of both operations depended on the ARA’s ability to import and distribute tremendous quantities of medical supplies despite shipping delays from the United States and crumbling Soviet transportation and infrastructure. It was also imperative to revitalize the Soviet public health system, as collaboration with local medical experts was essential to the success of the ARA’s mission.

**Under Soviet Rule,** **New York Times** **artist, September 11, 1921.** Even before the ARA arrived, the world was aware of the transportation issues plaguing Soviet Russia. A New York Times cartoonist laid blame for these woes at the feet of the Soviets and implicated them in preventing aid from reaching the starving masses.
**Under Soviet Rule,** **New York Times** **artist, September 11, 1921.** Even before the ARA arrived, the world was aware of the transportation issues plaguing Soviet Russia. A New York Times cartoonist laid blame for these woes at the feet of the Soviets and implicated them in preventing aid from reaching the starving masses.

MEDICAL RELIEF

Delivering medical supplies to some 15,000 institutions scattered over a region almost the size of the United States was a daunting task—even for the ARA. Shipping supplies across oceans was surprisingly the simple part. The ruinous condition of Russia’s transportation system proved the bigger challenge.

“Railroads hanging together, roadbeds unrepaired, derailed cars ditched. Thousands [of] cars deteriorating on sidings where rails and ties have been removed from under them.”
William Haskell, October 20, 1921

**[Transport Worker! Remember the starving children of the Volga region. Your intensified work on the tracks will give them bread.],** **circa 1921.** **Poster Collection RU/SU 845.** *Digital Record.* In the first half of 1922, the ARA undertook a massive campaign to transport corn and wheat seed in time to plant for the fall harvest. There were many obstacles, including the disastrous state of the railroad system. Miraculously, the transport of vital medicines and supplies from the ARA was never held up.
**[Transport Worker! Remember the starving children of the Volga region. Your intensified work on the tracks will give them bread.],** **circa 1921.** **Poster Collection RU/SU 845.** *Digital Record.* In the first half of 1922, the ARA undertook a massive campaign to transport corn and wheat seed in time to plant for the fall harvest. There were many obstacles, including the disastrous state of the railroad system. Miraculously, the transport of vital medicines and supplies from the ARA was never held up.

Basic medicines, such as quinine, aspirin, and iodine, as well as essential instruments and supplies, such as soap and surgical dressings, all required storage once they arrived and before distribution. Just procuring a suitable central warehouse in Moscow took weeks. Finding and training the personnel to keep it running efficiently was a feat. The scarcity of medical supplies made them prized goods on the black market, and warehouse guards were often the culprits stealing them.

**Medical Warehouse, Moscow, circa 1922.** *Digital Record.*
**Medical Warehouse, Moscow, circa 1922.** *Digital Record.*

^{Background image: Detail of Американский подарок [American Gift] by unknown Russian artist, gouache and ink on paper, early 1922. Poster Collection}^{RU/SU 1448}^.

An ARA Ship at Danzig (supplies en route to Russia), no date. Digital Record

USS Fox and a Grain Ship (left) in the harbor, Odessa, circa 1922. Digital Record

American Grain Ships at Docks, Odessa, circa 1922. Digital Record

The Port Operations, Petrograd, winter 1922. Digital Record

Russian Transport Lines Used by ARA. Digital Record

Arrival of the first American corn in the city of Simbirsk, as photographed by Nellie Gardner, of New Hampton, Iowa, who worked for the ARA's publicity department.

Congestion of Relief Trains on Russian Railways. ARA Russian operational records, box 32, folder 1. This ARA map shows the massive jam-up of corn trains west of the Volga River in March 1922. Each circle represents an individual train consisting of two to three dozen cars.

Assembling Medical Supplies for shipment to the Districts, Medical Supply Depot, Moscow, circa 1922. Digital Record

“The most striking thing about Samara is the sight of great furry camels in the snow dragging little sleds loaded with goods and bossed by great furry peasants in the most alarming headgear of the picture-book Cossack type.”
Dudley Hale, Samara, March 5, 1922

Transportation by Camels, Samara, winter 1922. Digital Record. Camels filled in for horses as beasts of burden in the arduous journey transporting ARA supplies from the railheads to the villages along the middle and lower Volga.

Convoy of 50 sleds of Medical Supplies, Ufa, Urals, winter 1922. Digital Record

Transportation by ARA Car (outside the ARA Russian Unit Motor Transport Headquarters), Moscow, circa 1922. Digital Record

Transporting supplies by truck and trailer, ARA Warehouse, Kazan, circa 1922. Digital Record

Handling Medical Supplies, Petrograd, January 11, 1922. Digital Record

Handling Cod Liver Oil, Petrograd, January 11, 1922. Digital Record. ARA physicians employed cod liver oil as a therapeutic to address an enormous array of dietary deficiencies—vitamins, minerals, essential fats—which made the population highly susceptible to other diseases.

Handling Medical Supplies, Petrograd, winter 1922. Digital Record

Medical Warehouse, Petrograd, circa 1922. Digital Record

The ARA Medical Division’s success relied on the collaboration of American staff with local medical professionals. The ranks of local doctors, dentists, nurses, and hospital staff had been thinned from disease exposure, famine, and grossly inadequate working conditions. Sensitive to their plight, the ARA provided them with food and clothing packages. They also organized and provided food to staff in ambulatory clinics and pharmacies, which offered free medical care and medicines.

**Letter from Dr. A. B. Musa & W. H. A. Coleman to Dr. Henry Beeuwkes, April 6, 1922.** *ARA Russian operation records, box 202, folder 2.* Often the ARA district physician would take control of local institutions—hospitals, ambulatories, dispensaries, pharmacies, laboratories—that had been shut down and their staffs let go. This approach restored the jobs of local health care workers and medical services for the local population.
**Letter from Dr. A. B. Musa & W. H. A. Coleman to Dr. Henry Beeuwkes, April 6, 1922.** *ARA Russian operation records, box 202, folder 2.* Often the ARA district physician would take control of local institutions—hospitals, ambulatories, dispensaries, pharmacies, laboratories—that had been shut down and their staffs let go. This approach restored the jobs of local health care workers and medical services for the local population.

Assigned to each district was an American physician, whose chief responsibility was to supervise the distribution of the 1,222 varieties of medical supplies imported by the ARA. That is, the district physicians were intended to be bureaucrats. What usually kept the job interesting and sometimes rewarding was the opportunity to observe and favorably influence the work of their Russian colleagues.

_{Background image: Samara Medical Department, Col. Frederick Foucar (front center), Maj. Charles L. Hall (front left), circa 1923. Charles L. Hall papers.}_{Digital Record}_.

Medical Warehouse, Minsk, 1922. Digital Record. Gauze, surgical dressings, and bandages were in extremely short supply before the arrival of the ARA. Signs directed patients with injuries or cuts to bring their own bandaging material. What remnants existed in hospitals were cleaned, sterilized, and reused, but remained a dingy color since there was only cold water and no laundry soap. The deplorable conditions and scant supplies forced the postponement of all but emergency surgeries. The ARA distributed thousands of meters of gauze and bandages. Local physicians noted that a single ARA allotment of supplies, intended to serve 2-3 months, was more than “all issues received from the government during the last two years.”

Laboratory supplies and equipment provided by the ARA, circa 1922. Digital Record

ARA Dispensary (Pharmacy), Saratov, operated under army supervision, 1922. Digital Record. Variant 1. Variant 2. The ARA placed three large orders—for medicines, hospital supplies, and equipment—with the American Red Cross in New York. The initial requisition was placed in early September 1921 and arrived in December. Further requisitions were informed by district reports about their specific needs. “Probably the most popular drugs that we imported in large quantities were quinine, neosalvarsan and cod liver oil,” Beeuwkes wrote. ARA physicians employed cod liver oil as a therapeutic to address an enormous array of dietary deficiencies—vitamins, minerals, essential fats—which made the population highly susceptible to other diseases.

ARA pharmacy, circa 1922. Digital Record

A corner of the packing room, Rostov Medical Warehouse. Here shipments were prepared for over 900 Medical Institutions, circa 1922. Digital Record. ARA inspectors initially found hospitals and dispensaries depleted of most supplies and medicines, with many forced to close. In response to this “medical famine,” the ARA imported massive quantities of essential medicines and all manner of supplies to support hospitals, children’s homes, refugee centers, ambulatories, and dispensaries with the tools needed to combat and treat disease. Fully equipped and staffed hospitals would once again be able to house and care for patients.

The Narcotic Vault, Odessa, circa 1922. Digital Record

Unpacking hospital supplies and instruments, Odessa, 1922. Digital Record

Store Room for ARA medicines, Dr. Wreden's Hospital, Petrograd, circa 1922. Digital Record. American medications could treat a vast array of illnesses. Antiseptics and astringents cleaned; styptics stopped bleeding; and analgesics and anesthetics reduced pain. By 1922 quinine was favored over arsenic trioxide to treat malaria. And Salvarsan, or Neosalvarsan, became the drug of choice for syphilis and relapsing fever. Purgatives were also critical, the most popular being cold drawn castor oil. Quinine was the single most precious medicine imported by the ARA. “A single bottle of quinine was worth three months’ pay of the average laborer,” Dr. Beeuwkes noted.

Russian staff with hospital equipment supplied by the ARA, circa 1922. Digital Record

Linen Room, Dr. Wredon's Hospital, Petrograd, circa 1922. Digital Record

X-Ray Room at Lenin Institute, Kazan. The X-Ray tubes were supplied by ARA, circa 1922. Digital Record

Trachoma clinic established by the ARA in Ufa, circa 1922. Digital Record

Samara - Regional Congress of Representatives of the Gubernia Medical Service, circa 1923. Digital Record. In each province—gubernia in Russian—all health measures and initiatives were under the purview of the gubzdrav, the provincial public health department, the local branch of the People’s Commissariat of Health in Moscow. The American doctors sought the cooperation of these officials in carrying out the medical program in their district.

The bed - gift of ARA (three boys with fractures). Clinic of Prof. B. Razumovsky, 1923. Digital Record. Dr. Beeuwkes was so taken with this photograph, sent to him in Moscow from district physician John Stack in Saratov, that he took the unusual step of passing it along to Herbert Hoover in Washington. It was an eye-opening illustration of the impact the ARA medical program was having.

Letter from Dr. Henry Beeuwkes to Herbert Hoover, March 17, 1923. ARA Russian operational records, box 336, folder 4. The previous photograph (Digital Record) accompanied this letter to Mr. Hoover, chairman of the ARA, to impress on him the good work being done in Russia.

Medical Supply Depot, Moscow, and personnel, circa 1923. Digital Record

Russian office staff, Dr. John Stack is 1st from left, second row, Saratov, circa 1923. Digital Record

Personnel of the Supply Division, Moscow, Headquarters Russian Unit ARA, circa 1923. Digital Record. Front row of Americans identified from left to right: Walter E. Saville, James E. Callahan, Frank H. Holden, J. E. Seykora, G. S. Carden, W. Janicki, Frederick B. Lyon, and William C. McMahon.

ARA Moscow Medical Staff, Spiridonovka Palace, Moscow, circa 1923, Courtesy of the Bess Rattray Collection. Dr. Henry Beeuwkes is seated at center, hat in hand. Behind him to the left (over his right shoulder) is his secretary, Arnold Rattray; over his left shoulder is Dr. John E. Toole.

“The heroism of these doctors, feldshers, and nurses cannot be over-praised. Hundreds met death fighting disease, without weapons, with the same dogged courage that Russian soldiers, without ammunition, met death trying to stay the German advance.”
H. H. Fisher, The Famine in Soviet Russia 1919-1923 (1927)

Spotlight: Russian Doctor Vladimir Levit

In October 1921, the ARA set up local committees tasked with selecting the children to be fed in ARA kitchens. The committee in Simbirsk consisted of two teachers, one engineer, six doctors, and a local government representative. The ARA chose local surgeon Vladimir Levit to chair the committee.

Levit was born outside Kiev in 1883 and graduated from Kharkov (today Kharkiv) University Medical School in 1906. He began his medical career in the Ardatovsk Zemstvo in Simbirsk province, first as a general practitioner and then, beginning in 1914, as a surgeon in the Ardatov hospital. By the time the ARA arrived on the scene, Levit was well known throughout Soviet Russia. He played a vital role in the work of the ARA in Simbirsk.

On September 9, 1922, Dr. Levit departed Simbirsk for Irkutsk to become head of the surgical faculty at Irkutsk University. District Supervisor Edward Fox wrote to Beeuwkes that day: "As you know, and can appreciate, it is with regret that we note his departure, for by his skill, energy, and capability, as well as his organizing efficiency, he has made himself a valuable member of our unit." Levit was stopping in Moscow for a few days on personal business, Fox informed Beeuwkes, “we feel here in Simbirsk that any supplies given him for distribution in Irkutsk will be wisely and carefully handled."

“He takes with him our best wishes for his success and happiness in his new field.”
Dr. Edward Fox, Simbirsk District Supervisor

From 1926 to 1953 Levit headed the surgical desk at the clinic of the 2nd Moscow University. During the Second World War he served as deputy to the chief surgeon of the Soviet Army. He died in Moscow in 1961.

_{Background image: Dr. Beeuwkes (left) and Dr. Levit, Simbirsk, 1922.}_{Digital Record.}

SANITARY RELIEF

The ARA insisted on standards of cleanliness before handing over supplies to hospitals and children’s homes. This served to promote sanitation and hygiene and prevent the spread of disease.

As part of the campaign to combat louse-borne diseases—typhus and relapsing fever—the Americans established free baths, a service subsidized with corn rations. Those visiting the bathhouse were provided with soap and had their clothes sterilized while they bathed.

**Line up at Bathhouse. The branches will be used to scrub themselves with**, circa 1922. *Digital Record*
**Line up at Bathhouse. The branches will be used to scrub themselves with**, circa 1922. *Digital Record*

“The commodity most called for is soap. Very few institutions have any soap to bathe their patients or to launder the linen. Orenburg can use all the soap the A.R.A. possesses.”
Dr. O. O. Beck, Orenburg, April 20, 1922

American Forces in Germany (AFG) surplus crates provided to ARA Russia, circa 1922. Digital Record. ARA workers in the famine districts immediately appealed to their Moscow headquarters to send soap and disinfectants. Freddie Lyon, arriving in Orenburg in November 1921, wrote that arrival of soap there would be a “Godsend.” The shortage of this precious item persisted through the winter. “The greatest need in every hospital is soap,” Dr. Beeuwkes said on March 1, 1922. In time, the much-desired soap arrived, eventually 2.4 million pounds of it.

A closeup of this photograph reveals that the AFG government supplies are crates of Honor Bright soap by Larkin Co. (Buffalo, NY).

Line at Bath house getting soap, circa 1922. Digital Record. Variant Digital Record. Small bars of soap can be seen at right in a wooden crate, while a branch can be seen behind the boy standing in front of it. Bathers would bring branches like this with them to scrub themselves. These particular bathers have been identified in annotations as being foreigners leaving Russia and that they would get the tetra-vaccine administered here as well.

Bath House established by Dr. Foucar at Samara, circa 1922. Digital Record. Variant 1. Variant 2.

Bath House established by Dr. Foucar at Samara, circa 1922. Digital Record

Bathing - at Odessa. These children are waiting for their turn. The bath house was organized, equipped + operated by the ARA. During Sept 1922 over 35,000 children were fed and bathed. Digital Record

Odessa. Bathing. The Bathhouse was organized, equipped + operated by the ARA. About 35,000 children were fed _ bathed in Sept. 1922. Receiving soap and towels. Digital Record

Refugee Camp, Kozyova, Minsk. Digital Record. Variant 1. The largest evacuation points for refugees traveling west into Europe were Kiev and Minsk. In both places, the ARA supplied large amounts of soap and disinfectants. Six large French disinfecting cameras (chambers)—funded by the American Red Cross—disinfected tons of lousey clothing, and physicians triaged those with diagnosed illnesses.

Bathhouse showers, Refugee Camp, Kozyova, Minsk. Digital Record

Bathhouse with Delouser Refugee Camp, Kozyova, Minsk. Digital Record. Variant 1.

Delousing against Typhus using a disinfecting camera, Refugee Camp, Minsk. Digital Record. Variant 1.

For water-borne diseases—cholera, typhoid, and paratyphoid A and B—the ARA worked with local health authorities to ensure safe drinking water by rebuilding water-purification systems and providing chloride of lime to disinfect the water. The ARA also organized local spring-cleaning campaigns, using corn rations as wages for teams of refugees mobilized to clean city streets of the filth that had accumulated over the previous five years and was now laid bare by the melting of the snow. A natural byproduct of these efforts was an improvement in psychological as well as physical health.

**Detail of Chlorinators of the Samara Water Works installed by ARA,** circa 1922. *Digital Record*. *Variant 1*. *Variant 2.* Soon after their arrival, the Americans reported a complete breakdown of local water systems and a lack of potable water. There was no filtration and water was being pumped from rivers near where the sewers emptied. The ARA worked to improve sanitation and provide safe drinking water by supplying chlorinators and chloride of lime. In Samara, Dr. Foucar requested two complete sets of Wallace & Tiernan Chlorine Control apparatuses to be attached to the water mains that supplied water to the city.
**Detail of Chlorinators of the Samara Water Works installed by ARA,** circa 1922. *Digital Record*. *Variant 1*. *Variant 2.* Soon after their arrival, the Americans reported a complete breakdown of local water systems and a lack of potable water. There was no filtration and water was being pumped from rivers near where the sewers emptied. The ARA worked to improve sanitation and provide safe drinking water by supplying chlorinators and chloride of lime. In Samara, Dr. Foucar requested two complete sets of Wallace & Tiernan Chlorine Control apparatuses to be attached to the water mains that supplied water to the city.

_{Background: Detail of a blueprint for the Wallace & Tiernan Co. (NJ) chlorine control apparatus (showing the manometer body assembly using the flex. conn. to injector), circa 1922.}_{Digital Record}_.

Laying a new sewer line, Miass, Ufa, ca. 1922. Raymond McKnight Sloan papers. Digital Record.

Dead lying on street in Ufa, March 1922. Raymond McKnight Sloan papers. Digital Record. "That famine and disease were actively present was readily forced upon one's attention, especially upon walking through the streets during the early morning hours, when to see a dead human body lying on the sidewalk in any part of the town was a common sight, no longer causing comment or attention." - Dr. Frederick Foucar, Samara, 1921.

Department of Sanitary Enlightenment, People’s Commissariat of Health. Холера болезнь заразная [Cholera is a Contagious Disease], circa 1922, chromolithograph. Poster Collection RU/SU 1322. Digital Record.

Граждане! Делайте себе противохолерные прививки. Только против прививки бессильна смерть [Citizens! Get your cholera vaccinations. Death is only powerless against vaccination], circa 1920, chromolithograph. Poster Collection RU/SU 985. Digital Collection. Even before the famine, the Soviet government had mounted an aggressive propaganda campaign to combat the spread of cholera, encouraging Soviet citizens to get vaccinated and warning against the dangers of overcrowding, unsanitary living conditions, and unsafe drinking water. A waterborne disease, cholera posed the greatest threat in summer. The ARA’s work in ensuring a supply of safe drinking water and their inoculation campaign helped to avert an epidemic in the summer of 1922.

Laying sewer and water pipes, Miass, Ufa, circa 1922. Raymond McKnight Sloan papers. Digital Record. Annotation on the back reads "Digging for gold in the streets of Miass - Ufa Urals District."

Refugees on the river bank in Ufa, circa 1922. Raymond McKnight Sloan papers. Digital Record.

VACCINES + SERUMS

Disease prevention involved a massive vaccination campaign, conducted mostly in the summer of 1922. The ARA arranged with the Pasteur Institute in Paris to manufacture 8 million doses of tetra-vaccine—for cholera, typhoid, and paratyphoid A and B—and 4 million doses of smallpox vaccine. Local medical institutions were supplied with vaccination materials, and special vaccination dispensaries were established to reach as many people as possible.

**Letter from the Institut Pasteur's service director regarding delivery of order No. 44 to the ARA, August 16, 1922.** *ARA Russian operational records, box 545, folder 11.*
**Letter from the Institut Pasteur's service director regarding delivery of order No. 44 to the ARA, August 16, 1922.** *ARA Russian operational records, box 545, folder 11.*

“The peasants at first objected to being inoculated, claiming that it was an invention of the devil,” Dr. Raymond McKnight Sloan reported from Ufa province. But the ARA made vaccination compulsory for children and adults receiving American meals or corn rations, which helped overcome vaccine hesitancy. In each ARA district, the American doctors established military-style “companies” of medical personnel and medical students to administer the vaccines.

**Inoculation for Cholera, circa 1922.** *Digital Record*. Inscribed on the back: This shows the inoculation of cholera of children who received the ARA supplementary food at the ARA dining room at Gagarinsky, Petrograd. Beneath (sic) the children are seen awaiting their dinners.
**Inoculation for Cholera, circa 1922.** *Digital Record*. Inscribed on the back: This shows the inoculation of cholera of children who received the ARA supplementary food at the ARA dining room at Gagarinsky, Petrograd. Beneath (sic) the children are seen awaiting their dinners.

_{Background: Typhoid inoculation, Petrograd, 1922.}_{Digital Record}_.

“To have vaccinated all of the children in the A.R.A. kitchens . . . while travel conditions have been almost impossible, warrants hearty congratulations to the doctor-inspectors who have accomplished this.”
Dr. John Toole, Saratov, June 22, 1922

The ARA also provided local laboratories with the means to manufacture vaccines and serums while also carrying out bacteriological and analytical work for surrounding hospitals. The improvement to both diagnostic and preventive practices was tremendous.

**Dr. Foucar (second from left) and Russian colleagues in front of crated laboratory supplies at Roux Laboratory, Samara, July 7, 1922**. *Digital Record*. In this photograph are Dr. Sosnovich (far left); Dr. Akker (center), who ran the Pasteur-treatment department of the Laboratory; Dr. Krylov (with cane), who was head of the institution; and Dr. Mukhranskii.
**Dr. Foucar (second from left) and Russian colleagues in front of crated laboratory supplies at Roux Laboratory, Samara, July 7, 1922**. *Digital Record*. In this photograph are Dr. Sosnovich (far left); Dr. Akker (center), who ran the Pasteur-treatment department of the Laboratory; Dr. Krylov (with cane), who was head of the institution; and Dr. Mukhranskii.

The Roux Laboratory in Samara was named for Émile Roux, co-founder and director of the Pasteur Institute in Paris, from which the ARA received much of its vaccine supplies. When the ARA first arrived, they found the Roux, like other Soviet laboratories, to be “a paralyzed and demoralized organization, producing nothing.” American aid transformed it into an “active and effective institution manufacturing all varieties of vaccines and sera in quantity, and carrying out important bacteriological work for surrounding hospitals,” according to Beeuwkes, but this change took time. Until then, the American Red Cross and Pasteur Institute were critical in supplying the ARA’s vaccination campaign.

Letter from E. J. Swift, American Red Cross, to M. C. Bryant, ARA Paris Representative, April 29, 1922. ARA Russian operational records, box 543, folder 11. The letter refers to the accompanying purchase order the American Red Cross (in Paris) has made on behalf of the American Relief Administration Russian Unit for tetra and smallpox vaccines from the Institut Pasteur de Paris.

Laboratory for the analysis of ARA Rations, circa 1922. Digital Record. Variant 1. Variant 2.

Letter from George A. Sloan, American Red Cross, to Col. J. W. Krueger, ARA, May 3, 1922. ARA Russian operational records, box 454, folder 2.

Memorandum from Dr. Walter P. Davenport to Colonel William Haskell, April 20, 1922. This short letter recommends a memo be issued regarding the vaccination of the ARA’s American and Russian personnel at Moscow headquarters. Vaccination of ARA staff, both American and local, was made mandatory, as Colonel Haskell's note appended to Davenport's memo makes plain: “I thought all Americans were required," Haskell wrote. "If not make it mandatory for all Americans. WNH.”

Vaccinating the staff of the ARA Headquarters at Morskaya 40, Petrograd, 1922. Digital Record. Variant #1.

Прививайте оспу [Inoculate (against) Smallpox], circa 1920, chromolithograph. Poster Collection RU/SU 1589. Digital Record.

Cholera inoculation, Petrograd, 1922. Digital Record. This mixed group of adults and children are refugees looking to leave Russia for the west.

Dispensary Personnel, Medical Department, ARA, Kiev, Ukraine District, May 30, 1922. ARA Russian operational records, box 861, folder 14.

Letter from W. H. A. Coleman, Orenburg District Supervisor, to ARA Director William Haskell, July 18, 1922. ARA Russian operational records, box 204, folder 1. Anecdotal evidence suggested that popular suspicion of vaccination ran deep. In Ufa, food proved to be the ultimate inducement. Dr. Sloan noted that, “the peasants at first objected to being inoculated, claiming that it was an invention of the devil. The Bashkirs particularly dislike the idea. However, with the lever of the corn ration behind it, the A.R.A. had not much difficulty in making them come round . . . when they realized that their corn ration depended on their being inoculated.”

ARA staff administering tetra vaccine to foreigners trying to leave Russia for home, 1922. Digital Record. Variant 1. Variant 2. Variant 3. As annotated on the back, the ARA took seriously the job of "preventing the spread of epidemics to the outside world."

ARA Dispensary, Kozyova Refugee Camp, Minsk, 1922. Digital Record. This vaccination and wound care station for refugees was sponsored by the ARA. The sign above the man at right reads (in Russian): “Cholera Threatens: Don’t Drink Raw [untreated] Water.” Other posted notices encourage people to wash their hands before eating and to visit the bathhouse.

Vaccination, Odessa, 1922. Digital Record.

Refugees receiving the tetra vaccine, Rostov, June 1922. Digital Record.

ACHIEVEMENTS

Millions were likely saved by America’s timely intervention, though it is impossible to say how many. The ARA’s total expenditures amounted to $61.5 million, equivalent to over $1 billion today. Of that amount, $7.6 million went to medical relief.

By restoring basic public health care, the ARA revitalized the work of Russian physicians, scientists, and medical staff.
The operations of hospitals and laboratories improved tremendously. Vaccination rates soared. Infection rates declined. The food and medicine provided by the ARA eased the difficulties of daily life and allowed people to return home.

_{Background image: Detail of a children's hospital on the Fontanka River (Obukhovskaya Hospital), Petrograd, circa 1922.}_{Digital Record}_._{Variant #1}_.

**Operating Room of the 2nd Soviet Hospital, Saratov University, 1922**. Digital Record. If not for the medical supplies brought by the ARA, operations like this one by Dr. Razoumovsky and his team would not have been possible—even at a university clinic like this one. Specialized instruments, masks, surgical gowns, dressings, and sterilization supplies were just as critical to preventing infections at the time as they are today.
**Operating Room of the 2nd Soviet Hospital, Saratov University, 1922**. Digital Record. If not for the medical supplies brought by the ARA, operations like this one by Dr. Razoumovsky and his team would not have been possible—even at a university clinic like this one. Specialized instruments, masks, surgical gowns, dressings, and sterilization supplies were just as critical to preventing infections at the time as they are today.

**Form A, Monthly Medical and Sanitary Report, ARA Russian Unit, Medical Division, Moscow District, July 1922.** *ARA Russian operational records, box 189, folder 2.* This form is but one of many submitted monthly by all ARA district physicians after conducting regular inspections to assess institutional needs and capacity. It was ARA practice that nothing could simply be given away, that absolutely everything had to be accounted for. Today there is a vast archive of documentation at the Hoover Institution Library & Archives that attests to the tremendous efficiency and effectiveness of the ARA.
**Form A, Monthly Medical and Sanitary Report, ARA Russian Unit, Medical Division, Moscow District, July 1922.** *ARA Russian operational records, box 189, folder 2.* This form is but one of many submitted monthly by all ARA district physicians after conducting regular inspections to assess institutional needs and capacity. It was ARA practice that nothing could simply be given away, that absolutely everything had to be accounted for. Today there is a vast archive of documentation at the Hoover Institution Library & Archives that attests to the tremendous efficiency and effectiveness of the ARA.

GRATITUDE

The ARA mission came to a close in the summer of 1923 and tributes poured in from beneficiaries, including doctors, medical institutions, and medical students. They conveyed gratitude to the relief workers, the American people, and Herbert Hoover for providing aid in a time of extreme need.

These accolades often contain long lists of signatures, and many are adorned with artwork. The most affecting were composed by children from the homes, hospitals, and schools. Those paying tribute assured their saviors that the memory of America’s errand of mercy would never be extinguished.

**Dr. Foucar gets a send-off, Samara,** **June 1923.** *Digital Record*.
**Dr. Foucar gets a send-off, Samara,** **June 1923.** *Digital Record*.

Expressions of gratitude from the ARA’s beneficiaries and local staff members took many forms, among them festive farewell gatherings to honor departing Americans, formal letters of thanks to various ARA headquarters from local officials, and colorfully illustrated appreciations sent on behalf of the children in the countless institutions supported by the ARA, many of these souvenirs signed by appreciative children.

Appreciation letter from children fed by an ARA kitchen (Stolovaya No. 161), 1923. ARA Russian operational records box 522, folder 1.

English typescript on top of original handwritten letter of thanks from the medical faculty and students at Moscow State University (with 469 signatories), March 11, 1922. ARA Russian operational records, box 24, folder 2.

Спасибо A.P.A. [Thank you A.R.A.] letter from the Children’s Home for Epileptic Girls (Moscow) to Mr. Sabine, May 1923. ARA Russian operational records, OS Folder 4.

"Warm thanks to our 'American uncles' for the white bread and the sweet cocoa and the friendly help shown to us in 1922, a difficult year for everyone." Signed by children of the kindergartens of the city of Tetiushi, in the Kazan district. ARA Russian operation records, box 522, folder 1.

Letter of appreciation from Russian pharmacy managers to the Moscow section of the ARA, May 24, 1923. ARA Russian operation records, box 542, folder 10.

Appreciation letter from children at the 9th Summer School No. 1 with over 200 signatures, 1923. ARA Russian operation records box 522, folder 1.

Handwritten English transcript of originally Russian thank you letter from the professors and teachers at Saratov University to the ARA, January 17, 1922. ARA Russian operation records box 24, folder 2. The thanks expressed includes their recognition that the American aid proves "that brotherly solidarity has united the physicians of all the world into one concordant family."

Letter of appreciation from Ostroumov Hospital (Moscow) to the ARA, March 9, 1922. ARA Russian operational records, box 24, folder 2.

Cocoa and Kasha: "68th feeding point wishes you a Happy New Year!" At bottom is a poem by a 12-year-old boy named Pavel dated December 30, 1921. "Our Amerika is friendly / Gives help to all us kids / There's rolls, cocoa, and kasha / On our wretched table." ARA Russian operation records, box 522, folder 5.

Front and back of an appreciation letter to the ARA featuring a photograph of an ARA dining room in Saratov province (summer 1922), March 15, 1923. ARA Russian operation records, box 522, folder 4.

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Bread + Medicine
_{Saving Lives in a Time of Famine}

This introductory digital story grounds the online exhibition in the history of the Great Famine in Soviet Russia and Ukraine and the American Relief Administration's role in saving lives.

Doctors in Famine
^{_{Famine-Related Diseases + the American Relief Administration}}

Learn about the many kinds of diseases that plagued famine victims, as well as the amazing ARA doctors and their colleagues who helped contain spreading epidemics.

This digital story is a component of the Bread + Medicine: Saving Lives in a Time of Famine online exhibition, launched in conjunction with the eponymous exhibition presented by the Hoover Institution Library & Archives, curated by Hoover Research Fellow Bertrand Patenaude, and displayed at Hoover Tower at Stanford University from Sept. 19, 2022 - May 21, 2023.

Unless otherwise noted, all material comes from the American Relief Administration Russian operational records archival collection at the Hoover Institution Library & Archives.

Bread + Medicine Homepage

^{The Hoover Institution Library & Archives has placed copies of these works online for educational and research purposes. If you would like to use any of these works, you are responsible for making your own legal assessment and securing any necessary permission. If you have questions about this resource or have concerns about the inclusion of an item, please contact the Hoover exhibits team.}
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relief from disease

SAVING LIVES

MEDICAL RELIEF

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Spotlight: Russian Doctor Vladimir Levit

Image captions

SANITARY RELIEF

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VACCINES + SERUMS

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ACHIEVEMENTS

GRATITUDE

Image captions

Explore More

Bread + Medicine
_{Saving Lives in a Time of Famine}

Doctors in Famine
^{_{Famine-Related Diseases + the American Relief Administration}}

Library & Archives Newsletter

Our monthly newsletter covers new collections, projects, publications, and more.

SAVING LIVES

MEDICAL RELIEF

Image captions

Image captions

Spotlight: Russian Doctor Vladimir Levit

Image captions

SANITARY RELIEF

Image captions

Image captions

VACCINES + SERUMS

Image captions

ACHIEVEMENTS

GRATITUDE

Image captions

Explore More

Bread + MedicineSaving Lives in a Time of Famine

Doctors in FamineFamine-Related Diseases + the American Relief Administration

Library & Archives Newsletter

Our monthly newsletter covers new collections, projects, publications, and more.

Bread + Medicine
_{Saving Lives in a Time of Famine}

Doctors in Famine
^{_{Famine-Related Diseases + the American Relief Administration}}