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Measuring Sustainability in the Russian Arctic: An Interdisciplinary Study

by Votrin, Valery, PhD

Page 141

Table 4.20. Infant mortality in the Russian Arctic and Russia, 1998 to 2003, per 1000 live
Region 1998 1999 2000 2001 2002 2003

Murmansk 11,8 11,3 12,5 14,7 12,3 8,9
Nenets AO 19,5 19,3 24,4 20,1 18,2 29,3
Yamal-Nenets AO 14,6 16,0 14,4 15,6 14,0 12,7
Taimyr 16,2 15,4 19,7 24,3 21,5 26,0
Sakha 19,7 18,9 17,6 17,5 15,2 13,2
Chukotka 33,1 26,9 23,4 42,1 32,2 28,0
Russian Arctic average 19,1 18,0 18,7 22,4 18,9 19,7
Russia 16,5 16,9 15,3 14,6 13,3 12,4
Source: Rosstat (2004)
Of all Russian Arctic regions, infant mortality in Chukotka has reached disastrous levels
and is decisive for the general dynamics of infant mortality rate in the Russian Arctic. The region
seems to have become the leader in infant mortality which is twice the national average,
especially in 2001, with 42,1 infant deaths per 1000 live new born. Alcoholism and the resulting
poor maternal health are suggested to be the main reasons for the region’s infant mortality rate
which is the worst in Russia. 84 per cent of those infants who died in 2002 were indigenous
children (Rozhkov, 2003). Alcohol is particularly destructive for the indigenous population, and
alcoholism incidence in Chukotka is extremely high (see the next section). Poor health care and
lack of equipment and medicines in maternity houses were among other important reasons of
high infant mortality in the region.
Since 2002, “Chukotka’s Healthy Child” regional programme has achieved considerable
results in reducing infant mortality in Chukotka through targeted financing of equipment for
maternity houses and hospitals and attracting skilled labour from Russian central regions which
resulted in a 33.5 per cent drop in infant mortality between 2001 and 2003.
While in Chukotka infant mortality seems to decrease in recent years, after the peak of
2001, it seems on the contrary to increase in Nenets AO and Taimyr, reaching similar levels in
2003. This increase does not seem to be directly linked to alcoholism.
Developmental defects are among the main causes of mortality in the Russian Arctic; for
instance, their incidence in Severodvinsk in 2003 was 2,5 times than the incidence in
Arkhangelsk and 3,5 times higher than that in a number of other industrial cities in the
Arkhangelsk Oblast (Gosudarstvenniy doklad Arkhangelsk, 2004). Other causes of infant
mortality include asphyxia, birth traumas, and respiratory condition (Gosudarstvenniy doklad
Murmansk, 2003).
For those infants who survive the neonatal stage, environmental factors such as nutrition
and hygiene become more important in determining health and well-being. The quality of health
care is therefore of paramount importance. As in other FSU countries where health care is
formally free, informal payment systems, low earnings of health care workers and a lack of


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affordable medicines represent significant barriers for improving infant mortality rates (UNICEF,
2003). Health care sector (along with education) has always been among the most underfunded
social sectors in Russia. Recent economic growth means that there is now an opportunity to
reduce infant mortality by investing more resources in mother and child health care and
eliminating the misreporting of infant deaths (UNICEF, 2003). More research needs to be
carried out to improve the quality of data by conducting independent surveys to complement
official data (Aleshina and Redmond, 2003).

4.3.8 Alcoholism Incidence – Drinking to the Dregs
Alcoholism together with other important factors such as unemployment and inequality
significantly contributes to poverty and crime situation. Alcohol abuse among younger people is
potentially much more destructive as it limits educational achievement, restricts earning
potential, and undermines the health of a whole community. Alcohol consumption has a proven
effect on employment and wages level (Tekin, 2004).
For Russia with its long-standing alcoholism problem, this is one of the most important
social indicators. As McKee (2005) points out, the Soviet Union had a well-structured system of
alcohol abuse treatment in the form of a network of dispensaries and consultation rooms which
registered in 1984 around 3 million alcoholics, or about 2 per cent of the population. However,
the real number of people with alcohol dependency was estimated to be threefold higher. This is
because the official figures of the registration of alcoholics did not reflect the real situation. For
instance, about 150,000 people, or 5-6 per cent of those registered were detained compulsorily
by the police for deviant and semi-criminal forms of alcoholism. The self-registration was
reported to be much more seldom.
The post-Soviet Russia has retained a system of dispensaries and consultation rooms
(with closing many dispensaries) and continued to measure alcohol dependency by the primary
alcoholism incidence (the number of patients registered with this diagnosis for the first time). As
a group of Russian experts reports (Ivanets et al, 2000), this number has increased between
1990 and 1999 by 7,5 times. Another study (Koshkina and Kirzhanova, 2003) reported a 43 per
cent increase in the primary alcoholism incidence in Russia from 1999 to 2002.
As shown in the table above, between 1997 and 2003 the primary incidence of
alcoholism in Russia grew by 26,5 per cent.
Table 4.21. Alcoholism incidence in the Russian Arctic and Russia, 1997 to 2003, per
1000 inhabitants
Region 1997 1998 1999 2000 2001 2002 2003
Arkhangelsk 17,5 16,5 15,6 14,6 14,2 14,1 14,7
Murmansk 11,7 11,1 10,6 9,8 9,6 9,7 11,0
Tyumen 18,7 18,0 17,3 16,6 16,7 17,1 17,1
Krasnoyarsk 15,1 14,5 13,9 13,3 12,7 18,1 19,3
Sakha 17,5 18,4 19,2 20,0 20,7 18,9 19,7

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Chukotka 33,6 32,4 31,3 30,1 24,2 22,4 33,3
Russian Arctic average 19,0 18,5 18,0 17,4 16,4 16,7 19,2
Russia 11,9 11,1 10,8 13,1 14,1 15,4 16,2
Source: Rosstat (2004) 4
As Table 4.21 and Figure 4.15 suggest, alcoholism incidence in the Russian Arctic was

steadily high and above the Russian rate throughout the late 1990s and early 2000s.
Figure 4.15. Alcoholism incidence in the Russian Arctic



population 18,0



1997 1998 1999 2000 2001 2002 2003

Source: author’s calculations based on Rosstat (2004)
However, considering the increasing alcohol-related mortality and resulting decline in life
expectancy (WHO, 2004) and a 70 per cent increase in the incidence of alcoholic psychosis in
Russia between 1999 and 2002 when large quantities of poor quality alcohol, including imported
spirits, appeared in the Russian market (Koshkina and Kirzhanova, 2003), as well as growing
alcoholism among vulnerable groups (women, teenagers, etc) and the steady unrecorded use
of homebrews such as samogon, the indicator of alcoholism incidence should be considered as
inadequately representing the alcohol abuse situation in Russia since the number of
registrations is illogically low. Yet this alcohol indicator for which there are both national and
regional data is still used by the Russian authorities.
For the Arctic, alcohol abuse is considered a particularly serious challenge, along with
mental health, violence, and accidental death that are closely tied to rapid social changes
occurring in all aspects of life simultaneously with symptoms of cultural and social distress.
These symptoms, including alcoholism, are seen as the consequence of the inability to cope
with the changes (Czonka and Schweitzer, 2004; Young and Einarsson, 2004b). As shown in
the table above, the primary alcoholism incidence in most Russian Arctic regions, especially in


Data for oblasts only.


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Chukotka, is higher than the general Russian rate. Ivanets et al (2000) also report that the top
ranked place with the highest number of the first cases of alcoholism in 1999 was Tyumen
Oblast (11 per 1000 inhabitants) together with Hanty-Mansy AO (15) and Yamal-Nenets AO
(10) but the figures they use (apparently from another Russian study) are even lower than the
official figures. These discrepancies speak in favour of the argument that alcoholism incidence
(prevalence) is not helpful as an alcoholism indicator.
Neither similar comparable data for other circumpolar countries are available to provide
a comparison of alcohol-related harm using the alcoholism incidence. The helpful indicator that
might be used for this is alcohol consumption. Table 4.22 provides the country comparison of
per capita alcohol consumption for the Arctic countries, including Russia. The recorded alcohol
consumption in Russia was reported to be the highest in 1980, with 13 litres per capita,
compared to 12 litres in Denmark, 11 litres in Canada and 8 litres in Finland. The dramatic
impact of the anti-alcohol campaign in 1986 resulted in the reduced consumption (5 litres in
1987). Afterwards, the per capita consumption in Russia began to grow and reached 11 litres in
2001. At the same time, per capita alcohol consumption in other Arctic countries, e.g. Denmark
and Finland, is shown to have been steadily high throughout this period and in some years
markedly exceeded the alcohol consumption in Russia.
As discussed below, the alcohol consumption data for Russia as presented in different
reports do not always match. As the data source (WHO, 2002) indicates, in most cases these
figures comprise of the recorded alcohol consumption only. Factors which influence the
accuracy of per capita data are: informal production, tourist and overseas consumption,
stockpiling, waste and spillage, smuggling, duty-free sales, variation in beverage strength and
the quality of the data whereupon it is based. In some countries, including Russia, there exists a
significant unrecorded alcohol consumption that should be added for a comprehensive picture
of total alcohol consumption (WHO, 2002).
The unrecorded alcohol consumption in Finland and Denmark is estimated to be 2 litres
pure alcohol per capita for population older than 15 for the years after 1995 (WHO, 2004).
Another study (Poikolainen et al, 2002) estimated that in 1998, the per capita recorded alcohol
consumption in Finland was 7,1 litres and the unrecorded consumption 1,8 litres. The highest
unrecorded alcohol consumption in the Nordic countries was reported in Norway where the
proportion of the unrecorded alcohol is estimated at 25 to 30% of the total consumption (WHO,
In Finland, the annual number of deaths from alcohol poisoning is of a similar magnitude
to that for traffic accident deaths. It is a major public health problem, in contrast to most other
European countries where deaths from alcoholism and alcoholic liver cirrhosis prevail.
Compared to Finland, alcohol poisoning mortality in Russia has covaried closely with total
mortality (Poikolainen et al, 2002).


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Table 4.22. Per capita alcohol consumption in the Arctic countries, 1980 to 2001, litres of pure alcohol

Country 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Canada 10,91 10,84 10,54 10,13 9,97 9,82 9,67 9,78 9,51 9,11 8,60 8,35 7,85 7,86 7,86 7,85 7,72 7,95 8,06 8,29 8,26 8,23
Denmark 11,91 12,24 12,61 13,00 12,62 12,76 12,48 12,17 12,31 12,03 12,25 12,33 12,23 12,19 12,45 12,56 12,59 12,51 11,98 11,92 11,98 11,93
Finland 8,06 8,08 8,03 8,07 8,25 8,23 8,72 8,96 9,29 9,72 9,86 9,66 9,47 9,06 8,81 9,22 9,20 9,66 9,76 9,98 10,03 10,43
Norway 6,24 5,56 5,08 5,10 5,22 5,50 5,53 5,71 5,59 5,53 5,42 5,35 5,08 4,96 5,17 5,20 5,40 5,70 5,55 5,76 5,89 5,81
Russia 13,40 - - - 13,41 11,38 6,74 5,06 5,72 6,89 7,08 7,61 6,62 7,94 8,71 11,30 9,31 9,35 9,99 10,88 10,81 10,58
Sweden 7,77 7,27 7,42 7,08 6,96 7,04 7,33 7,21 7,38 7,58 7,53 7,48 7,63 7,58 7,82 7,45 7,04 7,28 6,98 7,07 6,98 6,86

Source: WHO (2002)


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Compared to the above data, the estimates for recorded per capita alcohol consumption
in Russia vary in the literature. One recent study (Rehm et al, 2006) reports that the per capita
adult alcohol consumption in 2002 in WHO region of Europe C which comprises Russia and the
surrounding countries was 14 litres, which was the highest of all WHO regions around the world,
even if take into account that “overall alcohol consumption in Europe is high in all regions”. The
authors note that the Nordic countries tended to have an average adult per capita consumption
that was a little lower than an average consumption of 13 litres for Western European countries.
It is important to note also that, while the Nordic countries are former spirits drinking countries,
i.e. those shifted from spirits to beer as the dominating beverage, Russia remains firmly the
spirits country where shift to beer is still continuing. Among all regions studied by Rehm et al
(2006), Russia and the surrounding countries displayed “the most detrimental drinking patterns”,
with the majority of males and females consuming alcohol.
The country also has a sizeable estimated unrecorded alcohol consumption of about 5
litres per capita (WHO, 2004). Particularly, an estimated one billion bottles of perfumes and
900,000 litres of window cleaning fluid were consumed in 1997 by the people in Russia for their
alcohol content which amounts to a total of between 3,5 and 4 litres of pure alcohol per person
(Miroshnichenko and Pelipas, 2001).
Analysing a long-term trend of alcohol consumption in Russia between 1980 and 1994,
Nemtsov (2000) estimated that alcohol consumption in Russia in 1984 exceeded 14 litres per
capita (10,5 registered + 4,2 unregistered). During the anti-alcohol campaign in 1986, alcohol
consumption in Russia fell to 11 litres and then began to grow due to a sharp increase in
estimated unregistered alcohol consumption to 13,6 litres (5 + 8,6) in 1993, followed by a slight
decline to 13,3 litres in 1994. As seen from above, current alcohol consumption in Russia has
returned to pre-1986 level. Alcohol consumption in Russia’s North and Northwest fell from 15,6
litres per capita in 1984 to 12,3 litres per capita in 1990. Urals (from 14 litres to 11,4 litres),
Western Siberia (14,8 litres to 12,8 litres) and Far East (16,7 litres to 13,3 litres) experienced the
similar trend (Nemtsov, 2000). Bobak et al (1999) also found that alcohol consumption in Urals
and Northwest was high, with rates about one-fifth of heavily drinking people. Andrienko (2002)
points out that after 1995 alcohol consumption in Russia declined at least up to the 1998 crisis,
following which it started rising again, and so did alcohol psychosis rate (4,7 in 2001 and 5,3 in
2002 per 1000 inhabitants). Significant increasing effect of alcohol on homicides was found:
e.g., of 24,350 people arrested for homicide in Russia in 1995, about 75 per cent were under
the influence of alcohol. Alcohol is frequently used by criminals to master courage or to repress
fear. Heavy alcohol drinking could lead to irrational behaviour of a person when he/she
inadequately appreciates the consequences of proceedings (Andrienko, 2002; WHO, 2004).
Alcohol exerts a major influence on the demographic situation in Russia. Apart from
health impacts, alcohol consumption plays a considerable role in the suicide rate, especially for


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male suicides. The rate of alcohol-related suicides is very high in Russia due to the very high
alcohol consumption rate. Changes in the alcohol blood level positive suicides were found to
closely correlate with changes in the alcohol consumption level, and the suicide rate closely
followed the dynamics of per capita consumption of alcohol. In 1984-1986 and 1991-1994, the
distribution of suicides’ age was close to that of the age distribution from fatal alcohol poisoning
(Nemtsov, 2003). The alcohol-attributable burden of disease in Russia and the neighbouring
countries was found to be the highest of all WHO regions worldwide and seems to have
increased slightly from 2000 (Rehm et al, 2006). The role of alcohol consumption in explaining a
large part of the Russian mortality trends for 1991-2001 “would appear reasonable”, with the
largest relative changes observed for those conditions that are directly related to alcohol –
unintentional poisoning and liver cirrhosis (Men et al, 2003).
While the Arctic suicide rate data were unavailable for this study, they are reported to be
very high (Bogoyavlensky, 2004; Czonka and Schweitzer, 2004; WHO, 2004; Young and
Einarsson, 2004b): it can be concluded that high alcohol consumption in the region plays its part
in the suicide rate. In fact, in the Arctic context alcohol was proven to be the most destructive for
the indigenous people who have a constitutional tendency rapidly to become dependent on
alcohol. The indigenous peoples of the Russian North have some of the highest recorded levels
of alcoholism, exceeding the Russian national average by twelve to twenty times. The
frequency of alcoholism has increased by 20 to 25 times among certain northern indigenous
peoples in recent years. During this time, the mortality rate from chronic alcoholism has
increased by 6.5 times among the male population in Chukotka and by 19 times among the
female population. It is generally recognised that the high frequency of injuries and deaths from
heart attacks and haemorrhages among the indigenous population is closely linked to
alcoholism (Krasovskaya et al, 2000).
Consequently, the picture of alcoholism situation in the Russian Arctic and in Russia as
a whole painted by the official figures on alcohol incidence looks quite optimistic. Inadequate
statistical registration, underreporting and lack of data hinder the reporting abilities of alcoholism
incidence as a useful alcoholism indicator in Russia and particularly in the Russian Arctic. Other
indicators such as per capita alcohol consumption are needed to monitor at national level the
country’s difficult alcohol situation which should be the focus of more coordinated policy actions
aimed at improving demographic and health issues in Russia.

4.3.9 Local NGOs – Let Us Participate!
A developed civil society is a vital element of sustainability, and its importance is
stressed by a separate section in Agenda 21 which highlights the need for all forms of public
participation, including indigenous participation (UN, 1992).
According to Domrin (2003), the number of registered public organisations in Russia has
reached about 350,000, including more than 70,000 social and non-for-profit organisations


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which are active and directly or indirectly involved in charitable work. Charity organisations may
unite between 1 million and 2.5 million citizens providing assistance and free services to some
20-30 million Russians, worth 15 billion roubles a year. As Table 4.24 below demonstrates, the
number of registered NGOs in all six Russian Arctic regions increased considerably between
2000 and 2003, with Murmansk and Sakha as clear leaders in NGO development.
Table 4.23. Number of registered non-governmental organisations in the Russian Arctic,
2000 to 2003
Region 2000 2003
Murmansk 1314 1631
Nenets AO 62 96
Yamal-Nenets AO 494 521
Taimyr 94 130
Sakha 1336 1624
Chukotka 73 116
Total 3373 4118
Source: Rosstat (2004)
However, while the number of NGOs is a good indicator of democratisation in a region,
the situation behind the numbers is far more complex. The concept of civil society is still highly
unpopular among the Russian public who consider it synonymic to democracy and other
“western” concepts that were transformed by the demagogues of the Yeltsin era into shallow
populist tools leading to outright abuses of the concept (Domrin, 2003). The author’s 2003
paper was itself an early signal of growing pressure on NGOs from the Russian state, and
recent developments (the adoption of the law on NGOs in late 2005, the increased public
control of NGOs in Russia and the recent murders of a number of prominent journalists,
including Paul Klebnikov and Anna Politkovskaya) were thus well foreseen. In fact, Golenkova
(1998) has earlier concluded that the prolonged suppression of civil society in Russia was
responsible for the ungovernable and destructive character of democratic transformation in
Russia which has been mainly orientated toward destroying the social institutions created at an
earlier time, while encouraging spontaneous tendencies of social development.
Other authors, however, are more optimistic about current trends in NGO development
in Russia. Hudson (2003) argues that the sheer number of NGOs in Russia and in particular in
the Russian Arctic that doubled between 1994 and 1997 and many of which can trace their
origins to the pre-1992 period can prove the existence and efficiency of Russian civil society.
From 2000 to 2003, total number of registered non-government organisations in the Russian
Arctic increased from 3373 in 2000 to 4118 in 2003, or by 18.1 per cent.
The second argument is less reasonable in the light of the recent developments
mentioned above: Russian national legislative activity, active support from NGO members, and
dependence on local and national government (both financial and otherwise), the author
suggests, have created a symbiotic relationship between NGOs and the Russian government

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that “suggest a departure from the traditional Russian state-society relationships…” Whereas
the growing number of Russian NGOs is indeed impressive, the recent law on NGOs and
increasing state control of NGOs’ activities and especially foreign financing are quite worrying.
The latter even prompted McIntosh Sundstrom (2005) to encourage foreign donors to continue
to finance Russian NGOs no matter what is happening in terms of the state pressure. Therefore,
it would be interesting to analyse the data on the number of NGOs in Russia after 2003. These
are, however, unavailable yet.
According to Smorchkova et al (2000), the number of NGOs in Russia’s northern regions
is only a fraction of what it was in the late 1980s and early 1990s. The Russian Arctic NGOs are
active in three major areas:

upholding citizens’ rights and freedoms with respect to information on the state of the

environment and the publication of that information in the national and regional media;
participation in the public environmental appraisal of projects which could endanger the

northern environment and in the EIA at the pre-project stage (collaboration with the state
structures and commercial organisations); and

public involvement in the environmental decision-making process, including with respect
to the use of natural resources (especially bioresources), the protection of traditional
nature use activities, road and pipeline construction, and the organisation of protected
natural territories, etc.
In many respects, the activities of the northern environmental NGOs resemble public
protest against the projects deemed widely harmful both for health and the environment, in
particular pipelines, dams, building up of protected areas, etc. The Russian Arctic NGOs are
well “capable of influencing environmental management decision-making” (Smorchkova et al,
Local indigenous NGOs are the best candidates to encourage public participation among
the indigenous population. The best example here is the Russian Association of Indigenous
Peoples of the North (RAIPON) which comprises ethnic associations of over 30 peoples of the
North and Far East. It conducts ethno-environmental and environmental projects in the field,
takes part in the drafting of legislation for the protection of the environment and zones of
traditional nature use in the Arctic and participates in the projects of a number of international
organisations (UNEP, GEF, WWF, IUCN, etc.). It has considerable authority and real capacity
and experience allowing it to participate in administrative decision-making on environmental
management in the Russian Arctic regions, and to collaborate with international organisations
(Smorchkova et al, 2000).


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