How Free-Market Ideologues Dismantled Health Care in Post-Soviet Georgia
After the fall of the Soviet Union, the Georgian health care system became a testing ground for shock-therapy privatizations. The result: soaring morbidity, the return of long-suppressed diseases, and the sidelining of preventive care.
A patient waits at a hospital for an examination in Tbilisi, Georgia. (Jonas Gratzer / LightRocket via Getty Images)
No sooner was the Soviet state created at the end of 1922 than its authorities had to deal with a series of epidemics. Reports at the time indicated seven million cases of typhus and 2.8 million cases of tuberculosis or syphilis — not to mention cholera, malaria, smallpox, scarlet fever, and typhoid.
These plagues all had severe biological consequences. But the Soviet government also recognized that poverty was the cause of many illnesses. Its representatives believed that to treat and prevent disease, a new society must address social and biological ills in combination, and the collective should bear responsibility for health outcomes.
Soviet authorities could see how modern industry was spreading illnesses in new ways. In Georgia, in the Russian Empire’s southern reaches, workers suffered appalling conditions in factories, while the main river in its biggest city, Tbilisi, was polluted from the dumping of toxic waste from manufacturing. Workers slept outside in mining towns during summer — and in the mines themselves during winter.
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