One of the main duties of a commander in his work is to ensure permanent battle-readiness of his (sub)unit is to care for the health of his subordinates.
Safeguarding the health of conscripts is a major priority for the Russian armed forces—at least, in theory. Internal army regulations contain detailed provisions for monitoring the health of soldiers and addressing problems when they arise. However, in reality these provisions are routinely ignored. Monitoring of soldiers’ health is often superficial or non-existent, and access to health care is severely impeded. Hazing prevents many conscripts from seeking medical care for their health problems. Those who overcome their fear and seek medical at on-base sickbays often receive substandard help and subsequently face repercussions from senior conscripts. Hazing even continues in some military hospitals.
The Military Code of Conduct attaches great importance to creating living conditions in the armed forces that are conducive to good health. 69 It defines ensuring strict observance of sanitary rules, appropriate shelter, and adequate food as among the “main aspects” of a military commander’s work.70 The poor living conditions of conscripts discussed in this report indicate that officers are failing in this duty. Many conscripts interviewed for this report attributed the health problems they developed during their service to poor living conditions. With striking uniformity, they linked stomach problems to their poor diet and festering sores to poor personal hygiene and drafty and damp living quarters. Personal hygiene was a major problem for many on their military bases. Several said they were given too little time to wash properly during the weekly shower they are entitled to.71 One conscript who suffered from festering blisters said he was afraid to go to the bathroom to wash in the evenings:
Others said they were not given changes of underwear for extended periods of time.73 Many conscripts and their mothers said that because of these conditions their clothing became infested with lice. One mother said: “There was also the following detail. His underwear, but also his uniform generally, were alive from the lice.”74 Another mother said: “When he came home on a leave of absence, I washed his uniform and [discovered] lice—lice and larvae in his underwear. As his leave was less than twenty-four hours, I washed, dried and ironed at night.”75
These living conditions, which, no doubt, contribute to the health problems of conscripts, contravene the Russian army’s internal regulations.
The Military Code of Conduct contains explicit and unequivocal language on access to medical care: A military serviceman may not hide an illness and is obliged to promptly report any illness to his immediate superior. In cases requiring immediate attention, the superior is supposed to grant the serviceman permission to go to the sickbay right away. If a condition is not urgent, the superior registers the health complaint in a registry and the conscript can go to the sickbay at the regular visiting hour.76 Additionally, the code requires commanding officers to monitor the health conditions of all staff during battle training and everyday life, prescribes weekly superficial physical examinations of all conscripts, as well as semi-annual, extensive examinations.77 These provisions, in theory, set out a level of access to health care that is consistent with the right to health as defined in the International Covenant on Economic Social and Cultural Rights.78
Yet, these norms are often ignored in practice. Several conscripts told Human Rights Watch that they only underwent in-depth examinations when transferred from one unit to another but not after every six months of service. One conscript told Human Rights Watch that superficial examinations were conducted every week while he was in a special training unit. He said he and his fellow conscripts had to undress to their underwear, after which the commander of his company and the medical doctor checked them for bruises and health problems. Once he was moved to a regular unit, these body checks ceased.79
Another conscript told Human Rights Watch: “In our unit, they checked our pockets for sharp objects every day but we never had any body checks. In the early months, I walked around with several large bruises...”80 Access problems exist at several levels. In some cases, conscripts did not seek medical care because senior soldiers pressured them not to or had tremendous fear of repercussions before seeking help. In others, some conscripts said that superiors whom they approached denied them permission to go to the sickbay. Still others said doctors turned them back without paying due attention to their health concerns when they sought medical help. This, in turn, has resulted in a widespread perception amongst recruits that it is pointless to seek medical care.
Human Rights Watch research shows that the practices described below have existed for a considerable number of years, and that the Russian government has apparently taken no effective steps to remove these obstacles to access to health care. Despite repeated requests, the government has refused to meet with Human Rights Watch to discuss this issue.81 The failure of the Russian government to ensure effective access to health care for conscript soldiers violates its obligations under the right to health.82
If you were sick, you were at fault.83
Conscripts from military bases across the country uniformly described a presumption that those who seek medical care do so to avoid the hardships of military service. Because of this presumption, both junior and senior conscripts pressure their peers not to seek medical care. Conscripts who ignore the pressure often face repercussions, including harassment, beatings, and extortion. As a result, many conscripts try to cure minor health problems themselves, rather than risk abuse by seeking professional care.
Alexander Kaiankin told Human Rights Watch that conscripts regard with suspicion peers who go to the sickbay:
Another conscript, who said he frequently had bruises from beatings, confirmed the pressure dedy put on conscripts to avoid medical care: “It was undesirable to go to the sickbay. If you go to the sickbay, you make things worse for yourself... They told us: ‘If you go to the sickbay, we’ll kill you.’ They threatened us.”85 Aleksei K. summed the situation up: “Honestly, if you weren’t too ill, it was too much of a problem to go to the sickbay. Nothing good was to be expected–they immediately started picking on you ...”86
Several conscripts told Human Rights Watch about the repercussions they faced after hospitalization. Igor K.’s story is illustrative:
Two months later, K. was hospitalized again with another bout of stomach problems. He spent another month in the hospital. When released, the attitude toward him had worsened. “A number of soldiers began to beat me and pick fights with me.” In October 2001, K. was beaten so badly that he was hospitalized with an internal injury that required surgical intervention. Upon return to the unit, the harassment and ill-treatment started again. After yet another hospitalization and renewed beatings, K. fled his unit.87
Several conscripts told Human Rights Watch that they sought permission from their superiors to report to the sickbay but were denied. For example, Vladimir O., who served in an Interior Ministry forces unit in Kirov Province, said that when he developed a cough, he tried to see a doctor. His superior told him that he could not go to the sickbay and had to continue to perform guard duty. O. told Human Rights Watch he has a long history of bronchial problems. After this incident, he fled his unit and returned home where he received treatment and was cured. Another conscript, Ilia B., asked permission from his sergeant to report to the sickbay when he experienced chest pains and generally felt sick but was denied. B. told Human Rights Watch he went to the sickbay anyway and was yelled at when the sergeant found out.
Conscripts overwhelmingly told Human Rights Watch that seeking medical care at on-base sick bays is pointless, in particular for minor health problems.88 Most said that they drew this conclusion after they or their peers sought care at sickbays but received none. For example, Vladimir Z. said he went to the sickbay because a stinging pain in his chest kept him from sleeping: “[The doctor] looked at me and said: ‘You’re all right, you’re healthy. Go back to duty.’” Another conscript said he tried to see a doctor after being beaten in the kidney area. According to the conscript, the doctor came outside at the regular visiting hour and apparently: “Who’s dying? Nobody. Ok.” He then left without so much as examining the conscript.89 Conscripts who at the time realized that they required professional medical attention told us they did not go to the sickbay because it was “pointless.” One conscript said that in his unit’s sickbay there was only a nurse “who loved to drink and only applies disinfectant.”90 Another said that “seeking medical care was useless because they only gave [nondescript] tablets and nothing else.”91 Reflecting remarks by a number of other conscripts interviewed for this report, Pavel P. said: “We cured ourselves. I wrote to my mother because they never had medication in the sickbay...”92
Violent hazing, an endemic phenomenon on many military bases throughout Russia, often does not stop at the doors of sickbays and military hospitals, and therefore interferes with conscripts’ right to adequate medical care. Human Rights Watch interviewed several dozen conscripts who said senior soldiers physically ill-treated them and forced them to perform a variety of chores for them in sickbays and military hospitals. These abuses took place primarily in the evenings and at night, after medical personnel and officers had departed senior conscripts in charge. In one case we documented, the victim committed suicide after a night of particularly cruel treatment.
International law prohibits governments from treating persons in an inhuman or degrading manner under any circumstances.93 This prohibition also applies to conscripts, although considering the special mission of the armed forces the threshold for inhuman and degrading treatment may be higher for conscript soldiers than for other groups in custodial situations, such as prisoners and persons committed to mental institutions.94 International law does not prohibit the performance of chores and other work by conscripts while they are in hospitals. Yet, Human Rights Watch believes that, in determining whether and what work can be assigned to hospitalized conscripts, the primary concern should be the health condition of the patient. Assignment of work that interferes with their recovery would violate the right to the highest attainable level of health.
Most conscripts who had spent time in sickbays told Human Rights Watch that harassment and hazing continues there. Human Rights Watch documented, among others, the following cases:
Harassment and hazing also occurs in some military hospitals. While most young men interviewed for this report said they were treated well in military hospitals, about a dozen conscripts said they faced harassment, humiliation and sometimes ill-treatment in them. Conscripts particularly singled out military hospital 442 in St. Petersburg, although we also received allegations of abusive treatment in military hospitals in Novocherkassk and Kislovodsk. Several interviewees stressed that the abuses occurred primarily in the evening and night, after senior medical personnel left the hospital.
Five conscripts described various types of inappropriate treatment of patients in military hospital 442. Several told Human Rights Watch that senior soldiers there forced them to work or do chores for them during the day and got drunk and became abusive at night. Dmitrii Kosov, who was in the hospital in early 2001 for several weeks, said:
In a separate interview with Human Rights Watch, Roman Davydov, who was in the hospital at the same time as Kosov, confirmed Kosov’s testimony.99
Vitalii K., another conscript, told Human Rights Watch that the dedy in the military hospital frequently got drunk at night and became abusive. They forced him and other junior conscripts to leave the military base to get alcoholic drinks for them. They also regularly put them all in a row in the night and forced them to do physical exercises. K. noted that these abuses always took place in the evening, when the doctors and other officers had left for the day.100
Human Rights Watch received similar reports from other conscripts who fled the same hospital. The mother of one said her son, hospitalized for an ear infection, told her that “it is impossible here, worse than in the regiment.” She said second year soldiers got drunk at night and became abusive, forcing them with “shoves and kicks” to run errands for them.101 Her son eventually ran away from the hospital. So did Anatolii T., who was getting treatment for heart problems and festering foot sores. He told Human Rights Watch that the senior soldiers in his ward found out that he had previously gone absent without leave and started harassing him:
One interviewee observed that conscripts who were sent directly from military bases to the hospital, rather than through a soldiers’ rights group, were particularly vulnerable to abuse.103 He said:
Human Rights Watch also received reports of harassment and abuse in several other military hospitals, although it was unclear whether the abuses there are as widespread as in military hospital 442. We documented, among others, the following cases:
The court found the perpetrators guilty of humiliation of their fellow servicemen causing serious consequences, and sentenced them to prison terms ranging from a year and a half and four years.107
68 Article 326 of the Military Code of Conduct.
69 Article 329 of the Military Code of Conduct state that military commanders must strive to “enhance the conditions of service and life of military servicemen” by requiring “strict observance of the sanitary norms and demands of the military regulations for housing military servicemen, organizing their nutrition, provision of water...” They also should ensure “timely and full provision for every military serviceman the prescribed norm of nutrition.”
70 Soldiers themselves face a similar duty: “maintaining and strengthening the health...of military servicemen is an important and integral part of their preparation for fulfilling their soldier’s duty” (Article 326 of the Military Code of Conduct). Article 334 further states that: “Every military serviceman has to take care of maintaining his health, may not hide illnesses and must strictly observe rules for personal and community hygiene...” These provisions reflect the position of the Committee on Economic Social and Cultural Rights, which has explained the right to health as “an inclusive right extending not only to timely and appropriate health care but also to the underlying determinants of health, such as access to safe and potable water and adequate sanitation, an adequate supply of safe food, nutrition and housing...” (General Comment 14. The Right to the Highest Attainable Standard of Health, Committee on Economic, Social and Cultural Rights, 22nd sess., 2000, para. 11, see: http://www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.2000.4,+CESCR+General+comment+14.En?OpenDocument (accessed October 24, 2003).
71 One conscript said fifty conscripts had ten minutes to bathe in a bathroom with only four showerheads. Article 335 of the Military Code of Conduct stipulates that conscripts must wash their full bodies once a week in the bathhouse. It also requires them “to wash their hands and face in the morning and brush their teeth; wash their hands before meals; wash their hands and face, brush their teeth, and wash their legs before sleep; shave regularly, and cut hair and nails in a timely fashion; and to change underwear, bed sheets, foot bindings, and socks once per week on bath day.
72 Human Rights Watch interview with Vladimir Z., November 4, 2002, Cheliabinsk. Human Rights Watch’s research into violent hazing found that abusive soldiers frequently use bathrooms or other closed off locations to harass and ill-treat their junior colleagues, in an apparent attempt to avoid being seen.
73 Another conscript said he and his peers were not given a change of underwear for a full month, while the Military Code of Conduct clearly states that underwear has to be changed once a week.
74 Human Rights Watch interview with Nina S., mother of Egor T., April 13, 2002, St. Petersburg. T. served in units 6716 (Lembolovo, Leningrad Province) and 6717 (St. Petersburg) of the Ministry of Interior’s troops. Nina S. and Egor T. are pseudonyms.
75 Human Rights Watch interview with Olga and Nikolai Grushko, parents of Evgenii Grushko, April 18, 2002, St. Petersburg.
76 Article 349 of the Military Code of Conduct.
77 Articles 341 and 342 of the Military Code of Conduct.
78 The Committee on Economic, Social and Cultural Rights considers access to health services one of the essential elements of the right to health. This includes “equal and timely access to basic preventive, curative, rehabilitative health services and health education; regular screening programmes; appropriate treatment of prevalent diseases, illnesses, injuries and disabilities...” (General Comment 14. The Right to the Highest Attainable Standard of Health, Committee on Economic, Social and Cultural Rights, para. 17).
79 Human Rights Watch interview with Petr K., July 31, 2003, St. Petersburg. K. served in the Ministry of Defense’s unit 67616 in Kamenka, Leningrad Province. Petr K. is a pseudonym.
80 Human Rights Watch interview with Anton S., July 31, 2003, St. Petersburg.
81 In November 2002, Human Rights Watch contacted the Central Military Medical Commission of the Ministry of Defense to seek a meeting to discuss some of the findings of our research. After initial telephone contact, on November 21, 2002, we sent a letter to General-Major Valerii Kulikov, head of the Central Military Medical Commission, in which we set out the purpose of our research and outlined a series of issues for discussion. However, our request for a meeting was denied.
82 States have a positive obligation to provide conscripts with adequate health care as they are “unable, for reasons beyond their control, to realize the right themselves by means at their disposal.” General Comment 14. The Right to the Highest Attainable Standard of Health, Committee on Economic, Social and Cultural Rights. para. 37. Russia has formulated rules for access to health care for conscripts that are consistent with that obligation. Russia is bound, by the requirement of progressive realization, to ensure proper implementation of these rules. Russia’s failure to do so constitutes an act of omission, as defined in para. 49 of General Comment 14.
83 Human Rights Watch interview with Maksim Komlev, April 8, 2002, St. Petersburg.
84 Human Rights Watch interview with Alexander Kaiankin, April 18, 2002, Sosnovo, Leningrad province.
85 Human Rights Watch interview with Anton A., April 18, 2002, St. Petersburg.
86 Human Rights Watch interview with Aleksei K., October 4, 2002, Uriupinsk, Volgograd Province.
87 Human Rights Watch interview with Igor K., April 13, 2002, St. Petersburg. K. served in unit 3526 of the Ministry of Interior’s troops in Lebiazhe, Leningrad Province. Igor K. is a pseudonym.
88 Sickbays are areas on military bases where a small medical team provides basic medical care to soldiers who have been injured or have fallen ill. Soldiers who require more than basic care are sent to military hospitals.
89 Human Rights Watch interview with Dmitrii Kosov, April 11, 2002, St. Petersburg.
90 Human Rights Watch interview with Alexander Kaiankin, April 18, 2002, Sosnovo, Leningrad Province.
91 Human Rights Watch interview with Igor K., April 13, 2002, St. Petersburg.
92 Human Rights Watch interview with Pavel P., April 19, 2002, St. Petersburg. P. served in unit 01375 of the railroad troops in Mga, Leningrad Province. Pavel P. is a pseudonym.
93 See, e.g. ICCPR, article 7 (“No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment”). Article 7 is not subject to derogation (article 4).
94 For example, initiation rites that border on degrading treatment may be acceptable in the armed forces as a means of building the kind of group solidarity that is the backbone of any army. They may not be acceptable in other situations. However, such initiation rites should have a legitimate goal, may not be arbitrary, and may not unjustifiably threaten the health of the conscripts.
95 Human Rights Watch interview with Aleksei Dryganov, April 10, 2002, St. Petersburg.
96 Human Rights Watch interview with Vitalii K., October 2, 2002, Volgograd and a letter from K.’s mother to the soldiers’ rights organization Right of the Mother in Volgograd, dated July 23, 2002. K. served in the Ministry of Defense’s unit 45935 in St. Petersburg. Vitalii K. is a pseudonym.
97 Human Rights Watch interview with Alexander O., October 2, 2002, Volgograd. O. served in unit 42091 in Krasnodar Region. Alexander O. is a pseudonym.
98 Human Rights Watch interview with Dmitrii Kosov, April 11, 2002, St. Petersburg.
99 Human Rights Watch interview with Roman Davydov, April 13, 2002, St. Petersburg.
100 Human Rights Watch interview with Vitalii K., October 2, 2002, Volgograd.
101 Human Rights Watch interview with Galina K., mother of Alexander K., April 18, 2002, St. Petersburg. K. served in military construction unit 31502. Galina K. and Alexander K. are pseudonyms.
102 Human Rights Watch interview with Anatolii T., April 13, 2002, St. Petersburg. T. served in unit 6716 of the Ministry of Interior’s troops in Lembolovo, Leningrad Province. Anatolii T. is a pseudonym.
103 Soldiers’ rights groups often arrange for conscripts who flee their units to be hospitalized for a reassessment of their fitness for military service. The parents of these soldiers and soldiers’ rights groups closely monitor their treatment while in the hospital.
104 Human Rights Watch interview with Alexander Kaiankin, April 18, 2002, Sosnovo, Leningrad Province.
105 Andriushenko’s father bitterly disputes this conclusion. He believes the senior soldiers not only humiliated his son but eventually also murdered him.
106 Verdict of the Vyborg Garrison Military Court of January 18, 2002.
108 Human Rights Watch interview with Stanislav U., October 4, 2002, Uriupinsk, Volgograd Province; and Human Rights Watch interview with Evgenii G., October 4, 2002, Uriupinsk, Volgograd Province. U. served in units 6794 (Astrakhan Province) and 3033 (Persianovka, Rostov Province) of the Ministry of Interior’s troops. G. served in unit 2062 in Kaspiisk, Dagestan. Stanislav U. and Evgenii G. are pseudonyms.