Documentary : U.S. Doctors Pay a Soviet House Call : The team of physicians from Alaska found vast differences in medical care. They also found an appreciative collection of patients.

Dr. Fritz Craft, 34, an American dentist filling teeth in a hospital in this remote seaport on the Bering Sea, could not believe it when his first adult patient jumped up and hugged him at the end of his appointment.

Then it happened again. And again.

Anesthesia, it turned out, is rarely used when repairing cavities in the Soviet Far East. So for the first time in most of their lives, Craft’s Soviet patients were experiencing painless dentistry.

No wonder the outbursts of emotion.

For 32 members of an Alaskan medical expedition to this part of Siberia, the example was just one of many they discovered during a 17-day tour of the Soviet Union’s northeasternmost corner--a tour that underlined for them and for a Times reporter allowed to accompany the mission vast differences between U.S. and Soviet health care.

Often, conditions and procedures were primitive by American standards. The visitors saw novel techniques unfamiliar to most in the United States, some of them showing medical promise, others smacking more of folk medicine. There was the “bone-stretching” procedure, the use of enormous quantities of electricity in shock therapy, the use of ultraviolet light tubes as treatments for colds.

“Any time a child has an earache, sore throat, runny nose or cold, we have them sit with an ultraviolet light in their ear, nose or mouth for a few minutes,” explained the Soviet doctor on duty in the medical ward of the Fairy Tales Kindergarten in Bilibino,

site of the world’s only nuclear power station above the Arctic Circle.

As he spoke, a little girl and a boy were seated at a tiny table with ultraviolet light tubes up their nostrils. Another girl had a tube in her mouth. “Colds in this, the coldest place on Earth, are passed around quickly,” the doctor noted. “We found that the ultraviolet light treatment has cured and reduced colds in our kindergarten by 40%.”

The ultraviolet machine is just one of the numerous exotic medical devices never before seen by the American doctors who visited clinics and hospitals in the small cities of Pevek, Bilibino, Anadyr and Magadan, and a number of rural communities in Magadan Oblast (region), across the Bering Sea from Alaska.

Steve Carr, 42, a physician’s assistant with the Alaska State Dept. of Corrections, visited a hospital in Talja where he saw 1,000 volts of electricity fired through the body of a woman being treated for depression.

“The hair on her head stood straight up,” Carr said. “I was told the electricity was run through her to realign her nervous system. She was seated in a chair mounted on thick rubber mats. Obviously, she wasn’t grounded. If someone had touched her, they would have been electrocuted.”

In the United States, a typical shock treatment--known as electroconvulsive therapy, or ECT--would use 150 volts of electricity, according to an American mental health specialist.

The Russians here have other techniques that would look strange to an American doctor. Heated demitasse-size suction cups are placed on patients’ backs to keep fluids from settling in lungs and are put on other parts of the body for all sorts of aches and pains.

Many traditional home remedies are used in hospitals--herbal medication, hot packs on the chest, mustard plasters, chopped garlic around the neck, hot tea, honey and vodka.

High-frequency current is prescribed for muscle stimulation. Ultrasound is a common procedure. Weird-looking electromagnetic field machines with a claw-like device suspended over one’s head are supposed to cure headaches.

All these are part of normal treatment in hospitals where medicinal mud is often applied on the belly of a pregnant woman, on the belly of a woman wanting to get pregnant, for arthritis, bursitis, and other such ailments.

The American doctors were fascinated with the possibilities offered by some of the Russians’ exotic procedures but expressed a great deal of skepticism about most of the unorthodox practices they saw in the hospitals.

One unusual surgical procedure developed here, however, has already been introduced in Alaska--the Gavril Ilizarov bone-stretching technique. Orthopedic surgeon Dr. Michael Holloway, 45, has used the procedure 40 times in Alaska since he was here on a similar expedition last year. It is applied to cases where a patient, due to either birth defect or injury, has one leg shorter than the other.

Holloway explained the procedure this way: Wires drilled into bones are attached to external metal rings. The rings are connected to rods and bolts that are turned with a wrench one-fourth of a millimeter four times a day. When the desired length is achieved, the bone is held in place to allow consolidation.

When performed properly, there is regeneration “not only of a healthy bone, but also of skin, muscle, blood vessels and nerves lengthening up to 10 inches in the leg,” Holloway said. “People that are crippled don’t have to stay crippled with this remarkable discovery.”

What the Soviet health care system lacks is at least as striking as some of its more unusual procedures and techniques.

Although there are many doctors, there is a serious shortage of specialists. The system also lack materials and supplies. Needles and syringes, for example, are used repeatedly.

There is an acute shortage of birth control products, and abortions are common. In a Pevek hospital last year, there were 900 abortions and 500 births.

Anchorage ophthalmologist Marvin Greendahl, 46, hoped to perform a simple surgery on interpreter Tatiana Khokhorina’s 3 1/2-year-old son, who has a congenital cataract with 50% vision in the affected eye. But he was unable to operate, he said, “because, unfortunately, there is no high-tech ophthalmology equipment in the entire Magadan region.”

“If Tatiana’s son does not have the operation, he will lose sight in the eye,” Greendahl said. “I’m making arrangements to fly the boy to Alaska for surgery later this year. It’s impossible to do the type of eye surgeries here that we do every day in the United States.”

Royann Royer, 35, who teaches dental hygiene at the University of Alaska, found a great fear of dentists among children here. “They cry with pain because there is no anesthesia. Dentists have no X-ray machines. Dental equipment is low-speed, prolonging pain.”

Unfortunately, the children also tend not to brush their teeth every day. It’s easy to understand why. Toothpaste is a product in seemingly perpetual short supply throughout the Soviet Union, and the local variant “tastes terrible,” noted Craft. “When I gave them American toothpaste, they went bananas over it. They wanted to brush more.”

Common medical practice here often seems bizarre by U.S. standards, starting with the pay of the doctors.

Under the past 73 years of communism and the dictatorship of the proletariat, doctors and nurses, along with engineers and teachers, have made among the lowest salaries in the country--half to one-fifth as much as common laborers, mechanics, bus drivers and miners. It is from the working class, not the professional class, that much of the leadership of the country is derived.

Dr. Nina Tihovska, 38, a cancer specialist in Magadan City, earns 500 rubles a month (the equivalent of about $800 at the official exchange rate)--twice as much as doctors in other parts of the Soviet Union because of Siberia’s remoteness and harsh climate. She said the reason 70% of Soviet doctors are women is because men prefer to earn much higher salaries as workers, leaving the lower-paying jobs to women.

Joe Ryan, a hospital administrator, and Steve O’Connor, a paramedic, were quickly ushered out of a maternity ward in Pevek, a seaport nearly on top of the world, at the edge of the Arctic’s East Siberian Sea and icebound most of the year.

“You’d have thought we had the plague,” said Ryan, 57, director of the Indian Health Service Hospital in Bethel, Alaska.

What Ryan and O’Connor didn’t know was that in general, only women are permitted in Soviet maternity wards. Even the new father is forbidden to see his wife or child for six days, when they leave the maternity wing of the hospital.

Unlike America, where hospitals discharge patients as soon as possible, here a 15- to 30-day stay is common for a relatively minor problem or procedure.

Soviet hospitals try to make up for their technical shortcomings in other ways. “The Soviet doctors seem to be knowledgeable and their surgical skills appear to be excellent,” commented Alaska hospital administrator Joe Ryan.

Also, he added, “there is a great deal of loving and care on the part of Soviet doctors and nurses.

But they lack modern instruments and technology. It is like the 1930s.”

In Bilibino, Galina Nikonchok, 35, a hospital head nurse, showed Brian Saylor, 42, of the Anchorage Health Department, the record room where a red cloth-covered medical record book is kept for every person living in the city.

Each book starts with a birth certificate. Every time the person visits a doctor or a hospital, an entry is made in the book until the final recording of the death certificate. If a person moves, the record book is sent to the hospital in the new location.

Children’s hospital walls are decorated with colorful murals and drawings of fairy-tale and other characters, including even Mickey Mouse. Children wear Mickey Mouse T-shirts by Soviet artists.

Communist propaganda posters line hospital corridors. In one hospital were photographs from the Afghanistan war. In hospitals throughout Magadan Oblast, one can see V. I. Lenin and Mickey Mouse side by side.

The 32 members of the Alaska medical expedition flew from Anchorage to Provideniya in a chartered Aeroflot turboprop. From there the expedition split into four groups, flying to various centers in rural areas of the Magadan region. Helicopter flights were made to remote camps where Soviet medical brigades provide health care for nomadic reindeer herders.

Ted Mala, 43, a physician and University of Alaska professor, led the expedition. Alaska’s Democratic Gov. Steve Cowper has described Mala as “the key player in the unfolding relations between the Soviet Far East and Alaska.”

Mala went to Moscow in 1985 and later visited the Siberian Academy of Medical Science. He is a founder of the International Union for Circumpolar Health

and was the organization’s first secretary.

With a membership consisting of all nations at the top of the world, the union’s purpose is to research health problems common to the global far north.

In June, 1988, Mala became founder-director of the Institute for Circumpolar Health Studies at the University of Alaska with an initial $500,000 funding from the Alaska Legislature. He led his first medical expedition to Siberia last summer. His Soviet counterpart, who coordinates the expeditions in the Soviet Union, is Dr. Alexsei Lebedev, 47, the minister of health for Magadan Oblast.

Mala is credited by many with melting the “ice curtain” that previously existed between Alaska and its neighbor across the Bering Sea. America’s first male Eskimo physician, Mala attributes his success in breaking down the barriers between the two nations “to the magic of my heritage,” and adds, “You see, my father was an Eskimo and my mother was Russian.”