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Once-mighty Russia fades to a dying population

KSTINOVO, Russia -- Welcome to Kstinovo, population 1 .

Antonina Makarova, 78, spends her days watching news and soap operas in her peeling wooden dacha, the only inhabited structure in two lanes of sagging cottages that once were a village. Her nearest neighbor, 80-year-old Maria Belkova, lives in adjacent Sosnovitsy, population 2. But Belkova can't hear anymore, and all in all, Makarova finds the television better company.

``All the houses here were filled with people. There was a cheese factory. But now everyone else has died. God has taken care of them, and he's still making me suffer," Makarova said. ``Even the thieves have disappeared."

The Tver region, along the upper reaches of the Volga River 130 miles north of Moscow, is dotted with more than 1,400 villages such as Kstinovo marked ``nezhiloye" -- depopulated. Since 1989, the number of people here has shrunk by about 250,000 to about 1.4 million, with deaths outnumbering births more than 2 to 1.

The Tver region is far from unusual in this country.

Russia is the only major industrial nation that is losing population. Its people are succumbing to one of the world's fastest-growing AIDS epidemics, resurgent tuberculosis, rampant cardiovascular disease, alcohol and drug abuse, smoking, suicide, and the lethal effects of unchecked industrial pollution.

In addition, abortions outpaced births last year by more than 100,000. An estimated 10 million Russians of reproductive age are sterile because of botched abortions or poor health. The public healthcare system is collapsing. And many parents in more prosperous urban areas say they can't afford homes large enough for the number of children they would like to have.

The former Soviet Union, with about 300 million people, was the world's third-most populous country, behind China and India. Slightly more than half of its citizens lived in Russia. The country has lost the equivalent of a city of 700,000 people every year since the collapse of the Soviet Union in 1991, only partially offset by an influx of people from other former Soviet republics. A country that sprawls across one-eighth of the globe is now home to 142 million people.

The losses have been disproportionately male. At the height of the power of the Soviet Union, its people lived almost as long as Americans. But now, the average Russian man can expect to live about 59 years, 16 years less than an American man and 14 less than a Russian woman.

Sergei Mironov, chairman of the upper house of Russia's parliament, said last year that if the trend didn't change, the population would fall to 52 million by 2080. ``There will no longer be a great Russia," he said. ``It will be torn apart piece by piece, and finally cease to exist."

That may be an overstatement, but there are serious questions about whether Russia will be able to hold on to its far eastern lands along the border with China over the next century or field an army, let alone a workforce to support the ill and the elderly.

Russian officials, flush with revenue from record prices for the country's oil exports, have started to respond. President Vladimir V. Putin pledged payments this year of $111 a month to mothers who choose to have a second child, plus a nest egg of $9,260 to be used for education, a mortgage, or pensions. He also called for renewed efforts to attract ethnic Russians living in the ex-Soviet republics.

``Russia has a huge territory, the largest territory in the world," Putin said. ``If the situation remains unchanged, there will simply be no one to protect it."

The economic earthquake of Russia's transition from communism to capitalism plunged tens of millions into poverty overnight and changed the value systems upon which many had planned their lives.

A small minority, mostly in urban centers such as Moscow and St. Petersburg, were able to exploit the absence of rules in the chaotic 1990s to become fabulously wealthy. But such a profound social transition, coming at the end of a century of war, revolution, and ruthless social experimentation, condemned a great many more to a deep malaise.

Those who lost out have proved susceptible to drinking, smoking, and other habits that killed millions of Russians even in the best of times. In more extreme cases, they kill themselves.

Russia's suicide rate, at about 36 per 100,000 people, is second only to that of Lithuania, according to the Serbsky National Research Center for Social and Forensic Psychiatry. In some remote areas of Russia, the rate exceeds 100 per 100,000.

Some say the cause of Russia's problems can be found in communism's willful destruction of generations of the country's most capable and adaptable people.

``Seventy-five years of Bolshevik life in this country led to the formation of a tribe of people which was cultivated to listen to orders, and fulfill them," said Alexander Gorelik, a St. Petersburg physician. Stalinism, he said, aimed for ``the planned and gradual physical destruction of the most moral, the most creative group of the population."

``There is such a thing as a will for life," he said. ``And the whole trouble is that the Russian public in general, and especially the male population, has a big deficiency in this area."

Russia has a long history of alcohol abuse. Soviet President Mikhail S. Gorbachev tried to tackle the problem 20 years ago by limiting the production and distribution of liquor. When he did, male life expectancy increased three years.

But massive drinking resumed when the controls were eased. The average Russian drinks 5 gallons of pure alcohol a year, causing an estimated 900,000 deaths over the past decade through acute alcohol poisoning, fights, and accidents, according to figures released by Tatyana Yakovleva, head of the Russian parliament's healthcare committee, at a recent conference in Moscow. Others have permanent brain damage or liver damage from homemade alcohol.

It has been five years since Svetlana Glukhova was diagnosed as HIV-positive, but she says she still has no idea whether she needs drug therapy. Doctors at the only AIDS center in her city do not have the necessary laboratory equipment to decide that.

She does know that even when she took her first AIDS test, the sores on the fingers she once used to inject heroin already were failing to heal.

The United Nations says Russia has the worst AIDS problem in Europe, fueled by ``extraordinarily large numbers of young people who inject drugs." But the disease has spread widely through the population, and more than half of all new cases result from heterosexual intercourse. Officially, 340,000 Russians are infected with HIV or AIDS, but the UN says the number could easily be four to 10 times higher.

Compounding the problem, most Russian victims are young. The prevalence of the illness among young people threatens to add to Russia's demographic meltdown by killing them before they can bring a new generation into the world.

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