Sir.—Dr Wallace's marginal comment about pediatric care in the Soviet Union is an interesting description of the way pediatric care is supposed to work there. As Dr Wallace says, three weeks' observation does not make one an expert.
Russian emigrés with young children are experts on the system of health care for children in the USSR, having lived with it for years. Those now in Boston describe care as abominable, feldshers as poorly trained, and pediatricians as uninterested, inexpert, and undertrained. Many physicians, including pediatricians, expect to be paid by the family for providing anything more than cursory care. Emergency services outside of major metropolitan areas do not provide prompt care for children. Medications are often hard to find or impossible to obtain and special diets for sick infants are not available in much of the country. Even milk-substitute formulas can be a rarity in many districts. As the