Medical care for Russian cosmonauts on board the ISS

Established with the personal participation of O.G. Gazenko, the Russian system of medical care for cosmonauts has been largely preserved to this day. The system was fully functional on board the orbital complex Mir and, with appropriate modifications, has been adopted as the core of the medical care for Russian members of ISS crews. In 2000–2008, 22 cosmonauts were members of 17 ISS missions lasting from 140 to 216 days. The main functions of the medical care system were to control health, physical, and mental performance, and to support space research. Readaptation to normal gravity was, in most cases, similar to what has been typical on the return from Russian orbital stations; some deviations are accounted for by the use of in-flight countermeasures. The paper presents some aspects of the theoretical work of Academician Gazenko in the field of medical care in space flights. It outlines the principles of ISS medical management. The integrated medical support system combines medical equipment and items available in the Russian and U.S. segments; the integrated medical group consists of flight surgeons, medical experts, and biomedical engineers of international partners and coordinates the planning and implementation of medical operations. In addition, challenges of health care in the phase of ISS operation are defined.