One winter day, 80-year-old Antonina Vizhinskaya got a call from her district social workers: Would she and her husband, Viktor, care to visit a sanatorium outside Moscow, free of charge?


The couple, along with about 100 other elderly Russians, spent the next three weeks enjoying the sanatorium's clean rooms, good food and attentive personnel.


"It was a good rest for old people like us and we could never afford it on our pension," Vizhinskaya said. "We wouldn't mind going there a second time."


What she did not know was that they had the United States to thank, at least in part. In complex, often roundabout ways, some U.S. aid is making its way through a bureaucratic web to ordinary Russians.


A recent report by the U.S. Senate Foreign Relations Committee concluded that the average Russian is not "aware of or affected by international assistance or the reforms that it is supposed to foster."


Apart from "George Bush's thighs" -- a popular name for chicken legs sent by the former U.S. president's administration -- few Russians could point to any specific U.S. aid.


But some of it does trickle down.


Unlike the World War II shipments of canned beef remembered by many older Russians, today's American aid focuses on programs more than people. It includes defense conversion plans, agricultural commodities and advisers sent to promote democracy and free enterprise.


In Vizhinskaya's case, the tangled chain of transactions that led to a sanatorium stay began with U.S. agricultural products sold at commodity exchanges.


Russia's humanitarian and technical aid commission distributed the proceeds to social, health and farming programs.


"You could say there's U.S. money in those sanatoriums, but people in the street might not know it," said the commission's humanitarian-aid director, Nikolai Anisimov.


The commission expects to get the equivalent of about $32 million from 1993 sales of U.S. grain, corn, peanuts, rice, chicken and other products, Anisimov said.


Some U.S.-financed programs show quick results, such as a $6 million housing project for discharged army officers in the Volga River city of Nizhny Novgorod, to be completed this summer.


Others take longer. For example, Washington has assisted the effort to privatize state property and has contributed more than $5 million to the International Finance Corp., which assists in privatization.


U.S. programs send volunteers to help with farming or industry, and experts on economics, the judiciary or democratic institutions.


Those are the ones that raise the most doubt about the direction and efficiency of American efforts. The Senate committee report suggested that too much money was spent on short visits by U.S. experts, and questioned the effectiveness of exchange and training programs. Brian Foster, who runs a farmer-to-farmer program in Moscow for Volunteers in Overseas Cooperative Assistance, disagreed.


"What is a Russian farmer going to learn from my father, for example?," he said. "That keeping records, writing down costs and revenues, is probably the most important management key a farmer can have. And farmers here don't know that."


The Senate report said, however, that too many aid decisions were made in Washington with little attention to local conditions.


Anisimov, of the Russian government commission, cited the case of 11,000 tons of soybean oil that arrived last year despite Moscow's advice that Russians prefer sunflower-seed oil. Also, he said, the oil was in drums too large for consumers but too small for factories to repackage economically. It took a long time to find buyers and 1,900 tons of the soybean oil remain unsold.


Russian officials say solving the country's problems requires much more than humanitarian aid.


"The most important thing for us is equal partnership, the opening of foreign markets to our products to help us boost economic growth," said Anatoly Krasikov, spokesman for President Boris Yeltsin.


Anisimov said Russia needs new technologies and equipment, but is unlikely to get it because "people don't want to offer help and then face a potential competitor."