From Big Medical Encyclopedia

FUMES, P e with p at l and Chad — the state in the Central Africa. Territory of 1284 thousand sq.km. The population apprx. 5 million people (1982, assessment). The capital — N'Djamena (211 thousand zhit., 1982). In the administrative relation the country is divided on ^префектур. Ofits. language — French.

At the end of 19 — the beginning of 20 centuries France won Ch., having turned it into the colony. Under pressure of the national liberation movement on August 11, 1960 France

provided to Ch. independence. In 1975 army officers carried out a coup d'état. For country government the Supreme Military Council and provisional government was created. In

August, 1978 the national unity government is created. In

January, 1979 situation in the country became aggravated again. As a result of a conference in Lagos (Nigeria) with participation of all contradictory military-political forces in August, 1979 the decision on creation of the transitional government of national unity is made. The country, however, remained in the power of the interethnic and social contradictions aggravated with intervention of external forces armed conflicts between various groups continued. Transition to peaceful life was outlined in 1980 in the country, but at the beginning of 1982 the situation became aggravated again.

Climate of the country to the North from 15 — 16 °C. highway tropical desert. In the south climate equatorial and monsoonal with a dry winter season (October — November till April — May).

H — the agrarian country. 85% of the amateur population are engaged in agriculture. Communal land use prevails. All types of works are carried out by manual tools. The main place in national economy is taken by cultivation of cotton for export. For internal consumption grow up millet, an ambercane, rice, wheat, corn, tobacco, a sugarcane. The industry is presented by generally small enterprises for processing of page - x. products.

The economic situation of the country remains heavy because of continuous armed conflicts.

Living standards of the population low. In the country unemployment is constantly spat. About 90% of the population are illiterate. Ethnic structure: to a tube, house, Masa, Sara, etc. The natural movement of the population according to official figures, published in editions of WHO, is characterized by the following indicators: birth rate — 44,0, the general mortality — 21,0, a natural increase-23,0 for 1000 us., child mortality — 200,0 on 1000 live-born (1979 — 1980).

The most complex problem of health care of the country is considerable spread of infectious and parasitic diseases. In 1978 94 545 cases of malaria are registered. Considerably number went. - kish. diseases: typhoid 34 cases, bacillar dysentery of 5485 cases, amebiasis of 33 300 cases, infectious hepatitis 3361 cases. 1872 cases of a pulmonary tuberculosis and 780 cases of a leprosy are registered. From parasitic diseases the trypanosomiasis (93 cases), a leushmaniosis (206 cases), considerable number of a schistosomiasis (14 661 cases), etc. is noted. In 1978 2782 cases of trachoma were revealed. At children whooping cough, scarlet fever, chicken pox, measles, diseases of insufficient and irrational food is registered. An important problem of health care are venereal diseases: in 1978 6399 cases of syphilis and 12 589 cases of gonorrhea are registered.

Management of health service in the country is performed by Min-in of health care, work and social affairs. The country is subdivided into 14 districts of health care. In 1978 — 1981 in the country the four-year plan was realized, in Krom much attention was paid to fight against infectious and parasitic diseases, creation of the central laboratory of public health care, the organization of national security service of health of mother and child, implementation of the program of expanded immunization of the population, etc. The important place in the country is allocated to development of rural medicine in connection with implementation of the program of WHO on primary medical - a dignity. the help based on training of rural workers of health care (for February, 1979 50 people are prepared). For carrying out researches in the field of primary medical - a dignity. the help and training of personnel the indicative zone of public health care is created.

In 1977 in the country 33 institutions for hospitalization of patients on 3553 beds functioned (8,5 on 10 000 us.), from them 4-tsy the general type on 1690 beds and 29 local and rural BCs on 1863 beds. Extra hospital help was given in 19 centers of health care, 121 out-patient clinics, 8 centers for fight against the main local diseases and in 2 policlinics. Primary medical - a dignity. the help in a number of areas appears rural medics. The name and content of work of healthcare institutions of Ch. not always corresponds to the concepts accepted in the USSR (see Treatment and prevention facilities abroad).

In the country in 1978 90 doctors, 9 druggists, 713 nurses, 39 midwifes, 220 assistants to nurses, 178 auxiliary workers worked at public service.

For training of personnel in the country the National school of public health care and social service where train nurses, nurses-midwifes, social workers and other personnel is created.

Bibliography: The sixth review of a condition of health care in the world, 1973 — 1977, the p. 2, page 87, Geneva, 1981; World health statistics annual 1984, Geneva, 1984; World health statistics annual 1980, Health personnel and hospital establishments, p. 21, Geneva, 1980; World health statistics annual 1980 — 1981, Infectious diseases, p. 3, Geneva, 1981. A. A. Rozov.