GERMAN DEMOCRATIC REPUBLIC (GDR) — the state in Central Europe. On 3. borders on the Federal Republic of Germany, on Yu.-V. with Czechoslovakia, on V. — on Poland. On S. it is washed by the Baltic Sea. The area of GDR — 108,2 thousand km 2 . The population apprx. 17 million people (1975). Average population density 155 people on 1 km 2 . The urban population makes 76%. The largest cities (1974): Leipzig (571 thousand), Dresden (508 thousand), Karl-Marx-Stadt (304 thousand), Magdeburg (276 thousand), Halle (241 thousand), Erfurt (203 thousand), Rostock (210 thousand).
Germans make St. 99% of the population. Ofits. German. The capital — Berlin (the population of 1098 thousand people, 1975) without the population Zap. Berlin having the status. In the administrative relation the territory of the country is divided into 15 districts.
Relief: big, sowing. the part of the territory of the country is occupied with the Central European plain, yuzh. areas — medium-altitude mountains. Temperate climate: on Page and S.-Z. sea, in other areas transitional from sea to continental.
GDR — the socialist republic. The people's democratic system is proclaimed on October 7, 1949. Creation of GDR was a decisive milestone in the course of peaceful and gradual development of antifashistsko-democratic revolution in socialist, a natural result of fight is mute. working class under the direction of SEPG in the union with all workers for formation of the peaceful democratic state in East Germany.
Overcoming resistance of an upper bourgeoisie, the population of GDR under the direction of SEPG and with the constant economic help from the USSR organized recovery of the destroyed national economy. In 1949 — 1952 were complete antifashistsko-demokrati-cheskiye transformations in the country and transition to construction of socialism is carried out. The VI congress of SEPG (1963) adopted the program of the developed construction of socialism. In 1968 the new constitution which proclaimed GDR the socialist state was adopted. All political power in GDR is carried out by workers. The supreme legislative body of the government — National Chamber, all political parties and the largest public organizations of GDR are presented to a cut. The national Chamber elects the State Council which considers laws, adopts the decrees which are subject to the approval by National Chamber, the Supreme executive body of the government — the government (Council of ministers) elected by National Chamber exercises supervision of legality of activity of the supreme bodies of justice etc. Local public authorities in districts, areas, the cities and the Village Councils — national representations which obraeut executive bodies — councils and the commissions.
In spite of the fact that GDR was torn off from historically developed bases of supply with raw materials (they were in Zap. Germaniums), for short historical term it surpassed the level of industrial development of the respective territory of pre-war Germany and on the volume of industrial output entered 10 leading countries of the world. Stable and continuous economic growth is inseparably linked with support and the cooperation (fixed by long-term agreements) to GDR with the USSR and other socialist countries. GDR — the member of SEV, in structure to-rogo it is the large exporter of high-quality products of mechanical engineering, electrical equipment, electronics, consumer goods.
The VIII congress of SE PG which took place in 1971 summed up the results of socialist construction in GDR, noted that GDR entered a stage of creation of the developed socialist society and defined the main objective of five summer plans for 1971 — 1975 — further rise in the material and cultural standard of living of workers on the basis of high rates of development of production.
The IX congress of SEPG which took place on May 18 — 22, 1976 confirmed once again unity of economic and social policy as a basis of social development, the providing forced development of health care and social security.
Social economic transformations for years of socialist construction, achievement in the field of health care promoted decrease in indicators of the general and especially child mortality. So, by 1975 in comparison with 1946 the general mortality decreased almost twice, and the nursery — more than by 8 times (tab. 1). In GDR one of the lowest in Europe the level of maternal mortality — 2,33 on 10 Ltd companies of sorts (1974).
Age structure of the population is characterized by a high share of elderly people (16,4% — and are more senior 65 years, 1974) that to some extent exerts impact on an indicator of the general mortality.
In 1973 average life expectancy made 68,75 years for men and 74,24 years for women.
After the end of World War II epid, a situation in the country was heavy; considerable distribution was gained went. - kish. infections (typhoid, dysentery, etc.). Thanks to the measures taken by the Soviet military authorities and bodies of the democratic power medical - a dignity. effects of war were quickly liquidated. Incidence of a typhoid in 1947 — 1948 in comparison with 1946 was reduced by 5 times, in 1974 incidence of a typhoid and a paratyphoid made only 1,0 on 100 thousand population. Incidence of diphtheria decreased with 526,14 in 1946 to 0,01 in 1973 by 100 thousand population, and in 1974 there was no case. Since 1963 diseases of poliomyelitis were not registered. Incidence of tuberculosis (new cases) was reduced with 504,0 in 1950 to 39,3 in 1974 by 100 thousand population. Especially falloff of incidence of tuberculosis is noted among the children's population (1,7 on 100 thousand children aged to 14 years in 1974 against 308,8 in 1954). Incidence of syphilis was reduced with 220,0 in 1947 to 2,9 by 100 thousand population in 1974. All these facts are caused by social and economic transformations for years of socialist construction, a number of nation-wide actions for fight against infectious diseases, and also considerable achievements of health care and medical science in GDR.
In structure of incidence diseases of upper respiratory tracts, digestive organs, cardiovascular diseases, malignant new growths, accidents and injuries prevail. Among cardiovascular diseases growth of a myocardial infarction at men and an idiopathic hypertensia at women is noted. Considerable distribution was gained hron, by nonspecific diseases of lungs, a diabetes mellitus. Among causes of death (according to 1973) on 100 thousand population cardiovascular diseases (663,0), on the second — malignant new growths (223,0), on the third — accidents and injuries are in the first place (54,0).
The organization of health care in GDR is founded on the principles of socialist health care: unity and planned nature of medical aid, its free of charge and general availability, high qualification, preventive orientation, communication of medical science and practice of health care, participation of the population in health protection. Implementation of the socialist principles of health care, full assistance of the USSR allowed to create and strengthen the state health system in GDR. Specific weight of still existing private sector and religious and communal hospitals decreases every year and in 1974 made 16% against 28% in 1960.
In 1949 the Ministry of Health of GDR was created, five managements are a part to-rogo: treatment-and-prophylactic, protection of motherhood and childhood, science and medical education, pharmaceutical and management of sanitary inspection. On places district, regional, city and rural public health departments which bear responsibility for the organization and the management function to lay down. - professional, and a dignity. - protivoepid, activity of all services and institutions functioning in this territory. Heads of departments are chief physicians of districts and areas.
According to article 16 of the Constitution of GDR each worker has right to maintenance in case of a disease and an old age. Implementation of this right is assigned to bodies of health care and social security.
Hospital help to not cynthion in 1975 would be given in 577, the having 182 200 beds. The events held on enlargement to lay down. - professional, institutions, led to reduction of quantity of hospitals in comparison with 1960, however their power on average considerably increased. In 1975 security of the population with beds made 10,8 beds for 1000 zhit. Specialized medical aid is the central medical institutions (district-tsy, a wedge,-tsy medical f-tov high fur boots, medical academies and research medical institutes) specialized-tsami — psychiatric, infectious, etc., and also various on a profile-tsami (see tab. 2).
In 1974 in GDR 31 centers of an artificial kidney functioned. In the large cities there were 5 centers for a heart surgery, 5 centers for surgery of vessels, the centers of an intensive care are created.
Extra hospital help to the population is given by both polyclinic departments of hospitals, and independent (not integrated with hospitals) policlinics, out-patient clinics, first-aid posts (city and rural), and also clinics. In out-patient and polyclinic institutions of the patient has the right of the free choice of the doctor (the therapist, the pediatrician, the gynecologist, the stomatologist). For medical service and health protection of workers at the industrial enterprises MSCh in which work is constructed by the principle of a shop uchastkovost are created.
The networks of out-patient and polyclinic institutions of various type given about increase are presented in tab. 3.
Much attention is paid to development of a dispensary method in work to lay down. - professional, institutions. Medical examination captured certain contingents of the healthy population and patients with nek-ry diseases. Medical examination of the population is carried out as in out-patient clinics, policlinics and MSCh, and in specialized clinics (in 1974 in the country there were 500 clinics). Patients with a diabetes mellitus, rheumatism, diseases of blood, cardiovascular diseases, new growths, dermatovenereal diseases, tuberculosis and some other diseases are subject to special dispensary observation. Medical examinations are subject also pregnant women, athletes and other groups of the population. Clinics perform mass routine maintenances of the population for the purpose of early tuberculosis detection, malignant new growths, diseases of bodies of blood circulation and other diseases.
In GDR in 1954 on the basis of service of acute management the service of emergency medical service is created. As a part of it in the 70th in the large cities specialized crews of emergency medical service (cardiological, etc.) which are provided with specially equipped motor transport are organized.
Protection of motherhood and the childhood
According to article 35 of the Constitution of GDR the state undertakes care of health protection of mother and the child. In GDR the wide network is created to lay down. - professional, institutions on protection of motherhood and the childhood. In 1975 937 clinics for women and more than 10 200 children's policlinics and consultations functioned. Maternity homes had 7143 beds for pregnant women. Ginekol. patients are hospitalized in specialized departments and-tsy (10 544 beds, 1975). Considerably the quantity of beds in child care facilities increased (15 640 beds in 1975 against 10 632 beds in 1960). For health protection of pregnant women special rest houses which number in 1974 made 11 on 480 places against 5 on 309 places in 1951 are created 99% of pregnant women give birth in the conditions of a hospital. To large families welfare payment is established. At the birth of each child mother receives a one-time allowance, and with the birth of the third child and more — a monthly allowance before achievement of full 14 years by children. Besides, large families have privileges at payment of apartments, at construction of the new house, the right for additional living space and a number of other material privileges. The paid issue on 18 weeks is guaranteed to women on pregnancy and childbirth (6 weeks before childbirth and 12 weeks after the delivery). At work the special break is provided to the nursing mother for feeding of the child. For the working mothers having 3 and more children (up to 16 years), 40-cha-sovaya worker are entered week and the minimum issue increases. On each 100 children to 3-year age there are 40,3 (1974) places in a children's day nursery. If the place in kindergarten is not provided to the child, then to a family the monthly monetary help depending on the number of children is given. For all children and teenagers up to 18 years dispensary observation is carried out more constantly. In the country is available apprx. 200 consultations concerning a family and marriage.
Sanitarno - epidemiological service
Since 1952 the environment, medical behind hygiene, is controlled by bodies state a dignity. inspections, edges also holds preventive events for public health care from infectious diseases.
In nation-wide scale coordination of all actions, control of observance dignity. norms and rules exercises Control of sanitary inspection of the Ministry of Health of GDR, in districts and areas — district and regional a dignity. inspections which are headed by the district epidemiologist.
GDR is available 22 district in-that hygiene (sanepidstantion) which are the research and practical centers for problems of hygiene and epidemiology. Important part of work dignity. inspections scheduling of inoculations and control of its performance is. So, at the end of 1957 vaccination of BTsZh was carried out by 100%. Vaccination of the children's population against diphtheria, whooping cough, tetanus, measles, smallpox, poliomyelitis is entered. Exercises control of quality of production of vaccines State scientific issle-dovatelsky in-t of serums and vaccines.
Much attention is paid a dignity. to education of the population. Central in-t dignity. educations in Dresden the dignity is the scientific and methodical center of all. - a gleam, the work which is carried out in the country. In the cities and rural areas interdepartmental bodies a dignity are created. educations. In a dignity. - a gleam, work labor unions and activists Ob-va of the Red Cross take great interest.
The sanatorium help
All sanatoria and the resorts of GDR are under authority of the Ministry of Health. The sanatorium help is received by all citizens in the presence of the conclusion of the doctor free of charge through labor unions or through regional and county councils. In the last the special commissions solving aopros about providing the place in sanatorium to those persons who do not participate on an old age and other reasons in labor process work and are not members of families of workers. Among balneol. resorts the largest are Vizenbad with hot springs, Brambakh (see) with radioactive mineral waters, Bud-Eljster (see) with ferruterous, carbonic, the guide-rokarbonatnymi and sulphatic waters; there are also resorts of Bints, Bad-Shandau, Bad-Kyozen, Obervi-zental, etc.
In GDR there are 190 sanatoria on 27 thousand places (1974). In 1974 received sanatorium treatment 194,8 people on 10 000 population (in 1972 — 187,5).
The medicinal help and the medical industry
Production of medicines was organized preferential after 1945. For years of socialist construction it is created developed medical and pharm. the industry, products a cut is world-renowned. The need for medicines for the country becomes covered for 90% at the expense of self-produced and for 10% due to import.
In 1975 in GDR there were 1379 independent drugstores. Besides, at large policlinics also there would be independent drugstores or pharmaceutical departments (58), 567 points of delivery of drugs work.
Health care workforce
In 1975 in the republic there were 31 300 doctors (1 doctor on 538 zhit.), 7720 stomatologists and dentists (1 doctor for 2183 zhit.), 3054 druggists (1 druggist on 5517 zhit.) and apprx. 200 thousand people of an average and support medical staff.
Training of doctors is conducted on 6 medical f-takh high fur boots in Berlin, Leipzig, Halle, Yen, Rostock and Greyfsvalda and 3 medical academies (in system of the Ministry of Health) — in Dresden, Erfurt, Magdeburg. Since 1969 training of doctors is carried out according to the 5-year program. Since 1976 after the 5th course students pass 12-mesyach-nuyu internship. In 1974/75 academic year the 9597th studied studentov-Me-dikov, finished education of 2481 people, including dentists.
For receiving a rank of the specialist doctor graduates of the highest medical educational institutions improve skills according to the four-year program for one of 35 medical disciplines. Theoretical and practical training of specialists is carried out by Academy of improvement of doctors. In districts and areas the appropriate territorial authorities of health care carry out on base to lay down. institutions of an action for improvement of medics. In the country 15 district centers of improvement (branches of Academy of improvement of doctors) and in each area the relevant centers for professional development function.
The paramedical staff prepares at medical schools with 3 years' training in 13 specialties. In 1974 in 58 average special medical schools 12 035 pupils were accepted. Methodical management of schools is performed by Ying t improvements of paramedical staff.
Training of druggists is carried out in high fur boots on natural f-takh. In 1974 493 students-headlights-matsevta studied. A pharmaceutical education was got 102 people
the German science has rich history. The significant contribution to development of natural sciences and medicine were brought by such scientists as Para-tsels, A. Galler, K. Wolf, I. Müller, T. Shvann, G. Helmholtz, R. Virkhov, R. #оя, Zibold (E. K. of J. Siebold, 1801 — 1861), A. Bir, T. Billroth, etc.
The main efforts of scientists of GDR are directed to development of problems of prevention, diagnosis and treatment of cardiovascular diseases, malignant new growths, operational injuries, tuberculosis, rheumatism, diseases of lungs of not tubercular etiology etc. The significant contribution to the organization of health care and medical science of GDR were brought by the therapist T. Brugsh, the surgeon F. Zauerbrukh, the surgeon and the organizer of health care Tsetkin (M. of Zetkin, 1883 — 1965), the dermatovenerologist Linzer (To. Linser, sort. in 1895), the obstetrician-gynecologist of X. Kraatts, pharmacologist Jung (F. Jung, sort. in 1915) etc.
Planning of scientific research carries out Council for planning and coordination and the problem commissions at the Ministry of Health of GDR together with Academy of Sciences of GDR. A lot of work on scientific research is carried out research in-you by the Ministries of Health and Academies of Sciences of GDR (central in-you Academies of Sciences of GDR: molecular biology, oncology, on studying of cardiovascular regulyation, food, microbiology and experimental therapy; institutes of the Ministry of Health of GDR: working medicine, pulmonary diseases and tuberculosis, diabetes, applied virology, control in-t of vaccines and serums, medical diagnosis, hygiene and microbiology, hygiene of children and teenagers, scientific medical information, museum of hygiene). Besides, in development of scientific problems active part is taken by departments, in-you and clinics medical f-tov high fur boots, medical academies.
GDR since 1958 on the basis of the intergovernmental agreement carries out cooperation with the Soviet Union in medical science and health care. Joint scientific research is concentrated on 5 problems: cardiovascular eabolevaniye, malignant new growths, immunology and prevention of infectious diseases, occupational health, development and use of laboratory diagnostic and analytical systems in medicine and the COMPUTER in health care. Besides, scientists of GDR carry out scientific cooperation with medical institutions of other socialist countries.
In 1976 in GDR 51 medical magazines and 28 medical collections were issued.
The budget of health care reflects care of the government about health of the population; expenses on health care increase from year to year. In 1974 they made 7434 million marks, i.e. 5% of the general budget of the country.
Bibliography: Statistical year-book of member countries of Council of Economic Mutual assistance 1975, M., 1975; Gesundheits-schutz in der Deutschen Demokratischen Republik, Dresden, 1972; Das Gesundheits-wesen der Deutschen Demokratischen Republik, B., 1971 — 1974; Statistischen Jahr-buch der Deutschen Demokratischen Republik, B., 1955 — 1975; Winter K. Das Gesundheitswesen in der Deutschen Demokratischen Republik, B., 1974.
K. Vinter, I. Missbakh, V. V. Shuvayev.