SOCIALIST REPUBLIC OF VIETNAM (SRV) — the state in Southeast Asia, on the Indochina peninsula. Vietnam a narrow strip up to 616 km wide in the north, 375 km in the South and 46,5 km in the central (narrowest) part was stretched in the meridional direction, along east coast of the peninsula on 1750 km. Borders on China, in the West in the north — on Laos and Kampuchea, it is washed by the South China Sea, from the East — the gulf Bakbo, from the southwest — the Gulf of Thailand. The territory — 332,6 thousand km 2 . The population — St. 54 million (according to 1981). The capital — Hanoi (2,7 million inhabitants). SRV is divided into 40 provinces and the cities, 471 counties and 8465 communities. From 2000 to 10 000 inhabitants live in each community. Ofits. language — Vietnamese.
Vietnam has centuries-old history (St. 4000 years). Since the end of 19 century and till 1945 Vietnam was the French colony as a part of the French Indochina. The August revolution of 1945 in Vietnam led to creation of the first in Yugo-Vos-tochnoy Asia state of national democracy — in September, 1945 the Democratic Republic Vietnam (DRV) was proclaimed.
More than 8 years the Vietnamese people were forced to protect the freedom from encroachments of the French colonialists trying to restore colonial orders in Vietnam. As a result of dedicated fight, support and the help from the socialist countries, solidarity of all progressive forces of the world the Vietnamese people in war of Resistance (1946 — 1954) won a victory.
According to the Geneva accords of 1954 the territory of Vietnam was temporarily divided by the line of demarcation drawn approximately on the 17th parallel (down the river Ben-hoy) then in defiance of the Geneva accords in October, 1955 in the territory of the Southern Vietnam with assistance of the American imperialists the puppet state relying on economic and military aid of the USA — the so-called Republic Vietnam was created. Openly interposing in the matter of Vietnam, the USA tried to immortalize split of the country. From 1965 to 1973 they were directly involved in operations against forces of national release in the Southern Vietnam.
Meanwhile DRV together with patriotic forces of the South of Vietnam combated for implementation of the Geneva accords, for carrying out free elections in all country for the purpose of its reunion. 1954 — the 1975th years became years of the Vietnamese revolution proceeding under the uniform management of one party in all country which is temporarily divided into two parts. The party of workers of Vietnam (since 1976 — the Communist Party of Vietnam) carried out at the same time two strategic tasks — construction of socialism in the north and implementation of the national people's democratic revolution in the south. the 1960th year was marked by creation (on December 20) of the National Front of Liberation of the Southern Vietnam (NFLSV), in structure to-rogo the patriotic forces of the country directed by Communist Party conducted dedicated armed struggle against the Saigon authorities. In June, 1969 at the initiative of NFOYuV the Provisional revolutionary government of the Republic the Southern Vietnam (VRP RYuV) was created.
On January 27, 1973 in Paris the Agreement on the termination of war and restoration of peace in Vietnam was signed, from the Vietnamese earth the American and other foreign troops were disengaged. In the spring of 1975 as a result of offensive actions of patriotic forces and a popular uprising in the South Vietnamese cities the reactionary system in Saigon was overthrown. On April 30, 1975 all territory of the Southern Vietnam passed under control of patriotic forces. On April 25, 1976 a general election in National assembly of uniform Vietnam and at its first session took place (on June 24 — on July 3, 1976) governing bodies of the country were elected, the decision on the new name of the state — the Socialist Republic of Vietnam (SRV) is made, and the capital of SRV proclaimed Hanoi. Saigon was renamed into Ho Chi Minh.
According to the constitution adopted on December 18, 1980 the unicameral National assembly elected by the population for 5 years became the supreme body of the government and legislature. During the period between its sessions functions of the collective head of state (the collective president) are performed by the State Council headed by the Chairman. The supreme executive and administrative organ of SRV — Council of ministers.
The most part of the territory of the North, northwest and internal districts of the country is occupied by the mountains which are deeply dismembered by valleys. In a northern half of Vietnam the located ridges prevail in parallel; in the southern half of the country of the mountain form the longitudinal sublime strip developing of wide arrays, plateaus and the plateau with a smoothed surface. At sea coast low plains, the most considerable of are located to-rykh are in the north.
The climate is monsoonal, subequatorial with frying in the south both cool in the north in the winter and sharply expressed maximum of rainfall in the period of a wet monsoon. Rainfall in a year 1330 — 2000 mm drop out. places (hl. obr.' in mountains) more than 3000 mm. In the second half of summer and in the fall in the north of Vietnam quite often there are typhoons. Average air temperature of the coldest month is from 15 ° (January) to 25,8 ° in the south (December), the warmest in the north — 28 — 29e (in the north — in June, July, in the south — in April).
Workers of SRV, despite considerable difficulties, achieved significant progress in socialist construction. For 1975 — 1978 the release of the electric power increased by 1,6 times, became — in 2,7, cement — by 1,5 time, to products of mechanical engineering — for 60%. Acreage for this period increased on 1,5 million hectares. In 1975 — 80 production of agriculture increased by 18,7%, including grain more than for 10%. The Communist Party and the government of Vietnam carry out work but to strengthening of the state and cooperative sectors of economy. In 1980 in public sector it was made apprx. 58% of a gross public product and nearly 50% of the national income. The great value is attached to rational use of internal material and human resources at steady improvement of management and planning of economy. Care and of growth of professional level of workers and employees is big. SRV maintains trade and economic relations more than with 60 countries, exporting products of the mining, coal, wood-processing and food industry, agriculture, and also handicraft thin zhestvennye products; import of SRV is made by cars, industrial equipment, vehicles, oil products, fertilizers, food, cotton. The main trade partner — the USSR (St. 50%, export and 46% of import).
Vietnamese make 88% of all population of the country including more than 60 nationalities. On plains of the South there live Khmers, in sublime and mountainous areas of the North — mountain conceal, Mao, Mang and mountain Mona, in the southwest — mountain Khmers, in the southeast — chama. Among the most part of the believing population the Buddhism which is closely bound with Taoism, Confucianism, a cult of ancestors is widespread. Average population density makes 163 people on 1 sq.km; 48% of the population of the country make men and 52% — women. Apprx. 80% of the population lives in rural areas. The main vital rates are given in tab. 1.
Dynamics of maternal and child mortality in the country is given in tab. 2.
The average duration of the forthcoming life increased from 50 years in 1970 up to 60 years in 1978.
Backward economy, effects centenary colonial and not near-nialnogo domination and boundless operation, 30 years of difficult and intense struggle against aggressors have an adverse effect on the state of health of the Vietnamese people. In structure of incidence and mortality of the population of Vietnam the leading place is taken by infectious and parasitic diseases. So, in 1981 indicators of incidence went. - kish. infections (on 100 000 people of the population) were the following: cholera 7,5, typhus and paratyphus 9,1, bacterial dysentery 89,3, amoebic dysentery 118,3, viral hepatitis 49,1, diarrheal diseases 949,7. Though incidence and malaria mortality in the country decreased a little, but remain, especially in the south, on rather high level. In 1981 the indicator of incidence made 348,1, and among the reasons of mortality malaria took the second place in the country. Incidence of tuberculosis gradually decreases that is promoted by performing vaccination of BTsZh (in a crust, time they are obligatory for all newborns in maternity hospitals). In 1977 the indicator of incidence of tuberculosis made 339,0, in 1978 — 132,8 in 1979 — 136,2, in 1980 — 81,24, in 1981 — 68,1. The quantity of children's infections in the country decreases from year to year that it is possible to connect with implementation of the expanded programme of immunization.
Along with infectious pathology and hron. diseases of a stomach, duodenum, respiratory tracts even more often in Vietnam cardiovascular pathology (arteriosclerosis, coronary insufficiency, a myocardial infarction, rheumatism, a hypertension at elderly people), oncological, mental, inborn and hereditary diseases come to light. Rate of mortality of the population from cardiovascular diseases is one of the highest causes of death in structure.
During the war in Vietnam of army of the USA applied the herbicides and defoliants made on special compoundings. Airplanes of the USA disseminated above the ground Vietnam not less than 57 thousand tons of the «orange mix» containing impurity of the highly toxic and extremely stable substance which is usually called by dioxine. It is one of the strongest and artful poisons known in a crust, time, It differs in high and acute toxicity at one-time introduction to an organism and at the same time is capable to collect in an organism, showing at the same time even more high toxicity. At nonlethal, even insignificant doses dioxine causes diseases, including cancer, breaks the genetic device of people. The frequent cases of infertility and abnormal pregnancies observed in Vietnam, the birth of dead children, progressing of tumoral diseases and leukoses — result of direct and indirect impact of dioxine on the genetic device of people. Ability of this poison to cause inborn defects in posterity is especially dangerous. The Vietnamese doctors investigated cases of pathology of pregnancy in the province Benche (in the delta of the Mekong River) where herbicides repeatedly dissipated. Frequency of spontaneous abortions increased twice here, and inborn defects of a fruit increased from 0,14 to 1,78%, i.e. more than by 10 times. According to gynecologic-tsy Ho Chi Minh, the frequency of an extrauterine pregnancy sharply increased and reached 4,6% against 0,6% in Northern Vietnam.
The Ministry of Health of the Socialist Republic of Vietnam bears responsibility to the government for rendering medical - a dignity. the help to the population of the country, for effective use of the material funds allocated for needs of health care. The Minister of Health is a member of government council.
The structure of the state network of medical institutions and health services has 4 levels. The first of them providing primary medical - a dignity. the help, it is presented in each community, at the industrial enterprise, in state farm, logging enterprise by a first-aid post with beds (in a communal first-aid post — 5 — 10 beds, in first-aid posts of institutions, enterprises 1 bed on 200 working). The problem of first-aid posts includes rendering primary medical aid, carrying out sanitary and anti-epidemic, sanitary and educational work, overseeing by pregnant women and obstetric aid, sale of medicines. Each first-aid post is staffed by 1 paramedic (sometimes the doctor), 2 — 3 nurses, 1 midwife, 1 worker of traditional medicine. On average 1 medic is the share of 1000 inhabitants, and in institutions, the enterprises — on 100 working. The population of a community finances construction of a communal first-aid post, pays the salary to medics while the state provides equipment of first-aid posts with tools and training of medical staff for them. First-aid posts of the enterprises and institutions are completely on the state providing. The second level — district. The medical commission heading medical service of this level is under supervision of district national committee. In each county there would be one multi-profile with number of beds from 50 (in mountain) to 150 — 200 (in the flat county), one sanitarnoprotivoepidemichesky and one antimalarial department, one drugstore, one local policlinic. On average the population of the county totals 25 000 — 30 000 people or 4 — 5 communities. The third — city (provincial) level. The city or provincial public health department directs work of medical institutions here. In its direct subordination are available: a multi-field hospital on 500 — 1000 beds, children's hospital, a maternity home, tubercular hospital and hospital of traditional medicine, the station of ambulance, sanatorium, average medical school and the specialized stations, such as a sanepidstantion, on planning of a family, dermatovenerologichesky, antitubercular, antimalarial, ophthalmologic, psychiatric (dispensary character), antigoitrogenic (in mountain districts). The fourth — the central level presented by the Ministry of Health (in its structure — office, treatment-and-prophylactic, sanitary and anti-epidemic, planned, financial managements, protection department of health of the managerial personnel of the state, management of pharmaceutical business, appliances, science and technology, shots, traditional medicine, political management), the joint pharmaceutical plants, research institutes, multi-field and specialized hospitals, hospitals for personnel workers, sanatoria, medical and pharmaceutical in-ta, Meditsina publishing house (in Hanoi with branch in Ho Chi Minh), in-volume of medical information, medical library, the House of sanitary promotion and health protection. At the Ministry of Health there are leading experts on each medical specialty, to-rye participate in the organization of specialized medical aid and control of work of specialized medical institutions.
The bed fund of the country consists of the state and «national» beds (in communal first-aid posts). For the end of 1982 the number of the state beds made 127 886, and «national» — 19 969; security of the population with beds equaled 37,8 on 10 000 persons. 7 research in-t and 676 various hospitals had beds (including 77 specialized). The task of BC includes stationary and extra hospital treatment of patients, preparation and improvement of medics, carrying out research and the organi-zatsionno-methodical management of medical institutions of subordinate level.
Much attention is paid to protection of motherhood and the childhood. In each multi-profile there would be obstetric and pediatric departments. Obstetric beds make 15%, and nurseries — 25% of all bed fund of BC. In the country of 78 maternity homes. Pregnant women are exposed to surveys before childbirth three times, almost all childbirth happens in medical institutions. Women are granted the paid prenatal and postnatal leave lasting 75 days. - (15 days) workers of heavy and harmful professions, and also living in mountain and boundary districts on far islands have the right for additional issue. In case of the birth of twin 30 days are provided in addition, and at the birth of triplets — 60 days and a grant for purchase of necessary things.
Sanitarno - anti-epidemic service in the country heads sanitary and anti-epidemic management of the Ministry of Health. A number of research in-t is under its supervision: Institute of hygiene and epidemiology (Hanoi), Ying t of hygiene (Ho Chi Minh), Ying t of food, Ying t of a malariology, parasitology and entomology, Ying t of occupational health, Pasterovskiye in-you Ho Chi Minh and Nyatyanga, Ying t of vaccines, etc. At the city or provincial level sanepidstantion, and on district — sanepid-groups function. At the ministries and head departments of industrial and production character there are stations of occupational health, in a crust, time functions 6 such stations.
In the country there are 98 sanatoria located preferential in the resort area on large enterprises dispensaries function. In a crust, time in SRV two large balneological sanatoria are created (Mi Liam in the province Ha Tuyen and Kuangg Han in Kuangg Nin's province).
In 1980 in the country there were 12 936 doctors, 29 061 paramedics, 9363 nurses, 2833 midwifes, 4687 druggists with secondary education and 2667 other medics with secondary education. Security of the population with doctors (on 10 000 people) increased with 1,9 (1976) to 2,48 in 1981
Medical educational institutions of Vietnam let out annually 1400 doctors, 400 druggists with the higher education, 4000 average medics of all categories. In the country 4 medical, 1 pharmaceutical, 1 medico-pharmaceutical in-t and medical f-you work at two universities, 46 averages of medical schools and 1 average pharmaceutical school. Duration of training of doctors of 6 years, druggists 5,5 years, average medics 3 years. Proceeding from the need for scientific shots and shots for specialized BCs, students of medical higher education institutions undergo after the 4th course primary specialization within 2 years, and future druggists — within 1,5 years. Annually the Ministry of Health sends for the purpose of improvement apprx. 100 medics to the brotherly socialist countries.
On the basis of research in-t and the central BCs are organized short-term (1 — 3 month) advanced training courses of the doctors working in provinces; provincial would will organize improvement of the medics working in counties, and district-tsy — the medics working at communal level.
The leadership in research in the field of medicine is assigned to management on science and technology and the Academic council at the Ministry of Health. In the country there are 24 research establishments, among to-rykh the 20th the scientific researcher - skikh in-t and 4 branches.
Scientific research is concentrated on questions of a condition of public health care, functional indicators of physiological norm and basic researches of the state of health of the population of Vietnam. Production of new vaccines and drugs from medicinal plants is improved. Effects of the defeats received by defenders of Vietnam during war are studied. Ways of eradication of infectious, parasitic and social diseases are investigated. New methods of inspection of patients, diagnoses and therapies, including surgical cancer therapy of a liver are developed (in combination with an immunotherapy). In the country General society of medicine of SRV, society of traditional medicine works.
Snowballing of the national economy of SRV and the related problems of development of health care determine great value for Vietnam of experience of other countries, first of all by the USSR. The plan of training of medics and step-by-step expansion of works in the field of health care according to the periods of development of the national economy is made, the special attention is paid to questions of labor protection, food, geriatrics and gerontology, hygiene of the environment, the material and technical resources necessary for this purpose are created.
In the resolution of the IV congress of the Communist Party of Vietnam (December, 1976) importance of public health care is emphasized, new tasks and ways of their purposeful decision are specified. This document has the extreme mobilizing importance for workers of health care of the Socialist Republic of Vietnam.
Table 1. BIRTH RATE, MORTALITY AND the NATURAL INCREASE of the POPULATION of SRV FOR 1976 — 1981 (on 1000 inhabitants)
Table 2. MATERNAL AND CHILD MORTALITY In SRV FOR 1976 — 1981.
Bibliography: Socialism and health care, problems of health and physical development of the person, under the editorship of S. Ya. Chikin, page 129, M., 1981; The Sixth review of a condition of health care in the world, 1973 — 1977, the p. 2, page 484, M., 1981; World health statistics annual, Health personnel and hospital establishments 1980, p. 88, Geneva, 1980; World health statistics annual, Infectious diseases, cases, 1980 — 1981, p. 125, Geneva, 1981.
Dang Hui Cuang.