From Big Medical Encyclopedia

TAJIK SOVIET SOCIALIST REPUBLIC, Tajikistan (T.) — the federal republic located in the southern part of the USSR in the southeast of Central Asia. Borders on China, Afghanistan; internal borders — from the Uzbek and Kyrgyz SSR. The area is 143,1 thousand km 2 , population of 4119 thousand people (1981). The capital of Dushanbe (530 thousand zhit., 1983). 4 areas (Leninabad, Kulob, Kurgan-Tyubinsky and the Gorno-Badakhshan Autonomous Region) and 8 districts of republican subordination are a part of the Tajik SSR.

The Tajik SSR is formed as the autonomous republic as a part of the Uzbek SSR on October 14, 1924; On October 16, 1929 it is transformed to the Tajik SSR and on December 5, 1929 directly was a part of the USSR as the equal federal republic.

Relief of the Tajik SSR mountain: 93% of the space are occupied by the mountains relating to systems of Tien Shan, Gissaro-Alay and Pamir, at the same time nearly 1/2 territories are at the height more than 3000 m above sea-level. Flat spaces — generally river valleys of the Turansky lowland and intermountain hollows.

The climate is continental, characterized by sharp seasonal and daily temperature variations and rainfall.

Subsoil of T. are rich with various minerals: fields of lead, zinc, gold, noble spinel, lazurite, etc. are long since known. More than on 70 fields industrial development of St. 25 types of mineral raw materials is conducted. On their base the ore mining, oil, gas and chemical industry successfully develops. On water resources of T. takes the second place in the USSR (after RSFSR).

Having taken a way of socialist development, the Tajik SSR for short historical term became the republic with the developed industry and the mechanized agriculture, advanced culture and science. Industry of T. it is presented by more than 90 industries and types of production. In its structure the easy and food industries prevail. The leading industry of agriculture of the republic is cotton growing. Production of grain, forage, oil-bearing, subtropical crops, geraniums, tobacco, vegetables, melon cultures, grapes, and also forestry, silkworm breeding is developed. The important place in agriculture belongs to livestock production.

Socialist transformations in a rural hoz-v — creation of the large high-mechanized collective farms and state farms conducting economy on a modern technological basis promoted significant growth in the monetary income of collective farms, to-rye in 1980 were in 17 times more in comparison with 1940. The national income in 1980 grew in comparison with 1960 by 3,5 times. Capital investments reached 970 million rubles. The cost of industrial output made 3 billion 506 million rubles (in the prices of 1975).

Before establishment of the Soviet power in T. there was an insignificant number competent; now it is the republic of continuous literacy. For years of the Soviet power in the republic 10 higher education institutions, 38 averages of special educational institutions, a number of research establishments are created.

Geographical, natural and historical conditions determined big irregularity in accommodation of the population by the territory of the republic. Valleys and intermountain hollows are densely inhabited; e.g., in the Gissar valley population density reaches 100 and more people on 1 sq.km. In mountain districts population density makes 4 — 10 people on 1 sq.km. East Pamir where 0,4 persons are the share of 1 sq.km is least inhabited.

T. — multinational republic. Its indigenous people — Tajiks — one of the most ancient people of Central Asia (58,8%, on a census of 1979), live also Uzbeks (22,9%), Russians (10,4%), Tatars (2,1%), Kyrgyz (1,3%), Turkmens (0,4%), Ukrainians (0,9%), Jews (0,4%).

The basic changes which happened for years of the Soviet power in economy and culture of the Tajik SSR exerted decisive impact on rates of reproduction of the population, its structure and placement. Population in 1981 in comparison with 1913 increased almost by 4 times; 35% make urban population and 65% — rural. Growth of the population happens generally at the expense of a natural increase. On a natural increase (30,4 for 1000 zhit., 1980) T. wins first place in the USSR that is result not only high birth rate, but also improvement of welfare of the people, a health system, decline in mortality and increase in life expectancy. High rates of development of productive forces of the republic promote big inflow of the population from other republics of the USSR.

The medicine at the Tajik people arose in an extreme antiquity. It passed a difficult way of development. In pre-revolutionary time of T. represented edge of poverty, ignorance and diseases. The health of workers was affected by severe conditions of work and half-starved existence. The health care as system did not exist. The imperial government in the Central Asian possession spent for the organization of medical aid for only 14 kopeks on 1 zhit. in a year. The Bukhara emirate on these purposes in general did not make any expenses. The available single medical institutions generally intended for service of the local feudal nobility, military personnel and imperial officials. Traditional medicine was in hands of ignorant tabib, sorcerers, charlatans, bakhsh, gadalshchik and representatives of clergy. Insanitary zhilishchnobytovy conditions, lack of a water supply system, the sewerage promoted free spread of such infectious and parasitic diseases as malaria, smallpox, cholera, plague, typhus, syphilis, trachoma, diphtheria, leysh-manioza, a dracunculosis, tuberculosis, a leprosy, and also other diseases with a high level of mortality.

The available statistical data on incidence on the Hodzhentsky County (1916) show that 70% of stationary and 80% of abmula-even patients made faces of € inf. diseases.

Thanks to systematic economic recovery, improvement of social living conditions of the people, expansion to lay down. - prof. of actions in the republic are liquidated smallpox, plague, cholera, malaria, typhinias, fever of fathers-patachi, trachoma long ago; in tens of times incidence of a typhoid, dysentery, brucellosis and a malignant anthrax decreased. Prior to isolated cases incidence of a sapropyra, diphtheria, poliomyelitis, tetanus is reduced. The health system began to form in T. after the October revolution actually from scratch: in 1913 in the republic would be only 1 on 40 beds. By 1929 was already 22 to lay down. - the prof. of establishment on 990 beds. The health care gained snowballing after formation of the Tajik SSR; there were first hospitals and out-patient clinics in the cities and areas, institutions on protection of motherhood and the childhood, and also sanitary and anti-epidemic institutions, tropstantion, sanitary and bacteriological laboratories, etc. were created.

Health care workforce. In 1913 in the territory of present T. only 13 doctors and 32 average medics worked, among to-rykh there was no of number of radical nationalities.

After establishment of the Soviet power doctors and average medics from sister republics began to arrive to the republic (RSFSR, Ukraine, etc.). Along with it in the republic measures for creation of base for training on site were undertaken. At the beginning of the 30th in of Hodzhente (nowadays Leninabad) the medical technical school, in Sta-linabade (nowadays Dushanbe) — medical in-t and medical technical school opened. The first doctors from among Tajiks were U. M. Muminov and X. U. Umarov, the t of university which ended medical f-in 1931. In the mid-thirties medical technical schools let out the first average medics. Educational institutions of the republic, however, could not satisfy fully quickly growing needs for medical shots. A part of doctors in T. were directed from other republics.

From total number of the persons working in 1982 in a health system of the republic in institutions horaneniya the St. 10 thousand doctors and more than 25 thousand average health workers was sensible.

Growth of security of the population with medical shots from 1913 to 1980 is reflected in tab. 1.

Medical education. Training of specialists with the higher medical education (doctors, pharmacists, stomatologists) is carried out in Tajik state medical in-those of Abu Ali Ibn-Sina, Ying t created in 1939 annually releases apprx. 600 specialists. Besides, every year in medical higher education institutions of the country from T. direct entrants.

Average medics (paramedics, midwifes, nurses, dental technicians, druggists, dignity. paramedics, medical technologists) prepare 6 medical schools, annual release to-rykh more than 2000 people.

Specialization and improvement of medical shots are carried out on base f-that improvements of doctors at Tajik state medical in-those, TsIU and other in-t of improvement of doctors of the country. Besides, doctors improve skills on annual exit cycles of improvement, republican seminars and by a training in scientific research institute of the country. Professional development of average medics is carried out in the Republican school of professional development of average medics organized in 1981 and also in medical schools on bases republican and regional to lay down. - the prof. of institutions.

Hospital help. The data characterizing growth of network of hospitals in the republic and security of the population with bed fund are provided in tab. 2. Data demonstrate that in 1980 the bed fund in Tajikistan was in 990 times more in comparison with 1913 and almost by 9 times — in comparison with 1940. Reduction of number of medical institutions happened due to their reorganization and enlargement.

In the republic the wide network of medical institutions is created, edges gives the chance to render timely stationary medical aid to the population not only in the cities, but also in the most remote mountain corners. Specialization of bed fund and equipment is on a large scale carried out to lay down. institutions by a modern oborudobaniye and equipment.

In the republic nurseries inf function. hospitals, antitubercular hospitals, etc. In Dushanbe the hospital, largest in the republic, on 1610 beds functions. Also other centers are organized nephrological, burn, cardiological, pulmonary, rheumatological, hematologic. Intensively the resuscitation and anesthesiology service develops: intensive care unit and anesthesiology are created in all large to lay down. - the prof. institutions.

The oncological help to the population extends and improved. Further development was gained by specialization of the therapeutic help (gastroenterology, endocrinology, etc.).

Intensive care unit of the Republican cardiological clinic.

Extra hospital help. For the purpose of approach of specialized medical aid to the population the network of clinics, out-patient and polyclinic institutions, etc. is created. In 1980 extra hospital specialized help was given both in specialized offices of policlinics, and in 17 antitubercular, 3 oncological, 15 skin venerolo-gicheskikh, 7 psychoneurological, 3 endocrinological clinics. In the republic 5 medical and sports clinics and 70 stations and departments of emergency medical service function.

The number of medical visits grew on 1 zhit. with 1,8 in 1940 to 7,3 in 1981 (taking into account medical visits of patients at home).

Protection of motherhood and childhood. High rates of birth rate, considerable percent of children in the republic emphasize exclusive importance of a problem of health protection of women and children.

The first institutions of protection of motherhood and an infancy were organized in 1925 in Dushanbe.

Further every year the network of obstetrical And child care treatment-and-prophylactic, preschool and sanatorium facilities (in rural areas they were created according to the standard project and with attraction of financial resources of collective farms and state farms) extended; the quantity of maternity, gynecologic and children's beds increased.

In 1980 in T. 12 maternity homes and 66 delivery rooms on 3992 beds functioned; 140 children's BCs and departments on 6503 beds. Much attention is paid to questions of the organization of the specialized help to children. In 1982 the specialized help to children in out-patient clinics and policlinics turned out on 18 — 21 specialties in the cities and on 6 — 8 — in rural districts.

In institutions of obstetric aid departments (chamber) of nursing of premature children are created, at all large nurseries-tsakh — departments (chamber) of resuscitation and an intensive care, pathology of newborns and nursing premature. Specialized pediatric crews (including resuscitation) at stations (departments) of emergency medical service are organized; their number constantly increases.

For approach of the qualified medical aid to the women and children living in the remote rural areas on the basis of the central regional BCs (TsRB) are created and mobile obstetric and gynecologic and pediatric crews function.

In a health system of the republic 27 specialized children's sanatoria are created (cardiological, pulmonary, tubercular, etc.). The network of nurseries' milk kitchens develops (with 45 in 1975 to 103 in 1980) ’. In rural areas distributing points are open. The network of preschool institutions extends. If in 1965 the number of children was equal in a constant children's day nursery (gardens) to 55,0‘ to one thousand, then in 1980 in 720 preschool institutions it reached 109,0 thousand; specialized groups (day nursery gardens), boarding schools for sick children are created. Considerable improvement of indicators of health of women and physical development of children is result of this lot of work.

Dental help. If in 1940 there were 42 dental and dentoprosthetic offices, in to-rykh only 6 stomatologists, 59 dentists y 16 dental technicians worked, then in 1980 in the republic 10 dental policlinics (5 — in Dushanbe, 4 — Leninabad, 1 — in Qurghonteppa) and considerable number of dental and dental surgeries in policlinics, hospitals functioned, at school institutions. Stomatol. help to the population of the remote mountain districts is given by special crews, to-rye are equipped with the necessary equipment. Department of maxillofacial pathology is available in Dushanbe (on 60 beds) and in the Leninabad region (on 50 beds).

Children's department of a city hospital No. 2, Dushanbe.

Medical care to employees of the industrial enterprises, construction and transport is one of the most important tasks of bodies of health care of the republic. In 1947 in the Tajik SSR MSCh for service of workers of ore mining industry in the settlement of Konsaye and for miners — in Shurab were for the first time organized. In the 50th in T. 27 medical and 43 medical assistant's health centers functioned 4 MSCh with hospitals with a general power at 130 beds. In 1963 the Republican clinic on professional pathology with department on 50 beds was organized. In 1980 medical aid by the worker was rendered 11 MSCh with hospitals with a general power at 755 beds, 34 medical health centers, 321 medical assistant's and 87 shop sites. Besides, to workers of the industry specialized medical aid is rendered in regional, city, regional and republican to lay down. - the prof. institutions, and also in clinics of the Tajik medical institute (see).

Medical care to country people. In the republic considerable work on improvement of rural health care is carried out. The central regional hospitals became the centers of rendering the qualified and specialized help to villagers; the volume of the rendered medical aid to country people by specialists of republican, regional and city clinical BCs increases. The network rural medical' out-patient clinics gained the further development. Their number with 78 in 1977 increased to 139 in 1982 Besides, in the village 114 rural local BCs, 1225 medical and obstetrical centers function.

For improvement of the organization of ambulance and emergency medical service to country people stations of ambulance in areas with the population of St. 100 thousand are created zhit.

Work on the organization of interdistrict highly specialized departments is continued (traumatology, ophthalmology, otorhinolaryngology, urology, etc.). The network of mobile medical service grows (medical out-patient clinics, women's and children's consultations, fluorographic, physiotherapeutic offices, a wedge, laboratories, etc.). More widely means a dignity began to be used. aircraft. In April, 1983 in Dushanbe the All-Union meeting on exchange of experience of the organization of medical and sanitary providing the shepherds occupied with distant-pasture livestock production was held.

The plan of measures on further improvement medical - a dignity is developed. providing and to improvement of health protection of country people. Together with other ministries and departments it is necessary to carry out work on construction in the village of medical and obstetrical centers, medical out-patient clinics and local BCs according to standard projects. For these purposes funds of collective farms and, state farms are widely raised.

The sanitary and epidemiologic service in the Tajik SSR began to develop since 1928 when the special resolution about a dignity was accepted. bodies of the republic the sanitary and anti-epidemic department at Narkomzdrava was also organized. The first dignity. malarial, pasterovsky and chemical and bacteriological stations (in Kulob, Dushanbe and Hodzhenta) were institutions in the republic; the first complex dignity. institutions — SES, to-rye began to create in 1932. In 1980 a dignity. - epid. the service was presented by 57 SES, 2 disinfection and 1 antiplague stations. As a part of SES it is developed 80 bacteriological and a dignity. - a gigabyte. laboratories, including 13 — on utility hygiene, 12 — on hygiene of food, 9 — industrial, and also radiological, toxicological, physical and chemical and other laboratories.

The considerable attention is paid to improvement of the cities and other inhabited places, environmental control. 559 water supply systems and 294 systems of the sewerage (1980) work in the republic, 95 gas-dust removal constructions are opened up.

Development of network dignity. - epid. institutions, strengthening of their material and technical resources allowed to strengthen the state dignity. supervision to increase quantity and to improve quality a lab. control methods that led to decrease inf. also provided to incidence a dignity. - epid. wellbeing of the republic.

Sanatorium help. Many to lay down. mineral springs in the territory of T. were known for a long time, however development of resort matter in the republic began only in the 30th. So, in 1934 at the height of 1740 — 1960 m the republic's first klimatobalneologichesky resort of Hodge-Obigarm on 25 seasonal beds began to function above sea-level. In 1947 the resort of Obigarm on 50 seasonal beds was organized. In 1953 in Shoambara's kishlak (26 km from Dushanbe) the balneological sanatorium on 25 seasonal places opened; in 1954 near Ur-Tyube the seasonal balneary of «Havatag», and in 1959 — a seasonal balneary of Garmchashm on.25 beds began to function (on Pamir). In 1977 the sanatorium of Uratyube on 350 places and 150 places opened in the summer in the winter. In the republic there are salty lakes with therapeutic silt mud (Aksukon and Tanapchi, etc.).

All sanatoria are specialized. In Hodge-Obigarm's resort the people having diseases of bodies of the movement, cardiovascular system, hron, pathology of female generative organs and upper respiratory tracts are treated. In the resort of Obigarm successfully treat nervous, gynecologic and skin, and in Shoambara's sanatorium — l. - ki ni. and hepatic diseases. Sanatoria of Uratyube and «Zoom-is glad» of generally cardiological profile.

For years of the Soviet power in sanatoria of T. new standard cases are built, in them the bed fund is considerably increased, labor-intensive processes are mechanized, providing with medical shots is improved. In 1981 in sanatoria and institutions of rest of the Tajik SSR it was treated and 154 353 people, including in rest houses and boarding houses of 22 689 people had a rest.

Commercial bottling of waters of Shoambara, Faizabad, An craw, etc. is organized.

Sanitary education. In the years of formation of the Soviet power dignity. - a gleam, work in T. it was carried out by generally medical workers of military and sanitary parts. Actions of bodies of health care for fight against diseases were to a certain extent slowed down by the superstitions and prejudices existing at that time at the most part of the population, negative attitude to the Soviet medicine. To a dignity. - a gleam. to work from the very first days of the Soviet power the teachers and other representatives of the intellectuals knowing local language and holding authority with the population were attracted. In the 30th concerning health protection various exhibitions began to be organized. It was more and more published leaflets, instructions, posters, methodical collections and others a dignity. - a gleam. materials. The first House of sanitary education in the republic was organized in Dushanbe in 1938 Medical and a gigabyte. education of the population in 1980 was carried out by 25 houses and 13 offices of a sanprosveshcheniye, 126 national high fur boots and 25 f-tami health.

Trading floor of a drugstore, Dushanbe.

Pharmaceutical business. Before revolution in all territory present T. only one small private drugstore in Hodzhente was, edges in 1917 it was closed. In 1924 the republic's first drugstore in Dushanbe was open; in it 4 druggists worked. The first shop of a sangigiyena was the same year organized. In 1929 at Narkomzdrava of the republic the Head pharmaceutical department was created, 10 drugstores were under authority to-rogo already. In 1940 in the Tajik SSR 71 drugstores functioned (12 — in the cities and 59 in rural areas).

In 1980 the pharmacy chain of the republic consisted of 4 regional and 1 city pharmaceutical managements, 4 pharmaceutical warehouses, 4 control and analytical laboratories, 352 drugstores (147 — in the cities and 205 — in rural areas), 36 central regional, 13 sick-lists and 8 interhospital drugstores, 583 pharmaceutical points and 18 branches of drugstores. In the republic functions pharm. the factory which is releasing, products of 67 names of pharmaceuticals, with an annual volume of release of goods on 920 thousand rubles.

Along with proliferation of pharmacy chain its quality indicators immeasurably grew and improved. Drugstores are equipped with the advanced equipment and sovr. pharmaceutical furniture, in a new way planned use of floor space of drugstores; many innovations on simplification of work of druggists are entered.

New progressive forms of service of the population are implemented: 11 offices pharm work. information, according to recipes of doctors issue of medicines through branches of drugstores at large policlinics, etc. is made.

Increase in material well-being and cultural level of workers, approach of the medical and medicinal help to the population, increase in budgetary appropriations to lay down. - the prof. of institutions on acquisition of medicines promoted sharp increase in issue of pharmaceuticals and products of medical appointment.

Building of the galenovy workshop of pharmaceutical factory, Dushanbe.

Development of medical science. Before revolution of T. represented a white spot for science. After establishment of the Soviet power scientists are representatives of Russian and other people of the USSR became pioneers in creation sovr. medicine in T. Uzhe in the first years of education Tajik the ASSR by means of the Russian scientists A. A. Makaryin, L. F. Paradoksov, M. N. Keshishyan, A. I. Shurenkova, etc. began studying of regional pathology, first of all mass infectious and parasitic diseases of edge. Still in the late twenties attention of researchers attracted questions of the prof. of pathology, epidemiology and prevention inf. diseases, improvement of the environment, improvement of water supply of the cities and villages, fight against malaria and other tropical diseases. Since 1928 studying inf. pathology and parasitic diseases E was engaged. N. Pavlovsky who organized and headed a number of large expeditions. In 1930 to the republic there arrived the first large expedition Central tropical in-that, to-ruyu E. I. Martsinovsky headed. However there were not enough these researches for permission of the numerous tasks facing medical science of the republic. It was necessary to create own scientific shots and institutions. At the beginning of the 30th in of Dushanbe and Hodzhente 4 scientific research institutes were organized.

Since 1935 scientists together with practical workers started studying of such eurysynusic then diseases as malaria and intestinal infections, a tick-borne spirochetosis, leyshmanioza, a brucellosis, etc., began to develop questions of water supply of the inhabited places, improvements of the population, practical events for the prevention of quarantine diseases were held.

Considerable development of medical science was observed in post-war years. In 1946 from T. the group of doctors was sent to scientific institutions of Moscow.

Ying t created in 1959 in Dushanbe at AN of the Tajik SSR of regional medicine (nowadays — Institute of gastroenterology) began the activity with studying of questions of food of the population, traditional medicine, use of local officinal herbs, resort resources. In 1971 the problem laboratory of pathology of women, hereditary and inborn diseases was organized, on base the cut in 1980 was created by scientific research institute of motherhood and the childhood.

In promoting and implementation of achievements of medical science in practice the important role is carried out by the Health Care of Tajikistan magazine issued since 1933.

Every year the number of uche-nykh-physicians from national shots grows. In 1981 in the republic there were St. 300 doctors with academic degrees, including 51 doctors of medical sciences. Among them 16 people have an honorary title zasl. the scientist, two are elected in structure of the USSR Academy of Medical Sciences, two — in structure of AN of the Tajik SSR, four are conferred a rank of the winner awards of Abu Ali Ibn-Sina. Not only in the republic, but also beyond its limits names of M. G. Gulyamov, Yu. B. Iskhaki are known (see t. 10, additional materials), X. X. Mansurova, Yu. N. Nuraliye-va, A. T. Pulatova, Ya. A. Rakhimova, K. T. Tadzhiyeva, N. U. Usmanova, K. A. Hasanova, A. I. Shurenkova, etc.

In 1982 in the Tajik SSR functioned 24 republican scientific medical about-va.

Coordinates all researches which are carried out in a health system and controls the Academic medical council functioning since 1932 at M3 of the republic.

Budget of health care. From year to year allocations for needs of health care increase. In 1981 the budget of health care made 161,0 million rubles that is 23 times more, than in 1940 when only 6,9 million rubles were allocated for health care.

The table 1


The table 2


Bibliography: The national economy of the USSR in 1982, the Statistical year-book, M., 1983.

I. A. Sazhenin.