The UZBEK SOVIET SOCIALIST REPUBLIC, Uzbekistan — the federal republic, is a part of the USSR. It is formed on October 27, 1924. It is located in the central and northern parts of Central Asia and occupies the space of 447,4 thousand km1, the population of 17039 thousand people (for January 1, 1983). Average population density 38,1 zhit. on 1 sq.km. The capital — Tashkent (1949 thousand inhabitants, 1983). The ASSR, 12 areas, 158 districts, 120 cities and 87 settlements of city type are a part of the Uzbek SSR Karakalpak. In the republic along with such most ancient cities as Samarkand, Bukhara, Tashkent numbering more than 2 thousand years there are cities, origin to-rykh is directly connected with a victory of Great October socialist revolution; from 120 cities of the republic 101 it is created for years of the Soviet power. The most part of the territory — the plain, smaller — the foothills and mountains. In the republic the largest rivers of Central Asia — the Syr Darya and Amu Darya flow. Climate continental. The extreme southern part of the territory of the republic belongs to subtropical, and northern — to moderated to climatic zones.
More than 100 nationalities and nationalities live in the republic. The main population — Uzbeks (68,7%); the Russian — 10,8%, Tatars — 4,2%, Kazakhs — 4,0%, Tajiks — 3,9%, Karakalpaks — 1,9%, Koreans — 1,1%, etc.
In 1897 only 2% of the population of Uzbekistan were competent, in the middle of the 20th century. The Uzbek SSR became the republic of general literacy.
The Uzbek SSR — the advanced industrial and agrarian republic with the high-mechanized agriculture winning first place in the country on production of cotton (about 6 million t a year), silks, a kenaf, astrakhan fur, mechanical cotton pickers, the cotton-processing equipment, etc. The power industry, nonferrous metallurgy, coal, mining, chemical, gas, oil, easy, food and other industries gained broad development. Development of Mirzacho'l is in recent years complete, virgin lands of the Fergana Region, high rates conduct development of the Qarshi steppe. Thanks to it Uzbekistan turned into one of the largest rice and ovoshchebakhchevy regions of the country.
Demographic processes reflected extremely difficult situation of the population, low level of sanitary culture, the actual lack of medical aid in pre-revolutionary Uzbekistan. The general mortality reached to 30 — 35 for 1000 the population, the nursery — to 400 — 500 on 1000 been born that it was 65 — 70% higher, than in the central regions of Russia. Average life expectancy made 27-^ 30 years.
Increase in the material and spiritual standard of living of the population
after the victory of Great October socialist revolution, development of health care, the state measures for protection of motherhood and the childhood, improvement of labor and domestic conditions led to considerable decrease in the general mortality and increase in a natural increase of the population (tab. 1).
On indicators of an annual increase in population Uzbekistan takes the second place in the USSR.
Zabolevaye of m awn. For the short historical period thanks to broad social transformations and development of socialist health care to Uzbekist
natural smallpox, cholera, plague, malaria, a tick-borne encephalitis, a typhinia, a parasitic worm were not liquidated. Especially great success is achieved in elimination of malaria. Before Great October socialist revolution more than 80% of the population of certain counties of present Uzbekistan were struck with malaria, mortality from a cut, e.g., on the Tashkent County made to 170 for 1000 persons. In 1932 in the republic 717 thousand cases of malaria, in 1950 — apprx. 121 thousand were registered. Since 1961 malaria is almost liquidated. Considerably incidence of a paratyphoid-mi and other intestinal infections decreased. Great success and in decrease in incidence of tuberculosis is achieved.
Health care workforce. Created by works of great scientists-physicians Ibn-Sina, Ismail Dzhur-dani, Yusuf Tabiba, etc. east medicine reached high development and exerted noticeable impact on progress of world medical science. However could use its achievements generally feudal bayskaya verkhush
and clergy. To other population help was given by representatives of so-called traditional empirical medicine: bone-setters,
massage therapists, izvlekatel of a parasitic worm, sorcerers, etc. After accession of Central Asia to Russia the first appeared to lay down. institutions (1868), to-rye generally serviced military and officials. The indigenous people because of ignorance of Russian and low power of hospitals and out-patient clinics practically could not use medical aid. In 1983 in comparison with 1914 the number of doctors increased in the republic more than by 397 times, average medics more than by 682 times (tab. 2). On security with doctors the republic advances not only the countries of Asia, but also many advanced European states. Dedicated work of physicians of Uzbekistan is appreciated by the Homeland: the rank of the Hero of Socialist Work is given 5 people, the national doctor of the USSR the 2nd persons. Among working in a crust, time of medics with awards and medals are awarded 1560 persons. Are awarded an honorary title of the honored doctor of the Uzbek SSR 427 people, the honored druggist of the Uzbek SSR 27 people, the honored worker of health care the 62nd persons.
Hospital help. In 1983 in Uzbekistan there were 1225 medical institutions of all departments, in to-rykh there were 207 thousand beds that more than by 200 times exceeds their number in 1914 (tab. Z).
Essential changes happened in structure of bed fund, to-rye are connected with specifics of demographic processes in the republic (rather high rates of birth rate and a share of children as a part of the population), and also active process of specialization of medical aid. So, total number of beds in 1981 increased in comparison with 1940 by 10 times, and pediatric — by 18 times, otorhinolaryngological — by 30,2 times, oncological — by 36,6 times etc. According to the resolution of the Central Committee of the CPSU and Council of ministers of the USSR «About measures
for further improvement of health care and development of medical science in the country» (1968) and resolutions of the government of the republic in Uzbekistan the program of design and construction of large multi-field and specialized hospitals and clinics, clinics of scientific research institute and medical institutes is successfully carried out. Construction of the largest medical complex at Tashkentskokhm comes to the end medical in-those on 2820 beds, with the educational audiences providing training more than 9 thousand students and interns. Construction of clinics of scientific research institute of tuberculosis, scientific research institute of obstetrics and gynecology, scientific research institute of medical parasitology, etc. is complete. Practically in all regional centers, in many cities are constructed large multi-profile-tsy.
Timely implementation in practice of health care of the latest methods and diagnostic aids and treatment is carried out according to recommendations of profile scientific research institutes and departments of medical institutes. It is promoted also by creation and expansion of network of the specialized centers (cardiac, vascular, cardiorheumatological, pulmonary, allergological, burn, children's surgery, etc.). In 1983 the level of hospitalization of the population made 23,3%.
Extra hospital help. For years of the Soviet power there was a systematic growth of network an out-patient floor and clinical at the h -
births (tab. 4).
Except the institutions specified in the table, extra hospital help to the population of the republic is given by 46 MSCh, 207 stations and departments of emergency medical service, 14 stations of sanitary aircraft, etc. In the large cities are created special-tsy emergency medical service, integrated with stations of emergency medical service, in structure to-rykh toxicologists ches Kia, urological and other crews are organized specialized cardiological, neurologic, resuscitation.
Specialized extra hospital help along with clinics is given also in 270 endocrinological, 248 urological, 192 dermatovenerologic, 143 psychoneurological offices of policlinics. In 1983 city dwellers made 89,5 million visits to doctors, rural — 60,7 million. The same year emergency medical service serviced St. 5,7 million people, by sanitary aircraft — St. 100 thousand persons.
From 20th in the republic the specialized service on fight against tuberculosis began to be created, the first antitubercular clinics were organized. Originally methodical management of network of TB facilities was performed by profile clinics of in-t, and since 1937 of scientific research institute of tuberculosis — scientific and practical establishment with a hospital on 650 beds. In the republic antitubercular clinics, offices and tubercular-tsy, and also specialized sanatoria, W function. h activity therapy tubercular sanatorium of «Pakhtali-Kul», in Krom along with medical rehabilitation inservice training of recovering is provided. The coverage of the population fluorographic surveys in 1982 exceeded more than twice similar on -
the Tashkent branch of All-Union scientific center of surgery of the USSR Academy of Medical Sciences.
kazatel of 1970. Prevention of tuberculosis by vaccination is widely carried out, revaccinations and others to lay down. - the prof. of actions, that provided decrease in incidence of tuberculosis over the last 10 years more than for 40%.
Work on fight against cardiovascular diseases in the republic is coordinated by scientific research institute of cardiology and department of medical institutes. The specialized network including 5 cardiological clinics, 218 cardiological offices, and also specialized departments power apprx. 3,2 thousand beds is created. There are 159 offices of functional diagnosis and 552 offices of an ECG. Training of qualified personnel of cardiologists is conducted, the number to-rykh annually increases. The cardiac help in the republic appears the Tashkent branch of All-Union scientific center of surgery of the USSR Academy of Medical Sciences, at a number of departments Tashkent state medical in-that, etc. With tselyo prevention cardiovascular z and about l e in and N and i i
mass inspections of the organized and unorganized population are performed, the persons belonging to groups of the increased risk of a disease with their subsequent medical examination come to light. The republican interdepartmental program for the prevention and decrease in incidence of cardiovascular diseases is developed and began to be implemented. In Tashkent the register on the patients who had a myocardial infarction is made. A result of systematic work of all medical institutions of the republic was the stabilization reached in recent years and even nek-paradise a tendency to decrease in frequency cordial with-with at d and with t y x a zaboleva and 11 ii.
For fight against malignant new growths in a respa bl and ke the special network is created to lay down. institutions, including 17 oncological clinics and 220 offices. Besides, this work is carried out by others to lay down. - the prof. institutions. Annually routine maintenances take place apprx. 4 ml and. persons.
Regional and city oncological clinics are not only to lay down. - the prof., but also the organizational and methodical centers for all network of healthcare institutions of the republic for fight with onkol. diseases. In comparison with 1940 network onkol. institutions increased more than by 26 times, and number of beds in them — more than by 36 times. Equipment by their modern X-ray radiological equipment and effective remedies of treatment improved. As a result of earlier identification onkol. diseases and their more successful treatment the specific weight of almost healthy faces after the carried-out special treatment considerably increased. Work on coordination of preparation, specialization and improvement of shots of oncologists in the republic are carried out by scientific research institute of oncology and radiology and profile departments of medical institutes of the republic.
Before Great October socialist revolution in Uzbekistan there was almost no medical aid to the population which had eye diseases though trachoma was one of the most widespread diseases among indigenous people. By the beginning of 1968 trachoma was almost liquidated. In 1983 in the republic there were 17 BCs and 15 clinics, 411 eye offices, departments of eye diseases of medical institutes and Tashkent in-that improvements of doctors.
Dental help. In 1914 in the territory of Uzbekistan stomatol. the help, edges was almost unavailable to the population, rendered only 39 dentists. At the Soviet power this type of medical aid in the republic quickly develops: in 1940 functioned 6 stomatol. institutions, in 1983 — 145, the number of stomatologists increased for the same period almost by 13 times. In 1954 at Tashkent state medical in-those it is open dental for f-t. To the population of mountain districts and sites of distant-pasture livestock production stomatol. help is given 18 mobile stomatol. automatic installations. In the cities of the republic it is organized urgent stomatol. help.
Protection of motherhood and childhood. The first obstetrical establishment — a maternity shelter on 4 beds — was open in 1880. Tashkent charitable about-vom. In 1914 in the territory of Uzbekistan only 63 midwifes worked. Mortality of women in labor reached 2,3%. After Great October socialist revolution creation of the state system of protection of motherhood and the childhood in Uzbekistan was one of the first main and most difficult problems of health care. Its implementation demanded overcoming stagnancy, centuries-old religious superstitions and prejudices of indigenous people. In 1983 in comparison with 1924 the number of clinics for women, children's policlinics and out-patient clinics increased more than by 185 times (in 1924 — 10, in 1983 — 1855 institutions).
In the republic the accurate system of prenatal observation and patronage of pregnant women is organized. Annually the number of the pregnant women put under systematic observation of the doctor of clinic for women in early durations of gestation, number of the specialists doctors pregnant with observation inspected on a Rhesus factor, and also coverage increases (the therapist, the stomatologist, etc.). In the cities practically all childbirth is conducted by the qualified medical staff in stationary conditions, and in rural areas all women are provided with medical aid at childbirth, most of them give birth in maternity hospitals or obstetric departments of the central regional BCs. Clinics for women, medical and obstetrical centers carry out mass routine medical examinations of the women working at the industrial enterprises in institutions and collective farms for the purpose of identification of early forms ginekol. and onkol. diseases and ensuring their timely treatment. At clinics for women offices on prevention and treatment of female infertility, pathology of a climacteric, children's gynecology are organized. In maternity homes much attention is paid to nursing of newborns and especially premature children. Departments for premature births and for nursing of premature children are created. Since 1970 in Tashkent specialized obstetrical institutions for women with cardiovascular pathology, diseases of kidneys, Rh incompatibility, toxoplasmosis, tuberculosis, a viral hepatitis, etc. are organized. Similar chambers or departments at obstetrical institutions function in areas of the republic. In development of the specialized pediatric and obstetric and gynecologic help the big role belongs to profile departments of medical institutes, and also NIR opened in 1927! protection of motherhood and an infancy (since 1974 scientific research institute of obstetrics and gynecology). The big share of newborns in the large families (having more than 4 children) is characteristic of Uzbekistan. In 1950 in large families 33,1% of all newborns, and in 1978 — 38,4% were born.
All this causes certain features in the organization of medical aid to children. Are organized the specialized nursery surgical, ophthalmologic, traumatologic, neurologic, urological and other types of the help. Annually the number of routine maintenances of teenagers and children increases, indicators of their physical development improve. Considerably incidence of children of acute intestinal infections decreased, smallpox is liquidated, incidence of diphtheria is reduced to isolated cases. In the republic in connection with demographic features a number of new forms of the organization of the help to children and mothers is implemented; a seasonal day nursery and kindergartens will be organized; in staff of rural medical out-patient clinics the position of the pediatrician, is entered into staff of wivessky consultations — patronage midwifes, in staff of medical and obstetrical centers — nurses for overseeing by children of the first two years of life; special transport is allocated to maternity homes for transportation of newborns and their mothers; pediatric sites are broken up into smaller units; specialized pediatric crews of emergency medical service, etc. will be organized. Special hospitals «Mother and Child» or the relevant departments for improvement of the women hospitalized together with the child in children's hospitals that allowed to revitalize annually along with sick children more than 10 thousand women will be organized. In the republic mortality of children, especially aged till 1 year of life is considerably reduced.
Medical care of workers. Medical care by the worker of the industrial enterprises, construction and transport along with polyclinic network are rendered by 46 MSCh, 287 medical and 1643 medical assistant's health centers. Continuously the network of shop sites increases (in i960 of — 83, in 1983 — 386). Annually quality increases and the percent of coverage routine medical examinations working increases that along with improvement of working conditions promotes the prevention of occupational diseases. Professional incidence in a number of the industries of the national economy is considerably reduced (in mechanical engineering industry, agriculture, etc.).
Medical care of country people. Continuously the network of medical institutions increases in rural areas and number of specialized beds in them. The number of medics increases, quality of medical aid improves, edges
it appears on 28 specialties. Regional and interdistrict specialized departments open: physiotherapeutic, ortopedo-herbs-matologicheskiye, otorhinolaryngological, etc. Average power of regional BCs in 1983 made 670 beds, the central regional BCs — 342 and rural local BCs — 61 bed. Reorganization of advisory policlinics of regional BCs is carried out, the role of organizational and methodical departments of the last is strengthened. Construction and equipping of medical and obstetrical centers, rural local BCs, dispensaries, pharmaceutical institutions at the expense of means of collective farms and state farms is widely conducted.
With and N and t and r N about - epidemiological service. The leading place in health care of the republic belongs a dignity. - epid. service, successful work a cut promoted overcoming heavy heritage of the past. In the region where before Great October socialist revolution the extent of a water supply system was estimated in only several kilometers, the sewer network actually was absent, and work on improvement of the inhabited places was carried out only in the territory where imperial officials lived, feudal bayskaya a top and clergy, no measures were taken for simplification of the hardest service conditions at the single industrial enterprises. For years of the Soviet power the network of collective-farm and state-farm water supply systems (only for years of the tenth five-years period in the village 3185 km of a water supply system are constructed) annually increases. A lot of work on improvement of the cities and kishlaks is carried out. Serious work was carried out by SES according to the prevention and reduction of negative effects of rapid development of the diversified industry of the republic and broad mechanization of agriculture. In the republic there are 15 toxicological, 16 physical. - chemical laboratories and departments and 17 — for definition of toxic chemicals. The St. 780 thousand laboratory and tool researches is annually carried out. Development and successful implementation of a complex of sanitary and anti-epidemic actions provided considerable decrease in incidence inf. diseases, and also the prevention of a drift and spread of especially dangerous infections from a number of the foreign countries adjoining on the republic. In 1983 in the republic functioned 225 SES (2 republican, 12 regional, 52 city, 159 regional). For years of the ninth and tenth five-years periods practically in all areas
the Trading floor of the Central drugstore of Tashkent.
buildings of the regional and regional SES equipped with the modern equipment and the equipment are built (gas chromatographs, polarographs, the vibroshumoizmeritelny equipment, etc.). Work dignity. - epid. services of the republic it is carried out under the scientific and methodical management of staff of scientific research institute of sanitation, hygiene and occupational diseases, scientific research institute of epidemiology, microbiology and infectious diseases, the Tashkent branch of scientific research institute of virology of the USSR Academy of Medical Sciences.
Sanatorno - the resort help. Uzbekistan is rich with resort resources: 100
Klim Ticheskikh of areas, 61 mineral springs and 30 salty and mud lakes are recommended for practical use. All-union value the resorts of Chimion (see Resorts) have, Uch-Kizil with the waters close on the structure to waters of the resort of Sochi, Chartak (see) with water like waters of the resort of Tsqaltubo, etc. In 1982 in the republic 80 sanatoria on 20,4 thousand beds (in their 1940 there were 29), 23 rest houses and boarding house on 5,7 thousand beds functioned. In development of resort business the big role was played by the scientific research institute of balneology and physical therapy organized in 1919 which is scientific center on studying climatic balneal and others to lay down. factors of resorts of the republic.
Sanitary education is carried out by all to lay down. - the prof. network of the republic. Will organize this work and perform methodical management of 2 republican, 12 regional and 64 city regional houses and 79 offices a dignity. educations. In Uzbekistan universities of health (337), school of young mothers and fathers (240), schools of new life (78) and others were widely adopted, in to-rykh over 53 thousand persons study.
Pharmaceutical business. Before Great October socialist revolution in the territory of Uzbekistan there were only 33 drugstores (from them the majority private), to-rye functioned only in the cities (1 drugstore serviced up to 200 thousand zhit.), there were no enterprises for production of medicines, educational and scientific institutions. For years of the Soviet power a lot of work on the organization of pharmacy chain (tab. 5) is carried out. The enterprises for production of medicinal and bacterial drugs are created. The median number of inhabitants on 1 drugstore decreased from 38,1 thousand in 1940 to 9,8 thousand in 1983.
The special state farm on cultivation, reception and packaging of medicinal plants, etc. is organized.
Medical education. Training of specialists with the higher medical and pharmaceutical education is carried out at medical institutes — Tashkent (see. The Tashkent medical institute), Andijan, Samarkand, Average and Asian medical pediatric and Tashkent pharmaceutical (see. Medical institutes, the tab.), to-rye in 1983 released apprx. 4 thousand doctors and druggists. The paramedical staff is trained by 25 medical schools. Professional development of doctors is carried out in Tashkent in-those improvements of doctors where 5 thousand specialists annually study. Retraining of average medics (annually to 8 thousand people) it is carried out at medical institutes, on republican courses, departments at medical schools, and also on local bases (nearly 2,5 thousand people a year).
Medical science. The health care of the Soviet Uzbekistan leans on network of research establishments and medical institutes, collectives to-rykh carry out basic and applied researches in the leading directions of medical science and health care. In the republic the scientific research institute and their branches, the central research laboratories, medical and pharmaceutical in-you, in-t of improvement of doctors function. For the scientific achievements it is known in our country and abroad fili-
it is scarlet All-Union scientific center of surgery of the USSR Academy of Medical Sciences, to-ry has the unique equipment, the equipment and highly qualified personnel performing the most difficult surgeries on heart, vessels, a liver and other bodies. At the advanced boundaries hmed. sciences are researches of scientists of Uzbekistan on transplantology, in particular on creation of new medicines for overcoming a tissue incompatibility (batriden, etc.), and also development of methods of an out-patient hemodialysis, etc. Cardiologists of Uzbekistan revealed regional features of development and a wedge, courses of cardiovascular diseases. Some suggestions for improvement of methods of their diagnosis and treatment are developed, medicines from local raw materials are offered. Neuropathologists of the republic made a certain contribution to a problem of studying of inflammatory diseases of a brain. In the Uzbek scientific research institute of oncology and radiology complex therapy of cancer using a local and general hyperthermia, ultrasound, electromagnetic fields, laser radiation is carried out. Implementation in practice of results of researches of phthisiatricians of the republic promoted improvement of quality of activity of antitubercular network. Experiment of Uzbekistan on elimination and decrease in incidence of nek-ry parasitic diseases found application in a number of foreign countries. Scientists of the republic managed to receive highly effective polyvalent antivenene serums, and also serums against a sting of a spider of a karakurt, to-rye with success are used not only in the USSR, but also are exported to the countries of the Middle East. On the basis of wide use of results of scientific research of hygienists of the Uzbek SSR considerable work on environmental control, improvement of working conditions in the industry
Polyclinic department of multi-field children's hospital in an array Yunus-Aoad of Tashkent is done.
and in agriculture, especially during the work with pesticides. Original works of scientists of Uzbekistan about mechanisms of adaptive reactions, absorption and transport of protein as cells, new aspects of a pathogeny of toxic hepatitis gained recognition. A certain contribution to further development of domestic medicine is made by the scientific hematologists and pathologists who revealed regional features of emergence and a current of a number of diseases of the hemopoietic system, microbiologists, epidemiologists, virologists and infectiologists, works to-rykh promoted the prevention and decrease in incidence of a brucellosis, hemorrhagic fever and Ku-likhorad-which, a viral hepatitis, salmonellosis, etc.
For big merits in development of medical science in structure of the USSR Academy of Medical Sciences were chosen:
A. A. Abi-Dov (see t. 10, additional materials), E. I. Atakhanov, And. 3. Zakhidov, R. K. Islambekov, D. N. Maksumov, I. K. Musabayev, 3. I. Umidova, Page III. Shamsiyev; To 64 scientists the honorary title «The honored worker of science of the Uzbek SSR» is given.
In Uzbekistan there are 37 republican and over 150 regional medical societies, in to-rykh more than 50 thousand doctors are integrated.
The budget of health care of the republic is visually characterized by table 6, the average discharge per capita on health care increased from 13 kopeks in 1914 to 46 rub 77 kopeks in 1983.
The table 1
VITAL RATES in the territory of UZBEKISTAN from 1910 to 1983
(on 1 000 people of the population)
the Table 2
INDICATORS of GROWTH of SECURITY of the POPULATION with MEDICAL SHOTS in the territory of UZBEKISTAN since 1914 on 1 98 3 g.
The table 3 GROWTH of NUMBER of MEDICAL INSTITUTIONS AND SECURITY of the POPULATION of UZBEKISTAN with HOSPITAL BEDS from 1914 to 1983
The Table 4
DYNAMICS of DEVELOPMENT of NETWORK of MEDICAL EXTRA MEDICAL INSTITUTIONS IN the UZBEK SSR from 1940 to 1983
The Table 5 GROWTH of NETWORK of PHARMACEUTICAL INSTITUTIONS IN the UZBEK SSR from 194 0 to 1983
The Table 6 GROWTH of the BUDGET of HEALTH CARE IN UZBEKISTAN DURING the PERIOD since 1914 on 198 3rd Mr.
Bibliogr. - And r and p about in U. A. Development of medical science in Uzbekistan for 5 0 years, Medical zhurn. Uzbekistan, No. 10, pages 1 6, 19 67; Zairov K. S. Development of health care in Uzbekistan in 60 years of the Soviet power, in the same place and 10,
page 16, 1 9 77; Kadyrov A. A. Formation and development of the Soviet health care in Uzbekistan, Tashkent, 1976; Hudaybergenov A. M. Progress and perspectives of health care of Uzbekistan, Owls. zdravookhr., L'z 12, page 22, 1982.
A. M. Hudaybergenov.