The ESTONIAN SOVIET SOCIALIST REPUBLIC,
Estonia — the federal republic; it is formed in 1940. It is located on 3. the European part of the Soviet Union on the bank of the Baltic Sea. The area is 45,1 thousand sq.km. The population of 1 518 thousand people (for January 1, 1984), from them in the cities and settlements of city type there live 1 082 thousand people, in rural areas — 436 thousand persons. The capital — Tallinn (458 thousand people for January 1, 1984). In the administrative relation the republic is divided into 15 areas. There are 6 cities of republican subordination — Tallinn, Tartu, Pärnu, Kohtla-Järve, Narva, Sillamäe.
The main population (according to the All-Union population census of 1979) — Estonians (64,7%); Russians make 27,9%, Ukrainians of 2,5%, Belarusians of 1,6%, Finns of 1,2%, Jews of 0,3% and a face of others
of national sty 1,8%. By 1984 in comparison with 1940 population of ESSR increased by 44%.
Climate E. transitional from sea to continental. The winter is rather soft, wet with frequent thaw.
In the national economy E. the leading place on the volume and number of busy workers belongs to the industry. The industries of mechanical engineering demanding small expenses of metal, extraction of slate, electricity generation and mineral fertilizers, fishing industry, the meat-and-milk industry, the nek-ry industries of light industry, and also the marine transport gained development. Agriculture specializes in large milk and meat livestock production, pig-breeding and poultry farming.
In the republic there are 6 higher educational institutions where studies apprx. 25 thousand students, 37 averages of special educational institutions where studies apprx. 23 thousand pupils.
In bourgeois E. there was no uniform state system of the organization of health care. The population was badly provided with the stationary
help. The most part of doctors was engaged in a private practice. After establishment of the Soviet power in 1940 all types of medical aid became free and available to all population. After the Great Patriotic War destroyed were recovered and constructed new to lay down. - the prof. of establishment.
For years of the Soviet power along with social and economic and cultural achievements the republic achieved great success in the organization of health care. Incidence inf. diseases (without flu and ORZ) decreased to the middle of the 80th in comparison with 1950 twice. The expressed tendency to decrease in incidence of acute intestinal infections, falloff of incidence of tuberculosis is noted. The general mortality of the population in 1983 decreased in comparison with 1940 by 29,4%, child mortality decreased by 5 times. The population of the republic given about the natural movement are presented in table 1.
Health care workforce. For years of the Soviet power in the republic security of the population with medical shots considerably increased. So, the number of doctors in 1983 in comparison with 1940 increased more than by 6 times, and number of average medics for the same period — more than by 11 times (tab. 2).
Hospital help. In 1940 in bourgeois E. there were 58 medical institutions on 5,1 thousand beds (47,7 on 10 Ltd companies of the population), including 27 BCs in city settlements, 8 district police officers of BCs, 1 tubercular rural-tsa, etc. For years of the Soviet power the bed fund in the republic considerably grew (tab. 3). In 1983 128 medical institutions on 18,6 thousand beds in system of the Ministry of Health of the republic, including 34 city-tsy, 11 central regional BCs, 8 regional BCs, 40 district police officers of BCs, 18 specialized clinics with hospitals (9 antitubercular, 2 oncological, 4 dermatovenerologic, 1 antigoitrogenic, 2 medical and sports), 1 hospital of emergency medical service, etc. functioned.
All TB patients are serviced in specialized institutions. In 1983 in the republic 9 antitubercular clinics functioned, to-rye completely provided the need for hospitalization of patients.
Special attention is paid to the organization of the republican specialized centers. In the republic there are two cardiological centers (in Tallinn and Tartu), 6 cardiological departments. In 1984 it is open Research for in-t of cardiology in Tallinn. In the Tallinn hospital of emergency medical service department of coronary and vascular surgery is organized, a cut is base of scientific research institute of the general and molecular pathology of the Tartu state university; in sanatorium Syprus in Pärnu special rehabilitation department for the patients who had a myocardial infarction functions.
Oncological help to the population of northern part E. renders a republican oncological clinic, and to the population of the southern part E. — Tartu city oncological clinic. In cities of republican subordination 6 ophthalmologic
Maternity home of Pelgulinnasky hospital, Tallinn are organized.
Võru regional central hospital.
Local hospital of the settlement of Loksa.
departments, in areas in surgical departments of BC beds for ophthalmologic patients are allocated. The microsurgery of an eye is applied in hospitals of Tallinn, Tartu and Narva. On the basis of republican hospital the republican Center of microsurgery of an eye is open. Allergological help to patients is given by the republican allergological center created on the basis of department of professional pathology and clinic of occupational diseases Ying-that experimental and clinical medicine of the Ministry of Health of ESSR. The endocrinological center is the republican antigoitrogenic clinic (Tartu). In the republic two nephrology units function: in the Tartu hospital and in Ying-those experimental and clinical medicine on the basis of one of
the Tallinn municipal hospitals. In three there would be artificial kidneys. On the basis of research laboratory of a me-talloosteosintez the burn center works with clinic of A. I. Seppo.
Extra hospital help to the population in 1983 was given by more than 700 out-patient and polyclinic institutions. In the republic of 17 independent policlinics and out-patient clinics in the cities, including 1 teenage policlinic in Tallinn, and 100 polyclinic departments in city and republican lechebnoprofilaktichesky institutions. The wide network of cardiological, gastroenterological, oncological, ophthalmologic and other specialized offices is created. The number of serviced - adult population on one local therapist in 1983 made 1861 persons, a median number of visits of doctors on outpatient appointment and visits by doctors of patients at home in institutions of system of the Ministry of Health of ESSR — 11,4 on 1 inhabitant a year. Routine maintenances for the purpose of early identification of malignant new growths and precancerous states in 1983 captured 64,9% of the population 30 years are more senior.
Acute and emergency medical service to the population in the city and in the village is carried out by 2 city stations and 29 departments of ambulance where 71 specialized crews, including an intensive care, cardiological, etc. work. The quantity of calls of ambulance for 1000 of the population in 1983 made 231.
Dental help in Estonia in 1983 was given in 3 dental policlinics (in Tallinn, Tartu, Narva), 37 dental departments at policlinics, 112 dental offices at the enterprises, collective farms, state farms and 108 offices at schools. The most intensively dental help developed in 1976 — 1983 when new dental policlinics in Tallinn and Narva, 59 dental offices were open at the enterprises, collective farms and schools. Much attention is paid to sanitation of an oral cavity at children, to actions for prevention of caries depending on the content of fluorine in drinking water.
Protection of motherhood and childhood. For years of the Soviet power the network of child care and obstetric and gynecologic treatment and prevention facilities increased in the republic more than by 5,7 times. During the tenth and eleventh five-years periods are constructed
Mud baths of local hospital of basic and indicative fishing collective farm of S. M. Kirov.
a maternity home in Narva, the infectious case of the Tartu clinical children's hospital on 150 beds, the Tallinn clinical children's hospital on 335 beds, children's policlinic in Pärnu, delivery, gynecology and pediatric rooms as a part of new central regional BCs in Haapsalu, Võru, Iygevasky, Rapla, Põlva and other areas are open.
Stationary obstetric aid provided 100% of women in labor. In 1983 continuous medical patronage captured 97% of children of the first year of life. The specialized help to children which is given on 18 specialties extended. Surveys of the neuropathologist in 1983 captured 60,6% of children of the first year of life, the orthopedist — 71,3%.
In 1983 in the republic 730 preschool institutions functioned, in to-rykh nearly 70% of all children under 7 years were raised. For the last decade 152 specialized groups for children with various defects of intellectual and physical development and sanatorium groups for often ill preschool children, 3 sanatoria for children with diseases of a respiratory organs with total quantity of places in them 250 are created.
Medical care to country people. For further improvement of service of country people reorganization of network of health care in rural areas is carried out. The network of modern rural out-patient clinics extends, the specific weight of small rural BCs and medical and obstetrical centers decreases. The main direction of development of health care — construction of the joint rural out-patient clinics with drugstores and apartments for medical staff and modern multi-profile central regional BCs. In 1983 in the republic there were 40 district police officers of BCs, 81 rural out-patient clinics and 224 medical and obstetrical centers.
Medical care by the worker of the industry, construction and transport. In 1940 in Estonia there were 4 medical and 11 medical assistant's health centers. In 1983 in the republic functioned 2 medical and sanitary speak rapidly, 10 medical and 254 medical assistant's health centers. The industrial enterprises with number working 1000 are also more serviced by shop sites, and with smaller number of working are attached on territorially - to the production principle to local therapists. In out-patient and polyclinic institutions and in hospitals preferential service of workers is provided.
Sanitary epidemiol ogichesky service. Development dignity. - epid. affairs originates from creation in 1888 of the sanitary station to Tartu and institutions in 1892 of a position of the city health officer in Tallinn. Creation of network dignity. - epid. institutions began in 1940. To bodies and institutions a dignity. - epid. services in a crust, time belong Sanitary and epidemiologic management of the Ministry of Health of ESSR, 1 republican SES, 18 city and regional SES,
1 basin SES, the disinfection station. In Tallinn the scientific research institute of epidemiology, microbiology and hygiene functions.
The state sanitary inspection is exercised by sanitary and epidemiologic stations — republican, city and regional. Since January, 1984 for the first time in the country management and financing a dignity is centralized. - epid. stations at the republican level — at republican SES.
SES laboratories apply hromatografichesky, photometric, polyarografichesky, ionometrichesky and other modern methods of the analysis. On implementation of modern analytical methods in practice of sanitary chemistry the Tartu city SES made significant progress. Sanitary and epidemiologic stations make hygienic examination of the industrial output produced in the republic, exercise supervision of design, construction and operation of objects of the national economy and the inhabited places, carry out control of environmental control, working conditions, life, rest and study of the population, and also carrying out a dignity. - a gigabyte. and sanitarnoprotivoepidemichesky actions, etc. The unified system of collection of information about the state of health of the population depending on a dignity is applied. state of environment. Health of the population in many respects depends on improvement of the inhabited places. In
1983 91,4% of living space of city housing stock were equipped with plumbing and sanitary. The main sources of pollution of the atmosphere are supplied heats-gas-eyes-stnymi with means. Actions for improvement of technical proizvodst*-venny processes, construction of modern treatment facilities, strengthening of control of polluters are provided from state a dignity. - epid. the service working in contact with other controlling services.
Sanitary education. Distribution of medical and hygienic knowledge among the population of the Estonian SSR will organize the republican House of sanitary education. A main objective of the carried-out work is promotion of a healthy lifestyle and education of the healthy younger generation. In system of sanitary education of the republic 25 thousand lectures, apprx. 90 thousand conversations and other actions are annually given on average. Radio, television, newspapers, magazines are widely used. In the republic there is a network of national high fur boots of medical and hygienic knowledge. Except hygienic training and education of various groups of the population the republican House of sanitary education will organize special advanced training courses for permanent members of staff on sanitary education. Since 1979 he publishes and extends a new form of evident propaganda — small-size posters, in to-rykh visualization is combined with the short text. The museum of health care where the Life and Health exhibition is exhibited is a part of the House of sanitary education, annually she is visited by more than 30 thousand people.
Sanatorium business. V E. the network of sanatorium institutions (about 20) allied and republican values is widely presented. Are most known the climatic and mud resort in Pärnu, mud — in Haapsalu, climatic — in Narva-Yyesuu (Ust-Narva); on the lake of Saaremaa and in Vyarska there are reserves of therapeutic mud and mineral waters.
Medical education. Training of doctors for healthcare institutions of the republic for specialties medical business, pediatrics, stomatology is conducted at medical faculty of the Tartu state university (see) where specialists in pharmacy also prepare. Preparation of average medical and pharmaceutical shots is carried out in three medical schools of the republic (in Tallinn, Tartu and Kohtla-Järve) on 7 specialties.
Specialization and improvement of medical and pharmaceutical shots is generally carried out on f-those specializations and improvements of doctors Tartu state un-that, and also in in-ta of improvement of doctors of Moscow, Leningrad, Kiev, Minsk and other cities. The organization of specialization and professional development of average medical and pharmaceutical personnel since 1972 is centralized and is carried out on courses of average medical workers with use as educational bases of healthcare institutions of ESSR.
Pharmaceutical business. In the republic in
1984 (in system of the Ministry of Health of ESSR) there were more than 250 drugstores (including 219 self-supporting), more than 260 pharmaceutical points, 2 pharmaceutical warehouses, 2 kontrolnoanalitichesky laboratories, a galenova laboratory. Annually several drugstores (generally rural) move to new buildings. Pharmaceutical institutions of system of the Ministry of Health of ESSR work apprx. 1,3 thousand people with the higher and secondary pharmaceutical education.
Medical science. With establishment of the Soviet power in E. ample opportunities for development of medical science and preparation of scientific medical shots opened. For coordination of research at the National commissariat of health care of ESSR in April, 1941 Academic medical council was founded, in to-ry prominent scientists of medical faculty Tartu state un-that and executives of the device Narkomzdrava of ESSR entered. The uniform state development plan for medical science and preparation of scientific medical shots was made. This work was interrupted with the Great Patriotic War. In post-war years the medical science in the republic began to develop intensively. The big role in formation, development of the Soviet medical science, in preparation of scientific shots and in overcoming post-war difficulties was played by prominent scientists of the Tartuosudarstvenny un-that V. M. Vadi, A. O. Valdez, E. Yu. Cara, To. X. Kyrge, E. G. Kyaer-Kingisepp, F. Ya. Lepp, A. Ya. Linkberg, E. I. Raudam,
Yu. M. Saarma, E. K. Siyrde,
A. Ya. Tomingas, L. X. Shotter, etc. Along with the important scientific research which is carried out at medical faculty Tartu state un-that and in scientific research institute of the general and molecular pathology, purposeful scientific work is carried out also by scientific medical institutions of system of the Ministry of Health of ESSR.
Questions of professional pathology, pulmonology, toxicology, oncology, gastroenterology, balneology, morphology, hygiene and physiology of work, scientific medical information, the scientific organization of work and methodical work are studied in Ying-those experimental and clinical medicine.
The main scientific activities Ying-that epidemiology, microbiology and hygiene are the epidemiology of bacterial, intestinal and viral infections and development of measures for their diagnosis and prevention; studying of questions of hygiene of the environment and development of measures for public health care; studying of development and the state of health of children and teenagers in the republic, a gigabyte. rationing of their physical activity.
tichesky and antibechic. R-Dimetilaminoetilovogo ether and, and - a diphenyl - and - ethoxy-acetic to - you are a hydrochloride; C20H25O3N • HC1:
In Ying-those cardiology questions of improvement of prevention, diagnosis and treatment of coronary heart disease, arterial hypertension, and also epidemiology of coronary heart disease in ESSR are developed.
In research laboratory of a metalosteosynthesis with clinic to them. A. I. Seppo is conducted development of a method of a metalosteosynthesis at fractures of tubular bones by Seppo's method and scientific bases and methods of ozonotherapy at osteomyelitis and thermal burns.
In the republic works 31 republican scientific specialized medical about-in, combining apprx. 90% of doctors. Besides, is available 9 city and regional about-in, the combining doctors of all specialties. Management scientific medical about - you is performed by Council of science medical foundations of Academic medical council of the Ministry of Health of ESSR.
Since 1954. The Ministry of Health of the republic started the edition of the collection of scientific works «Health Care of the Soviet Estonia», and since 1958 the magazine of the same name in Estonian («Noukogude Eesti Tervisho-id») began to be issued.
Budget of health care. Expenses on health care and physical culture from the state budget increased in comparison with 1945 almost by 20 times and made 108,8 million rubles in 1983.
the MAIN VITAL RATES of the ESTONIAN SSR (for 1000 the population) in 1940 — 1983
The Table 2 GROWTH of NUMBER of MEDICAL SHOTS AND SECURITY with THEM of the POPULATION of the ESTONIAN SSR from 1940 to 1983
The Table 3 GROWTH of NUMBER of HOSPITAL BEDS IN the ESTONIAN SSR from 1940 to 1983
Bibliogrgulordava Sh. A. and With the blackamoor A. A. Dostizheniya and the main directions of development of medical science in the Estonian SSR. Sov. zdravookhr., No. 2, page 16, 1976; R I am t with e p Century. Development of health care in the Estonian SSR, Tallinn, 1981. V. I. Ryatsep.