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Humanitarian sciences in Siberia

2018 year, number 2

REFORM OF RURAL MEDICINE IN EASTERN SIBERIA IN 1897: REASONS, FUNDAMENTALS, CONSEQUENCES

V.A. Shalamov, L.M. Dameshek
Irkutsk State University, 1, K. Marx str., Irkutsk, 664025, Russian Federation
Keywords: Иркутское генерал-губернаторство, имперский регионализм, реформа сельско-врачебной части, история здравоохранения, здравоохранение Восточной Сибири, генерал-губернатор А.Д. Горемыкин, врачебный инспектор Н.Е. Маковецкий, 1897 г, Irkutsk Governorate-General, imperial regionalism, rural medicine reform, health care history, health care of Eastern Siberia, Governor-General A.D. Goremykin, Medical Inspector N.E. Makovetsky, 1897

Abstract

The article is devoted to the reform of rural health care in Eastern Siberia carried out in the Irkutsk, Yeniseisk provinces and Yakutsk region in 1897, as well as Transbaikalia in 1901. This work continues research of Russian historians who studied reforms of health care system in these regions of the Russian Empire that did not have zemstvos. The authors characterize a condition of medical care for rural population of Eastern Siberia in the second half of the XIX century as extremely backward, close to its total absence. The population asked for zemstvos, which had considerably improved the health care system in the central provinces. However, introduction of zemstvos in Siberia was interfered by a number of reasons: existence of penal servitude and exile, numerous aboriginal population, lack of noble land tenure, close arrangement of borders, etc. Due to these reasons it was decided to undertake a reform, which considered the experience of medical personnel activity in zemstvos. The great role in the reform implementation was played by the Irkutsk Governor-General A. D. Goremykin and the medical inspector N. E. Makovetsky. Each East Siberian district had from one to seven medical sites headed by doctors. The medical personnel number increased by 60 % after the reform. At places of doctors’ residences hospitals with 10 beds were created. Hospitals construction dragged on and by the beginning of World War I only 86 % of the planned number of beds was available. The reform assumed to create the staff of special workers to fight against smallpox. Financing grew considerably at the expense of the additional tax. The austerity budget was adopted, so the population in some cases was forced to raise money for purchase of medicines, equipment of hospitals and qualified specialists’ invitation. Despite a number of shortcomings, reform improved medicine positions in the rural zone of Eastern Siberia, it also delayed the prospects for zemstvos introduction in the Siberian territories indefinitely.