Medical and sanitary service of northern part of Bukovyna after the First World War (1918-1928)

Abstract

The article deals with the main trends in the restoration and development of the medical and sanitary service in the territory of Northern Bukovyna in 1918-1928, during which martial law continued here, after which the territory became part of the Kingdom of Romania.In the first post-war period the population of the region found itself almost entirely without healthcare. Collapsed health system could not fight the spread of epidemic diseases through the region that also led to a complicated demographic situation in the post-war Bukovyna. The enduring spread of diseases among the population and, to a certain extent, the wish of Romanian authorities to use medicine for propaganda purposes forced the start of a comprehensive work to improve health and sanitary conditions in the region. The primary task that had to be urgently solved by the health service in the early post-war years has become the overcoming of the epidemics of infectious diseases that at the end of World War I led to great mortality among the population. Quite common among the residents of the region were dysentery, typhoid, typhus, relapsing fever, tuberculosis, and a number of pediatric respiratory infections – scarlet fever, measles, whooping cough, diphtheria, contagious parotitis, varicella and others. Some years there was an urgent need for the establishment of health centres, dispensaries. According to the law of 1923, the Health Service was divided into two parts: sanitary and hospital. The Sanitary Service was engaged in supervision, control and study of the health status of the settlements, the use of general and special preventive measures and prevention of epidemics, to provide medical care outside hospitals, educate the population about prevention and treatment of social diseases etc. The Hospital Service was responsible for hospital treatment and medical supervision of patients in hospitals. Bukovyna along with Khotyn district and the northern part of Moldova was included in the VIII sanitary region under the guidance of General Sanitary Inspectorate. For the operation of health service, Bukovyna was divided into five health areas, each headed by a Chief Physician. Areas were divided into sanitary districts. At the head of each one was the district doctor who had assistants, district midwives, and health agents. The duty of medical personnel was to countercheck social diseases. In this regard, 9 infirmaries and 27 dispensaries were founded in Bukovyna within 10 years (1918-1928).To avoid the spread of infectious diseases from abroad – an official centre «Grigore Ghica Vodӑ» was created to examine travellers at the border at the railway station in Nepolokivtsi.Also, in the first post-war decade for health services of the land the Sanitary Inspectorate has founded in Chernivtsi: Regional warehouse of medical instruments and devices; Regional warehouse of drugs, serums, vaccines and bandages, and the Institute of Hygiene.Compulsory preventive vaccination against smallpox and other infectious diseases was introduced. Doctors held free consultations in towns and villages both at home and in hospitals. At the same time, in the first post-war decade a decrease of doctors and paramedical staff is observed.Taking into consideration the shortage of a sufficient number of hospitals, clinics, doctors, nurses, lack of medicines, vaccines, therapeutic sera in Bukovyna, it should be ascertained that the state of epidemic diseases in the region in the early post-war years remained extremely hard. Only in the mid-20s such diseases as smallpox, typhus, and dysentery had been largely overcome thanks to vaccination, organizational and educational measures taken by the authorities. However, there remained high death rate from heart diseases, pneumonia, tuberculosis, due to difficult living conditions and inaccessibility of health care to the most.