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С.А. Абдыманапова. – Астана: Изд-во ЕНУ им. Л.Н. Гумилёва, 2004. – С. 75-77.
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ASSYMOVA DARIYA,
TASHIEVA SALTANAT
(Kazakhstan, Almaty city)
ALMATY CITY DWELLERS’ EVERYDAY LIFE IN THE 1920-1930S OF THE XX
CENTURY(STATE OF HEALTH CARE)
Health care sphere,regarless of ared , het it be city one or village one, is considered to be a decisive factor
of the human being life. From this point, in our opinion to be informed of this sphere’s state, and the quality
of service to the dwellers of Alma-Ata, which became the capital of the republic in 1929s, is one of the
most interesting topics. According to the archive documents’ fund, medical service rendered to the dwellers
wasn’t up to the standard. The dwellers often experienced typhus, infectious abdominal diseases, trachoma,
tuberculosis, plague, smallpox. The city hospitals hardly had clean beddings, that’s why the patients had to
use the dirty ones. Beds in the hospitals we in the crucial state, the patients may surely fall down of them.
There were shortage of dressings. Tattered bandages were in use. The patients were served meagre fare. In
1913 only 356 roubles and 60 copecks were allocated to the city hospitals. Medical treatment was chargeable.
The Kazakhs were to be treated after they had bought the «medical card». Local authorities used speak
ironically on the ocassion: «the Kazakhs will go to medical establishments against their will because the air of
hospitals is much more dangerous for steppe inhabitants than many of the diseases». In 1881 only 7 roubles
09 copecks were spent for treating Kazakhs and Kirgizes in Very hospital instead of 400 allocated roubles.
There were 10 doctors, 10 doctor’s assistants and 3 dental mechanics. In 1913 in Verny. They were engaged
mainly in private practice. Verny uezd-city health care department was established in the winter of 1919.
Pasterov station was opened at that time in the city. In 1920 in spring a typhuc hospital containing 25 beds
began to function. There weren’t enough water barrels, kerosene for lightening in the so called «infectious
hospital». The wards were equipped with plankings intead of beds, the only horse cart was at the disposal of
the whole hospital. Health care activities began in this way in Alma-Ata. In adition to a military hospital and
an in-patient department 5 more new hospitals had been built by 1927. 7 ambulatory clinics, a TB prohylactic
centre, riding first-aid service a malarial station, some chemist’s «shops» a medical shop rendered the dwellers
their service in the following year. In the late 1920s 34 doctors were employed, and their number reached
205 in 1939. By that time the number of hospitals have, increased from 2 up to 21, ambulatory clinics and
polyclinics, correspondingly-from 3 up to 38. According to the Zhetisu regional hospital record in the
concerning infectious disedses spreading from Februa ry 1-10 and March 1-10 in 1930, many of the dwellers
suffered the flu, spotted fever and relapsing fever. Infectious diseases spreading quickly took place because of
financing shortage and not taking preventive measures (Tables 1-2)
260
Zhetisu regional hospital Record (the therapeutic department) concerning infectious diseases spreading
from February 1-10, 1930. Table 1
Types of dis-
eases
were
registered
were
received
were treated were
tranferred
died
not sick
Influenza
12
17
-
-
1
28
Diptheria
-
1
-
-
-
1
Spotted fever 10
8
3
1
-
14
Mumps
5
6
7
1
-
3
Pneumonia
2
-
2
-
-
-
Zhetisu regional hospital Record (the therapeutic department) concerning infectious diseases spreading
from March 1-10, 1930. Table 2
Types of dis-
eases
were
registered
were
received
were treat-
ed
were
tranferred
died
not sick
Rubella
1
-
-
-
-
1
Typhoid
-
2
-
-
-
2
Spotted fever
23
12
-
-
-
35
Typhinia
25
15
12
-
-
40
Because of little money having been allocated to the Public Health Care department from Regional Health
care Department in 1926, half of the functioning health care institutions were closed.
Among them were:
1) In Alma – Ata: a children’s clinic stopped functioning, its 30 beds it were placed within the regional
hospital.
2) The regional hospital had only 150 beds.
3) In the infectious hospital from 50 beds only 30 remained.
4) The city outpatients clinic personnel was reduced up to 50 %
5) There were only 6 medical institutions and 151 employees in the city. Before it had had 8 medical
institutions with 388 beds, where 278 employees word.
Alma – Ata city council paying much attention to the social sphere, some measures were taken to improve
it.
Then the regional Paster hospital, regional insane hospital, Alma – Ata city hospital. Almaty regional
outpatients clinic, Alma – Ata sanitary inspection began to be financed from the city budget. Alma – Ata
infectious diseases hospital began functioning on February 17, 1925, and X – ray consulting – room – from
October 1 of the same year. A doctor was sent to Leningrad to master the profession of a rontgenologist. An
oculist’s service had been chargable before and certain means were allocated from the budget to make it free
of charge. Specialists treating ears, throat, eyes worked in the oculist’s hospital. At the expense of state budget
a malaria station started its work in June, 1925. Chemical bacteriological laboratory began functioning from
May, 1925. One more institution for mother and child was established in the Advisory Centre. 22 beds were
designated for children and 8 beds for pregnant. But it worked from May 10 up to October. Instead children
milk providing kitchen was opened at the expense of state.
By January 1, 1925 the following medical and sanitary institutions were functioning in Alma – Ata:
1. Regional Pasterovskaya station with the personnel of employees;
2. 30 bed regional insane hospital, 23 employees;
3. Central, ambulatory clinic of Alma – Ata, 20 employees;
4. 70 bed Alma – Ata city hospital, 54 employees;
5. Alma – Ata city sanitary inspection, 6 employees.
All these institutions were financed by the local budget. Because of means shortage, the staffs of the
following hospitals were cut down:
1. in the province insane hospital – 2 employees;
2. in Alma – Ata hospital – 6 employees;
3. in Alma – Ata Central outpatients clinic – 9 employees;
4. City sanitary inspection – 2 employees;
Regional insane hospital.
261
Before the flood in 1921 it was located in specially built, buildings, then the hospital was evacuated twice,
at the moment it is located in two old houses. The heavy repair of it and special insulator for mad patients is
necessary.
By December 1, 1924 31 patients had been registered, 51 of them were examined, they had been treated
11179 bed – days.
Alma – Ata City Pasterovskaya station.
The station is situated in the suitable building, but it needs repairing, including to substitute gridigon in the
yard where the rabbits are. Since October 1, 1925 two institutions have been funded from the state budget. 298
patients bitten by mad animals were examined and 3764 were vaccinated. Before July 1, 1925 Almaty city
hospital had 70 beds, and then at the requests of dwellers they increased to some more 15 beds.
2497 roubles and 10 copecks were allocated for repair works and the following was done:
the walls of till buildings were whitewashed, some stoves were reconstructed in the infectious diseases
department, new stoves were also fixed in the surgery department, the roofs of the buildings were painted and
the new windows were put in. In the new 1925-1926 fiscal year a laundry and ironing room were built at the
expense of State and local budgets (951 roubles)
In addition to it a disinfection chamber and clothes drying device were established. In the period under
review 2301 patients were registered and 46641 bed days were designated.
According to the staff 85 beds were distributed in the following way: 30 beds for policy holder (they are
in the other building). 10beds for obstetric department: 15 beds for infections diseases department the rest 25
beds for surgery, gynecological and abdominal patients.
However, this kind of distribution were made formally, the real facts are over and above norms, as examining
and treating of pregnants and infectious diseases patients was obligatory.
In the course of epidemic diseases spreading the number of infectious disease patients were over 40 patients
which exceeded the norm 2-3 times. That was the case for the pregnants , sometimes their number was under
15. Taking in to situation like that, women in childbirth were transferred from a narrow room to a 20 bed ward
that had been repaired. (10 beds of which were built at the expense of medical fund).
The number of the sick people for being treated in in-patient treatment was considerable, thus, conflicts
rose in case the patients weren’t admitted to hospital. It was a common thing when the relatives make the
patients stay in the hospital for a long time. Hospital staff had to place the patients of that kind in hospitals. In
connection with the facts above, provincial health care department applied for aid to increase the stuff at least
up to 200 beds.
Alma-Ata city central outpatient clinic.
It treated the insured patients and their family, member of executive committee and invalids. Other city
dwellers were rendered ambulatory care at the city hospital. The stuff was financed by medical fund ( 3
doctors: a midwife, ______, a recorder).
On an average, the outpatient clinic served 125-150 patients. It had the following consulting rooms for:
1. abdominal diseases;
2. obstetric and gynecological aids;
3. dental aid;
In the financial year 20846 patients were registered and were consulted 45541 times, while having been
treated.
Alma-Ata city dermatovenerologic hospital
(100 beded) It was reconstructed from the insulator which had been at the authority of public educational
inspection board, it began to treat children from April 18, 1925 By city Executive Committee decision in been
functioning under the supervision of Provincial health care department. In summer the hospital was located
in the former preselendik (migration) stop point. And the autumn it continued its work at the military hospital
buildings.
Beginning from the first day of its work up to October 1, 1925 its expenditure composed 8222 roubles and
63 copecks.
The hospital wasn’t equipped with necessary furniture. The stuff has been doing its best, but it couldn’t
provide clothes for all it’s patients. The medical provision was sufficient at that time.
Roentgen consulting-room
Three staff were admitted on October, in 1925-1926 fiscal year at the expense of local budget. The room
stuff didn’t work temporarily, as it’s head left the province because of his (her) poor health. At the late
February, 1926 after the doctor’s having arrived, who had been sent to Leningrad for mastering the profession
of roentgenologist, the stuff go on with its work.
262
Eye curing department
It administrated temporary medical assistance to parents. On an average, 100 patients were examined a day
and then an in-patient clinic with 10 beds was equipped after the credit had been assigned for buying devices.
The salaries of the employers and other expenses were paid through the chargeable medical service means and
not from the local budget.
And only from December 1, 1925-1926 fiscal year it began to be financed by the local budget. Specialists
curing ear, nose, throat and eye diseases worked there.
State health care institutions
Malaria station was opened in June, 1925. During a month organizational activities, studying of methods
against malaria were performed.
In addition to research works, the out patient clinic examined the patients. 1556 patients were registered,
examined at that period (8584 times), later a stationary chamber with 5 beds was established at the expense
of the state budget. And 1347 roubles and 18 copecks were allocated. To meet the requirements of life, a new
type of medical institution was opened near the province. Because the imperialist and civil war that Almaty
dwellers had experienced , resulted the rising of such diseases as: tuberculosis, syphilis, malaria and etc. To
overcome these difficulties the city authorities chose a way of clinical examination, and opened the new types
of medical and sanitary institutions. Their main goal was not only medical treating, but to do scientific and
research works and take preventive measures. And it promoted improving the dwellers health. Moreover, there
were tuberculosis and venerologic dispensaries.
Dermatovenerologic dispensary
Dermatovenerologic dispensary was opened on September 12, 1925. From this date up to March only
organizational activities and ambulatory care were performed, then sanitary preventive measures were taken.
At the period under review schools and orphanages were checked: (1577 children) and the sick children were
isolated from others in dermanto-venerologic dispensaries. 3 consulting rooms functioned there:
1. 805 patients were registered because of gonorrhea and its advanced form;
2. 4701 patients – concerning syphilis;
3. 1220 patients – because of dermal diseases;
600(0,6 gr.) ampoules of Necalvarsan were used. 2594 patients were registered, they were examined 6708
times. 1808 roubles and 54 copecks were a allocated to the dispensary in 1925
Chemical and bacteriological laboratory
It was opened in May, 1925. After Kazakh People’s health care department making a decision about
opening a laboratory at the expense of the state budget, an application was addressed to provincial executive
committee with the request of laboratory properties handing on to provincial health care department which was
in the possession of medtorg (medical trading department). At the same time 24 guinea were bought to test
vasserman reaction. Bacteriological laboratory made 913 analyses. 2610 roubles and copeeks were allocated
to the laboratory
Maternity and infant welfare centre
It was opened in January 1925 and could examine 20 patients a day. Till October 1925 it functioned
through 900 roubles allocated by former Turkistan public health care department and medical fund accounts.
Exhibition of pictures are exhibited there showing how to look after babies. Babies under 1 year old and
were examined 788 times, the ones under 1-3 – 430 times. The revealed diseases they had: gastrointestional
diseases, infectious diseases – 101, non-infectious diseases – 385. Expect the institution there was a mother’s
and baby’s house with 30 beds, including 22 beds for children and 8 beds for expectant mothers. It functioned
from May up to October,1925. According to Kazakh People’s health care committee’s order it was closed. The
replaced new institution – an advisory bureau with milk canteen – was included into the state budget.
During January and August in 1926 1000 mothers and children were examined at the advice bureau, and
their number reached 9000 at that period of time in 1927. In comparison with outcomes in 1926, the number
of women increased 4 times, and the children number – 2,5 times. The mother not only took advice, but they
realized the importance of them. The volume of milk canteen increased 3 times. Advice bureaus began their
work there.
At that period of midwife Anna Nikolaevna Petrova renting a flat in Pervo-Gildieskaya Street 4336, was
engaged in her job.
After Almaty had become the capital of our state, state of health care department began to improve. The
main reason of it was based on the fact that the population of the new city increased, and the main task of the
doctors and city authorities was to raise medical institutions service level. Owning to the replacement of the
sanitary-bacteriological cenrtre to Alma-Ata from Kyzyl-Orda control of typhus was to be consolidated.
263
Alma-Ata had a favourable climate condition thanks to its location, but the typhus was spread in most part
of the city, many the dwellers living outside the city suffered from this disease. According to statistics, 3500
inhabitants tended to get ill. As many of the Malaya Stanitsa dwellers experienced the infectious diseases
sanitary-bacteriological institute authorities sent the doctors instructors there to deliver lectures. Preventive
measures were taken against typhus: all the inhabitants were tested, the patients were to stay in the hospital
until they recovered completely. 28 schools were involved in conversations, the employees and pupils were
examined.
The institute staff issued leaflets about preventive measures against the disease. In order to give reliable
information about typhus a film was brought from Moscow.
Two medical institutions were opened in Alma-Ata: a tuberculous dispensary with a night sanatorium and
Medeu holiday home sanatorium.
Those two medical institutions were equipped well and the medical experts were of high quality. The clean
mountain air, good feeding at the Medeu sanatorium had favourable effects for quick recovering of patients.
Medeu holiday home rendered a service to 55 patients and clients. It was presumed that the number of them
would reach 67 in the nearest future. The patients of the holiday home regained the necessary weight and
recovered in due time. The peculiarities of the tuberculous dispensary were cleanliness and proper service.
Provincial social insurance department used to grant passes for 12 patients to Arasan holiday home.
In April, 1928 a week – long measure «For healthy generation» was held for revealing the pupils’ getting ill
reasons. Abundance of mental activities ( being busy with studies all day long ), not doing physical exercises
at all, not maintaining the requirements of hygiene, wrong nourishment were considered to be the dangerous
factors influencing our youth’s health.
It was revealed that 50% of the pupils at schools suffered from anemia, pulmonary diseases (tuberculosis)
In the course of studying pre - school children’s health, it was found out that most of them had poor health.
When a week, under developed child goes t school, his (her) lagging behind will make a progress. At school a
pupil is on the run, swallows dust and performs mental activities. Various diseases occur due to these factors.
Tuberculosis is in the first place among the diseases. Medical verification outcomes in РКФСР (RKFSR)
showed that 20% of pupils suffered from tuberculosis. They were the children of different ages. Many of them
lived under insanitary conditions and their living conditions were poor.
The children suffering from tuberculosis were often tired absent – minded, hot – tempered. The children of
that kind often didn’t get on well with teachers and were in the rank of these who left the school. They became
homeless and neglected. There were many reasons for these phenomena: transition period, war, starvation
period, pedagogical and social indifference and other reasons.
In January, 1929 in the report of the City Council, it was pointed out about the organizing of the first aid
medical service (rendering of medical service to the dweilers at home proved to be useless). It was a mistake
when the City Council members reduced the home service doctors number up to 1. During the epidemic
diseases spreading the only doctor wasn’t able to examine 50000 dwellers. The doctor usually chose 8 – 9
houses out of 20 – 30 addresses that were near the out – patient clinic, the others only relied on God’s mercy.
Moreover, the doctor wasn’t provided with the car, he (she) had to walk to the place of destination. Necessity
of medical aid grew day by day. As there was much work to do at the outpatients clinic, the local health care
department didn’t allow the doctor’s leave the place of their work, in case of examining the patient there,
sometimes the doctor wasn’t able to make right diagnosis, and not everybody could afford to call a doctor.
At an early June, in 1929, the the doctors of the city hospitals were to perform the function of daily alert
doctor. Up to that time only nurses used to do the duty like that. After Alma – Ata had become the capital, its
population began to increase. Only 40 medicine experts worked in the city.
Due to moving specialists from central institutions the local health care department issued an order according
to which the aid post heads, located in Alma-ata-Frunze (Bishkek) highway, must administer a medical aid to
the immigrants. The aid posts were located in Georgievka(a local hospital), Kordye (a doctor’s assistant aid
post), Otar (a doctor’s assistant aid post),Uzun-agash (a local hospital), Kaskelen (doctor’s assistant aid post)
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