History of Public Health in Russia

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History of Public Health in Russia

• From 1800s to 1917

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The first medical faculty was established in
1775at the University of Moscow.
Main buildings of the university in the Mokhovaya
Street, 1798.
3
Modern transportation cholera epidemic

• Unfortunately the great strides in modern
  transportation accelerated the spread of cholera
  from India in 1816 to the ports of the
  Philippines, China, Japan, Persian Gulf then
  north toward the Ottoman and Russian empires
  killing thousands by 1826.

4
Early 19th Century Russia Alexander I, Nicholas
I, and the birth of revolutionary movement
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Russia in the 1860s

• Great reforms
• Railway
• Growth of industry
• Commercial ties with the Orient

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Freeing of serfs (1864)

• Alexander II of Russia The great reformer

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Nikolay Ivanovich Pirogov
8
1870s-1880s

• Zemstvo or community physicians idealistic young
  people who had studied at Russian Universities
  during the period of relative liberalism which
  marked the early years of the reign of Alexander
  II

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Zemstvo Medicine

• A system of primary rural medical and sanitary
  services which was funded out of government
  subsidies and zemstvo taxation (available on no
  fee basis)

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Who was a zemstvo physician?

• In modern terms, the best equivalent would be
  primary care provider.

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Formation of Pirogov Society of Russian Physicians
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1880s

• S.P. Botkin recommended that Russia set up a
  powerful central administrative agency to direct
  public health affairs.

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Bacteriological revolution (1880s)

• History of I.I. Mechnikov
• Diphtheria serum-1893/94
• Bacteriology was now championed by community
  physicians who saw it a s tool to be used for the
  benefit of the people

14
Alexander III

• Famine of 1891-92
• Cholera epidemic 1892-93

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From the memo of Professor N. A. Veliaminov, 1901

• What is the sanitary state of Russia?-In
  comparison with the states of Western Europe, and
  even with our own Finland, it has to be admitted
  that it is dismal in the extreme the percentage
  mortality of the population is high, the average
  life expectancy is short, and there is a great
  amount of contagious, epidemic and endemic disease

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1905

• Making Russia Healthythe slogan of community
  physicians
• Cholera congress

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The opportunity for developing preventive
education work in connection with such a system
is practically unlimited We may therefore look
in the future, as zemstvo and municipal medicine
develop and acquire the educational and
preventive quality which is in accord with modern
progress, for unprecedented successes in the
control of preventable diseases in the great
sister Republic..
From the report of Charles Edward Amory Winslow,
APHA, 1917
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Community Medicine in Dissaray 1907-1914

• Stolypin and his reforms

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1918

• Establishment of Narkomzdrav, Centralized public
  health/medical system

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What was happening after 1917?

• In 1925, the Pirogov Society was forced to
  disband and the Hippocratic Oath was abandoned

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Summary

• Historically, Russian medical system was
  intertwined with the political situation in the
  county
• At the end of the 19th century, Russias system
  of zemstvo medicine provided a very good
  foundation for preventive care
• Zemstvo physicians became a powerful force in the
  early 20th century
• With the revolution of 1917, Russian medical
  system started to change rapidly with different
  theories existing about the fate of zemstvo
  medicine