CC BY
0TRAINING OF MEDICAL PERSONNEL IN UZBEKISTAN
Najmiddinov K.M.
Namangan State University - Phd student of the Department of History https://doi.org/10.5281/zenodo.13893773
Abstract. Training of medical personnel to maintain the health of the population in Uzbek SSR is considered one of the most important tasks. In this article, it is explained how the training of medical personnel and improvement of their qualifications was started in Soviet Uzbekistan. The issues of educational institutions training medical personnel and their material support are revealed on the basis of various evidences on the example of the regions of Fergana Valley.
Keywords: oncology, dentist, sanitation, Council of Ministers, obstetrician-gynecologist, therapist, pediatrics
INTRODUCTION
After the independence of Uzbekistan, the further development of the health care sector and strong reforms in the field of social protection of the population have become one of the most important priorities today. Protecting people's health and raising human dignity is the main factor in effective and consistent implementation of our current reforms.
During independence, number of reforms were carried out to protect the health of the population, and free medical services were strengthened by law.
In particular, wrong decisions and shortcomings were made by the Soviet government in the training of medical personnel and the systematic organization of their work. Today, studying such mistakes and shortcomings and drawing conclusions from them is one of the urgent tasks.
LITERATURE ANALYSIS AND METHODOLOGY
In colonial conditions, a number of scientists conducted scientific research in the field of health care and personnel training in Uzbekistan. Among them, researchers such as G. Mominova [5], A. Kadirov 6], P. Menlikulov [13] have studied comprehensively. This article presents new ideas and conclusions about this period using the scientific works of these researchers and new archival materials, materials published in periodical press publications. In it, based on methods such as data analysis and comparison, issues such as training of medical personnel in Uzbekistan during the Soviet government and the quality of their material support are covered.
RESULT AND DISCUSSION
In the years after the World War II, many new scientific research institutes were established in Uzbekistan. The institute of sanitation, hygiene and occupational diseases was reopened (1946), oncology and radiology (1958), pediatric scientific research institutes (1966) were among them. For example, in Uzbekistan, there were 11.9 doctors per 10,000 inhabitants (17 in the Union), 57.2 doctors per 10,000 people (70 in the Union). The death of children decreased by 10 times, and the average life expectancy of people increased twice. Uzbeks made up the majority of students in this medical school, but the textbooks were mainly in Russian. The lack of textbooks in their mother tongue for students who came to study from the regions prevented them from getting a perfect education.
In 1974-1977, a great increase was achieved in the training of doctors and medical staff in Fergana region. In 1974, 2,173 doctors were trained, in 1975, 2,276, in 1976, 2,474, and in 1977,
2,695 doctors were trained. In 1972, 7971 people were trained, 8558 people - in 1973, 9579 people - in 1974, 10081 people - in 1975, 10811 people - in 1976, and 11425 people - in 1977. [2,7.8]
In 1978, the supply of doctors and paramedics in Namangan region increased significantly. In 1978, there were 1907 doctors and 6867 secondary medical workers in the region, and 17.6 doctors and 63.4 secondary medical workers per ten thousand inhabitants. But there was a big difference between regions and cities. In addition, there were 2,871 medical positions in the region, 2,759 of which wre occupied, and 7,706 were secondary medical positions, of which 7,474 were employed. There were 678 medical institutions in Namangan region, including 76 hospitals, 22 outpatient clinics, 1 emergency medical station, 12 emergency medical departments, 19 single outpatient polyclinics, 94 health centers, 1 forensic examination bureau, 2 orphanages, 12 sanitary-epidemiological stations, 6 sanatoriums. [3,6.7]
In 1982-1983, 1050 nurses from the graduates of the 8th grade were admitted to medical schools of Tashkent, Andijan, Namangan, Termiz, Yangiyol, Chirchik Margilan, Kokand and Nukus. [4,14.30] 690 of them were trained in Namangan, 370 in Andijan, and 570 in medical schools in Kokand. In 1982, a total of 12,180 secondary medical workers were trained in 25 secondary medical institutions, 12,780 in 1983, 14,000 in 1984, and 15,000 in 1985 in day and evening education. defined.
On February 8, 1964, on the basis of the decision No. 74 of the Council of Ministers of Uzbek SSR "On measures for the further development of secondary medical education of the Republic" on improving the study and living conditions of students of medical institutions in the regions a number of works were carried out.[5,208] According to the decision, new buildings and dormitories for students were built for medical educational institutions in the regions, the material and technical base was improved for the production of high-quality nurses and paramedics.
In 1967, the healthcare budget of the Republic amounted to 247.6 million sums, that is, more than 23 sums per capita. In 1962, 168.6 million sums were spent from the budget, which was 19 sums per person. In 1967, there were a total of 16,843 doctors in Uzbekistan, of which 15,476 worked in the Ministry of Health of Uzbek SSR. Also, 54,668 secondary medical workers worked in the republic. In addition, there were 3,376 pharmacists and 879 dentists in the republic, and more than 60 percent of them were representatives of the local nationality. During this period, there were 105 doctors of science and 787 candidates of science work in 5 higher educational institutions, 12 research institutes. [6,28.31]
In order to fulfill the tasks, defined in the resolution of the Ministry of Higher Education of UzSSR dated January 6, 1975 No. 5 "On the further improvement of teaching of social sciences and political-educational work in secondary special educational institutions", the resolurion of the Ministry of Higher Education of UzSSR dated March 16, 1979 No. 3 "On further improving the quality of teaching social sciences in technical schools in the city of Tashkent", certain works were carried out to improve the teaching of social sciences at Namangan Medical Collage named after E.I. Atakhanova. The following social sciences were studied at the medical institute: 1) Fundamentals of philosophical knowledge 2) Fundamentals of scientific atheism. 3) Fundamentals of political economy 4) Social sciences 5) History. The teaching loads of teachers of social science have been completed. Student performance in social studies was 99.6 percent in the 1980-1981 academic year, and 99.7 percent in the 1981-1982 academic year. At school, 4 students received an unsatisfactory grade at the end of the exam session. [7,17]
Citizens of UzSSR under the age of 30 - men and women - were admitted to secondary special medical schools. People who have completed the eighth grade or high school education and successfully passed the entrance exams were accepted for evening and part-time studies, regardless of age. The state established privileges for entering these secondary special educational institutions. [8,4]
More than half of the students studying in medical schools were Uzbeks, and the personnel who graduated here were sent to work in the regions of the republic. Government benefits for specialists sent to rural regions - free accommodation and other communal facilities were provided. Additional remuneration was paid to medical workers who have worked for many years.
In 1968-1969, 98 medical workers worked in dispensaries of tuberculosis hospitals in Fergana region, while a total of 183 doctors were supposed to work. There was also a shortage of radiologists. Despite the fact that 98 people were appointed by the state, 70 x-ray doctors worked. 38 of them worked in the main staff, and 20 worked on a substitute basis.
In the 1970s, the personnel problem was the most important problem in Namangan region. In 1970, the staffing of treatment facilities in Namangan region was 91.1 percent. [9,14] In 1977, the difference between the number of doctors per capita in the districts of the region was clearly visible. For example, that year, there were 40.0 doctors per 10,000 inhabitants in the city of Namangan, it corresponded to 9 in Torakorgan, Namangan and Uchkorgon districts, and 5.5 in Chust district. [10,3.4]
Namangan region (1983) had 1,267,157 inhabitants, of which 728,001 were adults. There were 539,156 children under 14 years of age. Medical care was provided by a wide network of treatment and prevention institutions: 147 outpatient clinics, 6 city hospitals, 4 medical departments, 34 rural district hospitals, 11 central district hospitals, 50 rural medical centers; 2626 doctors worked in the region, 416 of them were therapists. [11,1]
By 1980, a total of 37 medical educational institutions were operating in the republic. 45,532 students in 1988 and 45,958 in 1989 were educated in medical educational institutions in Uzbekistan. Every year, 20,000 secondary medical workers were trained in the republic's medical institutions. Only 28-30 percent of them worked in their specialty. [12,209]
In the republic, there was no management and coordination work on the training of secondary medical workers, their allocation to work. In addition, there were no firm plans for improving the qualifications of secondary medical workers and their attestation. For example, in the 1990s, only 7.1 percent of secondary medical workers in Uzbekistan had a category. [13,68.69] According to the statistics of 1958, there were 17 in the RSFSR, 16 in Ukraine, 12 in Uzbekistan, 11 in Belarus, and 10 in Tajikistan for every 10,000 inhabitants. [14,16] In the general distribution, on average, 3 therapists, 1 surgeon, 0.7 - obstetrician-gynecologist, 2 pediatricians, 1 - epidemiologist, 0, 3 people - ophthalmologist, 0.1 - psychiatrist corresponded. [15,17]
These indicators show that there were great shortcomings in the training of personnel and the planning of their activities in the field of health care of the population in Uzbekistan. Compared to the developed countries of Western Europe, these numbers were 4-5 times lower in that period.
Of course, the work of training medical personnel in Uzbekistan increased year by year, but most of the medical personnel with higher education worked in treatment institutions of large cities. 80 percent of highly educated medical workers worked in city and district centers. [16,2]
During the years of Soviet rule, the appeals of the heads of health departments in Uzbekistan to the Ministry of Health of the republic asking them to provide staff to vacant states
were left unanswered. Because there was a shortage of personnel. The Ministry of Health sending representatives of the indigenous population to study at higher medical institutions was not sufficiently put on the agenda at that time. Therefore, a very small part of the personnel working in the regions were representatives of the local population. Doctors from other cities and villages and those who returned to their places as soon as the specified period ended. In this way, young personnel were sent instead of qualified personnel. This had a serious effect on the quality of public health protection and treatment. One of the reasons for leaving their place was the lack of accommodation.
The decision of the Council of Ministers of Uzbek SSR No. 2029 on November 20, 1950, "On the provision of free apartments, electricity and heat to medical service workers in working settlements in rural areas", the decision the Central Committee of the CPSU and the Council of Ministers of UzSSR No. 517 on July 5, 1968 "On providing communal benefits to doctors, secondary medical service workers, and pharmacists working in rural areas" were adopted, their implementation was not fully ensured. Until the 1960s, not a single residential building for medical service workers was built in the rural areas of the regions of Uzbekistan. [17,213,214]
In 1950, the number of doctors in UzSSR was 247,346, and in 1959, their number reached 379,501. For example, in 1953, there were 537 doctors working in Andijan region, and in 1959, their number reached 859. In 1958, their number was 33, radiologists decreased from 16 to 13 in 1958, and dermatologists decreased from 19 to 18, there were not enough therapists and pediatricians. In Andijan region, there were ophthalmologists only in 3 districts, and there were no neuropathologists in any district. In addition, obstetrician-gynecologists did not work in 10 districts, surgeons in 6 districts, and phthisis's in 12 districts. [21,19]
In 1957, not a single therapist-doctor worked in the treatment facilities of Kuva, Buvai, Baghdad districts of Fergana region. 7 out of 26 rural district hospitals in the region did not have a highly educated medical worker at all. [22,5]
The provision of medical personnel in rural treatment facilities during this period remained a serious problem. It was very difficult to organize special assistance in the field of surgery, gynecology, children's diseases, nerves, eyes and other diseases. Even mid-qualified medical staff did not meet the demand. CONCLUSION
In conclusion, it should be said that during the period of the Soviet government, there were several shortcomings in the training of medical personnel for the protection of public health. There was a constant shortage of personnel serving in various areas of public health care. In addition, a compact system for their quality training was not created. There were serious differences in the training of doctors and paramedics in the cities and villages of Uzbekistan. That is, there are more employees per 10 thousand urban residents, there were 2-3 times less employees in the villages. There was a shortage of employees in narrow specialties in all regions. The salaries of doctors were low. Doctors were sent to remote areas to work. They were officially provided with housing and other privileges, but in practice these were not fulfilled. It is necessary to draw a conclusion about the mistakes and shortcomings made during this period and create a compact and systematic form of training of higher and secondary specialized medical personnel. It was necessary to consider issues such as targeted training of medical personnel based on regions and application of privileges to certain medical specialties.
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