Rural medicine in the Podillia governorate under the conditions of the new economic policy (1921–1925)

Abstract

The aim of the article is to reconstruct, based on archival materials, a holistic picture of the functioning of the medical sector in a Podillia village in the 1920s, to identify the specifics of regional challenges and the effectiveness of the Soviet health care model in overcoming the consequences of the humanitarian crisis in the Podillia region. Research methodology. The research was based on the principles of historicism and objectivity, as well as general scientific (analysis, synthesis, logical, generalization), special methods of historical science (historical-comparative, problem-chronological, historical-systemic, historical-legal, historical-genetic). The objective and comprehensive coverage of the problem was facilitated by a historical-anthropological approach based on the study of medicine not simply as a system of institutions, but as the experience of survival of a particular person in conditions of socio-political changes. The scientific novelty of the study lies in the use of archival materials that allowed us to recreate the real state of rural medicine in Podillya against the background of the formation of a new structure of medical care in the countryside, as well as in carrying out a holistic analysis of the functioning of the medical sector of the region in close connection with the socio-economic processes of that time. Conclusions. The beginning of the 1920s was a time of contradictory restoration of medicine in the Podillya countryside from complete decline after the First World War and the Civil War to attempts to build a system of “socialist health care”. It can be stated that this period was characterized by a paradoxical combination: on the one hand, the ideologisation of medicine and a chronic shortage of resources, on the other, the laying of the foundation for systematic methods of combating epidemics and the formation of preventive medicine, which saved thousands of lives. However, success was achieved not so much due to new treatment methods, but rather due to strict administrative measures: mandatory vaccination, the deployment of isolation wards and mass sanitary propaganda. Carrying out sanitary and educational work allowed to stabilize the epidemiological situation, but at the same time turned medicine into an instrument of ideological control over the Podillia village. The modernization of rural medicine in the region took place in conditions of an acute shortage of personnel, medicines and equipment and was based on the enthusiasm of doctors, the remnants of the old material base and partly the assistance of international organizations. Despite the declarative freeness, in the early 1920s. there was a transition from state maintenance of medical institutions to strict self-financing and decentralization of financing. The transition to the local budget allowed to improve the situation of medical and pharmacy business, but it hit the village hard, since the peasants did not have the funds to maintain hospitals. In general, there was a gap between the propaganda slogans about the “best Soviet healthcare” and the real state of rural medicine.