Hungary

Hungary. Area - 92,916 sq. km, population (as of December 31, 1925) - 8,364,635 persons, population density - 90 persons per sq. km. Natural population movement is expressed in the following figures (per 1,000 persons): Table 1. Natural Population Movement. Years Birth rate General mortality Natural increase or decrease 1891-95 (average) 42.0 32.1 7.9 1896-1900 39.7 28.1 11.6 1901-1905 37.3 26.3 11.0 1906-1910 36.7 25.0 11.7 1911-1915 35.0 24.1 11.1 1916 36.3 23.3 13.0 1917 34.5 23.5 11.0 1918 34.7 22.3 12.4 1919 23.8 25.7 -1.9 1920 16.8 20.9 -4.1 1921 16.0 20.7 -4.3 1922 15.4 26.4 -11.0 1923 27.4 19.6 7.8 1924 31.2 21.4 9.8 1925 27.9 21.2 6.7 During the imperialist war, birth rates sharply decreased, general mortality increased (especially in 1915 and 1918), hence the decrease in natural increase, most sharply expressed in 1918. Population growth remained abnormally low until 1924, and only from 1925 did it rise to the pre-war level. Table 2 shows infant mortality up to one year of age (per 100 births). The normal decrease in infant mortality during the war halted, in certain years (1915) it showed a sharp increase, in subsequent years it continues to remain high and only in 1925 and 1926 falls below the pre-war level. Table 2. Infant Mortality. Years Number of deaths Years Number of deaths 1891-95 25.0 1917 21.5 1896-1900 21.9 1918 21.7 1901-1905 21.2 1919 15.7 1906-1910 20.4 1920 19.3 1914 20.7 1921 19.7 1916 18.6 1922 20.0 1923 18.6 1924 19.5 1925 16.7 1926 16.1 In terms of birth rate, general mortality, and infant mortality, Hungary gives higher figures than a number of other European countries (compare Belgium, Great Britain, Holland, Denmark, etc.). Mortality from infectious diseases for 1923-25 was expressed in the following absolute figures: Table 3. Mortality from Infectious Diseases. Cause of death Smallpox ...

634 Postpartum fever. ...

124.265 1923 1924 1925 1 ."365 926 857 555 425 423 650 280 84 25.758 The following table shows the distribution of deaths in 1926 by different causes of death: Table 4. Distribution of deaths in 1926. Cause of death Acute infections ........ Tuberculosis............ Syphilis ............. Cancer................ Congenital weakness...... Senile decay ..... Apoplexy........... Diseases of blood-forming organs . . » » respiration ....... » » digestion..... Other causes of natural death,- . Accidents....... Suicides .......... "Murders............. Other causes of violent death Sudden death and unclear causes ............ Absolute numbers % 4,2 14,6 0,3 4,9 10,9 13,9 3,8 9,8 10,8 10,8 11,6 1,7 1,8 0,2 0,2 0,5 Mortality from tbc, compared to other European countries, decreases very slowly. It is significantly higher than in most European countries.. Table 5 shows mortality (per 100,000 inhabitants) from tbc (all forms). Mortality from cancer gradually increases, although it remains lower than in most other European countries. For the period from 1901 to 1905 it averaged 425 per 1 million inhabitants per year, in 1906-10 it was 430, in recent years it ranged from 750 (1921) to 807 (1926) per 1 million inhabitants. Table 5. Mortality from tbc. Years 1901-05 Number of deaths 35 3 Years 1918 . 1919 . 1920 . 1921 . 1922. 1923 . 1924 . 1925 . 1926 . Number of deaths 319,0 339.0 302,0 276,0 291 .0 298.8 313,8 238.8 243,2 The organization of health care is under the jurisdiction of the Ministry of Labor and Prevention (Magyar Kiralyi Nepio-leti es Munkaugyi Ministerium), founded in October 1919. The Department of Hygiene, under the jurisdiction of the said ministry, consists of the following departments and sections: 1. Public health-functions: a) sanitary legislation, management of sanitary physicians; b) training of physicians, auxiliary medical personnel, pharmaceutical personnel, midwives, personnel for patient care and social assistance sisters. 2. Sanitary police- a) fighting epidemics, vaccination; b) municipal sanitation (water supply, sewerage, cemeteries), supervision of the production and trade in food products, prison medicine. 3. Social hygiene-fighting tuberculosis, venereal diseases, alcoholism, cretinism, pellagra, etc.; sanitary education; public nutrition; housing sanitation; professional hygiene. 4. Child protection-protection of the health of mothers, infants and children. 5. Therapeutic medicine-medical institutions, pharmaceuticals, resorts and physical culture. 6. Housing hygiene. 7. Social insurance. 8. Service for war invalids. At the minister (a lawyer by education) there are 3 state secretaries, two of whom must be physicians. Of the 336 employees of the ministry-8 physicians. The advisory body of the ministry is the State Council of Public Health. Among the major medical institutions under the ministry's jurisdiction, the Hygiene Institute, the Hygiene Museum, the Central Bacteriological Institute, the Pasteur Institute and some others should be mentioned. In each department and major city at the prefecture there are two commissions: municipal and administrative, dealing with health issues. Municipal (sanitary) physicians are appointed by the prefect. There are 25 in the departments and 11 in major cities. District physicians-201; in each district a district sanitary council functions. Every city or commune with a population of 5,000 or more must have a communal physician. In 1924 there were 799 such. In each commune there is a communal sanitary council. Individual branches of health care are presented in the following form: Municipal sanitation. 1. Water supply. Of 48 cities in H. only 17 have water supply systems (1924). The majority of the population uses well water. The ministry has a special fund, from which the poorest communes receive grants for improving water supply.-2. Housing hygiene. The housing problem is severe. In 1924-25 out of 8,800 people without apartments in Budapest, only 2,500 could be accommodated; many lived in railway cars. In the province out of 40,000 in need of apartments only 23,000 could be accommodated. There is also special sanitary legislation on the construction of new housing. Fighting infectious diseases. Mandatory notification applies, in addition to acute infectious diseases, tbc, trachoma, pellagra, ankylostomiasis and bites by rabid animals. There is a law to combat infectious diseases, providing rules for the transportation of infectious patients, isolation, disinfection, fighting infectious diseases in educational institutions, etc. In particular, each commune with a population of more than 1,000 must have an infectious disease barrack for isolating infectious patients. Mandatory smallpox vaccination was introduced by law in 1876, in 1887 mandatory revaccination for children aged 12 was also introduced. Fighting social diseases. 1. Tuberculosis in H., as indicated above, remains very high. In particular, in Budapest, where pre-war mortality from tbc was no more than 2.7 per 1,000 inhabitants, it rose in 1923 to 4 per 1,000, in 1924 to 3.98, in 1925 to 2.91 per 1,000. Mortality from tbc in these years in Budapest was the highest among major European cities. The public fight against tbc in H. began in 1898. In 1902 near Budapest the first sanatorium for tuberculosis patients was established by the "Sanatorium Society" ("Queen Elizabeth Sanatorium"). In 1924 a state committee to combat tbc was organized. Its tasks include, in particular, the development of dispensaries, the number of which was 31 in 1924. The "Stephanie" Society (see below) fights childhood tbc. There are four large sanatoriums for tuberculosis: two in the insurance fund with 80 and 200 beds, the "Queen Elizabeth Sanatorium" with 530 beds and the one built in 1924 near Budapest with 620 beds.-2. Fighting venereal diseases. The "Teleia" society has done great work. The number of patients admitted to its institutions was 3,652 in 1909; gradually increasing, it reached 16,871 in 1922. In 1925 a Committee to combat venereal diseases was organized. The number of beds for venereal diseases was 1,401 in that year. Prostitution is regulated. Each prostitute must appear for a medical examination 2 times a week. According to the law, official prostitution can be practiced by women not younger than 17 years.-3. The fight against alcoholism is carried out by several societies, united by the Central League of Societies to combat alcoholism.-4. A prominent place is occupied by the fight against cancerous diseases (collection and processing of materials, treatment). In Hungary there is a special Institute to combat malignant tumors. Protection of motherhood and infancy is concentrated mainly in the "Stephanie" society, receiving a state subsidy (operating since 1921). The society has a Central Institute in Budapest, 108 dispensaries, 15 "Milk Drops", 4 consultations, etc. At the end of 1926 the society had 196 physicians on its staff. In dispensaries, consultations are given to pregnant mothers and children up to 3 years old. Organizations for child protection served about 35,000 children in 1925. There are a number of institutions for defective children. In Budapest there is a special organization of school sanitary physicians. Medical institutions are under the jurisdiction of the state, insurance and public (Red Cross and others) organizations and private individuals. The number of physicians in H. in 1925 was 5,962, medical students were 3,078. The health budget for 1927/28 amounted to 60,344,560 pengő (100 pengő=90.6 Swiss francs), which is 8% of the total state budget. Of this amount, 2,188,710 p. goes to the maintenance of the central apparatus, 42,247,020 p. to public health, 5,005,010 p. to sanitary institutions, $.740,850 p. to child protection, 787,500 p. to worker insurance, 51,490 p. to charitable institutions and 873,980 p. to pensions for war invalids. The item "Public health" included: 825,000 p. for fighting infectious diseases, 100,000 p. for water supply works, 100,000 p. to the "Samaritan Society", 24,000 p. to venereal dispensaries, 35,000 p.-to tbc dispensaries, 100,000 p. to the State Hygiene Institute, 46,000 p.-to the Hygiene Museums and 16 million pengő for the treatment of the poor. With funds from the Rockefeller Foundation, an Institute of Social Hygiene is established, with these same funds the "Bureau of Sanitary Reforms" is maintained, which studies the sanitary condition of Hungary and carries out sanitary and educational work.