Railroads

RAILROADS (medical-sanitary service). In the USSR, the network of railroads has a length of 74,656 km (1928). In administrative and economic terms, the network is divided into 26 separate lines, each conducting its own business and managed by separate administrations, but united in their work by the unified People's Commissariat of Ways and Communications for the entire Union. Railroad economy includes not only railroad tracks with all their equipment, track and station buildings, and rolling stock, but also a number of auxiliary industries, ranging from railroad workshops to large plants (locomotive and car-building, wood-treating, etc.). Residential buildings for workers and employees are also included in this system. The entire transportation economy is served by 1,139,000 workers and employees, who together with their families constitute the so-called "transport population," which in 1927 in the USSR was equal to 3.5 million people. - In medical-sanitary terms, railroads, passengers, and the transport population are served by 26 road health departments, subordinate to the People's Commissariats of Health, which include medical-sanitary administrations of ways of communication (or corresponding other transport units). In coordination with the health departments of provincial, gubernatorial, and district executive committees, road health departments coordinate their work on the basis of a special resolution of the Council of People's Commissars of March 23, 1927. In the future, a gradual merger of these health departments is planned. The budget of transport health departments in 1927/28 amounted to 42 million rubles, of which 5.6% from the state budget, 9.1% from the funds of the NKPS, Sovtorgfleet, and other economic bodies, and 85.3% from the insurance fund for medical aid. Medical aid is provided in 1,742 medical offices (1927-28) and on 12,300 hospital beds (3.5 beds per 1,000 population). Dental aid is provided by 611 dental offices. There are 70 feldsher (physician assistant) stations. The sanitary organization consists of 185 sanitary districts (1 district per 302 km and per 19,000 population). Of auxiliary institutions, there are 52 sanitary-hygiene laboratories and 122 disinfection teams. The fight against malaria is conducted by 20 malaria stations, the fight against social diseases-24 tuberculosis dispensaries and 12 venereal disease dispensaries. For the isolation of patients removed from trains, there are 20 isolation-passing points, in addition to the isolation of employees and for the sanitary processing of resettlement, military, and other groups, for which these points are equipped with passing-type baths and disinfection chambers. For transporting patients to hospitals, sanitary cars (see Car) are used, specially equipped for this purpose. Protection of motherhood and infancy is carried out by 104 children's and women's consultation offices, 55 nurseries and 1,262 maternity beds. Protection of the health of children and adolescents is ensured by 400 doctors of children's polyclinics, 17 children's preventive outpatient clinics, and a network of pedological offices. The study and fight against occupational morbidity is conducted by the Central Laboratory for the Study of Occupational Morbidity on Transport (in Moscow) and 6 peripheral psycho-physiological laboratories (occupational dispensaries). Mobile installations (in cars) are widely used, which supplement the work of stationary institutions, visiting smaller intermediate and remote points; these include: dental office cars, mobile children's consultation offices, disinfection chamber cars, laboratory cars (sanitary-hygiene and bacteriological), mobile malaria stations, "plague trains" or cars (in areas threatened by plague epidemics), health education exhibition cars, bath and isolation cars, and the aforementioned sanitary cars (in total over 600 cars). To protect the borders from the importation of epidemics from other countries, there are border medical-observation posts with a passing system (baths, disinfection chambers, isolation rooms); there are three such posts (in addition to maritime medical-observation stations). The transportation of contagious patients, lepers, mentally ill, and persons bitten by rabid animals is regulated by special rules. Sanitary supervision (current and preventive) is conducted by district sanitary doctors, housing-sanitary and sanitary-food doctors. Supervision over the transportation of food cargoes is carried out by the latter together with transport veterinary doctors (see Perishable Goods). Disinfection and disinsection of passenger cars (see Disinfection) and stations, service and residential premises is carried out by disinfection teams in major hubs headed by special doctors; mechanical cleaning and cleaning of these premises is carried out by the corresponding transport services, and disinfection of freight cars after transporting livestock is carried out by veterinary-washing stations of the NKZem. All the work and activities of sanitary workers are regulated on the basis of the resolution of the Council of People's Commissars on sanitary bodies (August 7, 1928) by special provisions, orders, and instructions of the NKZdr and NKPS. The main issues of construction and medical-sanitary affairs are discussed at all-union and road congresses of transport doctors. There have been four all-union congresses of transport sanitary doctors: I-in Moscow in 1923, II-in Leningrad in 1924, III-in Tiflis in 1925, and IV-in Leningrad in 1928. Such congresses also existed in the pre-revolutionary period (1898, 1900, 1902). There were 3 congresses of transport health departments (in 1922-1924 in Moscow). (Occupational hazards of railroad workers-see Transport Workers.)