Romania

ROMANIA. The area of R. is 295,000 km², and the population in 1930 was approx. 18 million, of which 11.8 million were Romanians, while the rest of the population, in descending order of size, consisted of Hungarians, Jews, Russians, Germans, Bulgarians, Turks, Poles, Tatars, and other predominantly Slavic nationalities. Statistical data on population movement are inaccurate. According to official data, population movement in recent years was as follows: Birth rate and mortality rate 1924 1925 1927 1930 Birth rate per 1,000 . Mortality rate per 1,000 . . Natural increase per 1,000........ 37.3 23.2 14.1 35.62 21.29 14.33 34.7 21.3 13.4 35.0 19.4 16.4 Infant mortality under 1 year was in 1924--200.8 per 1,000 live births, in 1927--209, in 1928--184, and in 1930--197. There is a large difference in population movement in cities and rural areas; thus, in 1927, the birth rate (per 1,000) was 22.8 in cities and 38.3 in rural areas, and the mortality rate (per 1,000) was 18.5 in cities and 24 in rural areas. Romania, like pre-revolutionary Russia, is a country of high birth rate and high mortality rate, as well as very high infant mortality, and both mortality and birth rate have hardly changed in recent years. Organization of healthcare. In 1926, a ministry of health and social welfare was organized. In 1930, a new law was passed which abolished this ministry of health as an independent unit. All institutions of the ministry of health were transferred to the ministry of labor, which received the name of ministry of labor, health, and social welfare. The health administration became one department of this ministry, with a state secretary at its head. The administration was decentralized, and all health organizations, even those dependent on other ministries, were organized according to the same plan. The ministry of health and labor was entrusted with the function of coordinating the activities of various health departments and those not included in this ministry. The organizational scheme is as follows: attached to the health department there is a general advisory committee with subcommittees for infectious diseases, medical aid, hygiene and sanitation, pharmaceutical, infant protection, social welfare, care of the mentally ill, and forensic medicine. The center is subordinate to three scientific-research and pedagogical institutes: the Institute of Sera and Vaccines, 3 institutes of hygiene (of which the newest has just been opened in Iasi), and the Institute of Pharmaceutical Chemistry.-The entire country is divided into 7 sanitary regions, with a general inspector at the head of each. These are subordinate to the chief physicians of 71 departments. The sanitary condition of Romania is exceptionally grave and reflects with exceptional clarity the backwardness of the country with its still surviving feudal regime, the incredible oppression and exploitation of the broad masses of workers and peasants. Poverty and chronic hunger, darkness and ignorance of the peasantry create particularly favorable conditions for the development of a number of diseases, many of which have an epidemic character. Infectious diseases. Typhoid and typhus are endemic and show no tendency to decrease. Typhus rages mainly in Bessarabia and adjacent areas, where the impoverishment of the peasantry is particularly great. According to official data, 1,456 cases of typhus were registered in 1929, and 1,857 cases in 1930. In 1927, a large epidemic of poliomyelitis spread throughout Romania, which ended only in 1928. Except for smallpox, the fight against all infections is very weak, as appropriations for healthcare are extremely inadequate. Social diseases. Tuberculosis and the fight against it. In 1926, a law on the fight against t.b.c. was published, providing for mandatory registration of t.b.c. patients and mandatory hospitalization of patients in the contagious period of the disease, but this law has not yet been implemented due to lack of funds. In fact, the fight against t.b.c. is carried on by three private societies: the society for the prevention of t.b.c. and aid to poor patients, founded in 1901, the society for the isolation of tuberculosis patients, founded in 1913, and the society for the fight against children's t.b.c., founded in 1909. In 1926, the three societies together owned 7 sanatoriums for adults, one children's sanatorium, and 30 dispensaries. The state owns 4 special t.b.c. hospitals with 255 beds and one sanatorium with 100 beds. In addition, there are 9 dispensaries in Bucharest. In 1927, the ministry of war opened a sanatorium with 120 beds for the Bucharest garrison. There are also several small sanatoriums in the provinces. All societies jointly organize children's summer sanatorium colonies, which had over 1,800 beds in 1926.-Venereal diseases. Statistical data on the prevalence of venereal diseases are extremely inadequate. The fight is carried on mainly by treating syphilitics. According to medical data, 60,319 cases of syphilis were registered in 1925, 65,565 in 1927, and 146,707 in 1928, not counting patients in hospitals. There are reasons to believe that these figures are much lower than reality. In the army in 1928, there were 4,013 cases. In 1924, rural centers for the fight against syphilis were created with the participation of the Red Cross. In 1928, the ministry of health subsidized 110 centers for the treatment of syphilis, of which 32 were in large cities and 78 in rural areas. Other departments (ministry of labor, railway administration, etc.) also own 31 dispensaries for the treatment of syphilis. In 1928, 7,600 patients were treated in these dispensaries. All these data show that syphilis is extremely widespread in Romania. Trachoma. Trachoma is very widespread in Romania, but there are no exact statistical data on its prevalence. Trachoma is most widespread in Moldavia, then in Oltenia, Dobrudja, Wallachia, and finally in Bessarabia and Transylvania. No organized fight against trachoma is being conducted. There are eye departments in some hospitals, but no special departments for trachoma patients. In 1924, a commission was created under the sanitary council of the ministry of health, which worked out a number of measures necessary for the fight against trachoma, but none of these measures has been implemented due to lack of funds.-Malaria is extremely widespread, especially in the Danube valley and along the course of other rivers. Both tertian and tropical forms are observed. Statistical data on the number of cases are very incomplete and contradictory. Thus, in 1925, 164,262 patients were treated for malaria, while in 1924 the number treated was 183,836. In 1928, the number of patients decreased to 82,786. The fight against malaria is carried on mainly by distributing quinine to the population through private practitioners. In 1924, 1,762 kg were distributed, in 1925--1,535 kg, in 1926--3,368 kg, in 1927--3,605 kg, and in 1928--only 810 kg due to lack of funds. The ministry of war carries out quininization of the army in malarious areas. Appropriations for the fight against malaria are extremely weak (1 million lei in 1924). In 1927, a special commission of specialists was created at the ministry to study the problems of malaria and methods of fighting it. Twelve mobile laboratories were created for blood examination for malaria.-Goiter is very widespread in the mountainous parts of R., in the Carpathians, etc. In 1924, 16,264 cases were registered. Hospital care. There are three categories of hospitals: some are dependent on the ministry of health, others on communes and departments, and third on private societies and institutions. In 1926, there were 315 general state hospitals with about 15,000 beds, 6 hospitals for the mentally ill, 6 sanatoriums with 255 beds, and 4 sanatoriums for children. In 1924, there were 40 communal and departmental hospitals, independent of the state, with 7,506 beds. Finally, in 1928, there were 102 private hospitals with 7,499 beds. Many of them serve as university clinics. In the districts, there are also rural ambulances with beds for infectious patients, functioning in case of epidemic. There are beds at the ambulances and consultations. Pharmacy. The number of pharmacies is limited by law, the opening of new pharmacies is allowed only with the permission of the Higher Sanitary Council, approved by the ministry of health. In 1927, there were 1,925 pharmacies and 498 pharmaceutical warehouses in Romania. The right to produce sera and vaccines belongs exclusively to the State Institute of Sera and Vaccines (named after Prof. Cantacuzino) and the Serological Institute of the veterinary faculty in Bucharest. Protection of motherhood and childhood. There is almost no legislative protection of motherhood. Assistance to pregnant women is provided in maternity shelters, special dispensaries, and consultations at hospitals. Social assistance at home is provided by social welfare sisters and midwives. All this takes place in private practice. The protection of children is entrusted to the Social Welfare Administration. In addition, there are a number of private societies for the aid of children. In 1928, there were approx. 30 dispensaries for infants in different cities, 7 shelters for children from 0 to 7 years, 2 for children from 7 to 17 years, 4 for deaf-mutes, 3 for the blind, and 2 for the mentally retarded. There were also 115 nurseries and dispensaries founded by private societies and subsidized by the state.

Some state institutions and private enterprises also maintain nurseries and dispensaries for their employees. School hygiene is the responsibility of the state. In practice, school medical supervision exists only in Bucharest and in two or three large cities. In 1927, Bucharest had 40 school doctors and 5 special school dispensaries. By law, each secondary school should have a school doctor, certified by the Institute of Hygiene and controlled by the state (law of 1928). This law is in fact not applied. Labor protection. Industry in R. is weakly developed, with the largest number of workers in the mining industry. In 1926, out of 302,082 hired workers, there were employed: in mines-60,175, in the oil industry-32,323, in milling-50,235, in metallurgy-44,748. Labor protection is in its infancy. By the law of April 8, 1928, the length of the working day was set at 8 hours, with a maximum of 48 hours per week. The law applies to mines, quarries and other types of mining industry, to transport workers with the exception of manual transport. Excluded from the law are members of the same family working under the direction of the head of the family, sailors, persons holding responsible positions, artisans working at home, domestic servants. Working hours can be transferred from one day to another, provided that the length of the working day does not exceed 10 hours. In continuous industries, work is allowed up to 56 hours per week, in others it may also be extended if necessary. In practice, the law is not observed and the length of the working day is very great. Social insurance. Until 1932, three different laws on social insurance were in force in R.: Austrian in the territories captured from Austria-Hungary, Russian in Bessarabia and Romanian in Old Romania. In 1932, the legislation was unified and the old Romanian law was taken as its basis. All types of insurance apply only to hired workers in industry. Excluded from it are commercial employees, agricultural workers and servants. In 1926, there were a total of 990,000 insured persons, of which 550,000 in Old Romania, 400,000 in Bessarabia, 40,000 in Bukovina. In case of temporary loss of working capacity, the worker is paid 50% of his salary, regardless of age and length of service, for 16 weeks. In case of loss of working capacity, 66²/₃% of the basic salary is paid as a rent or pension. This pension consists of two parts: a constant minimum, independent of the worker's length of service and age, and another part, depending on the time during which contributions to social insurance were paid. Old-age pensions are all of the same size. The insurance fund is composed of sums paid by the insured, although formally employers also participate in the contributions, however the entire burden of contributions falls on the hired workers themselves. In case of accidents, benefit is paid starting from the 4th day, if incapacity lasts more than 4 days, and from the first day if it lasts more than 8 days. For temporary incapacity, 35% of salary is paid with a maximum of 98 lei per week for single persons and 50% with a maximum of 140 lei per week for married persons. In 1932, most pensions were not paid due to lack of money in the treasury. Medical education and doctors. Medical education is built on the French system, with a course duration of 6 years. Despite the extreme need of the country for doctors and preventive measures, the government has taken in recent years measures to limit the number of students in universities in order to "reduce the influx into the medical profession". In addition, there are a number of restrictions for Jewish students, who go abroad to study by the hundreds, mainly to France. Thus, in 1930, there were over 600 medical students from Romania in Paris. As a result of all these measures, the number of medical students has decreased sharply in recent years. There are only three medical faculties: in Bucharest, Iasi and Cluj. From 3,576 in 1924, the number of students decreased on all three faculties to 2,441 in 1928. In 1926, there were 6,966 doctors in R. In 1928, 324 doctoral degrees were issued and 103 doctors with foreign degrees were allowed to practice. In 1925, courses for training hygienists were opened in Bucharest and Iasi. In addition, there are several schools for training social welfare sisters, 7 midwifery schools, which issued 159 diplomas in 1926, 4 schools of sanitary agents, which issued 195 diplomas in the same year. There are no data on the number of midwives and sanitary agents. The health budget is negligible and has a tendency to decrease while the military budget grows every year. In 1927, the health budget was 2.19% of the total budget, and in 1928 only 2.05%. It should be added that the payment of local doctors is beggarly, and the larger part of the extremely meager health budget goes to the maintenance of the central organs of the ministry and a few show institutions.