Waterways of Communication

WATERWAYS OF COMMUNICATION (medical-sanitary service), playing a huge role in the economy of the USSR, can represent a great danger to the population from a sanitary-epidemiological point of view if there is insufficient sanitary supervision. Until 1900, there was no sanitary supervision on river routes. The constant development of plague and cholera epidemics in the lower reaches of the Volga and their spread by ships upstream finally drew the attention of the former tsarist government to waterways of communication, and in 1900 the first sanitary supervision was organized on the Volga River, specifically in the most active and frequently cholera-threatened reach from Nizhny Novgorod to Astrakhan. Then, in subsequent years, sanitary supervision was extended to the Kama River and the waterway from Rybinsk to St. Petersburg (the number of doctors for servicing such a vast waterway was about 10). On other river routes there were no permanent doctors, and doctors were invited only to participate in commissions for examining ships. In 1912, sanitary supervision was established on all river routes, and the number of doctors was already about 40. To organize and unify the activities of sanitary supervision at the Main Directorate of Inland Waterways and in the districts, the positions of senior physician were introduced, and sanitary posts were organized locally headed by sanitary physicians. In the direct disposal of the Ministry of Ways of Communication on river routes there was a small number of ships, workshops, basins, and a small number of workers; the entire huge river fleet of ships and rafts and the workers on them were in a medical-sanitary sense outside the direct subordination of the ministry. Governmental sanitary supervision over river ships and rafts was limited in its rights only to the observation of the sanitary condition of ships and rafts. There was also no sanitary organization on sea routes, with the exception of the quarantine service in ports (established on the basis of the international sanitary convention). During epidemics, city physicians were invited to observe the sanitary condition of ships and port territory. Medical aid on river and sea routes was organized weakly, and that only for transport employees. At sanitary posts there were small outpatient clinics, in which the sanitary physicians themselves conducted admissions; in ports there were infirmaries managed by port physicians. For shipworkers of the huge sea and river fleet, almost no medical aid was organized (in especially large points there were hospitals of private shipowners). With the nationalization of the river and sea fleets in 1918, when the greater part of them passed to the state and all workers on water transport were united in a single Union of Water Transport Workers, numbering with their families about 500,000 people, the Soviet government took into account the necessity of organizing medical-sanitary service on water transport, and organizing medical-sanitary affairs in this area had to be done completely anew. From the beginning of the revolution until 1918, the organization of medical-sanitary affairs on waterways was in the medical-sanitary department of the Main Directorate of Water Transport, and then in 1918 by a government decree it was transferred to the NKZdrav. In 1918, at the NKZdrav of the RSFSR, a Water Medical-Sanitary Department was established, on which were laid the organization and unification of medical-sanitary affairs on water transport (river and sea). In 1924, by a decree of the SNK of July 4, medical-sanitary service of the transport of the union republics was transferred to the NKZdrav of the respective republics. At present, to organize and direct medical-sanitary affairs on transport (railway, sea, and river) in republican centers at the NKZdravs of the RSFSR, UkrSSR, and ZSFSR, medical-sanitary directorates of communications have been established, and in central points of individual water areas—water departments of public health as peripheral organs of the said directorates. Until 1924 there were the following water departments of public health: North-Western (Leningrad), Baltic (Leningrad), Northern (Veliky Ustyug), White Sea (Arkhangelsk), Amur (Blagoveshchensk), Turkestan (Tashkent), Siberian (Omsk), Caspian (Baku), Volga (Nizhny Novgorod), Moscow-Oka (Moscow), Azov-Don-Cuban (Rostov-on-Don), Upper Dnieper (Kherson), Black Sea (Odessa). At present, on waterways, some departments of public health have been united, others have been attached to railway health departments. The health departments have in their composition a number of specialists in various branches of sanitary affairs. By a decree of the SNK of the RSFSR of August 7, 1928, it was proposed to the NKZdravs to begin the gradual unification of territorial and transport medical-sanitary organizations. All waterways of communication (river and sea) in a medical-sanitary sense are divided into medical districts and sanitary districts, which are under the jurisdiction of the corresponding water departments of public health (some medical districts and sanitary districts are under the jurisdiction of road health departments). Sanitary districts have been established in all major points (sea and river). The number of sanitary districts on January 1, 1928, was 131. For rendering medical aid on waterways of communication, on January 1, 1928, there were 210 medical outpatient clinics, 50 polyclinics, 52 hospitals; in major points—tuberculosis and venereal dispensaries. The greater part of watermen needing treatment in tuberculosis and venereal dispensaries use the dispensaries of gubernatorial health departments. In places sparsely populated by watermen, where there are no special transport treatment institutions, watermen use the treatment institutions of gubernatorial health departments. On water transport, in addition to the permanent type of treatment-sanitary institutions, temporary medical points are opened at large piers. In winter, during the wintering of ships in basins, medical points are also opened. At the head of a sanitary district stands a sanitary physician, who has an assistant. In the disposal of sanitary physicians locally there are: sanitary-hygienic and bacteriological laboratories (on January 1, 1928—40), disinfection squads, in large points—rat-extermination squads with corresponding disinfection installations and apparatus. In malarial areas there are malaria stations (on Jan. 1, 1928—12). The duties of sanitary physicians of water transport include: studying working conditions on water transport, the living conditions of watermen, morbidity among watermen, sanitary supervision over housing, food, and water supply of watermen, sanitary supervision over ships, rafts, dredging machines, hydraulic structures (lighthouses, locks, dams), over port territories, towpaths, shipyards, workshops, basins, piers, debarkaders, fighting epidemics on waterways, sanitary-propaganda work among watermen, etc. The duties of sanitary physicians also include studying all professions of watermen and observing the sanitary condition of their workplaces, as well as the sanitary condition of waterways. In the matter of supervising the sanitary condition of floating means (ships, rafts, etc.), sanitary physicians are guided by a special instruction on sanitary inspection of ships and rafts. For ships there are special sanitary rules, providing sanitary norms, the arrangement of premises on ships, water supply on board, heating, lighting, storage of products on board, maintenance of ship premises, as well as sanitary measures. See also: Towpath, Medical-Surveillance Stations and Points.

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Metaxa.