История здравоохранения в Каракалпакстане в 1917 - 1924 годах

Аннотация

Ключевые слова: В данной статье рассматривается раннее развитие Каракалпакстан, системы здравоохранения в Каракалпакстане в период с история здравоохранения, 1917 по 1924 год, ознаменованный Российской Российская революция, революцией, Гражданской войной и установлением общественное здравоохранение, советской администрации. В работе, основанной на советская медицина, архивных материалах, опубликованных исследованиях и Центральная Азия. современных сообщениях, описывается состояние медицинского обслуживания до советской власти, влияние политических потрясений и первые меры по организации инфраструктуры общественного здравоохранения в регионе. INTRОDUСTIОN At the beginning of the 20th century, Karakalpakstan was an economically underdeveloped and medically underserved territory within the Amu Darya region, administered successively by the Khanate of Khiva and later by the Russian Empire. The collapse of imperial governance in 1917, followed by the Russian Civil War and the establishment of Soviet power, transformed nearly all aspects of social life, including healthcare. This period laid the groundwork for the gradual institutionalization of Soviet- style medical services in the Karakalpak region. MАTЕRIАLS АND MЕTHОDS Before the Bolshevik Revolution, healthcare in Karakalpakstan was extremely limited. The region had no developed hospital infrastructure. Medical services were largely provided by feldshers (medical assistants), traditional healers, and itinerant practitioners. Epidemic diseases such as smallpox, malaria, typhus, and tuberculosis were widespread. Maternal and child mortality rates were among the highest in Central Asia. Under the Russian Empire’s Turkestan Governorate-General, only sporadic efforts were made to expand modern medicine into peripheral areas like Karakalpak settlements along the lower Amu Darya. RЕSULTS АND DISСUSSIОN In the early 1920s, Soviet authorities began introducing more structured administrative measures in the Karakalpak territories to overcome the fragmented and largely traditional healthcare practices inherited from the Khiva Khanate and the Russian Empire. A notable milestone was the creation of dedicated health sections (zdravotdely) within local revolutionary committees, which were tasked with coordinating sanitary efforts and distributing scarce medical supplies. By 1922, the People’s Commissariat of Health of the Khorezm People’s Soviet Republic began regular reporting on morbidity rates, which was a significant step forward compared to earlier periods when no systematic epidemiological records were kept. These reports consistently highlighted malaria, typhus, trachoma, and smallpox as the leading causes of mortality. In response, health departments prioritized three main directions: 502 Жамият ва инновациялар – Общество и инновации – Society and innovations Special Issue – 06 (2025) / ISSN 2181-1415 Combating epidemic diseases: ➢ Large-scale disinfection of wells and irrigation canals, often supervised by sanitary doctors dispatched from Tashkent. ➢ Quarantine measures during outbreaks of typhus and relapsing fever, which were frequent in 1921–1923 due to poor nutrition and population movements. ➢ Distribution of quinine for malaria, though supplies were often insufficient. Organizing maternal and child healthcare: ✓ The first maternity care points (roditelskiye punkty) were established in Nukus and nearby settlements to address extremely high maternal mortality rates. ✓ Midwives trained in Tashkent were sent to Karakalpak villages to provide both delivery assistance and basic hygiene instruction. Expanding feldsher-midwife stations: Feldsher stations functioned as the primary medical units providing first aid, vaccinations, and health education. By the end of 1924, more than 10 such stations had been set up across populated areas along the lower Amu Darya, despite chronic understaffing. Another important aspect was the emphasis on health propaganda. Health workers conducted lectures at red yurts – mobile educational units intended to reach nomadic and semi-nomadic Karakalpak communities. These red yurts distributed posters and pamphlets in Karakalpak and Uzbek languages, explaining the benefits of vaccination and elementary rules of personal hygiene. For many rural residents, this was their first encounter with modern public health information. At the same time, Soviet administration faced deep-rooted mistrust among the local population. Some traditional healers and religious leaders opposed vaccination campaigns, believing them to be harmful or sacrilegious. Archival correspondence between Khorezm health officials and the Commissariat of Health of Turkestan ASSR frequently emphasized the need for patience and cultural sensitivity [1]. Additionally, the period saw the first attempts to train local Karakalpak medical cadres. Although the majority of doctors were Russian or Tatar, short courses were organized in Khiva and Turtkul to prepare feldshers and sanitary