HEALTH SINCE 1945: TRANSITION PERIOD, PART 4

When Stalin died in March 1953, as we said earlier, the days of his satellite followers were doomed. Thus, Vulko Chervenkov /1900-1980/, himself: - a miner's son, who passed through "Lenin's Institute for International Politics", via Party work in the "committees" for culture, to Party work in the "central" apparatus. Chervenkov slavishly copied Stalin until April 1956, when, he was replaced by Anton Yugov - a Macedonian. However, the real power in Bulgarian political life from 1956 to 1989 was vested with the secretary of the Bulgarian Communist Party, Todor Zhivkov /1911-1998/, and under his direction Bulgaria remained the loyalest supporter of Soviet policy in the Warsaw Pact.

In the mainstream, an intensive social-economic development of the country in the Third Five-Year Plan, led to significant system processes with a reflection on health care, as well. Together with a changing canvas of lifestyle and working, parallely to, a heavy industrialization, a vivid cooperatization, etc - urbanization gained momentum. What we see in Table 1, bellow, the population structure of Bulgaria covering the period 1944-1967:

Obviously, the urban population proportion is rapidly increasing and in 1967, 48.5 % of the total number are living in the towns and 51.5 % - in the villages. The migration of peasant population into the towns occurs at the expense, mainly, of the younger population rendered imperative by the industrialization process on a nationwide scale and developing at a very high rate.

The demographic development of the country during the years of people's government is characterized in Table 2, bellow, demographic development of the population of Bulgaria over the period 1944-1967:

We see, that, infant mortality rate has sharply lowered - from 120.6 per 1000 born alive in 1944, it falls to 33.1 for year 1967. Ever since 1944, the birthrate on a nationwide scale has augmented, reaching 24.6 per 1000 population in year 1948; thereafter, it showed a tendency for decrease.

On an organizational level, further, were elaborated some aspects of health care network and within the context of town-village controversy. The leading principle was - "bridging over differences between workers and peasants". How to achieve this task? In a long term perspective, this, is a matter of folk psychology and we are not in a position to discuss the question. There is a multitude of literature written in the bulgarian parlance, but, let us stay abreast with our theme. Now, in order to provide a qualified and ready service for the workers in the manufacture - there, decree from "Ministry of Health" on 24 February 1953. The aim was to promote preliminary and periodical medical examinations for the workers, with, expertise for incapacity. These are rudiments of "screening" and "monitoring" procedures, as early as, the 50s in Bulgaria. Within a caveats mentioning, that, even earlier and before the WWII were functioning the "factories for health" - but, let us confess they had their precursors in the utopian literature. In Bulgaria, workers health care grew on a local basis and culminating in the 70s with WHO's project - "Dispensarization model in Gabrovo district, Bulgaria" /editor note, we'll talk about that later/.

In our opinion, socialist transformation of health care in the village is more interesting and deserves a special attention. This was done in a pace, when, collectivization of agriculture accorded such megacomplexes - i.e., TKZS, DZS, MTS, etc /N.B. transliteration is in bulgarian/. The bulgarian village gives good opportunities to sustain and nourish the labor of the peasants. At first hand, when, urbanization of the country was not advanced and infrastructure roadways, building construction, etc were developed on a smaller scale - there, booming was extensive integration of village "district" health hospices. The number of such establishments was - 92 hospices with 1500 beds in year 1951; 266 hospices with 4028 beds in year 1957, etc. Later in the 60s an involution process began and, subsequently, new structures emerged in the face of "rural policlinics". These numbered, about, 300 in the end of year 1969 and were integrated to the "district" and "regional" hospitals, namely - with limited specialized cabinets.

Another establishments, founded with decree from "Ministry of Health" on 17 July 1953, were called - "Maternity and Infantile Homes" with operation carricula rules. What is given bellow is some statistics for the period 1944-1967, but, we will be back on the issue later to do some reasoning. Whereas during year 1944 there were only 7 "maternity and infantile homes" with 280 beds and not a single public nursery "creches", than, in year 1967 the "maternity and infantile homes" grow up to 31 with 2218 beds. In addition, 674 seasonal "creches" with 17 466 beds were established throughout the country. Thus, favorable conditions were provided for adequate cares and education of the children, enabling the mothers to put their efforts in the production and research. The flagpoints in this type of health care, include:

- complete dispensarization carried out for all pregnant woman, as well as, systematic observation ever since the very first week of gravidance.

- dispensarization by inclusion in special observation lists of all children, as early as, in the first month of life.

- requirement, that, each delivery takes place in a hospital unit or maternity home is of paramount importance for the state and organization of obstetrical aid.

Finally, few words should be said for the geriatric and sanatorial care in the country. They are within the framework of minister Dr. Petar Kolarov, who, held his post in the long summer from 1950 to 1962. Many efforts were made for securing normal life conditions for solitary old people and invalids with severe physical or mental defects. Here is some statistics for period 1944-1967:

- 126 social service units have been established with 9774 beds, against, 26 asylums for old in year 1944.

- 174 sanatorial units with 15 659 beds have been established for providing sanatorial-resort treatment, against, 20 units with 2134 beds during year 1944 - i.e., the sanatorial beds available per 10 000 population has increased from 3 to 19.