Development of a Rural Healthcare System in Tomsk Province in the Late XIX – Early XX centuries

Abstract

The present research featured the rural healthcare system in the late XIX – early XX centuries in the Tomsk Guberniya (Province). The research objective was to deduce the stages of formation of the rural healthcare system and to show the decision-making mechanism at the different levels of government. The author analyzed administrative acts and reference books, as well as various documents that reflect discussing the problems of expanding the rural healthcare system at lower administrative levels. The analysis made it possible to identify the needs of rural population, as well as to see differences in views on the formation of the health districts. Before opening a new medical district or relocating an existing one, many factors were taken into account, e.g. the requests of local residents, the level of their material support of the medical institution, landscape and geographical aspects, etc. As a rule, decisions were based on rational arguments. The government of the province was responsible for gathering data, correcting proposals, and planning further development. The results were assessed and approved on the central level. Some proposals coming from the provincial administration did not find support of the center. The author identified two stages of large-scale expansion of the rural medicine in the Tomsk Province: 1898–1910 and 1912–1914. The First World War ruined the plans for 1915–1917.