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The history of health care

  


On May 28, 1918 government of Azerbaijan People Republic was created by leadership of Fatali khan Khoiski in the Ganja. One of the first decisions of the government of People Republic was connected with establishment of Ministry of Health on June 17, 1918. Khudayat bey Rafibeyov, the graduate of Medical Faculty of Kharkov University, surgeon by specialization was appointed as minister of health. 
The Ministry had 5 main departments: city and forensic medicine department, medical statistics, pharmaceutics, rural heath care, veterinary and sanitary departments. By instructions of the ministry free medical service was provided to population, new hospitals, medical aid posts were opened drug depots, laboratory buildings were built and required equipments had been purchased. 
Government has worked out the comprehensive plans for improvement of medical service, for strengthening struggle against epidemics, and had adopted decisions in this regard. Very serious duties have been put in the decision in front of Ministry of Health, recently organized by the government. Most important of them was to create condition for protecting health of the population and strengthening the fight against insanitariness. 
At the same time, problem of strengthening of fight against epidemics, improvement of medical care in regions, and provision of them with medical personnel and drugs were at the focus of attention, too. 
According to the information got from archives documents, 33 hospitals had carried out activity in the regions at the time of People Republic of Azerbaijan. 
They had in personnel structure 1 physician, 2 doctor\'s assistants, one midwife and one inoculants staff. Ambulatory services have been carried out in rural areas free of charge. Basic duties of the rural existing hospitals and stations of doctor\'s assistant were hospitalization of infectious patients, neutralization of sports of illness. 1 physician was assigned to 75 thousands of persons of the republic’s population. Republican parliament taking into account the situation had adopted a decision to broaden nets of rural hospitals in the 1920r and to set 35 new hospitals and 56 stations of doctor\'s assistants for this purpose and 43 millions 321 thousand 950 manats had been allocated for it. According to this decision it was intended to open 19 hospitals, 27 stations of doctor’s assistant in Baku province, and 15 hospitals, 34 stations of doctor\'s assistant in Ganja province, 1 hospital, 26 stations of doctor’s assistant in Zagatala region. Right provision of health care with medical preparations is one of the main features of the medical and healthcare activity. Namely for that reason the pharmaceutics department of the Ministry of Health had accumulated purchasing of medical preparations in own hands.  
At the end of 60 years - the beginning 70 years a great revival in the socio-economic, scientific and cultural life has been observed. In all areas of the national economy, in science and education, art and culture, health and life a period of fast development began. Only during 1970-1980 hundreds of largest health care facilities were built.
Although the beginning of the 1990-es accompanied by difficulties in the first years of people\'s struggle for independence but those years are significant with scientific searches directed at using the gained results in practice in Azerbaijani healthcare. The reforms carried out gave its yields in the field of medicine, the basis for increase of efficiency and intensification of public health was formed.
Analytical laboratory have been organized in Baku at the state chemist\'s and under it for preparation of drugs, bacteriological preparations and curative serums and for carrying out forensic inspections. In order to provide health care entities with medicine and medical tools on time and correctly the central depot was established. At the same time new city ambulance stations, 9 drugstores started to operate and free services was rendered to patients. 
In 2006, at meeting held in February at the Cabinet of Ministers in connection with the specific instructions of President Ilham Aliyev regarding healthcare a major turning point in this area was established. The funds allocated to health increased to more than 4 times in last 5 years. In the last 2 in Baku city and in the regions construction reconstruction and capital repair works are carried out in about 80 medical institutions.
After adoption and implementation of 9 state programs in different directions of healthcare a number of serious problems were solved.
Fortunately, Azerbaijani healthcare closely cooperates with the World Health Organization and as a result the medical innovations happened all over the world are reflected in Azerbaijan.

The history of surgery and surgeons
The initial development of clinical surgery in Azerbaijan is associated with creation (1920) of Baku State University and its medical faculty. Professor V.I.Razumovski, that had great contribution in organization of the university was a prominent surgeon clinician of Russia. The first student enrollment in education center was 25-30 students. The education on surgery began in the 1922-1923. At that time in the absence of the national staff the heads of departments of surgery were invited from Russia (professors Okinsevich, B. Finkelstein, etc.). At hospital surgery department (head B. Finkelstein) the first assistant was Azerbaijani M. Mirgasimov. During the first years unworthiness of clinical databases of the university and as well as the lack of professional surgical staff did not allow the creation of a wide range of surgical services. The operations carried out were mainly due to chronic and acute blind intestine and ruptures. The operations carried out on the the stomach and gall tracts had character palliative nature.
In 1930, establishment of the independent Institute of Medicine and surgery departments of hospitals, using its base for clinical purposes at surgical departments gave an impetus to the development of this area. At that time M. Mirgasimov and M. Topchubashov were already the doctors of medical sciences. Either M. Mirgasimov or M. Topchubashov are scientists-surgeons with great contributions in the development of surgery in the history of Azerbaijan.
The practical activity of chief of urology and neurology department of Azerbaijan State Doctors Improvement Institute named after Aziz Aliyev, academician M. Javadzade, director of the II department of surgical diseases of AMU B. Agayev, head of Traumatology Department of Moscow Institute Dental institute, professor A.Imamaliyev  was started at surgery chair of the Hospital.
The creation of other leading academic school of surgery is associated with the name of Mustafa bey Topchubashov. Since 30-es of the twentieth century operations of this surgeon in the abdomen and chest area led to recovery of hundreds of patients and his recognition in the former Soviet Union as highly skilled surgeon clinician and gaining of people\'s sympathy.
Proposed in 1938 by Mustafa Topchubashov the idea of analgesia, which makes the base of injectionanelgezy narcosis (close to physiological sleep) today are used in all types of anesthesia around the world.
Azerbaijan Academy of Sciences was founded in 1945 and Professor Mirasadulla Mirgasimov was elected its first president. M. Topchubashov became one of 16 active members of the academy. Electing of 2 surgery professor of Medical Institute of Azerbaijan as  president and full members of Academy of Sciences was an indication of high development of medicine and as well as surgery at that time.
The second half of the 60-es of XX century and 70-es is characterized by training of a new generation of scientific-pedagogical personnel and creation of developed areas of surgery.
In 1961, the Scientific-Research Institute of Clinical and Experimental Surgery was established (now the Scientific Surgery Center named after academic M.A.Topchubashov). The first director of the institute and the head of 2nd facultative surgery chair, corresponding member of the department of Azerbaijan Academy of Sciences, professor F.A.Efendiyev had a very big role in the establishment of the Institute. 
In accordance with the development of surgery at the Institute of Medicine in 1970-es  the departments of oncology, urology, traumatology, neurosurgery and anesthesiology were created. Successful actions were implemented for training of young surgeons of the school and gaining of practical experience and close familiarization with scientific innovations. 
In 1985, opening the Ministry of Health Diagnostic Center (director O.K.Shiraliyev) and the installation of computer tomography and giving for use was one of the most accurate diagnostic methods in medical world as a whole. Promotion of endoscopic diagnostics and endoscopic surgery with the new technology was related to the activities of this center.
The development of surgery in republic is of great importance in the field the expansion of its international relations. Today, Azerbaijan Medical University and its surgical departments established scientific and practical relationship of with dozens of medical universities and medical centers around the world. 
On the initiative of Azerbaijan Scientific-Practical Surgical Association and the Medical University 4th congress of Euro-Asian Surgeon and gastroenterologists in 1997-2008 caused visiting to our country the world\'s most famous surgeons and creation of new relations. In this connection a young surgeon staff was provided with opportunity to become familiar with new technology at medical centers of these countries, with modern diagnostic methods and to improve practical experiences.



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