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ჯანდაცვის სისტემა საქართველოს დამოუკიდებლობის პერიოდში (1918-1921) - The Health Care System of the Period of Georgian Independence (1918-1921)

Authors:

Abstract

26 may 1918 is most important date in the history of the Georgia. In the short standing period of Independence of Georgia in 1918-1921, significant reforms were implemented in the Georgian healthcare system. The Government of the Republic of Georgia has started to organize and manage health care at the state level for the first time in the history of the country, to implement financial and moral support of the projects related to medical reform, preparation of national medical staff. The reforms implemented in the field of health care have contributed to the development of civil and democratic society in the country. 1918-1921 წლებში, დროის მოკლე პერიოდში საქართველოს ჯანდაცვის სისტემაში განხორციელდა მნიშვნელოვანი რეფორმები. დამოუკიდებელი საქართველოს რესპუბლიკის მთავრობამ ქვეყნის ისტორიაში პირველად დაიწყო ჯანდაცვის სახელმწიფო დონეზე ორგანიზება და მართვა, სამედიცინო რეფორმასთან დაკავშირებული პროექტების ფინანსური და მორალური მხარდაჭერის განხორციელება, ეროვნული სამედიცინო კადრების მომზადება. შეიძლება თამამად იმის აღნიშვნა, რომ ჯანმრთელობის დაცვის დარგში განხორციელებულმა რეფორმებმა საკუთარი წვლილი შეიტანეს ქვეყანაში ცივილიზებული საზოგადოებრივი ურთიერთობების დამკვირვების და დემოკრატიული საზოგადოების საქმეში.
kavkasiis universiteti
CAUCASUS UNIVERSITY
axali epoqis dasawyisi -
saqarTvelos demokratiuli
respublika
(1918-1921)
BEGINNING OF A NEW ERA -
THE DEMOCRATIC REPUBLIC OF
GEORGIA (1918-1921)
saerTaSoriso samecniero konferencia miZRvnili saqarTvelos
demokratiuli respublikis daarsebis 100 wlisTavisadmi
The Internaonal Scienc Conference is held to commemorate the 100th
anniversary of establishment of the Democrac Republic of Georgia
Sromebis krebuli
PROCEEDINGS
1-2 ivnisi, 2018
June 1-2, 2018
_ 218 _
Tengiz verulava
medicinis akademiuri doqtori, ilias saxelmwifo universitetis
profesori
jandacvis politikisa da dazRvevis institutis direqtori
CafiZis gadaudebeli kardiologiis centris uwyveti ganaTlebis
skolis direqtori
jandacvis sistema
saqarTvelos damoukideblobis periodSi (1918-1921)
mimdinare wlis 26 maiss Sesrulda saqarTvelos saxelmwifoebriobis aR-
dgenis 100 wlisTavi. 1918 wlis 26 maisiT daiwyo Tvisobrivad axali etapi
saqarTvelos saxelmwifoebriv aRmSeneblobaSi. daibada XX saukunis evro-
puli tipis, axali, saparlamento demokratiuli saxelmwifo.
arsebobis xanmokle periodis ganmavlobaSi qveynis mTavrobam SeZlo
mTeli rigi mniSvnelovani RonisZiebebis gatareba: ganaxorciela sasamarT-
lo reforma, Camoayaliba adgilobrivi marTvis organoebi, profesiuli
kavSirebi, miiRo respublikis konstitucia.
1918-1921 wlebSi, saqarTvelos damoukideblobis mokle periodis um-
Tavres movlenas warmoadgenda universitetis daarseba. 1918 wlis 26 ian-
vars (Zveli stiliT) daviT aRmaSeneblis xsovnis dRes, 13 saaTsa da 20 wuT-
ze gaixsna Tbilisis universiteti. es iyo pirveli erovnuli universiteti
ara marto saqarTveloSi, aramed mTel kavkasiaSi. universitetis daarse-
baSi didia ivane javaxiSvilis wvlili. profesorTa sabWom universitetis
pirvel reqtorad airCia petre meliqiSvili.
samedicino ganaTleba
1918 wlis 27 Tebervals universitetis profesorTa sabWos sxdomaze
gadawyda samkurnalo fakultetis Seqmna. imave wlis 17 ivniss profesorTa
sabWos sxdomam, romelsac eswreboda `qarTvel eqimTa da bunebismetyvelTa
sazogadoebis~ Tavmjdomare spiridon virsalaZe, miiRo gadawyvetileba, rom
seqtembris TveSi gaxsniliyo sabunebismetyvelo-samaTematiko da samedici-
no gaerTianebuli fakulteti. profesorTa sabWo aRniSnavda: `samkurnalo
fakulteti aucilebelia universitetisaTvis, am fakulteteze Cveni xalxis
Svilebis ltolva yovelTvis Zlieri iyo. misi Seqmna niSnavs did gamarjvebas
am saqmisa~. gaerTianebuli fakultetis pirvel sxdomas, romelic Catarda
1918 wlis 20 oqtombers, eswrebodnen p. meliqiSvili, a. benaSvili, a. naTiSvi-
li, ar. xaraZe, z. yanCaveli, sp. virsalaZe, i. TikanaZe da g. muxaZe. amas garda,
sxdomas eswrebodnen prof. iv. javaxiSvili da i. yifSiZe.
1919 wlis 29 aprils universitetis samedicino fakultetis pirvel dekanad
arCeul iqna aleqsandre naTiSvili. igi Semdgom arCeul iqna universitetis pir-
_ 219 _
vel proreqtorad saswavlo-samecniero nawilSi. aRsaniSnavia, rom 1918 wlis 15
noembers Tbilisis universitetis samedicino fakultetze aleqsandre naTiSv-
ilma waikiTxa pirveli leqcia adamianis normul anatomiaSi.
universitetis daarsebis pirvelive wlebidan samedicino fakulte-
tze moRvaweobdnen: novorosiis (q. odesis) universitetis damsaxurebu-
li profesori petre meliqiSvili, medicinis doqtorebi _ spiridon vir-
salaZe, grigol muxaZe, ivane TikanaZe, eqimebi __ mixeil winamZRvriSvili,
Salva miqelaZe. Semdgom wlebSi maT SeuerTdnen: xarkovis universitetis
prozeqtori, medicinis doqtori aleqsandre naTiSvili (1919 w.), yirimis
(simferopoli) universitetis profesori, medicinis doqtori aleqsandre
aladaSvili, xarkovis baqteriologiuri institutis mecnier-TanamSrome-
li svimon amirejibi, novorosiis (q. odesa) univeristetis privat-docenti
ivane beritaSvili, ekaterinoslavis (axlandeli dnepropetrovskis) univer-
sitetis profesori nikoloz kaxiani, xarkovis univeristetis privat-do-
centi, medicinis doqtori varlam moseSvili (1919 w.), moskovidan _ mixeil
asaTiani, petrogradidan _ medicinis doqtori aleqsandre maWavariani,
moskovis universitetis privat-docenti, medicinis doqtori gabriel Ram-
baraSvili (1920 w.), odesis samedicino institutis profesori, farmaciis
magistri iovel quTaTelaZe, novorosiis (q.odesa) univeristetis profe-
sori, medicinis doqtori svimon gogitiZe (1921 w.) da odesis samedicino
universitetis prozeqtori, doqtoranti vladimer JRenti (1922 w.). maT
mier Camoyalibda qirurgiis, Terapiis, mean-ginekologiis, kardiologiis,
farmakologiis da sxva mimarTulebebis qarTuli samedicino skolebi, rom-
lebmac udidesi roli iTamaSes rogorc saqarTveloSi samedicino mecnier-
ebis ganviTarebaSi, aseve axalgazrda samedicino kadrebis momzadebaSi.
1920 wlisaTvis universitetis samedicino fakultetis profesor-mas-
wavlebelTa saerTo ricxvi udrida 138-s, maT Soris iyo 21 profesori, 5
docenti, 3 privat-docenti.
studentebi saswavlo praqtikas gadiodnen mixeilis saxelobis saavad-
myofoSi, olRas saxelobis sabebio institutSi, amierkavkasiis rkinigzis
Tbilisis saavadmyofoSi da sxv. aRniSnuli saavadmyofoebi warmoadgenda
universitetis bazas da amasTanave saukeTeso saSualeba iyo, rom studen-
tebs Rirseuli ganaTleba mieRoT.
universitetis garda, qveyanaSi Seiqmna samedicino personalis mosamza-
debeli moklevadiani kursebi. 1918 wels simon amirejibma daaarsa medikos
laborantTa mosamzadebeli eqvsTviani fasiani kursebi. aseTi kursebis
mizans warmoadgenda iseTi deficituri kadrebis momzadeba, rogoricaa:
eqimi-laborantebi, provizorebi, umcrosi provizorebi, mowyalebis debi.
jandacvis sistemis marTva
1918 wlis noemberSi Sinagan saqmeTa saministroSi Seiqmna samedici-
no-sanitariuli departamenti, romelic ganagebda qveyanaSi janmrTelobis
_ 220 _
dacvis saqmes. departamenti jandacvis sferoSi erTian, koordinirebul da
centralur principze damyarebul xelmZRvanelobas axocielebda. depar-
tamentis ufrosis Tanamdebobaze dainiSna simon jafariZe. samedicino-san-
itariuli departaments eqvemdebareboda veterinaruli momsaxureba.
1920 wlis TebervalSi saqarTvelos Sinagan saqmeTa ministrma p. WiWinaZem
dasamtkiceblad waradgina brZanebis proeqti saqarTvelos samedicino-sani-
taruli departamentis bazaze janmrTelobis departamentis Seqmnis Taoba-
ze. Tavis moxsenebaSi ministrma p. WiWinaZem didi adgili dauTmo qveyanaSi
jandacvis mdgomareobis sakiTxs. igi gansakuTrebiT xazs usvamda malariis,
tuberkulozisa da sqesobrivi gziT gadamdebi daavadebebis gavrcelebaze.
miuxedavad imisa, rom farTo RonisZiebebi Catarda partaxtiani tifis ep-
idemiis winaaRmdeg, dadebiTi Sedegebis ver miaRwies. proeqtis Tanaxmad,
aRniSnuli gamowveuli iyo sxvadasxva samedicino dawesebulebis arakoor-
dinirebuli qmedebebiT. igi moiTxovda yvela samedicino dawesebulebis
axladSeqmnili janmrTelobis departamentisadmi daqvemdebarebas. kanoni
janmrTelobis departamentis daarsebis Sesaxeb miRebul iqna 1920 wlis
13 ivliss. janmrTelobis departamentis Tavmjdomared dainiSna spiridon
virsalaZe. departamentis movaleobas Seadgenda qveynis janmrTelobis
dacvis sistemis muSaobis warmarTva. janmrTelobis departamentis pasux-
ismgeblobaSi Sedioda:
a) respublikis yvela samedicino-sanitariuli organizaciebis saqmiano-
baze zedamxedveloba;
b) sakarantino sakiTxebi;
g) tuberkulozis, malariis, qoleris, Wiris, tifis, sqesobrivi gziT
gadamdebi da sxva daavadebebis marTva;
d) eqspertizis sakiTxebi;
e) samedicino-sanitariuli statistikis Catareba;
v) saxelmwifo mniSvnelobis dasasvenebeli kurortebis saeqimo sanitar-
iuli marTva;
(z) saafTiaqo da farmacevtuli sakiTxebi;
T) samedicino-sanitariuli kanonis Sesrulebaze monitoringi, samedici-
no-samecniero sakiTxebis SemuSaveba.
departaments marTavda sabWo, romlis SemadgenlobaSi Sediodnen qvede-
partamentebis ufrosebi. sabWos xelmZRvanelobda departamentis ufrosi.
samedicino dawesebulebebis qseli
qveynis teritoria dayofili iyo mazrebad, olqebad, qalaqebad. mazra
warmoadgenda yvelaze msxvil administraciul-teritoriul erTeuls. Se-
sabamisad, iniSnebodnen samazro, saolqo, saqalaqo eqimebi. geografiuli
da epidemiologiuri Taviseburebebis gamo TiToeul regioni moiTxovda
gansxvavebul midgomas. svaneTi gamoirCeva maRalmTianobiT da endemuri
Ciyvis problemebiT. Sesabamisad, svaneTis mxares gansakuTrebuli yuradRe-
_ 221 _
ba eqceoda. igive SeiZleba iTqvas axalqalaqze, romelic aseve gamoirCeva
maRalmTianobiT da erovnuli da aRmsareblobiTi TaviseburebebiT.
saqarTvelos demokratiuli respublikis samkurnalo qseli dayofili
iyo 3 seqtorad:
a) saxelmwifo samedicino dawesebulebebis qseli;
(b) municipaluri samedicino dawesebulebebis qseli;
g) kerZo samedicino dawesebulebebis qseli.
garda aRniSnuli seqtorebisa, qveyanaSi samkurnalo saqmes emsaxureboda
kerZo praqtikis mwarmoebel eqimTa korpusic.
1919 wlis monacemebiT, saqarTveloSi funqcionirebda 45 saavadmyofo
1200 sawolze. TbilisSi arsebobda 17 saeqimo ubani, xolo quTaisSi _ 13.
axali samedicino dawesebulebebi Seiqmna foTSi, ozurgeTSi, axalqalaqsa
da svaneTSi.
jandacvis sistemis erTeuls warmoadgenda samkurnalo-meTvalyure
sadgurebi da adgilebi. samedicino-sameTvalyureo sadgurebi ganixilebo-
da rogorc sanitarul-epidemiologiuri sadgurebisa da ambulatoriuli
momsaxurebis erTgvari nazavi.
1920 wlis noemberSi miRebul iqna dadgenileba, romlis mixedviT saxel-
mwifos finansuri daxmareba unda gaewia adamianTa calkeul jgufebisT-
vis. kerZod, omSi daRupulTa ojaxebisTvis, epidemiebTan brZolis dros
daRupulTa ojaxebisTvis, Sromis unardakargul saeqimo personalisTvis
(eqimebs _ 15000 man., xolo ferSlebs _ 10000 man. aRniSnuli Tanxa maT sa-
Sualo wliur xelfass Seesabameboda). brZanebas xels awerda saqarTvelos
damfuZnebeli krebis jandacvis komitetis Tavmjdomare, cnobili eqimi
ivane gomarTeli.
damoukidebel saqarTveloSi samedicino momsaxureba ar iyo ufaso,
Tumca, saxelmwifo cdilobda fasiani samedicino momsaxurebis realur,
mosaxleobis ekonomikuri mdgomarebis adekvatur cifrebamde dayvanas,
rac fasebis ganaxevrebiT gamoixata. am mxriv, quTaisi iyo pirveli qalaqi,
sadac mosaxleobisTvis ufaso samedicino daxmarebis gaweva gamocxadda.
am praqtikis pionerad gvevlineba quTaisis cnobili eqimi samson Tofuria.
misi saavadmyofo ufasod emsaxureboda mosaxleobas. am mxriv, aRsaniSnavia,
rom soxumSi gaixsna pirveli muSaTa afTiaqi, romelic wamlebs mosaxleo-
bas ufasod awvdida.
wiTeli jvris erovnuli organizacia
saqarTvelos damoukideblobis gamocxadebis Semdeg dRis wesrigSi dad-
ga sakiTxi wiTeli jvris erovnuli organizaciis Seqmnisa. 1918 wlis 11
seqtembers Catarda saqarTvelos wiTeli jvris sazogadoebis damfuZne-
beli kreba. krebas eswrebodnen noe Jordania (mTavrobis Tavmjdomare) da
grigol giorgaZe (samxedro ministri). kreba gaxsna wiTeli jvris saer-
TaSoriso komitetis warmomadgenelma, eqimma mixeil zandukelma. ruseTis
_ 222 _
wiTeli jvris mTeli qoneba, rac Tavmoyrilia saqarTveloSi, gadaeca qa-
rTul wiTel jvars. wiTeli jvris sazogadoebam TbilisSi didi mTavris
quCaze gaxsna saavadmyofo, romelic ufasod emsaxureboda mosaxleobas.
wiTeli jvris sazogadoebasTan daarsda mowyalebis debis sazogadoeba,
romlis debulebis Tanaxmad, mowyalebis debs moeTxovebodaT da evalebo-
daT qarTuli enis codna.
saafTiaqo saqme
saqarTvelos demokratiul respublikaSi didi mniSvneloba eniWebo-
da saafTiaqo saqmesac. 1918 wels Camoyalibda saqarTvelos farmacevt-
Ta sazogadoeba. 1918 wlis dekembers Catarda saqarTvelos farmacevtTa
sazogadoebis yriloba. yrilobaze miRebul iqna gadawyvetileba saqarTve-
loSi farmacevtuli saqmis axleburad, drois moTxovnaTa Sesabamisad war-
moebaze. rekomendacia mieca qveyanaSi kerZo afTiaqebTan erTad saqalaqo
(municipaluri) afTiaqebis ganviTarebis xelSewyobas.
Jurnal-gazeTebi
saqarTvelos demokratiuli respublikis periodSi daarsda qarTuli
samedicino Jurnal-gazeTebi. 1919 wels gamoica pirveli samedicino peri-
oduli Jurnali `eqimi~. saredaqcio kolegiis gancxadebiT, igi warmoadgen-
da saqarTvelos eqimTa da erovnuli samecniero sazogadoebis gamocemas,
`samecniero-sazogadoebriv samedicino Jurnals~. 1918 wlis ianvarSi ga-
moica `saqarTvelos eqimis TanaSemweTa sazogadoebis~ axali yovelTviu-
ri Jurnali `eqimis TanaSemwe~. 1919 wels gamovida yovelTviuri Jurnali
`farmacevti~. 1920 wels gamovida `WleqTan mebrZoli sazogadoebis~ Jur-
nali `Wleqi da masTan brZola~, romelic gamodioda or kviraSi erTxel.
jandacvis organizaciis sakiTxebi qveyndeboda municipalur JurnalebSi:
`eroba da qalaqi~, `Cveni qalaqi~.
saxelmwifo cdilobda mosaxleobaSi aemaRlebina sanitariuli ganaTle-
ba. ganaTlebis ministris brZanebiT gadawyda saganmanaTleblo samkurnalo
wignakebis dabeWdva: `qarTvel eqimebs kargad moexseneba, Tu ra umweo md-
gomareobaSi imyofeba Cveni xalxi saeqimo daxmarebis mxriv. sxvaTa Soris,
es garemoebac xels uwyobs xalxSi aTasgvari crurwmenebis gavrcelebas,
rasac, samwuxarod, mkvidraT aqvs gadgmuli fesvebi ara Tu soflebSi, _
qalaqebSiac ki. gasaWiris dros xalxi garbis marCielTan, rom misgan gaigos
Tavisi awmyo da momavali. mokled rom movsWraT, Cveni xalxis umravlesoba
jer kidev bneliT aris moculi, da ase iqneba, sanam misi social-poli-
tikuri mdgomareoba ar Seicvleba. magram dRevandel pirobebSic ki ker-
Zo Taosnobas didi sargeblobis motana SeuZlia. amitom qarTvelTa Soris
wera-kiTxvis gamavrcelebeli sazogadoebis samwignobro seqciam ganizraxa,
dabeWdos mTeli rigi samkurnalo wignakebisa... wignakebi unda daiweros
mecnierulad da mdabiurad, rom gasagebi iyos saSualo mkiTxvelisaTvis.
_ 223 _
amgvarad, 1918-1921 wlebSi, drois mokle periodSi saqarTvelos jandacvis
sistemaSi ganxorcielda mniSvnelovani reformebi. damoukidebeli saqarTve-
los respublikis mTavrobam qveynis istoriaSi pirvelad daiwyo jandacvis
saxelmwifo doneze organizeba da marTva, samedicino reformasTan dakav-
Sirebuli proeqtebis finansuri da moraluri mxardaWeris ganxorcieleba,
erovnuli samedicino kadrebis momzadeba. SeiZleba Tamamad imis aRniSvna,
rom janmrTelobis dacvis dargSi ganxorcielebulma reformebma sakuTari
wvlili Seitanes qveyanaSi civilizebuli sazogadoebrivi urTierTobebisa
da demokratiuli sazogadoebis damkvidrebis saqmeSi.
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loSi da qarTveli eqimebi, Tbilisi, 1971
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saqarTvelo, 1985
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_ 224 _
Tengiz Verulava
PhD in Medcine, Professor
Ilia State University
THE HEALTH CARE SYSTEM OF THE PERIOD OF
GEORGIAN INDEPENDENCE (1918-1921)
Summary
May 26, 1918 is the most important date in the history of Georgia. In the short period
of Independence of Georgia in 1918-1921, founding Tbilisi State University was one of
the greatest events. It was the rst Naonal University in Georgia and the whole Cauca-
sus. On February 27, 1918, a Medical Faculty was founded at the Georgian University. It
became the center where many well-known Georgian medical sciensts were educated.
In November 1918 Medico-Sanitarian Department at the Ministry of Internal Aairs
was established, the head of which was appointed Simon Japaridze.
Georgia was divided into districts, regions and cies. Correspondingly were assigned
district, regional and city doctors. Approach to each region was dierent. Special aen-
on was paid to Svane and Akhalkalaki. The network of the medical instuons was
divided into 3 sectors:
• Network of state medical instuons;
• Municipal medical instuons;
• Private medical instuons;
Special aenon was paid to pharmacies. There were two types of pharmacies: city
(municipal) and private.
In February of 1920 the Minister of Internal Aairs, Mr. Chichinadze submied a
dra decree of establishment of the Department of Health on the basis of the Medi-
co-sanitarian Department. The dra was approved in July 13. Mr. Spiridon Virsaladze
was designated the Head of Department.
The Department of Health was responsible for:
• Supervision over the acvies of all medico-sanitary instuons of the Republic;
• Issues of quaranne;
• TB, malaria, cholera, plague, STDs, typhus and other diseases;
• Experse issues;
• Conducng medico-sanitarian stascs;
• Sanitary management of recreaonal zones of state importance;
• Issues of pharmacy and pharmaceucals;
• Monitoring of the correct accomplishment of medical-sanitary law, elaboraon
of medical-scienc quesons.
According to the data of 1919 there were 45 hospitals for 1200 beds in Georgia, 17
medical staons in Tbilisi and 13 in Kutaisi. New medical instuons were established
in Po, Akhalkalaki, and Svane region. Medical-supervisory staons are considered
as units of health care system and were a kind of mixture of sanitary-epidemiological
_ 225 _
staons and ambulatory services.
The rst medical journal `The Doctor~ was published in 1919. In January 1918, a
new monthly journal `Doctor’s assistant~ was issued. In 1919 was published monthly
journal `working pharmacist~. In 1920 biweekly journal `Tuberculosis and Prevenve
Medicine~ was published.
Thus, in 1918-1921, during the short period, signicant reforms were implemented
in the Georgian healthcare system. The Government of the Republic of Georgia started
to organize and manage health care at the state level for the rst me in the coun-
tr y’s history, implement nancial and moral support of the projects related to medical
reform and prepare naonal medical sta. The reforms implemented in the eld of
health care have contributed to the development of civil and democrac society in the
country.
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