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History of development of the dermatovenerological service in Minsk region

Before the revolution, there were no special outpatient departments for patients with venereal and skin diseases. All dermatovenerological care was only available at private doctors and in rural areas - at quacks. At that time, traditional Belarusian settlements were characterized by extremely overcrowded living conditions and lack of baths, which consequently lead to the development of pediculosis and scab.

The first information about the dermatovenerological service in Minsk region appeared in 1893, when according to the order of the Medical Department, part of the population of the Minsk province (Stankovo, Koidanovo, Sverzhensk, Uzda, Kletsk and other districts) was examined for syphilis by doctor A.E.Livshits. Out of 45 138 people examined, 1836 patients were found to have clinical manifestations of syphilis (4067, 5 cases per 100.000 population). 

        During the first years of the establishment of the Soviet power, dermatovenerological care was provided by therapists and private venerologists who were mainly concentrated in Minsk, Borisov and other big cities. Anti-epidemic measures were not implemented at that period of time.

According to A.N.Shapiro, in 1932, the citizens of the Dzerzhinsk district were examined for venereal and contagious skin diseases. As a result, out of 4170 people examined, only 4 new cases of syphilis (95, 9 per 100.000), 43 cases of scabies (1031, 2 per 100.000) and some isolated cases of trichophytosis were found.

By the year of 1941, a number of hospitals, outpatient departments and obstetric units in Minsk region increased considerably as compared   with 1913. During the Great Patriotic War, most treatment and preventive care establishments were destroyed at the occupied territories. The incidence of infectious diseases, syphilis and gonorrhea including, increased sharply. Immediately after the liberation of the region from the German fascists, health care bodies took steps aimed at restoration of treatment and preventive care establishments, dermatovenerological network including. In July of 1944, according to the Order of the Peoples’ Committee of Health Care of the BSSR, Minsk Regional Dermatovenerological Dispensary was founded. Order №1 about the establishment of the Dispensary with 8 staff doctors was adopted on 08.07.1944.

D.M. Pashkevich was appointed the first Head Doctor of the Dispensary. Later, this post was occupied by Maria Abramovna Kirzon (1944-1945) and Alexander Arsentevich Umanets (1945-1946).

Zinaida Moiseevna Karaeva became the Head Doctor of the Dispensary in 1946 and held this post permanently till 1973. She is a veteran of the Great Patriotic War, was awarded many medals and the Award for excellence in health care, the author of a number of scientific articles on mycology. Up-to-date network of dermatovenerological establishments, as well as in-patient departments for dermatovenerological patients were created in the region under her leadership.

One of the first employees of the Dispensary (according to Order № 1) was Vera Ivanovna Rudakovskaya, veteran of the Great Patriotic War, who worked at the Dispensary as a nurse from 1944 to 1993.

         At that time, Minsk Regional Dermatovenerological Dispensary had Out- and In-Patient Departments. Some months later, the In-Patient Department was transferred to Clinical Hospital № 2 in Minsk. At first, the Dispensary was located in Revolutsionnaya Street, then in Malyavschinskaya Street. Later, it occupied some rooms on the base of the Regional Sanitary Station in Podlesnaya Street. In 1960, it moved to the former building of Minsk Rural Department of Health Care in Starovilensky Tract, 53 and existed there for more than 40 years.

During the first days of the establishment of the Dispensary, anti-epidemic work on detection and treatment of venereal diseases was started. These diseases were widely spread at the territory of Belarus occupied by German fascists. Simultaneously, the fight against contagious skin diseases was initiated. At that time, a large number of the population was affected by trichophytosis and favus.     

Minsk Regional Dermatovenerological Dispensary conducted active organization and methodical work in the region, much attention was paid to the development of a network of dermatovenerological establishments. In 1947, besides the Regional Dispensary, 5 dermatovenerological rooms were opened. At that time, they were headed by feldshers. In 1951, 2 Regional Dermatovenerological Dispensaries and 12 dermatovenerological rooms were founded.

As a result of the conducted activity, which embraced treatment, diagnostics and prevention, the incidence of venereal and contagious skin diseases decreased from year to year.

In 1951, Minsk Regional Dermatovenerological Dispensary started mass prophylactic examination of the population. Special expeditionary teams of doctors, nurses and laboratory assistants from the Regional Dispensary were formed and sent to the districts with the largest incidence of syphilis. At that period of time, there were three teams working in Holopenichi, Begoml and Berezino districts. At the beginning of the 50-s, due to a wide spread of contagious skin diseases, doctors-dermatovenerologists as members of such teams, made rounds of the houses, aimed at sanitation of the centers of infection in Stolbtsy, Minsk district and others. Prophylactic examinations were also carried out at children’s homes and boarding schools, the main task being sanitation of children. At that time, there were 35 children’s homes at the territory of Minsk region. Among them, 29, 3% of children had dermatomycosis in 1948-1950. In order to treat the children, children’s homes  in Zykovo, Puhovichi, Borisov and Minsk were turned into temporary in-patient departments for 460 beds.

The doctors from the Regional Dispensary controlled the treatment of patients in rural departments. X-ray epilation rooms were founded in the districts to treat mycotic lesions of the hairy part of the head, as well as serologic laboratories for diagnosing syphilis.

Doctors-dermatovenerologists took an active part in fighting pustular diseases at the state farms and machine stations. In 1953, when mass clinical examination of machine operators was started in Minsk region, these doctors    

actively participated  in this work. Instructive letters were sent to all district dermatovenerologists. Doctors from the Regional Dispensary visited machine stations to render practical and methodical assistance. Temporary disability due to pustular diseases was analyzed. Prophylactic examinations of machine operators for detecting skin pathology were conducted regularly, which lead to a decrease in pustular diseases. In 1954, the number of disability cases at the state farms due to this pathology was 4, 1 with 20 days of disability per 100 working people; while in 1957, these figures made 1,1 and 7,4, accordingly.  

In 1947, the Night Preventive Clinic was opened on the base of the Regional Dispensary.  

At that difficult period of time, doctors-dermatovenerologists  received   great assistance from the specialists of the Belarusian Research Institute of Dermatovenerological Diseases immediately after its foundation in 1932. Beginning with 1945, consultations of patients by Academician A.Ya. Prokopchuk were organized at the Dispensary.

In the 60-s, the incidence of syphilis was minimal; the number of patients with favus, trichophytosis, scabies and soft chancre decreased considerably.

At that time, laboratory service was also developing. In 1948, Serologic Laboratory was founded. In 1949, it was headed by Elena Mihailovna Pavlova, who occupied this post for 42 years. Being a highly qualified specialist, she introduced up-to-date methods for diagnosing syphilis. It was due to her efforts that in the 80-s, serologic diagnosis of syphilis was organized in every district of the region, with 6 cenralized serologic laboratories being opened.

A joint work of medical and non-medical departments on timely detection and prophylaxis of contagious skin and venereal diseases was initiated. Beginning with 1973, a jurisconsult started working at the Regional Dispensary.

On the 1st of January, 1988, 7 dermatovenerological departments for 360 beds worked in the region on the base of interdistrict dispensaries and central district hospitals.  

In 1993, Bacteriological Laboratory was founded in the Regional Dermatovenerological Dispensary. For the first time in the republic, cultural method of diagnosing gonorrhea was used for patients of obstetric and gynecological institutions in Stolbtsovsky district of Minsk region. In the 80-s, cultural diagnosis of gonorrhea was conducted in every district on the base of centralized bacteriological laboratories of dermatovenerological dispensaries or  on the base of laboratories of district sanitary epidemiologic stations.

A great role in the organization and development of dermatovenerological service in Minsk region belongs to Head Doctors of Minsk Regional Dermatovenerological Dispensary.

L.A.Boiko started working at the Dispensary in 1964, being the Head Doctor from 1973 to 1991. During these years, a network of in-patient departments at the dermatovenerological dispensaries was expanded, FTA and TPI laboratories were organized in the region, the incidence of syphilis was stabilized during the epidemic rise in the 70-s.

A.A. Kipnis worked at the Dispensary from 1973, being the Head Doctor during 1991-1998. A large amount of work on timely detection of venereal and contagious skin diseases in the region was carried out under his leadership. The work of Interdepartmental Councils and Disease Control Headquarters on fighting venereal and contagious skin diseases was initiated. The incidence of scabies decreased considerably. The foci of childhood venereal morbidity in Borisov were eliminated. Dermatovenerological departments were opened in Volchkovichi and Ostroshitsky-Gorodok Hospitals.

L.A.Koloskova worked at the Dispensary from 1978, being the head Doctor during 1998-2013. She was awarded the Award of excellence on health care, was the member of the Council of the Republic of the National Assembly of the Republic of Belarus of the second convocation. Her efforts were directed to the improvement of the material and technical basis of the Regional Dispensary, as well as of the Dermatovenerological Dispensaries in Molodechno and Slutsk. She contributed much to the development of luminescent diagnosis of sexually transmitted diseases (STDs). At that time, PCR-Laboratory was created where advanced molecular and genetic methods for diagnosing infectious diseases were introduced. A network of cosmetic rooms (beauty parlours) was developed.  

Head Doctors of district dispensaries also made a large contribution to the development of dermatovenerological service. Among them, N.G. Grishkov  (1959-1983) and V.I.Hodenok (1977-2008) from Soligorsk Dispensary, V.K. Zubritsky (1974-1997) and P.I. Zaborovskaya (1979 to present) from Slutsk Dispensary, A.K. Lobanok (1967-1985) and V.V. Haetsky (1985-2005) from Molodechno Dispensary, K.I.Ignatovich (1960-1999) and T.G. Milkota (1976 to present) from Vileika Dispensary, D.G. Kornilova (1952-1977) and S.A. Kombarov (1976-2013) from Borisov Dispensary. 

Laboratory service of dermatovenerological dispensaries also played a great role in the development and improvement of diagnosing venereal diseases. Heads of Centralized Serologic Laboratories, such as E.M. Pavlova (1949-1991) and T.P. Mihalevich (1991-2006), as well as K.A. Rapatsevich (1980-2006), the Head of the Bacteriological Laboratory, did a lot in this field.

Doctors-dermatovenerologists, who worked in the system of dermatovenerology for many years, also contributed much to the development of the dermatovenerological service. Among them:  E.I. Shirokova (1944-1984), A.T. Pintusova (1944-1979) and M.S. Tolstaya (1972-2009) from Minsk Regional Dermatovenerological Dispensary; T.F. Shestakovich (1976 to present) from Molodechno Dispensary; G.P.Kniga (1978-2014) from Soligorsk Dispensary; E.N.Vysotskaya from Zhodino Dermatovenerological Room; N.F. Gorodkova (1976-2015) from Krupsky Dermatovenerological Room; I.V. Tsvirko (1952-1994)  and M.P. Fitsuk (1972-1999) from Stolbtsy Dermatovenerological Room; O.N. Kuzmich (1971-2015) from Borisov Dispensary.

At present, there are 5 Dermatovenerological Dispensaries, 20 Dermatovenerological Rooms, 10 Cenralized Laboratories (5 Serologic and 5 Bacteriological) in the region, State Health Establishment “Minsk Regional Dermatovenerological Dispensary” being the organizational and methodical center.

The Regional Dispensary is included to the structure of the Central Health Department of Minsk Regional Executive Committee and is an independent specialized out-patient establishment for providing qualified dermatovenerological care to the population of the attached area and the region as a whole using advanced medical technologies and complying with the dispensary principles of treating patients with skin diseases and STDs. The Regional Dispensary also delivers organizational and methodical management  support to the dermatovenerological establishments in the region.  

The material and technical basis of the Regional Dispensary improved considerably in 2002 after moving to the rentable areas of Minsk Children’s Hospital in Brovki Street, 7.  On 10.11.2017, according to the Order of Minsk Regional Executive Committee №257 of 30.11.2017 “About donation”, the rentable areas were transferred to the operative management of the State Health Establishment “Minsk Regional Dermatovenerological Dispensary”.

On the base of the Dispensary, PCR-Laboratory was organized, where molecular and genetic investigations for a number of infections (chlamydia, mycoplasmosis, trichomatosis, cytomegalovirus, herpes simplex; human papilloma virus, type 16, 18) are performed.

Up-to-date methods of diagnosis and treatment of skin diseases and STDs have been introduced: FTA-diagnosis of chlamydia and syphilis, ELISA-diagnosis of chlamydia, genetal herpes, toxoplasmosis, cytomegalovirus, helicobacter pillory; cultures for ureamycoplasmosis, bacterial cultures for flora and fungi; determination of sensitivity to antibiotics and antimycotics; diagnosis of allergic diseases; microscopic investigation for fungi, demodex and itch mite. 

Cosmetology services are actively developing too.

Today, State Health Establishment “Minsk Regional Dermatovenerological Dispensary” is an impressive health care facility located in the center of Minsk with up-to-date equipment and advanced methods of examination and treatment of patients with dermatovenerological diseases and cosmetic problems.