[The development of rural medicine and hygiene].
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The health service of Papua New Guinea is targeted at village level primary health care, through aid posts and health centres. There is an increasing demand for providing these facilities with basic diagnostic laboratory services at the health centre level. To accomplish this, an inservice training program has been established to train existing health workers in specific laboratory skills. A management support scheme has also been instigated to ensure that the most effective use is made of these laboratory-trained staff. This has created a team of rural laboratory workers to support the clinical management of patients in rural locations throughout Papua New Guinea.
Saku Hospital in Usuda-machi of Nagano Prefecture is famous for its medical activities for rural people. The activities of Saku Hospital were practiced not only in the hospital but also in the local community. Immediately after the establishment of the hospital, in 1945, doctors and nurses visited patients in their homes. In the medical activities, at the village, the hospital staff discovered a lot of latent diseases among the rural people. To clarify these diseases, the staff surveyed the life of the villagers based on medical ecology, as well as the medical treatment. Latent diseases were analyzed from a medical and social viewpoint. As a result, the staff came to recognize the importance of the prevention of disease, as well as medical treatment. To prevent diseases, the hospital started health promotion activities in the 1950s, cooperating with the administration of the villages. Medical examination were carried out periodically and health education was promoted to improve the consciousness of the people regarding health. Medical activities of Saku Hospital, which were not limited to clinical medicine, proved "prevention is superior to treatment." This conclusion teaches us the importance of social medicine as well as that of biomedicine and indicates the way of future medical activities.
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In present social economic conditions of Republic of Tajikistan, health sector reform is carried out on basis of National concept of public health reformation. Its major elements are medical preventive institutions. They implement primary medical sanitary care in rural areas where most of country population is dwelling. Amelioration of corresponding material and technical background and enhancement of management mode aligned to WHO directives is intended.
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