Bulletin of the Transilvania University of Bra ov • Vol. 3 (52) - 2010 Series VI: Medical Sciences

SANITARY MONOGRAPH OF RÂ ŞNOV TOWN – AND THE SANITARY CAMPAIGN FROM 1938

Liliana ROGOZEA 1

Abstract: Developing sanitary campaigns in the county of Bra ov emerged as absolute necessity under the conditions of the first half of the 20 th century and especially during the period in-between World Wars. The case study comprised within the article herein – led to achieving the sanitary monograph of Râ nov town, valuable information source even within current period.

Key words: sanitary campaign, sanitary monograph, Bra ov medicine history.

1. Introduction [3, 4, 7] optimal methods of morbidity and mor- tality reduction. What happened in the first half of the 20 th This way, through the actions organized century at Bra ov were not determinant me- in 1933 there are: disinfections, children’s dical facts for the evolution of humankind. BCG anti-tuberculosis vaccination (63% in Bra ov remains an organization and coagu- 1932), anti-smallpox vaccination, preven- lation model of the local community in order tively sending children to seaside, isolating to face the medical issues brought along by a TB patients. sanitary system with many problems. It is We likewise remark the modern manner likewise the place where the doctors were of obtaining the data upon the sanitary actively involved in the prevention activity; situation within education units „ detailed therefore it might be a model for other and precise sanitary surveys were worked localities. The apparition of hospitals, upon by the circumscription doctors on all balneary structures, the elaboration of books schools throughout the county, knowing and treaties have made Bra ov a city wherein thereby the schools under all necessary the medical staff honored its presence and hygienic aspects ”. proved that, inclusively in a provincial town, Organizing public health at Bra ov has a medical life might have important few particularities; this way there are achievements for the respective community. worth noticing the quality of the sanitary monographs of the localities within Bra ov 2. Organization of public health [1, 2, 5, 6, County, a permanent preoccupation for 7, 8] achieving balanced medical circum- scriptions and the development of public The county sanitary service was an health campaigns. active organism, in permanent search for

1 Transilvania” University, Faculty of Medicine, Braov, . 108 Bulletin of the Transilvania University of Bra ov • Vol. 3 (52) - 2010 • Series VI

3. Public health campaigns. The specialized consultations are 1-2 times a campaign from 1938 [9, 10, 11, 12, 13, week given by the primary doctors from 14, 15] Bra ov, who go into the respective villages 1-2 times a week, in clusters of 7-8 Out of the public health campaigns individuals .” Beside the consultations, developed in Bra ov, the most complex is disinfections were initiated, samples were the one from 1938, presented in Gazeta de taken for para-clinical explorations, Transilvania numbers: 58, 61, 64, 79, 80, radioscopies were effected, medicines 88 and 89. The campaign was initiated by were administered. the Ministry of Health under the title Both examining doctors and primary “Sanitary Offensive” and benefited from doctors were under obligation to give the support of local authorities. Out of the lectures, in the end of the day, upon themes lot of villages where the campaign of public health. unfolded, the localities: Cristian, Vulcan. On community level, measures of , H ălchiu, , Rotbav, administrative order were discussed. Măieru , Bod, Sânpetru, H ărman. Satunou, For Bra ov „ special attention is given to Purc ăreni, Zizin missed; deemed as having tuberculosis and syphilis (pellagra and a better living standard; but in their case malaria are not issues tangent to the the decision was “ to be examined by the county); then dwelling, industry sanitation, doctor of the respective circ., according to street sweeping, watering, garbage the same method of the teams .”. removal, toilet cleaning .” The localities wherein the teams went During the campaign, the Ministry sent were: Z ărne ti, Poiana M ărului, , to Bra ov the Baths-Train and Roentgen Râ nov, łân Ńari, , Apa Ńa, , motor vehicle apparatus. “The baths-train, , Mârcu , Dobârl ău, T ărlungeni, consisting in water cistern and boiler, an Satulung, Cernatu, Sita Buz ăului, Vama air oven under pressure for disinfestations, Buz ăului, Bran, Simon, Moeciul de sus i a wagon with 40 warm water showers, a de jos, , irnea, Pe tera, M ăgura, dressing-undressing wagon and 2 wagons Tohanul vechi i nou, 29 of the 47 village for the staff is functioning in railway clusters undergoing the campaign, which stations from dawn till evening .” During represents 61.5%. the campaign, in the baths-train “11075 The team consisting in 7 examining individuals were bathed, which means doctors, named by the Ministry of 1.000 per day. Among these, there were Health, whereto the circumscription 4878 children, 3502 men and 2696 doctor, the nurse and local midwives, the women ”, “which imply that our population town hall delegate add, established is willing and is applied to take a bath, if it several working formations, which is possible and free .” Likewise “1096 would search every locality: „ visiting all individuals were cropped and trimmed, houses, all families, writing the found 1077 persons were de-loused through facts in the family sheets; the day result petroleum-oil unction and the clothes of being recapitulated in the day reports, 1470 individuals were disinfected-de- and all day reports in a village being loused, especially workers, gypsies, concentrated in an overall report of the tramps ”. respective village .” Roentgen apparatus had been used in The campaign was an occasion to ensure Bra ov for 5 days, making approximately medical assistance “Necessary consulta- 700-800 examinations per day, confirming tions are immediately provided; and many known cases of tuberculosis and ROGOZEA, L. : Sanitary Monograph of Rânov Town – and the Sanitary Campaign from 1938 109 registering others. chapters and appendices. In the campaign, the following doctors The sanitary cartography of all issues were involved: dr. Nicolae C ăliman, chief ensured not only a very good knowledge of doctor of the hygiene laboratory, dr. Ulpiu the territorial situation, the possibility of tefan, chief doctor of Bra ov town, dr. E. conceiving programs of sanitary education Colbazi, dr. Mo oiu, dr. Jakab, dr. M Papp or coherent prophylactic actions on the doctors at M ărzescu hospital, dr. level of the entire county, but also a O.Pecurariu, dr. T Pri cu, dr. E. Dorea, dr. modality of becoming acquainted with the M. Suciu-Sibiau, dr A. Wolf, dr. Citter, dr. neuralgic points in sanitary organization R. Dorca, doctors of the Polyclinic and the possibility to take adequate Ambulatory from Bra ov, dr. Lazarovici, measures in case an epidemy broke out. military doctor. Chapter I comprised information upon: In the 29 examined village clusters, there geographic position (altitude, latitude and are 16711 households, whereof were longitude, political borders and examined “15553, which is 92 per cent ... subdivisions, surface, distances, railways, The rest could not be examined, as either water ways, roads etc.), topography some houses were abandoned, not dwelled (description of hills, field valleys), geology or the dwellers had emigrated for some time (superficial stratum, foundation stratum, farther in order to work .” 52745 inhabitants special phenomena), hydrography (rivers, were examined, which is 72.7% out of the lakes, pools, river courses, subterranean population of the examined villages, waters), vegetation (forests, plants, aquatic whereof 85% were healthy. plants), terrain surface yielding corn, As regards the hygienic conditions, in wheat, vineyards, orchards, vegetable the 29 localities, only 2 were noted to have gardens etc.), fauna (wild, domestic centralized water system (aqueduct), in the animals), number and nature of industries, rest fountains existing: 3704 hygienic, use of the water motric force (dams, plants, 1629 not hygienic, however 7732 houses turbines, canals, irrigations), works of existed without their own fountain; public utility (streets, parks, street lighting, likewise 4203 houses had no toilet, 5510 aerial gas, electricity). were hygienic, and 5117 not hygienic. The Chapter II is dedicated to climatic data: majority of the houses were in wood, temperature (minimal, maximal, medium, (8574), the rest being of stone (7429) and thermal curve), humidity, precipitations earth (119). (rain, season distribution, maximum of There were given 36 conferences on precipitations), snow, ice, fog, winds (wind medical education, whereof 18 by the speed, season conditions). doctors of the central team and 6 by the Chapter III – Population has the circumscription doctors. following subchapters: population (details upon the census from the previous years), 4. Sanitary monographs of the localities population classification (sex, marital [16] status, age groups), population density, races and nationalities, religion, education One of the most important results of the (analphabetism, school attendance, local sanitary campaign was the elaboration of publications), local administrative orga- the locality sanitary monographs. nization, inhabitants’ occupations, econo- The sanitary monograph of every locality mic status (landlords and house owners, had a standard format, which comprised: a working hours, pauperism, cost of a plan draft of the locality under study, 5 working day, women and children at work 110 Bulletin of the Transilvania University of Bra ov • Vol. 3 (52) - 2010 • Series VI in industry or agricultural works, pregnant (official doctors, duties and adminis- women’s work). trative powers, organizing the work, Chapter IV – entitled Sanitary Genius efficacy). Proposals comprises the following items: 2. midwives, nurses or charitable sisters, 1. water feeding (public or private sanitary agents, veterinary agents etc., property, feeding source, quality of (number and professional training) drinking water, recommendations), 3. hospitals, dispensaries, care houses, 2. drainage and sewerage, laboratories; information upon the 3. human excretion removal (sewerage juridical status of buildings wherein and other methods, they function (property, rent etc.) 4. dung heap collection, depositing and use, 4. private doctors (number, the way of 5. garbage collection, depositing and use, exercising their profession) 6. human graveyards (surroundings, 5. social State protections plantations, proximity of drinking water 6. particular associations of social sources etc.) protection; the subvention received 7. animal corpse collection, animal from the State. graveyards, Chapter V gives us pertinent informa- 8. sanitary status of the buildings, tion upon the sanitary infrastructure of the 9. salubrity of the school buildings region, as well as upon the available (building state, cubing, natural lighting, human resources under both State and heating, yard, latrine), private regime. 10. prophylaxis measures (anti-larvae, of Chapter VI – facultative – is an disinfestation, deratization, de-lousing) economic analysis upon the budget, based – drying closets, disinfestation ovens, on the administrative expenses of the ambulances, village (appreciating if there is a deficit or 11. food control (meat, milk) – butcheries, not), the raised taxes, the village food halls, food markets, borrowings, the budget of the public health 12. quantity of consumed drinks, annually, services, the analysis of the public health at the pub or at home, budget, the cost of public health per capita. 13. different other problems of sanitary Chapter VII entitled biometry consists in genius (public baths, sanitary status of the tables III-VII. the terminal points of the We exemplify the manner in which this communication paths ). type of monograph was achieved through We note for this chapter not only the the data contained by the Râ nov locality great quantity of required information, but monograph; we note that in 1938 this also the fact there is about very pertinent locality had 5673 inhabitants, the majority information on the hygiene of the locality, being women (2952), 2401 being married, individuals. We have however no proof 184 widowers and 16 divorced. During the that these information were followed by respective period, in Râ nov there lived concrete actions of sanitary systemizing. (the majority) – 3447, Germans Chapter V : The sanitary administration – 1825, Hungarians – 129, Jews – 24 and comprises the answer to the following other nationalities 248. (table I and table issues: II). 1. organizing the State sanitary service

ROGOZEA, L. : Sanitary Monograph of Rânov Town – and the Sanitary Campaign from 1938 111

For the health budget, there is allotted 2,12% out of the overall village budget (78614 out of 3714210), the cost of public health per capita being of 14 lei, one third of the health budget money being used for paying the medical staff.

Sanitary Monograph of Râ nov - cover

The repartition on age groups is presented in the following graph: Sanitary monograph of Râ nov

Table III in the Monograph analyzes the population movement during the period

0 1928-1937, noting that the birth rate 0- 1- 5- 10- 15- 20- 25- 35- 45- 55- 65- pe average is of 25.5%, varying between 21% Rasnov 125 305 464 454 457 399 609 656 684 637 679 204 in 1935 and 31% in 1930, the average mortality is of 15.65%, varying between

13% in 1933 and 1934 and 21% in 1932, Repartition on age groups in Râ nov and the infantile mortality has an average during 1938 of 13%, varying between 10% in 1929 and 20% in 1932. In conclusion there is about a In Râ nov, 2 protection associations population surplus of 9.37% (minimum function, a Romanian and a Transylvanian 5.5% in 1931 and 12.5% in 1929). Saxon one; a medical dispensary; and the Table III contains the data during the medical staff serving this population period 1928-1937 as regards infantile consists in 7 persons: 1 official doctor, 1 mortality on age groups and months, the protection nurse, 2 midwives and 3 private majority of deceases being registered doctors. between 6 months and 1 year, as it ensues from the following graph:

112 Bulletin of the Transilvania University of Bra ov • Vol. 3 (52) - 2010 • Series VI

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937

6 luni - 1 an 44957351038 1-5 luni 33361080365 7-29 zile 7 6 3 3 4 2 2 0 4 1 1-6 zile 3 1 2 2 4 1 2 3 2 3 0-1 zi 1 1 2 4 4 1 0 2 1 2

0-1 zi 1-6 zile 7-29 zile 1-5 luni 6 luni - 1 an

Repartition on age groups of the deceases in Râ nov during 1938

As regards the deceases according to the month, we note that most deceases occurred in the month of July (28 out of the total of 179), with a peak in the month nov of September 1937. sept

Table with the infantile mortality in iulie Râ nov mai 01 02 03 04 05 06 1928 1 1 2 1 3 2 martie 1929 0 1 0 1 0 1 1930 1 1 1 2 1 2 ian 1931 1 1 1 0 2 0 0% 20% 40% 60% 80% 100% 1932 1 2 1 2 2 3 1933 1 2 1 2 1 0 1934 1 0 1 1 0 2 1928 1929 1930 1931 1932 1935 1 0 1 0 3 0 1936 2 0 2 0 3 1 1933 1934 1935 1936 1937 1937 1 0 1 2 2 1 Repartition on years of the mortality in 07 08 09 10 11 12 Râ nov 1928 4 3 0 1 0 1 1929 3 3 3 1 1 1 General mortality affects, as we would 1930 2 3 3 1 1 1 expect, extreme ages, under 1 year and 1931 2 4 4 2 1 2 above 55 years, general mortality being 1932 5 5 3 2 1 2 1933 3 2 1 1 0 1 higher for the masculine sex than for the 1934 2 0 1 0 1 0 feminine one. 1935 3 1 0 3 3 3 1936 3 3 0 0 1 1 1937 1 0 7 3 0 1

ROGOZEA, L. : Sanitary Monograph of Rânov Town – and the Sanitary Campaign from 1938 113

To be noted that if the number of the tuberculosis cases is relatively constant, varying between 14 and 31 cases per year, 428; 49% in the case of measles and flu, we note 438; 51% there is an incidence peak in 1935.

65 malarie 4

65 female TBC 199 male 14

masculin feminin meningita 1 3 erizipel 4

244 difterie 33 56

General mortality on sexes scarlatin ă 98 200 febra tifoid ă i paratifoid ă 46

0 50 100 150 200 250 100%

80% Frequency of contagious and social

60% diseases in Râ nov

40% To be noted that during this period, in Râ nov, there was recorded no case of:

20% exanthematic typhus, smallpox, lethargic encephalitis, malignant pustule, tetanus,

0% chicken pox and pellagra and there was 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 recorded no case of homicide.

0-1 1-4 5-9 10-14 15-19 20-24 25-34 A subsequent comparative analysis of 35-44 45-54 55-64 65-74 peste 75 the data obtained from the monographs of

Bra ov localities would be very useful in General mortality on ages in Râ nov order to have a much clear image upon the during the period 1928-1937 evolution of the epidemiologic data. There is likewise useful to compare these data The main decease causes were, for the with the national ones. children, congenital malformations and the If we analyze the water sources from childhood diseases, the diarrhea and the 1938 we might conclude that the living enteritis, and, for the adults and elders, the standard for the respective period was heart diseases, the pulmonary tuberculosis, adequate; this way we note there are 49 the pneumonia, there existing however a fountains with wooden casing, 52 high number of deceases because of fountains with stone casing, 804 fountains senility. with pump, 4 springs or drinking fountains, The main contagious affections and the water stratum being at 1-8 meters depth social diseases affecting the population of and the water quality being appreciated to Râ nov during the period 1928-1937 are be good. presented in the graph no. 5. 114 Bulletin of the Transilvania University of Bra ov • Vol. 3 (52) - 2010 • Series VI

2. Ioanid L.: Organele sanitare locale vor întreprinde anul acesta importante ac Ńiuni menite s ă amelioreze starea sanitar ă a popula Ńiei din ora i jude Ń, Drum nou nr. 1328, 1949. 3. Rogozea L.: Aspecte ale medicinii bra ovene în perioada interbelic ă, Acta medica Transilvanica , nr.1, 2003, pg.56-60. 4. Rogozea L.: Bra ovul iatro-istoric , Ed. Universit ăŃ ii Transilvania, 2006, 217 pg. 5. Rogozea L. : O carte uitat ă pe nedrept –

„Serviciul Sanitar al României” de Ion “Gazeta Transilvaniei” newspaper, 1938 Bordea, Ars medica , nr. 2, octombrie- decembrie 2001. Likewise, the dwelling conditions were 6. Rogozea L.: Personalit ăŃ i ale good enough, 1308 houses being in stone medicinii române ti , vol. 1, Ed. and only 38 in wood and 16 huts. The Universit ăŃ ii Transilvania, 2006. majority of the houses consisted in 3 7. Stinghe V.: Realiz ări medicale la rooms (805), 2 rooms (341); there is Bra ov dela unire încoace, Gazeta however a number of 10 dwellings with Transilvaniei, nr.24, 1944, pg. 4. one room and also 190 dwellings with 4 or 8. Vătămanu N.; Br ătescu G.: O istorie a even more rooms. The majority of the medicinei . Bucure ti: Ed. Albatros, houses in Râ nov had latrine (1321) and 1975, 346 pg. x only 25 had no latrine. All these data 9. x x – Campania sanitar ă, Gazeta connected to the living conditions may also Transilvaniei, nr.58, 1938. x be correlated with the education level, only 10. x x – Campania sanitar ă, Gazeta 2% out of the population being analphabet. Transilvaniei , nr.61, 1938. x 11. x x – Campania sanitar ă, Gazeta Conclusions Transilvaniei, nr.64, 1938. x 12. x x – Campania sanitar ă, Gazeta The sanitary campaign from 1938 led to Transilvaniei , nr.79, 1938. x developing sanitary monographs that may 13. x x – Campania sanitar ă, Gazeta be taken as model by the sanitary Transilvaniei, nr.80, 1938. x authorities from any period. 14. x x – Campania sanitar ă, Gazeta Transilvaniei nr.88, 1938. x References 15. x x – Campania sanitar ă, Gazeta Transilvaniei , nr.89, 1938. x 1. Bordea I.: Serviciul Sanitar al 16. x x – Monografia sanitar ă a ora ului României, Igiena Public ă, 1905-1922, Râ nov, nr.89, 1938. Tipografia „Cultura”, 1924-