Development of Sanitary and Epidemiological Supervision in the Voronezh Region: Historical Retrospective and the Present

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RELEVANCE
The development of sanitary and epidemiological surveillance in the Voronezh region can be traced back to the earliest times, when special measures were taken to prevent the spread of such deadly diseases as plague, cholera, smallpox and leprosy. However, the main stages in the development of the sanitary service in the region are closely related to the development of a similar service in Russia.
TARGET
Consider the historical retrospective of the development of sanitary and epidemiological surveillance in the Voronezh region, highlight the main historical milestones and characterize the contribution of scientists and practitioners to the development of the service.
METHODS
Materials and methods
General methods of scientific research, analytical method.
RESULTS
The first recorded sanitary measures taken in the Voronezh region date back to the beginning of the 17th century. In 1709, Peter I issued a decree "On keeping the streets of the city clean and removing all types of sewage from them outside the city." Consequently, special sanitary guards were appointed and they were called foremen. This decree marked the beginning of organized sanitary control in the Voronezh region [1].
In 1775, the order of public charity was established in the Voronezh province. The establishment of the Order of Public Charity in the Voronezh province was a significant event that played a decisive role in the development of healthcare in the region. This initiative was aimed at addressing the pressing social problems of the time, including poverty, disease, and infant mortality, and was launched in response to the rapid growth of urbanization and industrialization in the area.
The Order of Public Charity was established as a voluntary organization with the main purpose of providing medical and financial assistance to the poor and disadvantaged members of society. Its creation was the result of the concerted efforts of prominent individuals from various social groups, including merchants, landowners, doctors and philanthropists. The leadership of the organization consisted of respected figures in the local community who worked tirelessly to raise funds, recruit volunteers and develop programs to support the poor and needy.
One of the key goals of the Order of Public Charity was the promotion of preventive medicine and public health education. To achieve this goal, the organization has created a network of hospitals and dispensaries throughout the region, staffed by doctors and nurses. These institutions provided essential medical care and educated the local population on the importance of hygiene, sanitation and vaccination in preventing the spread of infectious diseases.
The Order of Public Charity has also focused on the welfare of vulnerable groups such as orphans, the elderly and needy women. The Order created orphanages, homes and schools for these groups, providing them with a safe and supportive environment in which to live and learn. In addition, the organization provided training and employment services, enabling individuals to become self-sufficient and productive members of society.
The establishment of the Order of Public Charity in the Voronezh province has become a landmark event in the history of healthcare and social security in the region. His legacy continues to this day, as his work inspired subsequent generations of physicians and activists to advance social justice, equality, and human dignity. The Order of Public Charity serves as a model for public health and public service, emphasizing the critical role that civic engagement and public-private partnerships play in promoting the common good [2].
This order played a key role in the development of medical services and laid the foundation for its further growth. During this time, hospitals were established and sanitary control was established in all county towns. However, despite the positive shift in the development of medical and sanitary principles, the state of medicine remained extremely unsatisfactory.
Epidemics continued to devastate Voronezh Governorate, as evidenced by outbreaks of cholera, typhoid, scarlet fever, smallpox, whooping cough, and malaria from 1848 to 1850. These outbreaks killed about 13% of the province's population within two years. This unfortunate event highlighted the need for stronger and more effective measures to prevent and control the spread of disease [5].
The Voronezh province in tsarist times was known for its backwardness in terms of sanitary conditions. The province faced serious epidemiological problems, which required the creation of a specialized sanitary department. After the devastating cholera epidemic of 1892, the medical council developed a decree on sanitary and executive commissions, and in 1896 the post of provincial sanitary doctor was approved. Nikolai Ivanovich Tezyakov became the first experienced specialist in this field, having worked in this position for 7 years, and later became a major sanitary figure in the country.
In 1914, Academician Mikhail Akimovich Morozov took the initiative to createof the Pasteur station in Voronezh for the prevention of rabies in humans. In recognition of his contribution to the production of a dry smallpox vaccine, in 1951 Morozov was awarded the State Prize and the title of Honored Scientist of the RSFSR.
In 1937, the Voronezh regional anti-epidemic station began its activity to further strengthen the sanitary service of the region. By 1939, there were 15 sanitation specialists in the regional SES (industrial, food, school utilities). The number of sanitary stations increased significantly every year: five in 1938, eleven in 1939 and twenty-eight in 1940, including one regional, two city and twenty-five district stations.
Elizaveta Nikolaevna Bakhareva became the first head of the sanitary service in the region, holding the post of head of the regional sanitary and epidemiological station in 1948-1949. Her followers were A.A. Sheshenev (1953-1958) and N.N. Dolgov (1958-1964).
Despite the progress made in the development of the sanitary service, the Voronezh region still continued to face significant problems. In 1960, an outbreak of smallpox occurred in the region, requiring the vaccination of about two million people. The epidemic was successfully contained thanks to the prompt measures taken by the sanitary service [3].
The material and technical base of the sanitary and epidemiological service deteriorated during the Great Patriotic War, but by the 1950s the service had grown stronger, and the number of sanitary laboratories had increased. From 1964 to 1978, Valentin Alexandrovich Kamensky headed the Sanitary and Epidemiological Service of the Voronezh Region, strengthening the authority of the service and improving its material and technical base.
Yuri Nikolayevich Korzh served as chief physician from 1978 to 1988 and resolved the issue of self-financing the state sanitary and epidemiological service of the region, which led to the creation of associations for social and hygienic prevention.
From 1988 to 2012, Mikhail Ivanovich Chubirko, Doctor of Medical Sciences, Professor, headed the Office of Rospotrebnadzor for the Voronezh Region. He played an active role in the development of more than fifty federal regulations and eight by-laws, as well as more than eighty targeted programs to ensure the sanitary and epidemiological welfare of the population of the Voronezh region.
In general, the development of the sanitary and epidemiological service in the Voronezh region has undergone significant improvements and advances, ranging from basic anti-epidemic measures to a well-organized specialized service with qualified personnel and a strengthened material and technical base. The efforts of various leaders in this area contributed to the significant progress achieved in ensuring the sanitary and epidemiological well-being of the population of the Voronezh region [4].
The merger of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in the Voronezh Region and the Federal State Health Institution "Center for Hygiene and Epidemiology in the Voronezh Region", which provides the activities of the Office of Rospotrebnadzor, happened in 2004. In turn, the State Sanitary and Epidemiological Supervision of the Voronezh Region and the Office of the State Inspectorate for Trade, Quality of Goods and Consumer Rights Protection in the Voronezh Region have merged. The goal was to create two organizations to oversee consumer protection and health care in the region.
Doctor of Medical Sciences became the head of the Office of Rospotrebnadzor for the Voronezh Region. I. I. Mekhantiev (2013-present)
The head-chief physician of the FBUZ "Center for Hygiene and Epidemiology in the Voronezh Region" is MD, prof. Yu.I. Stepkin (2005-present)
State sanitary and epidemiological supervision in the Voronezh region is carried out by the Office of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare. The Department of Rospotrebnadzor, FBUZ "TsGiE in VO" contain eight branches each in the municipal districts of the region and one railway branch. Currently, the sanitary service is 100 years old (September 15, 2022) and its development is gaining momentum every day, including the repeated improvement of existing functions.
To date, the State Sanitary and Epidemiological Service of the Voronezh Region has been instructed to optimize the structure of Rospotrebnadzor institutions, improve the management and financing system, work with personnel, develop new regional regulations, regulations and programs to ensure the sanitary and epidemiological well-being of the population of the region. In addition, the activities of the service are aimed at improving social and hygienic monitoring, confirming the accreditation of laboratories in the branches of the Center for Hygiene and Epidemiology in the Voronezh region in the regions of the region, and preventing infectious diseases [5].
DISCUSSION
The importance of the preventive work of Rospotrebnadzor is difficult to overestimatea thread. By identifying potential risks and hazards in advance, the agency can take steps to prevent or minimize harm to consumers. This work includes conducting inspections and monitoring of businesses and organizations to ensure compliance with occupational health and safety regulations, as well as providing advice and educating the public on how to stay safe and healthy [1].
Rospotrebnadzor's preventive work also helps build public confidence in the safety and quality of goods and services, which is critical to business and economic success. By maintaining high standards of consumer protection, Rospotrebnadzor helps to develop a culture of accountability among businesses and encourages them to prioritize the health and safety of the Russian population [6].
Moreover, Rospotrebnadzor's preventive work plays a critical role in addressing emerging public health threats such as infectious and foodborne diseases. The Service works closely with other government agencies and international organizations to monitor and respond to outbreaks and develop effective strategies to prevent the spread of disease.
CONCLUSION
Conclusions:
In general, the historical retrospective and analysis of the current state of sanitary and epidemiological surveillance in the Voronezh region emphasize the importance of ongoing efforts to improve the infrastructure and capacity of institutions providing sanitary and epidemiological surveillance in the region.
By building on the achievements of the past, addressing the challenges of the present, and looking to the future, we can ensure a strong and effective public health surveillance system that can respond to emerging infectious disease threats and protect public health.

About the authors

Margarita Mikhailovna Bulgakova

Voronezh State Medical University named after N.N. Burdenko

Author for correspondence.
Email: litochka1203@gmail.com
ORCID iD: 0000-0002-3354-0340
SPIN-code: 2608-8439

student

Russian Federation, 10 Stusentskaya str., Vorovezh, 394036, Russia

Ivan Gennadevich Nenakhov

Voronezh State Medical University named after N.N. Burdenko

Email: rayhd@yandex.ru
ORCID iD: 0000-0001-7942-2844
SPIN-code: 9905-2934

Candidate of Medical Sciences, Associate Professor of the Department of Hygienic Disciplines

Russian Federation, 10 Stusentskaya str., Vorovezh, 394036, Russia

References