Молодежный инновационный вестник

2415-7805

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

9650

Conference Proceedings

Organization of emergency medical services in besieged Leningrad

Sazhinov

Ivan

ivan.sazhinov03@yandex.ruhttps://orcid.org/0009-0002-2352-1805Khorkova

Oksana V.

<div>Сandidate of medical sciences, associate professor of the department of organization, management and economics of healthcare</div>spbkafedra@inbox.ruhttps://orcid.org/0000-0002-0993-8340

National Medical Research Center named after V.A. Almazov

27122024

132108111

13032024

25062024

2024

Abstract: Introduction. The report "The work of emergency medical care in besieged Leningrad" presents a study of some issues of organizing the work of emergency medical services, the ethical aspects of the activities of medical workers during the siege of Leningrad from 1941 to 1944. The report is aimed at expanding knowledge about the organization of emergency medical care and understanding the problems of protecting public health in a historical context. Target. Study of the organization of emergency medical care to the population during the siege of Leningrad. The report aims to increase knowledge and understanding of the historical context, as well as the difficulties faced by health workers and patients during the siege. Research methods. Historical, sociological, analysis of archival documents and eyewitness accounts of the siege of Leningrad. Results. Based on the analysis of archival materials on the work of emergency medical services in besieged Leningrad, various aspects are considered, including organization and logistics, availability and quality of emergency medical care, as well as issues of professional ethics and morality of medical personnel. The report emphasizes the importance of preserving historical memory for present and future generations, the importance of studying the organization of medical care, the ethical and moral qualities of medical personnel, understanding the value of human life, and readiness to fulfill their professional duty.

emergencybesieged Leningradhealthcare organizationpublic health protection

скорая медицинская помощьблокадный Ленинградорганизация здравоохраненияохрана здоровья населения

September 8, 1941. 79th day of the war. The German Army Group North, and with it Mannerheim's army, surrounded Leningrad, the second most important city in the USSR. According to the Barbarossa plan, it was the cutting off of Leningrad and Kronstadt that opened the way for Hitlers troops to the Soviet capital. On the first day of the blockade, the enemy's primary task was to deprive the city of any means of subsistence. The Badaev warehouses, the main food hub of Leningrad, became the primary target for destruction on the maps of the German leadership. It was hunger that was supposed to break the spirit of the inhabitants of the city of the victorious October Revolution. After the defeat in the Battle of Moscow, Hitler signed Directive No. 39 on the transfer of German troops to defense on the entire Soviet-German front. For Leningraders, this news meant the worst thing - the blockade would be long. 872 days surrounded by the enemy, suffering from hunger and constant shelling, Leningraders desperately fought for survival. Despite all the difficulties, Leningrad doctors continued their work. Providing first aid in those years became the main task for all medical personnel. The person behind the organization of the work of the Leningrad EMS in those years was Meer Abramovich Messel, the chief physician of the city ambulance station. During the years of the blockade, many non-standard tasks were entrusted to his shoulders, which Meer Abramovich heroically solved throughout the entire period of the siege of the city by the enemy. There were many problems that the leadership of the Leningrad healthcare system had to solve. The first thing doctors at city EMS stations encountered was a shortage of fuel and lubricants. From October 1941, the daily fuel supply rate was reduced. EMS vehicles could only go to areas affected by bombing and to transport infectious patients. Doctors often had to carry victims to the hospital in their arms; in winter, they used sleds with a stretcher mounted on them. Problems with utility resources also affected emergency workers. Due to incessant artillery shelling, electricity was supplied intermittently, there was a shortage of water and heating was cut off. Frosts in the winter of 1941 were record-breaking. This has become a big problem for the normal functioning of hospitals. All this together led to moral and physical exhaustion of medical workers, who, under difficult conditions, had to endure 20-25 daily shifts per month. The city was constantly subjected to artillery shelling. From literature data, radiologist E.A. Pchelina recalls that one day Professor I.I. Dzhanelidze, who in those years was the head of the Scientific and Practical Institute of Emergency Medical Care, operated on Professor Kazarnovskaya, who was wounded by a fragment of an exploding shell on the street. Mira on the way to work at the Institute. Pasteur. At the time of the operation, a deafening roar was heard - several bombs were dropped in front of the institute: broken glass scattered throughout the operating room, plaster fell from the walls and ceiling. The surgeons managed to cover the operating field with their bodies. After changing gowns and linen, the operation continued safely. The number of lesions from bombings per day reached 170, the number of victims - up to 2000. When providing first aid to the wounded, the basic principles of Pirogov were implemented. The victims were sorted into 3 groups: severe, moderate and mild, to determine the order of timing of medical care and evacuation to specialized institutions. The wounded citizens had to be accommodated; for this purpose, the hospital network was reorganized - they were actually turned into emergency hospitals, increasing the bed balance by almost half. Two groups of medical care were organized depending on the condition of the wounded: emergency surgery and minor surgery with aftercare. The leadership of the NSR also realized the need to prepare for possible military operations in the city. Medicine supplies had to be redeployed from the centralized warehouse to all regional ambulance stations. If some area of the city is cut off by the enemy, then the supplies of medical supplies should be sufficient to provide the necessary medical care. Due to the huge number of wounded, city hospitals were overcrowded. But the townspeople also suffered from hunger. Visits were made daily to patients with nutritional dystrophy. According to M.A. Messel, first aid to patients consisted of giving stimulants, wrapping and warming. It was impossible to evacuate all the residents of the city under the difficult conditions of the blockade. However, since January 1942, the SMP Station was also entrusted with providing medical services to the population evacuated from Leningrad along the Ladoga Ice Route - the Road of Life. M.A. was appointed head of this area of medical staff activity. Messel. The clear organization of work helped doctors evacuate a large number of Leningraders from the besieged city. They were on duty at evacuation points in Kobon, Lavrovo, Zhikharevo and accompanied the trains, carried out disinfection and provided first aid. During the blockade, the Ambulance Station also worked as an outpatient facility. The townspeople knew where they were based, and many, realizing how busy doctors were, came to the stations themselves. The ambulance service also had an information desk. Information from all hospitals about admitted patients and dead residents flowed to the EMS station. During the years of the blockade, the Scientific and Practical Institute of Emergency Medical Care did not stop its work. 13 doctors remaining on staff in the period from 1941-1942. provided assistance to about 2,000 patients and performed more than 550 operations. Scientific work also did not stop. During the war years, research continued at the institute; as a result, employees wrote 59 scientific papers. In particular, the scientific director of the institute, Professor I.I. Janelidze published the monograph Bronchial fistulas of gunshot origin, for which he was awarded the Stalin Prize of the 1st degree. On January 27, 1944, Leningraders took to the streets of the city in a single impulse. Volleys were heard over Leningrad, but on this day the townspeople had no need to be afraid. On that day, the soldiers of the Leningrad Front under the command of Marshal Govorov finally removed the enemy ring. Lines from a poem by the siege poet Yuri Voronov convey the significance of this day: Salvo after salvo, The salute resounds loud. In the hot air, rockets brightly Bloom like a colorful crowd. But the people of Leningrad Quietly weep, Their joy is immense, But sorrow runs deep. For amidst the celebration Their pain is laid bare, Half of Leningrad is missing, Without you there. Leningrad spent 872 days in enemy captivity. Breaking the spirit of ordinary residents of the city of Lenin was one of the main prerogatives of the Nazi leadership. The doctors who stood up to protect the population accomplished a feat of labor and contributed to the collapse of the plans of the German invaders.

Книга II МЕДИКИ И БЛОКАДА: взгляд сквозь годы. Воспоминания, фрагменты дневников, свидетельства очевидцев, документальные материалы. Санкт-Петербург 1997 г.

Профессора и доктора медицинских наук Санкт-Петербургского научно-исследовательского института скорой помощи имени профессора И. И. Джанелидзе (1932 –2017) / [сост.: Багненко С. Ф., Ершова И. Н., Барсукова И. М. и др.]; под редакцией профессора В. Е. Парфёнова. — Санкт-Петербург: ООО «Русский Ювелир», 2017– 192 с.: ил.

Санкт-Петербургский научно-исследовательский институт скорой помощи имени И.И. Джанелидзе: 90 лет на службе Отечеству; под редакцией В.А. Мануковского. - Санкт-Петербург: ООО «Русский ювелир», 2022.-256 с.