Development of public medical care for children and adults in Carpatian region (end of the XIX - the first half of the XX century)

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Warsaw Medical University

Drohobych Ivan Franko State Pedagogical University

Vasyl Stefanyk Precarpathian national university

DEVELOPMENT OF PUBLIC MEDICAL CARE FOR CHILDREN AND ADULTS IN CARPATHIAN REGION (END OF THE XIX - THE FIRST HALF OF THE XX CENTURY)

Ivan Bilavych, Candidate of Pedagogical Sciences, Assistant

Mykola Pantyuk, Doctor of Sciences (Pedagogy), Professor,

Larysa Slyvka, PhD in Education, Associate Professor

Warsaw, Drohobych, Ivano-Frankivsk

Abstract

During the investigated period, the terms like «care», «public care», «medical care» and similar were actively used by doctors, public activists, educators, religious figures, which proves the existence of such a phenomenon, understanding of its importance to the Ukrainian community. The idea of public medical care had been developed amongst Ukrainian scientific, educational, and public circles of Halychyna from the end of the 19th century to 1939; the theoretical assets of scientists were actively implemented in the practical life of locals. The key notion of public (social) medical care is used in the following ways: voluntary care of public institutions about the health of the Ukrainian population of Halychyna, medical care for children and adults, treatment and prevention of diseases, constant supervision and control of health preservation of personality, etc. public health care halychyna

It is proved that such preconditions and factors as liberal character of domestic policy of the Austro-Hungarian monarchy, the reformation of education and health care systems, creation of a legislative framework for the activities of public associations, etc., have become an important basis for the self-organization of Ukrainians, Ukrainian national movement development, creation of the first Ukrainian medical societies, the birth of Ukrainian science, emergence of a cohort of outstanding figures in the medical sphere (I. Horbachevskyi, Ye. Ozarkevych, S. Okunevska-Morachevska, Ya. Okunevskyi, etc.), institutionalization of Ukrainian public health care in the form of medical, scientific, charitable and other community initiatives (Society of Galician Physicians, Medical Commission of Shevchenko Scientific Society, Medical Community, Lviv Polyclinic, «Narodna Litchnytsya», ULT, UHT, etc.).

The article analyzes the achievements of local doctors and scientists in the process of formation of Ukrainian medicine. We give a brief description of contribution of K.Voievidka, V.Yanovych, O.Malaniuk, Ye.Ozarkevych, Ya. Okunevskyi, R. Yarosevych and others doctors. Methodological basis of the research are leading positions of the theory of scientific knowledge, system-structural and cultural approach as a methodological way of studying of educational phenomena and pedagogical processes. The author applied anthroposophic approach that gave a reason to interpret this phenomenon through the prism of values, knowledge and norms of behavior.

Keywords: public medical care, medical students, medical education, children, adults, ukrainian doctors, Prykarpattya, I. Bely, K. Voyevidka, O.Malanyuk, E.Ozarkevich, Y. Okunevsky.

Анотація

РОЗВИТОК МЕДИЧНОЇ ОПІКИ ДІТЕЙ ТА ДОРОСЛИХ НА ПРИКАРПАТТІ (КІНЕЦЬ ХІХ - ПЕРША ПОЛОВИНА ХХ СТОРІЧЧЯ)

Іван Білавич, кандидат педагогічних наук, викладач І клініки анестезіології і інтенсивної терапії Варшавського медичного університету (м. Варшава, Республіка Польща)

Микола Пантюк, доктор педагогічних наук, професор, проректор з наукової роботи Дрогобицького державного педагогічного університету імені Івана Франка (м. Дрогобич, Україна)

Лариса Сливка, кандидат педагогічних наук, доцент кафедри педагогіки початкової освіти, ДВНЗ «Прикарпатський національний університет імені Василя Стефаника» (м. Івано-Франківськ, Україна)

Стаття присвячена висвітленню проблеми розвитку суспільної медичної опіки дітей та дорослих на Прикарпатті наприкінці XIX - у першій половині XX ст. Протягом досліджуваного періоду терміни, такі як «опіка», «громадська опіка», «медична опіка» та інші, активно використовувалися педагогами, лікарями, громадськими активістами, релігійними діячами, що доводить існування такого явища, розуміння його важливості в суспільстві. Ідея суспільної медичної опіки була розроблена в середовищі українських наукових, освітніх та громадських кіл Галичини досліджуваного періоду. Під ключовим поняттям суспільної (громадської) медичної опіки дітей та дорослих автори розуміють добровільну опіку, догляд громадських установ про здоров'я українського населення краю, медичне обслуговування дітей та дорослих, лікування та профілактика захворювань, постійний нагляд та контроль за здоров'язбереженням особистості тощо.

Лікарі, особливо студенти, викладачі, духовенство та громадські діячі брали активну участь у цьому процесі. Вони піклувалися не тільки про фізичне здоров'я особистості, але й про духовні, психічні та соціальні складники здоров'язбереження; не тільки надавали населенню краю безкоштовну професійну допомогу, а й зробили значний внесок у розвиток вітчизняного лікарського руху та медичної науки. Українські лікарі надавали медичні послуги найбільш вразливим сегментам суспільства, включаючи селян, учнів та студентів. Вони проводили лекції для дітей та дорослих, пропагували здоровий спосіб життя, поширювали знання про профілактику та лікування захворювань, шкідливості вживання алкоголю та куріння. Лікарі успішно боролися проти туберкульозу.

У статті проаналізовано здобутки лікарів Прикарпаття на ниві розвитку української медичної науки. Стисло схарактеризовано внесок І. Белея, К. Воєвідки, О. Маланюка, Є. Озаркевича, Я. Окуневського та інших лікарів. Методологічну основу дослідження становлять провідні положення теорії наукового пізнання, системно-структурного та культурологічного підходу як методологічного способу вивчення освітніх явищ та педагогічних процесів. Застосований автором антропософський підхід дав підстави осмислювати цей феномен через призму цінностей, знань, норм поведінки.

Ключові слова: суспільна медична опіка, учні, доросле населення, масове медичне просвітництво, українські лікарі, Прикарпаття, І. Белей, К. Воєвідка, О. Маланюк, Є. Озаркевич, Я. Окуневський.

INTRODUCTION

Problem statement.

In the early twentieth century, under conditions of foreign states domination and political oppression of the Ukrainian people, national public associations of Halychyna created a public system of health care for population of the region, thus offsetting gaps in the social policy of Austria-Hungary and Poland. Despite the imperfect health care system in the Austro-Hungarian Empire, that it gave impetus to the development of Ukrainian medicine and medical intelligentsia formation. Thus, December 2, 1867 Lviv medical doctors created Galician Doctor Society, which was originally only 47 people, then the number of members increased, soon having branches in the province. Pharmacists and dental technicians created their own societies for the protection of the rights. Society «Poliklinika Lvivska» emerged on the initiative of Lviv doctors in 1900. Its mission is to help patients for free, provide them drugs at a discount. «Poliklinika Lvivska» had clinic and laboratory. Doctors arranged conferences, published medical journals, that is combined practice and scientific work.

Founded in 1903 in Lviv «Narodna lichnytsia» society was the biggest event in the history of Ukrainian public health system. Not only Ukrainians, but also Poles, Jews, members of other minorities received here a full medical assistance for free. It had a supranational character. This distinguished «Narodna lichnytsya» from similar Polish or Jewish institutions where physicians carried about patients' ethnicity. The activity of «Narodna lichnytsya», Ukrainian medical association (1910), Ukrainian hygienic Society (1929) and other health agencies filled the gaps in public health system and assisted the most vulnerable segments, including peasants, pupils, and students.

Thus, this work of local doctors became the basis and prerequisite for the creation Ukrainian public health system. It was an alternative health care system, which was organized by Ukrainian doctors and public figures, Greek Catholic clergy and philanthropists. Doctors from the Carpathian region actively worked in these societies.

Analysis of recent research and publications. Despite the fact that some figures of Ukrainian doctors were the subject of consideration by a few scientists (L. Bech, Ya. Hanitkevych, I. Datsenko, P. Pundiy, B. Savchuk, etc.), the life of I. Beley, K.Voyedka, O. Malanyuk, E. Ozarkevich, Y. Okunevsky, etc is studied poorly.

AIM AND TASKS RESEARCH

The purpose of the article is to analyze the contract for medicinal science development (end of the XIX - the first half of the twenty-september).

RESEARCH RESULTS

An Analysis of the vital activity of Ukrainian doctors in Prykarpattya of the late XIX - early XX century argues that work of local doctors became a good foundation and a prerequisite for the creation of Ukrainian public health care system which was an alternative to the state one. It is selfless (unselfish, sacrificial and free) labor of Ukrainian doctors that provided medical care for Ukrainians (and members of other ethnic groups) for the period. Ukrainian doctors - patriots, citizens, so called «suspilnyky» - became true devotees of domestic medicine, they were its founders. It is they who laid a solid foundation for its further development.

Despite the fact that some figures of Ukrainian doctors were the subject of consideration by a few scientists (L. Bech, Ya. Hanitkevych, I. Datsenko, P. Pundiy, B. Savchuk, etc.), the life of Ivan Yakovych Beley is studied poorly. In science there is only a small work of I. Durbak «Ivan Beley, the first Ukrainian Doctor in the Congo», included in the book «Almanac of Stanislaviv Land» (New York - Toronto-Munich, 1975) (Hanitkevych Ya., 2012), L. Poltava's article «Ukrainian Doctor from Voinyliv in Africa» in the magazine «Illustrated Monthly Magazine of Ukrainian Youth «Krylati» (USA, 1970) (Poltava L., 1970) and others (Pundii P., & Hanitkevych Ya., 2012; Tsiupiak R., 2010).

Ivan Beley is a physician-ascetic, a doctor of medicine, a public and educational figure, a great humanist who wrote his own page in the chronicle of formation and development of Ukrainian (and global) medicine.

Ivan Beley was born in a peasant family on July 1, 1899 in a small town of Voinyliv, now a settlement in Kalush district of Ivano-Frankivsk oblast. After finishing primary Voinyliv school, he studied at Ukrainian gymnasium in Lviv. During the First World War, he served as a soldier in the Austrian army, participated in battles on the Italian front.

After the war, he voluntarily entered the ranks of the Ukrainian Galician Army, was in the Brigade of General Myron Tarnavskyi. After the captivity, Ivan Beley returned to his native land, joining medical department of the Ukrainian secret university in Lviv, but graduated from the faculty of medicine in Prague. After the diploma nostrification in Poznan, he married Myroslava Rubchak and settled in his native Voinyliv, where he worked as a doctor and took an active part in public life.

From 1928 he belonged to the Ukrainian Medical Association, worked as a physician in Voinyliv. He was the head of the «Enlightenment» society, often speaking on medical and literary topics. Due to his efforts the People's House was built in Voinyliv which is still preserved.

I. Beley was actively developing national cultural and educational life: he directed the drama circle, participated in performances; made numerous speeches on medical and literary topics in Voinyliv, Slobidka, Serednie, Siltse and other nearby villages (Poltava L., 1970; Tsiupiak R., 2010).

During the Second World War I. Beley worked as a district physician in Stanislaviv. With the Soviet troops approach he went with his family to Munich and worked with his doctor H. Shymanskyi in hospital of the internment camp Funk Kaserne. Thousands of Ukrainians and many people of various nationalities immigrated to different countries through this camp.

In the camp I. Beley met the Belgians and in 1946 with their help he moved to Belgium. There he studied French and attended the School of Tropical Medicine, because in order to work in the jungle of Africa it was necessary to know the peculiarities of nature and climate, people and diseases in hot countries (Tsiupiak R., 2010).

After completing medical training (he studied tropical medicine and learned Swahili for almost a year) he went to work in the Belgian Congo with his wife and children, Myroslav and Orysia. Locals soon witnessed that their physician being sensible and attentive treats patients cordially. They opened their hearts to him.

I. Beley treated malaria and other illnesses, operated, intersected limb fractures, etc.

He also actively engaged in public and social work, was developing local medicine: he organized building of ordinary cottages covered with palm leaves or straw, inside of which there were sanitary posts for fighting against malaria and provision of first-aid sanitation.

I. Beley organized training of local residents as sanitarians and nurses, taught hygiene, accustomed them to clean, taught how to provide first medical aid in bites of poisonous snakes and various diseases. In other words, he created medical mini-institutions. In the provinces of Kibango, Kindu, Kasanto, he saved thousands of people from various ailments (Poltava L., 1970; Tsiupiak R., 2010).

In Congo, Ivan Beley worked from 1947 to 1954. Under Belgian law, it was necessary for all Europeansevery three years to leave Congo for six months to Europe, in order to preserve their health. I. Beley's wife began to suffer in the sixth year of her stay in the Congo, and so it was the time to send her family to Belgium. A year later Ivan Beley due to his state of health also left the Congo (Poltava L., 1970; Tsiupiak R., 2010).

When I. Beley left the Congo, thousands of local residents gathered to see off a white doctor who was loved for his honesty, responsiveness, professionalism, genuine attitude.

In Belgium, the king of Belgium Baudouin at a special ceremony awarded Ivan Beley the highest award of the country - the Order and the rank of "Chevalier" - the royal knight (Poltava L., 1970, p. 17).

Residents of the Congo also paid tribute to their «white savior»; as noted by a Ukrainian researcher, writer, public and cultural figure Leonid Poltava, «on the far continent of Africa, thankful Congolese, they set up a monument to the doctor I. Beley, on which they engraved «To the White from the Black» (Poltava L., 1970, p. 17).

In 1956, I. Belly traveled and moved to Philadelphia in the United States. There he worked as a physician in the St. Joseph Hospital for fifteen years. Being an experienced specialist, he had a responsible job - rescued wounded people, healed burnt in fires, and seriously injured. And once again they were mostly dark-skinned.

Due to continuous hard work his heart could not stand. On July 2, 1970 Ivan Beley died. He was buried in the Fox Chase cemetery (a Ukrainian Catholic cemetery in Philadelphia) (Durbak I., 1975; Poltava L., 1970; Tsiupiak R., 2010).

Thus, Ivan Yakovych Beley is a Ukrainian doctor, a public and educational figure who wrote a bright page in the development of domestic and world medicine as a physician-humanist. He was forced to move to a foreign country and to work as a doctor on the African continent for a long time, and subsequently on an American (lived in Philadelphia until the end of his life), however, both in his homeland and in a foreign country, the Ukrainian doctor professed absolute truths: the best what you can take from a living is science and the highest wisdom is to be kind; by means of his medical practice he affirmed Christian values, among which - kindness and responsiveness, mercy, empathy, ability to share other person's pain, to support morally and provide high-quality medical assistance, solace in the heat and trouble, educate people.

Family of Okunevskyi is a classic example of a dynasty of physicians in Western Halychyna. In the family of Danylo Okunevskyi who was a priest, there were four children. Three sons devoted themselves to medicine: Ipolit Okunevskyi (1834-1902 ) became a priest and a doctor; Kyrylo Okunevskyi (? -?) was a doctor, one of the first Ukrainian, who was educated as a pharmacist and Athanasius Okunevskyi. Athanasius Okunevsky was born in 1833 in Ternopil region. In 1860 he graduated from the Lviv General Greek Catholic seminary. In 1863 he was ordained to the priestly rank. He married Carolyn Luchakivska. The first place of his work was Zalishchyky town, in 1864 - the city of Berezhany, and later in 1865 - Dolzhanka village in Ternopil district. Here his daughter, Sofiia Okunevska, was born on May 12, 1865. In 1866 the family moved to Rusiv, and in 1867 Athanasius Okunevskyi became a pastor in Sadky village near Zalishchyky. Suddenly, in 1870 his wife died. After his wife's death he moved to Bukovyna. Here he was working for eight years as a parish priest in Sadhora (Hanitkevych Ya., 2004a; Hanitkevych Ya., 2004b; Bilavych I.V., 2015).

In 1878 A. Okunevskyi asked for Metrpolia's permission to study at the Medical Faculty of the University of Vienna. In 1881 he successfully graduated as a doctorate of medicine. Since 1881 he had been working as a district doctor in Starozhyntsi (Bukovyna), later - in Kimpulunha (territory of Romania). In 1887 Athanasius Okunevskyi became a delegate of World Congress of doctors (Hanitkevych Ya., 2004a).

One of the most famous Ukrainian doctors in Halychyna was Yaroslav Okunevskyi. He made brilliant career in the military medicine. In 1877 he entered the University of Vienna, the Faculty of Medicine. In 1884 Ya. Okunevskyi began to serve as ship's doctor of the Austria-Hungary's navy, which was based in Croatia in city of Pula. He visited not only Europe and Asia, but also Africa, America and Oceania. His medical practice was highly awarded numerous awards by many sea states (Hanitkevych Ya., 2004b).

He was the author of the world's first Charter of Medical Service in Naval Forces (1900). Later, in 1914, he was promoted to Major General of Maritime Medical Service. Under his guardianship were thousands of sailors. At the beginning of World War II with the rank of rear admiral he was the head of Medical Service of the Admiralty of Habsburg fleet where he had worked with his colleagues and subordinated Ukrainian doctors - Captain V. Verbenets, Colonel

O. Zarytskyi and Colonel M. Rozhankovskyi etc (Hanitkevych Ya., 2012, p. 105-107). Ya. Okunevskyi was Chief Doctor and Chief of the Main Medical Department of the Staff of naval forces of the Austro- Hungarian Empire. For great merits (30 years of service) he became the first Ukrainian who was promoted to the Chevalier of Knight's Cross of Franz Joseph, the Knight of the Order of the Spanish queen, the French Legion of Honor, the Chinese Imperial Order of the Dragon, the highest title of Mandarin and many more awards. Ya. Okunevskyi perfectly possessed of military and medical knowledge, versed in the navigation and geography, fluently spoke English, French, Italian and German (Hanitkevych Ya., 2004a; Hanitkevych Ya., 2004b).

At the time of national liberation struggle Rear Admiral Ya. Okunevskyi organized Ukrainian sanitary service and headed it. He supplied the drugs for the Legion of Ukrainian Sich Riflemen, helped their sanitary service, donated funds and more. After proclamation of the West Ukrainian People's Republic he headed the State Medical Mission in Vienna. He provided medical supplies for Halychyna. He sent four sanitary trains for Ukrainian Galician Army. Ya. Okunevskyi contributed to the creation of the First Hutsul Regiment of the Marine Corps, which consisted mostly of the former Austro-Hungarian sailors [3]. Yaroslav Okunevskyi visited almost all countries of the Mediterranean basin. This gave an impetus to write essays about the countries in which he traveled, called «Letters from a foreign land» - a kind of vivid picture of Europe, Asia and northeast Africa of the late nineteenth century (laroslav Okunevskyi, 2009).

Due to the events of the Second World War, many Ukrainian doctors of Western Ukraine were forced to emigrate to Europe or the Americas. Therefore, their case had been continued by their kids in emigration. Among such was Kseniia Lidiia Yanovych, a doctor in the US, daughter of Volodymyr Yanovych (1868-1931 gg.) who was the first Ukrainian doctor in Stanislaviv (Pundii P., Hanitkevych Ya, 2012, p. 604). He was very popular among people, «he went to patients even in remote villages nearby». He often treated free of charge. He was a real «doctor-citizen». He was an important public figure in Halychyna of the early twentieth century. He was head of the branch of «Prosvita» association in Stanislaviv, one of the leaders of Ukrainian National Democratic Alliance (UNDO). Stanislaviv (now Ivano-Frankivsk) played an important role in the life of doctors Dmytro Yarosevych, Osyp Malanyuk and Kost Vojevidka.

Dmytro Yarosevych, who was the son of Roman Yarosevych (1861-1934), worked in the United States as psychiatrists. He was born in Bedrykivtsi (near Zalishchyky) in the family of priest. He studied in Kolomyia gymnasium where under the influence of I. Franko, and M. Drahomanov started to «feel himself like Ukrainian». His way to medicine is from theology to philosophy, philology, and then - medicine. After finishing the Faculty of Philology in Lviv he worked in Kolomyia gymnasium, taught classical philology and Ukrainian language and literature. His student was Vasyl Stefanyk, with whom they made friends (Pundii P., Hanitkevych Ya, 2012, p. 604). Further R. Yarosevych studied at Krakow University, Faculty of Medicine. V. Stefanyk also studied medicine there. After graduation R. Yarosevych started his medical practice in Borshchiv, where he was actively involved in social and political life of the region. He was member of the Ukrainian Social Democratic Party (USDP), of which in 1897 was chosen as a deputy to the Austrian Parliament. In Vienna he was «as an ambassador», beside political activity he also improved his medical knowledge, did «specialization in dentistry» at the Vienna clinic (Pundii P., Hanitkevych Ya, 2012, p. 604). In 1905 he opened his dental clinic in Stanislaviv (Pundii P., Hanitkevych Ya, 2012, p. 607). Simultaneously he worked as a doctor in the clinic for the railroad. He was elected as head of the Association of Railway Doctors of Stanislaviv Directorate of State Railways» (Pundii P., Hanitkevych Ya, 2012, p. 605).

Osyp Malaniuk was a lieutenant colonel of Ukrainian Galician Army, commandant of the first military hospital in Stanislaviv. He had been devoted to military medicine for 20 years (Pundii P., Hanitkevych Ya, 2012, p. 607). Like many doctors in Halychyna he came from a family of priest. He was born in Chortkivshchyna region. He studied medicine in Graz. He was one of the organizers of the Society of Ukrainian Students called «Sich» in Vienna. In 1989 he was graduated from doctorate of medicine in the University of Krakow [7, p.607]. During 1920-1930s he worked in Stanislaviv as surgeon and radiologist. He was the first doctor in the city who bought an x-ray machine for his office. He died in Graz (Austria) February 6, 1949. Yelysaveta Malaniuk, a daughter of the famous military doctor Osyp Malaniuk (1873-1949 gg.), worked as dentist in Austria.

Kost Voyevidka (1891-1944 gg.) was a famous specialist in the field of gynecology and obstetrics. He was killed by the Gestapo in March, 1944, together with his son (Pundii P., Hanitkevych Ya, 2012, p. 607). He was born in Prague in the family of Lev Voyevidka who worked as doctor in Kitsman in Bukovina and was the founder of the Ukrainian Medical Association in Lviv. In 1909 Kost Voyevidka entered the German University in Prague, the Medical Faculty. When First World War broke, the first units of the Ukrainian Sich Riflemen (USS) were formed. Kost Voyevidka as senior doctor voluntarily joined the USS. In 1915 he got off to finish his medical education in Prague and receive a diploma. Then he returned to the army, became the doctor at first in Rozvadiv, on the Dniester, and then in Verpolyanka. In 1916 during the battle at Koniuchy K. Voyevidka got to Russian captivity. In 1917 he along with Ivan Rychlo, the doctor, organized sanitary service for USS in Eastern Ukraine. Later, in 1918, he was sent by the Government of the Ukrainian National Republic to Berlin as chief of sanitary mission for Ukrainian prisoners - «the former soldiers of tsarist army» (Pundii P., Hanitkevych Ya, 2012, p. 608). From 1921 to 1923 he had been specialized in the field of gynecology and obstetrics in the Berlin clinic. In 1923 he became Assistant of well-known Professor Wagner in gynecological clinic at German University in Prague. In 1925 being a highly qualified specialist he returned to Halychyna and opened private clinic in Stanislaviv. Soon he became one of the best specialists among Ukrainian and foreign doctors, since 1941 he had worked as Director of the Hospital. By the way, Kost Voyevidka was one of the few doctors in Stanislaviv, who had his own car of «Mercedes» brand and held his own driver. Despite intensive medical practice, he found time for social activities. He was founder and head of the branch of ULT, longtime chairman of the Society of military graves protection, member of numerous Ukrainian associations and institutions (Pundii P., Hanitkevych Ya, 2012, p. 608).

CONCUSSION AND PROSPECTS FOR FURTHER RESEARCH

Thus, Ivan Beley, dynasties of Okunevskyi, Ozarkevych, Malaniuk, Voievidka, played an important role in the formation and development of Ukrainian medicine. They were not only military doctors, prominent academics, medical practitioners, but also the national conscious people, active public figures, members and organizers of many Ukrainian associations.

Further research requires the study of the activities of a well-known physician, public and state figure, scientist Ivan Kurovets.

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