Acta medico-historica Rigensia (2000) V: 141–148 DOI: 10.25143/amhr.2000.V.12 ACTA MEDICO-HISTORICA RIGENSIA
V
(XXIV)
ALAR SEPP, HELENA SEPP
SANITARY-TOPOGRAPHICALSTUDIES IN ESTONIA DURING THE 1920s AND 30s
The purpose of general and individual unnecessary illness and death. The of the
knowledge
poses the
of
goal
hygiene
must
of endogenous
prevention
to
of
as
far
possible
as
eliminate the exogenous
diseases is
possible only
to a
to
prevent
medicine presup-
preventive
of the diseases. On the whole, this
causes
be
is
hygiene
practice
means
that
of disease. The
causes
limited
extent
[l].
Introduction
19'"
In the
century, Tartu
was
in the
same
Czarist
region
Riga.
as
which had
strong intellectual links with Tartu. Hundred and hundreds Latvian students studied in Tartu receive
which offered ethnic Latvians the
University,
academic education and
an
Estonia’s first song festival started
had become the
identity. By
of Estonia's national
centre
with 3,000-5,000 students and the oldest
opportunity
academic fratemities'
19"'
held here in the
was
rediscover its national
to
organise
the late
the country
l9los, Tartu University
movement.
university
as
century,
to
[2].
ln the
1920s and 30s.
in the Baltics,
Tartu
was
the intellectual hub of Estonia. ln the
following
lopment
of
article
public
research
graphical University
we want
to
give
health in Estonia:
organised by
the
doctors knew how
them. In Tartu, Estonia, for ted
smallpox;
and
typhoid
to
cholera had been
fever and
history
of
of
sanitary-topo-
health of Tartu
public
national
gained
were
were
out
already
by public
not
how
to treat
almost eliminahealth
measures;
in decline. still the main killers:
infections and
its
university
of Estonia
vaccination had
virtually wiped
dysentery
gastro-intestinal
ln |9| 8 Estonia a
department
Republic
example,
third of all deaths in Estonia
for
short overview of the deve-
control infectious diseases, if
Nevertheless, infectious diseases culosis,
a
in the all counties of Estonia in the 1920s and 30s.
Public Health at the Birth of the
By |920,
readers
review of the
a
diphtheria
pneumonia.
accounted for
more
tuberthan
a
[3].
independence
which made it
possible
with the national staff who would
to
start
lay
the basis
working
on
141
different of
national health
a
up
health research in the In
Estonia
concerning
matters
setting
At
the
same
time it faced the serious task
was
of Public Health of the Tartu
The
speaking. former
of the Þ
sta
university
had left Estonia.
professors
scientists returned
At
was
the
a
became Estonianofthe
matter as most
time many well-known Estonian
their native country and started work
to
independent republic
University
complicated
same
public
University [4].
Estonian became the lan-
opened,
of tuition and administration. With the birth of the
Department
be said about
same can
of Public Health of Tartu
Department
|919, when the national university
guage
the
systems. The
care
at
the
University [s].
Ernst Fehrmann Until
|920 senior assistant,
Doctor of Medicine, Ernst Fehnnann. who had
leave, however, because he could Tartu University. He moved Then in |92|
he
was
elected full
ofthe Chair of Hygiene to
England
Riga
to
at the
gave lectures in
speak Estonian,
where he worked
elected assistant
was
1927 E. Fehrmann
not
professor
of
a
lecturer of hygiene
University
to
in
[6].
Six years later in
hygiene.
of hygiene. He worked
professor
Latvian
as
hygiene
as
from |922 until his
holder
a
emigration
in 1939 [7].
Alexander Rammul E. Fehrmann’s
University,
successor
He had
by nationality. he had worked
as
Public Health
[B].
degree as a
Tartu
at
University
an
of Public Health
Department
Alexander Rammul had wide his
improved
throughout he retired
was
the
changes
Republic The
142
the
at
Department
obtained his
professor
elected
at
Kasan
professor
in contemporary
major
} communal,
Republic
retiring
There to
was
come.
in 1940
hardly In the
of
doctor’s
in
University.
ordinary
at
the
hygiene,
Russian and also water
and food
as
western
hygiene,
he had
universion
which
German and French
of Public Health of Tartu of Estonia, that is up
to
[|o].
University
1940, when
was
expected
anyone, same
to
though,
to
bring along changes forsee the
extent
for
of the
year the Soviet Union annexed the
of Estonia.
period
among
1920—1940
saw
thesis (Paul Pöder, Mihkel Kask, fourteen
in
Department
of the first
period
Estonian
in |899 after which
[1 I].
Department.
virtual
knowledge
were
Head of the
Professor RammuPs the
on as a
was
several studies in Estonian, Russian,
published
was
[9].
knowledge
ties. His main research
Dr. Rammul
Hlopin
Russia and
to
from Kasan
professor
of Odessa in 1909. After that he had worked in Moscow
He leti Kasan for Tartu in |920 and
he
a
University
assistant for Professor G. V.
Later he had moved
University
at the
from Tartu
graduated
health service doctor and from |9| 5
studied and
was
Alexander Rammul, and also Doctor of Medicine, who
prize
thesis
by
students
the
accomplishment
Siim Lind),
[| 3].
[l2]
of three
Doctor’s
four Master’s thesis and
The title page ofthe book about the
description
of Saarema Island
sanitary-topography
143
Mihkel Kask One of the
students of
outstanding
most
professor
Rammul
was
Mihkel Kask
who, after defending his thesis, became senior assistant and lecturer
Department. food
M. Kask carried
on
his teacher's research
cation in Estonia, His dream
was
his whole life
University
a
who his
began
played
healthy individual.
to
bring
of Tartu in
an
not a
this dream into
1929, worked
knowledge was
abroad
(received support
clear for him from the
of their health and he tried
population [lB].
among
In |937 he
teach it his
began
public
possesses
special importance,
sources
more
that
to
a
classified the
most
place
since it remains life
everyday
situation in
general
extensive
undertaken
project
due to the lack of financial very
by
on
He worked from the in the
improved
his
[|7].
take
must
as
care
the whole
to
the radio, which
being
1933,
very
popular
compressed
published
as
in the
public
the
one
health
countics of Estonia
were
[22]
[23].
Alexander Rammul launched and led
far undertaken
such studies had confined
thorough preparation be doctors.
in
conditions of
living
The attention
was
[lifestyle].
diseases
etc.
possible
in order
single
to
of detailed
carried
mainly
and
out
1930®[2s]. of
paid
society.
then
was
concerned
studies that covered all the
came out
one,
All in all
the
studies
project. Yet, published
were
in 1928 and
comprised
about the Tartu district. I l collections
to
a
study
a vast
[24].
lt
was
on an
on
all the
sanitary-topographical unprecedented
areas.
question
® works
The
housing.
public
The
study
to
baths, nutrition,
study
make the results
Usually
preceded
by
was
launched in 1922
was
to
health aspects
social activities, health status. was
were
lists. Students of medicine, would-
the field works.
and
initiative
all counties.
study comprising
The aim of these studies
people
The other aim to
agrarian
unsatisfactory [2l].
released.
conditions in all ll counties of Estonia so
the
studies
Department
while the last
in 1938
as
on
The work
[2o].
of the fundamental
Estonian
accomplished
fonn. The first edition
years later,
ten
country has
concentrates
Department supported
the
resources
material about Saaremaa Island
habits
once
well
as
every week,
sanitary-topographical (medico-geographical)
no
than
themselves
people
his students
defended in
counties of Estonia. The State Health
as
one.
hygiene. participated
Sanitary-topographical (medico-geographical)
was
health edu-
hygiene [l s].
graduated
health in the Tartumaa district of Estonia
of information about
M. Kask
a
the and
people [l9].
situation of
in
He
regular presentations
The doctoral thesis of Mihkel Kask,
with
at
water
from Rockefeller Foundation, USA)
called “Health minutes” and took
were
treated and recovered
reality [l6].
studies,
beginning
to
public
the chair of
at
the chair of
at
role in
outstanding
and research
teaching
above mentioned sanitary-topographical
The
communal,
hygiene [l4].
ln 1930s Mihkel Kask,
It
on
drinking
prevalence
ascertain the
throughout water.
Estonia.
everyday
ofchronic and mental
different counties in
as
short
period
as
comparable [26].
145
Finances The interest of the
the
republic
This
is
at
All in all
l l collections
Content of
far from
was
had
study
to
good
[volumes]
and the
in
published
be
published
for the better
inspection
collections concentrated
published
fonn
were
cut.
[27].
released.
dwelling houses,
toilets and wells. Additional attention
on
to serve
were
the geograp-
as a
necessary
of health conditions? General
understanding
the rural
were
annually
were
compressed
all the counties of Estonia
on
hical. geological and climatic conditions, what
of the
sums
rather
a
the
by
situation Į of
collections
The first three parts of the
background
is demonstrated
study
it. Yet,® the
Department
that time
the
why
of Estonia in such
Republic
fact that the State Health
was
paid
to
baths
so-called
or
objects saunas,
health, eating habits,
of
use
alcohol, clothes, shoes and bodily cleanliness. Also, folk medicine. the pregnancy
period
and
taking
of infants
care
were
The studies showed that the situation in was
much lower than in
primitive most
huts without
of the
new
chimneys
farmhouses
general hygiene
Saunas
saunas
used
were
used for
not
were
example,
most
light; petroleum lamps
were
very
once a
widely spread
week
on
countryside
the studies, traditional and very
to
living
any
more.
well the conditions of ventilation,
poor. For
were
conveniences of electric other hand,
as
[2B].
in the Estonian
hygiene
According
towns.
described
the average
in
and
of the counties lacked any still used instead. On the
were
and
Yet.
lighting
among country folk.
popular
[29].
Problems and solutions All the counties shared
a
that
problem
was
pollution
of
drinking
paigns explaining
water.
the
The situation was
population.
thirds of the rural Under such
people
were
The aim and task of the do the
descriptions give in the 1920s in
fonning
[3
l ].
health
a
very
with toilets
provided
by
both
state
mortality living
as
well
policies
to
out cam-
carry
health of rural
the 20s and 30s
two
was
forced
on
the
and local authorities. was
to
out® to
health condition
general
what
depend
condition and food and other factors. These
precious picture
Unfortunately,
as
of
[3o].
of artesian wells
building
laws
the way of life, customs,
on
made
were
wells for the
sanitary-topographical study
and
morbidity
efforts
why
of artesian
pollution
them and favoured the
to
unsatisfactory although by
circumstances the
peasantry by corresponding
extent
That is
importance
serious- the
becoming
wells. Cattle—sheds and toilets often stood very close
of the life in the
the results of the
for the future,
as
Estonia
Republic
of Estonia
could not be
study was
fully
used
annexed in 1940.
Conclusion In conclusion
we
can
conditions and health
drawing public sanitary
146
say
care
attention
to
conditions in the
that the collections
published the main
Republic
during
the
on
description
period
problems helped
to
of Estonia. Rural
of
sanitary
under discussion and
improve notably
population
the
with poor
knowledge
in
importance
of
elementary hygiene hygiene by
in the
1920s had become conscious of the
the end of the 19305. Estonia had
country with modern standards in public health. For these
publications represent
They
can
as
well
of local
by explorers
as
conditions in the Estonian colourful
a
be reached and used
picture
of
valuable historical
by
researchers A
history.
source
in the first
history of
thorough description
life of Estonians
two
during
into
developed
a
contemporary reader
the social
on
counties between the
everyday
a
world
public
health
gives
wars
their
place.
of Estonia
a
® republic.
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|937
Alar Sepp. MD, lecturer Helena Sepp. MA, researcher
University E-mail:
148
ofTartu,
Department
[email protected]
of Public Health, Ravila 19, 504l I
,
Tartu, Estonia
