{"id":1086,"date":"2020-01-10T14:19:45","date_gmt":"2020-01-10T11:19:45","guid":{"rendered":"https:\/\/teoriveeylem.net\/?p=1086"},"modified":"2023-01-18T13:48:24","modified_gmt":"2023-01-18T10:48:24","slug":"sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf","status":"publish","type":"post","link":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/","title":{"rendered":"Sovyetler Birli\u011fi\u2019nde sa\u011fl\u0131k hizmetleri\ufeff"},"content":{"rendered":"\r\n<p><strong>\u015e\u00fckran Do\u011fan <\/strong><\/p>\r\n\r\n\r\n\r\n<p>D\u00fcnyada ve \u00fclkemizde \u00f6zellikle 1980 sonras\u0131 h\u0131z kazanan neoliberal politikalar\u0131n bir par\u00e7as\u0131 olarak hayata ge\u00e7irilen \u00f6zelle\u015ftirmelerden, sa\u011fl\u0131k hizmetlerinin azade kalmas\u0131 m\u00fcmk\u00fcn olamazd\u0131, olmad\u0131 da. Sermaye a\u00e7\u0131s\u0131ndan ciddi kar kap\u0131s\u0131 olarak g\u00f6r\u00fclen sa\u011fl\u0131k hizmetleri alan\u0131nda \u00e7e\u015fitli y\u00f6ntemlerle s\u00fcrd\u00fcr\u00fclen \u00f6zelle\u015ftirmeler bug\u00fcn \u00e7ok ciddi boyutlara varm\u0131\u015f durumdad\u0131r. Kapitalizm ko\u015fullar\u0131nda zaten hi\u00e7bir zaman tamamen \u00fccretsiz verilmemi\u015f olan sa\u011fl\u0131k hizmetlerinin \u00f6zel sekt\u00f6re daha fazla a\u00e7\u0131lmas\u0131 ve kamu pay\u0131n\u0131n s\u0131n\u0131rland\u0131r\u0131larak cepten harcamalar\u0131n art\u0131r\u0131lmas\u0131 SSCB\u2019nin fiilen de da\u011f\u0131lmas\u0131yla daha kolayla\u015fm\u0131\u015ft\u0131r. T\u00fcrkiye de bundan fazlas\u0131yla pay\u0131n\u0131 alm\u0131\u015f, \u00f6zellikle 1980 darbesinin a\u00e7t\u0131\u011f\u0131 yol ile sonras\u0131nda kim iktidar olmu\u015fsa \u00f6zelle\u015ftirme uygulamalar\u0131 ad\u0131m ad\u0131m s\u00fcrd\u00fcr\u00fclm\u00fc\u015f, hala devam etmektedir.<\/p>\r\n\r\n\r\n\r\n<p>Bu yaz\u0131, s\u00fcren \u00f6zelle\u015ftirmelerle sa\u011fl\u0131k hizmetlerine ula\u015f\u0131m\u0131n i\u015f\u00e7iler, emek\u00e7iler, yoksullar i\u00e7in g\u00fcn ge\u00e7tik\u00e7e zorla\u015ft\u0131\u011f\u0131 bug\u00fcnlerde, ger\u00e7ek anlamda ilk \u00fccretsiz sa\u011fl\u0131k hizmetini \u00f6rg\u00fctleyen sosyalist Sovyetler Birli\u011fi\u2019ndeki uygulamalar\u0131n hat\u0131rlanmas\u0131n\u0131 ama\u00e7lamaktad\u0131r.\u00a0\u00a0\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n<p>\u00c7arl\u0131k Rusya\u2019s\u0131nda sa\u011fl\u0131k hizmetleri as\u0131l olarak saray, soylular ve ordu i\u00e7in \u00f6rg\u00fctlenirken halka kalan, geleneksel y\u00f6ntemlerle kendini iyile\u015ftirmekti. \u00d6zellikle Avrupa k\u0131sm\u0131nda \u015fehirlerde kamusal hastaneler kurulsa da \u00fclkenin b\u00fcy\u00fck bir b\u00f6l\u00fcm\u00fcnde hastane ve hekim bulunmamakta, halk\u0131n yararland\u0131\u011f\u0131 sa\u011fl\u0131k hizmetleri hay\u0131rsever kurumlarca y\u00fcr\u00fct\u00fclmekteydi. Koruyucu sa\u011fl\u0131k hizmetlerinin \u00f6rg\u00fctlenmesinden s\u00f6z etmek ise neredeyse imkans\u0131zd\u0131.<\/p>\r\n\r\n\r\n\r\n<p>K\u0131rsal kesimdeki sa\u011fl\u0131k hizmetleri, a\u011f\u0131rl\u0131kl\u0131 olarak hekim yard\u0131mc\u0131s\u0131 veya pratisyen hem\u015fireye kar\u015f\u0131l\u0131k gelen feldsherler arac\u0131l\u0131\u011f\u0131 ile verilmekteydi. Rusya\u2019n\u0131n \u00f6zellikle Asya yar\u0131s\u0131nda sa\u011fl\u0131k ko\u015fullar\u0131 daha da k\u00f6t\u00fcyd\u00fc.<\/p>\r\n\r\n\r\n\r\n<p>1905 devrimi s\u0131ras\u0131nda Rusya\u2019da bulanan 23 bin hekimin \u00e7o\u011fu \u015fehirlerde hizmet vermekteydi. 1913 y\u0131l\u0131nda 80 milyon n\u00fcfuslu Rusya\u2019da bulunan sa\u011fl\u0131k kurumu say\u0131s\u0131 yakla\u015f\u0131k 3 bindi.\u00a0<\/p>\r\n\r\n\r\n\r\n<p>Yoksulluk ve sefalet nedeniyle 1913 y\u0131l\u0131nda do\u011fumdan beklenen ya\u015fam s\u00fcresi ortalama 32 y\u0131la kadar d\u00fc\u015ferken, \u00f6l\u00fcm oran\u0131 ise %29,1\u2019e y\u00fckselmi\u015fti. 1914-18 y\u0131llar\u0131 aras\u0131nda verem nedeniyle iki milyon ki\u015fi kaybedilmi\u015fti.<\/p>\r\n\r\n\r\n\r\n<p>Hekim e\u011fitimi 5 y\u0131ld\u0131 ve okullar\u0131n \u00e7o\u011funlu\u011fu erkekler i\u00e7indi ve paral\u0131yd\u0131. Kad\u0131nlar, sadece kad\u0131nlara \u00f6zel iki t\u0131p fak\u00fcltesine s\u0131navla al\u0131n\u0131rken, erkekler tan\u0131nm\u0131\u015f liselerden geliyorsa s\u0131navs\u0131z, di\u011ferleri s\u0131navla al\u0131nmaktayd\u0131.<\/p>\r\n\r\n\r\n\r\n<p>Devrim sonras\u0131n\u0131n ilk Sa\u011fl\u0131k Bakan\u0131 Dr. Sema\u015fko, \u00c7arl\u0131k Rusya\u2019s\u0131 sa\u011fl\u0131k hizmetlerini \u015f\u00f6yle tan\u0131mlamaktad\u0131r; \u201ckapitalist devletin t\u00fcm \u00f6zelliklerine sahipti; zenginler i\u00e7in daha iyi hizmet, yoksullar i\u00e7in daha k\u00f6t\u00fc hizmet. \u00d6nleyici hekimlik hemen hemen hi\u00e7 yoktur, yoksullara \u00f6zel bir bak\u0131m yap\u0131lmaz, sanatoryum sa\u011flanmaz ve tamamen zenginlerin tekelindedir.\u201d<\/p>\r\n\r\n\r\n\r\n<p><strong>SOVYETLERDE SA\u011eLIK H\u0130ZMETLER\u0130 VE ORGAN\u0130ZASYONU<\/strong><\/p>\r\n\r\n\r\n\r\n<p>Sovyet sa\u011fl\u0131k sisteminin \u00f6rg\u00fctlenmesi devrimle ba\u015flam\u0131\u015ft\u0131r. Sa\u011fl\u0131\u011f\u0131n toplumsal belirleyicilerinin iyile\u015ftirilmesi (bunlar\u0131n \u00e7o\u011fu t\u0131bbi de\u011fildir) sa\u011fl\u0131k anlay\u0131\u015f\u0131n\u0131n esas\u0131n\u0131 olu\u015fturur. Emek\u00e7ilerin maddi ya\u015fam ko\u015fullar\u0131n\u0131n ve \u00e7al\u0131\u015fma ko\u015fullar\u0131n\u0131n iyile\u015ftirilmesi, i\u015f\u00e7i sa\u011fl\u0131\u011f\u0131na \u00f6nem verilmesi, anne ve \u00e7ocuk sa\u011fl\u0131\u011f\u0131n\u0131n temelden ele al\u0131nmas\u0131, \u00e7evre, konut, hijyen vb. alanlarda yap\u0131lan temel de\u011fi\u015fiklikler ve \u00e7al\u0131\u015fmalar halk sa\u011fl\u0131\u011f\u0131n\u0131n belirgin iyile\u015fmesinde temel etmenler olarak ele al\u0131nm\u0131\u015ft\u0131r. Beslenme ve temiz g\u0131da, bar\u0131nma, istihdam, gebe ve \u00e7ocuk sa\u011fl\u0131\u011f\u0131, e\u011fitim, temiz \u00e7evre, \u00e7al\u0131\u015fma ko\u015fullar\u0131, temiz i\u00e7me ve kullanma suyu, \u00f6nleyici ve tedavi edici hizmetler; \u0130\u015f\u00e7i iktidar\u0131 taraf\u0131ndan sa\u011fl\u0131\u011f\u0131n temel ta\u015flar\u0131 olarak g\u00f6r\u00fclm\u00fc\u015f ve planlanm\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Devrimin d\u00f6rd\u00fcnc\u00fc g\u00fcn\u00fcnde, 13 Kas\u0131m 1917\u2019de yay\u0131nlanan kararname ile istihdam edilmi\u015f veya edilememi\u015f t\u00fcm i\u015f\u00e7i ve emek\u00e7iler sosyal g\u00fcvence alt\u0131na al\u0131narak, sa\u011fl\u0131k hizmetlerine eri\u015fim \u00fccretsiz hale getirilmi\u015ftir. Kararnamenin h\u00fck\u00fcmleri \u015funlar\u0131 i\u00e7ermektedir:<\/p>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\">\r\n<li>\u0130stisnas\u0131z b\u00fct\u00fcn \u00fccretli i\u015f\u00e7ilere, kent ve k\u00f6y yoksullar\u0131na sigorta<\/li>\r\n<li>Sigortan\u0131n b\u00fct\u00fcn hastal\u0131k, yaralanma, vandalizm (barbarl\u0131k, y\u0131k\u0131c\u0131l\u0131k), ya\u015fl\u0131l\u0131k, anal\u0131k, dulluk, yetimlik ve i\u015fsizlik gibi b\u00fct\u00fcn \u00f6z\u00fcrl\u00fcl\u00fck t\u00fcrlerini kapsamas\u0131<\/li>\r\n<li>Sigortan\u0131n b\u00fct\u00fcn maliyetinin i\u015fveren taraf\u0131ndan kar\u015f\u0131lanmas\u0131<\/li>\r\n<li>\u00d6z\u00fcrl\u00fcl\u00fck veya i\u015fsizlik durumunda tam tazminat sa\u011flanmas\u0131<\/li>\r\n<li>Sigortal\u0131lar\u0131n, sigorta kurumlar\u0131 \u00fczerinde tam kontrole sahip olmas\u0131<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p>Sosyalizm, sa\u011fl\u0131k harcamalar\u0131n\u0131 kapitalist \u00fclkeler gibi devlet \u00fczerinde \u2018y\u00fck\u2019 olarak g\u00f6rmez ve sa\u011fl\u0131k hizmetlerinin, insan ve toplum sa\u011fl\u0131\u011f\u0131n\u0131n zorunlulu\u011fu oldu\u011fundan hareket eder. \u0130\u015fte Sovyetler birli\u011fi bunun ilk uygulay\u0131c\u0131s\u0131 olarak d\u00f6neminin \u00e7ok ilerisinde \u00f6rnekler sergilemi\u015ftir.<\/p>\r\n\r\n\r\n\r\n<p>Sovyetler Birli\u011fi sa\u011fl\u0131kta da ilklerin \u00fclkesidir; Sa\u011fl\u0131k hizmetlerini n\u00fcfusu i\u00e7indeki herkese \u00f6nleyici ve tedavi edici hizmetler olarak \u00f6rg\u00fctlemi\u015f ilk \u00fclkedir. Bu hizmeti \u00fccretsiz sa\u011flayan ilk \u00fclkedir. Dispanserler arac\u0131l\u0131\u011f\u0131 ile hizmetlerin b\u00fct\u00fcnc\u00fcl uygulanmas\u0131n\u0131 hayata ge\u00e7iren ilk \u00fclkedir. Sa\u011fl\u0131k Hizmetlerini merkezile\u015ftiren ve Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 (Komiserlik) olu\u015fturan ilk \u00fclkedir. Anne-\u00e7ocuk sa\u011fl\u0131\u011f\u0131n\u0131 anayasas\u0131na ge\u00e7iren ilk \u00fclkedir.<\/p>\r\n\r\n\r\n\r\n<p>18 Haziran 1918 tarihli kararname ile sa\u011fl\u0131k hizmetleri merkezile\u015ftirilerek Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 olu\u015fturulmu\u015f ve sa\u011fl\u0131k \u00f6rg\u00fctlenmesinde ilk ad\u0131m at\u0131lm\u0131\u015ft\u0131r. Bakan olarak Lenin\u2019in yak\u0131n arkada\u015f\u0131 Dr. Nikolay Aleksandrovi\u00e7 Sema\u015fko g\u00f6revlendirilmi\u015ftir. SSCB\u2019yi olu\u015fturan her cumhuriyetin de birer Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 bulunmaktad\u0131r. Dr. Sema\u015fko, sa\u011fl\u0131k hizmetlerinin sosyalle\u015ftirilmesini \u201cdevletin herkese gereksindi\u011finde \u00fccretsiz ve nitelikli sa\u011fl\u0131k bak\u0131m\u0131 sa\u011flama sorumlulu\u011fu \u00fcstlenmesi\u201d olarak tan\u0131mlam\u0131\u015f, \u201cb\u00f6ylece \u00f6zel hastaneler ve muayenehaneler g\u00f6lgenin g\u00fcne\u015fte kayboldu\u011fu gibi yok olacaklard\u0131r\u201ddiyerek, \u00f6zel sa\u011fl\u0131k hizmetlerinin ve kurumlar\u0131n\u0131n yok edilmesinin zemininin nerede oldu\u011funu g\u00f6stermi\u015ftir.<\/p>\r\n\r\n\r\n\r\n<p>Burada Dr. Nikolay Aleksadndrovi\u00e7 Sema\u015fko\u2019yu tan\u0131tmak i\u00e7in bir parantez a\u00e7mak gerek. 1874 do\u011fumludur, 1893\u2019te Moskova da t\u0131p e\u011fitimine ba\u015flar. Hapislik ve s\u00fcrg\u00fcn y\u0131llar\u0131 nedeniyle 1901 y\u0131l\u0131ndaki hapisli\u011fi sonras\u0131 okulu bitirir. Samara\u2019da hekimli\u011fe ba\u015flar. Yeniden tutuklan\u0131r, cezaevi sonras\u0131 Cenevre\u2019ye gider ve Lenin ile \u00e7al\u0131\u015f\u0131r. Daha sonra Paris\u2019te hekimlik yaparken politik \u00e7al\u0131\u015fmalar y\u00fcr\u00fct\u00fcr, polis bask\u0131s\u0131 nedeniyle Paris\u2019ten ayr\u0131l\u0131r ve 1917 Nisan devrimine kadar Balkanlar\u2019da hekimlik yaparak siyasi \u00e7al\u0131\u015fmalarda yer al\u0131r. Nisan devrimi sonras\u0131 Rusya\u2019ya girerken tutuklan\u0131r. Eyl\u00fcl ay\u0131nda Moskova\u2019da hekimlik yapmaya ba\u015flar ve \u00e7al\u0131\u015ft\u0131\u011f\u0131 alandan vekil olarak se\u00e7ilir. 1917 Ekim devrimine kat\u0131l\u0131r, devrim sonras\u0131 Moskova \u015eehri Sa\u011fl\u0131k Departman\u0131 ba\u015f\u0131na ge\u00e7er ve sonras\u0131nda g\u00f6revlendirildi\u011fi Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u2019n\u0131 1930 y\u0131l\u0131na kadar s\u00fcrd\u00fcr\u00fcr.<\/p>\r\n\r\n\r\n\r\n<p>Devam edelim.<\/p>\r\n\r\n\r\n\r\n<p>Halk sa\u011fl\u0131\u011f\u0131n\u0131 korumak ve sa\u011fl\u0131k hizmetlerini d\u00fczenlemek amac\u0131yla sadece Lenin d\u00f6neminde, Lenin ve Dr. Sema\u015fko imzal\u0131 y\u00fczden fazla kararname yay\u0131nlanm\u0131\u015ft\u0131r. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131n\u0131n kurulmas\u0131 sonras\u0131 bula\u015f\u0131c\u0131 ve salg\u0131n hastal\u0131klara kar\u015f\u0131 olu\u015fturulan i\u015f\u00e7i komiteleri ile kamusal kurumlar\u0131n temizli\u011fi denetlenmi\u015f, halka temizlik e\u011fitimi verilmi\u015f, bitle m\u00fccadele \u00f6rg\u00fctlenmi\u015f, sabun da\u011f\u0131t\u0131m\u0131 yap\u0131lm\u0131\u015ft\u0131r. 1919 y\u0131l\u0131nda Lenin \u201cYa sosyalizm biti yenecek ya da bit sosyalizmi\u201d diyerek yap\u0131lan \u00e7al\u0131\u015fman\u0131n \u00f6nemine dikkat \u00e7ekmi\u015ftir. O d\u00f6nem hijyen son derece \u00f6nemle ele al\u0131nm\u0131\u015f, 1918 de hijyen y\u00f6netiminin merkezile\u015ftirilmesi, \u00f6zel hijyen m\u00fcfetti\u015fli\u011fi olu\u015fturulmas\u0131, halk\u0131n hijyen hizmetine eri\u015fiminin kolayla\u015ft\u0131r\u0131lmas\u0131 ve halk\u0131n bu \u00e7al\u0131\u015fmaya seferber edilmesi kararlar\u0131 al\u0131nm\u0131\u015ft\u0131r. Kanalizasyon sistemi ve hijyen amac\u0131yla hamamlar yap\u0131lm\u0131\u015ft\u0131r. A\u015f\u0131lama zorunlu bir hizmet haline getirilmi\u015ftir.\u00a0<\/p>\r\n\r\n\r\n\r\n<p>Sa\u011fl\u0131k sisteminin ve sa\u011fl\u0131k hizmetlerinin temel ilkeleri \u015funlard\u0131:<\/p>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\">\r\n<li>\u00d6nleyici sa\u011fl\u0131k hizmetlerine a\u011f\u0131rl\u0131k verilmesi,<\/li>\r\n<li>\u00d6nleyici ve tedavi edici hizmetlerin b\u00fct\u00fcnle\u015ftirilmesi,<\/li>\r\n<li>Sevk zinciri ile birbirine ba\u011fl\u0131 sa\u011fl\u0131k kurumlar\u0131nda hizmet verilmesi,<\/li>\r\n<li>Hizmetin \u00fccretsiz ve finansman\u0131n genel b\u00fct\u00e7eden sa\u011flanmas\u0131,<\/li>\r\n<li>Hekimler devlet g\u00f6revlisi, sa\u011fl\u0131k kurumlar\u0131 devlet kurumu, hizmet devlet hizmeti,<\/li>\r\n<li>T\u0131bbi ara\u015ft\u0131rma ve uygulama aras\u0131nda yak\u0131n ili\u015fki kurulmas\u0131,<\/li>\r\n<li>Sa\u011fl\u0131k sisteminin geli\u015fimine halk\u0131n kat\u0131l\u0131m\u0131n\u0131n sa\u011flanmas\u0131,<\/li>\r\n<li>Hijyen bilgisinin toplum i\u00e7inde yayg\u0131nla\u015ft\u0131r\u0131lmas\u0131,<\/li>\r\n<li>Sanayi ve tar\u0131m i\u015f\u00e7ileri ile ailelerine sa\u011fl\u0131k hizmetinde \u00f6ncelik verilmesi,<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p>Sa\u011fl\u0131k hizmetlerinin farkl\u0131 iklim, k\u00fclt\u00fcr, ulusal ve ba\u015fka yerel \u00f6zellikler dikkate al\u0131narak, \u00e7al\u0131\u015fma ve ya\u015fam ko\u015fullar\u0131n\u0131n gereksinimlerini kar\u015f\u0131layacak \u015fekilde planlanmas\u0131 temel al\u0131nm\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Sa\u011fl\u0131k hizmetleri merkezi sosyo-ekonomik plan\u0131n par\u00e7as\u0131 olarak haz\u0131rlanm\u0131\u015f ve y\u00fcr\u00fct\u00fclm\u00fc\u015ft\u00fcr. Yerel \u00f6rg\u00fctler kendi planlar\u0131n\u0131 haz\u0131rlam\u0131\u015f ancak genel plan ile birlikte ele al\u0131nm\u0131\u015ft\u0131r. Sa\u011fl\u0131k hizmetlerinin temeli, sa\u011fl\u0131\u011f\u0131 korumak \u00fczerinedir ve yurtta\u015flar\u0131n sa\u011fl\u0131\u011f\u0131 devlet g\u00fcvencesindedir.<\/p>\r\n\r\n\r\n\r\n<p>SBKP\u2019nin 1919 y\u0131l\u0131nda ger\u00e7ekle\u015ftirdi\u011fi 8. kongresindeki program\u0131nda sa\u011fl\u0131kla ilgili b\u00f6l\u00fcm \u015f\u00f6yledir: \u201cParti, toplum sa\u011fl\u0131\u011f\u0131n\u0131 koruma \u00e7al\u0131\u015fmalar\u0131n\u0131 esas olarak, hastal\u0131klar\u0131n geli\u015fmesini \u00f6nlemeyi ama\u00e7layan yayg\u0131n sa\u011fl\u0131k ve hijyen \u00f6nlemlerini y\u00fcr\u00fctmek \u00fczere temellendirmi\u015ftir. Bu anlay\u0131\u015fla parti, \u00e7al\u0131\u015fanlar\u0131n \u00e7\u0131karlar\u0131na hizmet edecek yayg\u0131n hijyen \u00f6nlemleri program\u0131n\u0131 belirler;<\/p>\r\n\r\n\r\n\r\n<p>1. a) Kentsel \u00e7evrenin temizlenmesi, toprak, su ve havan\u0131n kirlilikten korunmas\u0131,<\/p>\r\n\r\n\r\n\r\n<p>\u00a0\u00a0\u00a0 b) Hijyenik temelde halk mutfaklar\u0131n\u0131n olu\u015fturulmas\u0131,<\/p>\r\n\r\n\r\n\r\n<p>\u00a0\u00a0\u00a0 c) Bula\u015f\u0131c\u0131 hastal\u0131klar\u0131n geli\u015fim ve yay\u0131lmas\u0131n\u0131 \u00f6nlemek i\u00e7in tedbirlerin al\u0131nmas\u0131,<\/p>\r\n\r\n\r\n\r\n<p>2. Verem, cinsel yolla bula\u015fan hastal\u0131klar, alkolizm gibi toplumsal hastal\u0131klara kar\u015f\u0131 kampanya y\u00fcr\u00fct\u00fclmesi<\/p>\r\n\r\n\r\n\r\n<p>3. Herkese y\u00fcksek standartlarda \u00fccretsiz \u00f6nleyici ve tedavi edici hizmetler<\/p>\r\n\r\n\r\n\r\n<p>1920\u2019de yay\u0131nlanan kararname, sanayi b\u00f6lgelerinin yerle\u015fim yerleri d\u0131\u015f\u0131na kurulmas\u0131n\u0131 zorunlu hale getirmi\u015f, 1923 y\u0131l\u0131nda Meslek Hastal\u0131klar\u0131 Ara\u015ft\u0131rma Enstit\u00fcs\u00fc kurulmu\u015ftur.<\/p>\r\n\r\n\r\n\r\n<p><em>1920\u2019lerin ba\u015flar\u0131nda Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u2019nda \u015fu b\u00f6l\u00fcmler bulunmaktad\u0131r; <\/em>T\u00fcberk\u00fcloz, sifiliz (frengi), s\u0131tma vb. b\u00f6l\u00fcmleri kapsayan \u00e7evre hijyeni ve salg\u0131nlarla ilgili b\u00f6l\u00fcm, tedavi b\u00f6l\u00fcm\u00fc, sanatoryumlar, sava\u015f sanitasyonu<a href=\"#_ftn1\">[1]<\/a>, demiryollar\u0131 ve buharl\u0131 gemi sanitasyonu, ana ve \u00e7ocuk sa\u011fl\u0131\u011f\u0131, atletik sporlar ve beden e\u011fitimi alt b\u00f6l\u00fcmleriyle gen\u00e7lik sa\u011fl\u0131\u011f\u0131, bilimsel ara\u015ft\u0131rma \u00e7al\u0131\u015fmalar\u0131n\u0131n kontrol\u00fc ve \u00f6rg\u00fctlenmesi ile fizik tedavi.<\/p>\r\n\r\n\r\n\r\n<p>1917-1922 aras\u0131ndaki y\u0131llar sosyalizmin in\u015fas\u0131yla birlikte ayn\u0131 zamanda i\u00e7 sava\u015f y\u0131llar\u0131d\u0131r. Bu ko\u015fullarda bilim insanlar\u0131 sa\u011fl\u0131k sistemini \u00f6rg\u00fctleyebilmek i\u00e7in mum \u0131\u015f\u0131\u011f\u0131nda ve so\u011fukta toplant\u0131lar yapmakta, ara\u015ft\u0131rmac\u0131lar maddi yokluklar nedeni ile laboratuvar giderlerini maa\u015flar\u0131ndan kar\u015f\u0131lamaktad\u0131r. \u0130\u00e7 sava\u015f\u0131n bitmesiyle daha uygun \u00e7al\u0131\u015fma ko\u015fullar\u0131na kavu\u015fmu\u015flard\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Merkezi ilk be\u015f y\u0131ll\u0131k plan 1928 y\u0131l\u0131nda yap\u0131l\u0131r. Bu y\u0131la kadar bula\u015f\u0131c\u0131 hastal\u0131klarla ciddi bir m\u00fccadele y\u00fcr\u00fct\u00fclm\u00fc\u015ft\u00fcr. 1935 y\u0131l\u0131na gelindi\u011finde hastane yataklar\u0131n\u0131n, sanatoryumlar\u0131n, dispanserlerin, istirahat evlerinin, anne-\u00e7ocuk evlerinin say\u0131s\u0131 iki kat\u0131na \u00e7\u0131kar\u0131lm\u0131\u015ft\u0131r.\u00a0<\/p>\r\n\r\n\r\n\r\n<p>D\u00fcnyada \u00f6rnekleri olmayan bu uygulamalar kapitalist d\u00fcnyay\u0131 fazlas\u0131yla rahats\u0131z etmi\u015ftir. D\u00fcnyadaki halk sa\u011fl\u0131\u011f\u0131 hareketlerini ve SSCB deki \u00e7al\u0131\u015fmalar\u0131 da izleyen Rockefeller Vakf\u0131\u2019n\u0131n Uluslararas\u0131 Sa\u011fl\u0131k Kurulu, tedavi hizmetleri yerine koruyucu hizmetlere \u00f6ncelik verilmesi, \u00fccretsiz sa\u011fl\u0131k hizmeti sunulmas\u0131 ve sa\u011fl\u0131k\/hastal\u0131k anlay\u0131\u015f\u0131nda toplumsal fakt\u00f6rlerin temel al\u0131nmas\u0131 kar\u015f\u0131s\u0131nda rahats\u0131zl\u0131k duyar. 1922 y\u0131l\u0131nda \u201cToplumsal ve Mesleki Hastal\u0131klar Klini\u011fi\u201d a\u00e7\u0131lmas\u0131ndan ho\u015fnutsuz oldu\u011funu a\u00e7\u0131k\u00e7a dile getirerek, Sovyetler Birli\u011fi\u2019ndeki halk sa\u011fl\u0131\u011f\u0131 programlar\u0131na destek olmayaca\u011f\u0131n\u0131 belirtir.<\/p>\r\n\r\n\r\n\r\n<p><strong>SA\u011eLIK H\u0130ZMETLER\u0130N\u0130N \u00d6RG\u00dcTLENMES\u0130<\/strong><\/p>\r\n\r\n\r\n\r\n<p>Sa\u011fl\u0131k \u00f6rg\u00fctlenmesi y\u0131llar i\u00e7inde de\u011fi\u015fen ihtiya\u00e7lara g\u00f6re \u015fekillenerek, 1936 y\u0131l\u0131nda son haline kavu\u015fmu\u015ftur. SSCB Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u2019n\u0131n alt\u0131nda her Cumhuriyetin Sa\u011fl\u0131k Bakanl\u0131klar\u0131 bulunur. Her Cumhuriyet oblast ve kraylara b\u00f6l\u00fcnm\u00fc\u015f, oblast ve kraylar da kendi i\u00e7lerinde kentsel ve k\u0131rsal rayonlara b\u00f6l\u00fcnm\u00fc\u015ft\u00fcr. Rayonlar\u0131n alt\u0131nda da u\u00e7astoklar bulunur.\u00a0<\/p>\r\n\r\n\r\n\r\n<p><strong>Oblast<\/strong>lar, bir dereceye kadar \u00f6zerk olduklar\u0131ndan eyalet olarak ifade edilebilir. Benzer \u00f6zellikleri olan <strong>Kraylar <\/strong>ise s\u0131n\u0131rlar\u0131nda \u00e7ok geni\u015f k\u0131rsal alanlar bar\u0131nd\u0131rmas\u0131yla oblasttan ayr\u0131l\u0131r. SSCB cumhuriyetleri idari y\u00f6nden n\u00fcfuslar\u0131 500 binden birka\u00e7 milyona kadar de\u011fi\u015fen y\u00fcz\u00fcn \u00fczerinde oblast ve kraya ayr\u0131lm\u0131\u015ft\u0131r ve buralarda 600-1000 yatak kapasiteli kurumlar bulunur. Bu kurumlar \u00fcst uzmanla\u015fma e\u011fitim ve dan\u0131\u015fma merkezleridir.<\/p>\r\n\r\n\r\n\r\n<p><strong>Rayon,<\/strong> oblast ve kray alt\u0131nda yer alan idari birimi tan\u0131mlar. Bir \u015fehrin mahalle, semt veya il\u00e7esini ya da n\u00fcfusu b\u00fcy\u00fck k\u0131rsal bir yerle\u015fimi i\u00e7erebilir. 200-400 yatakl\u0131 bir hastane ve 15 kadar uzmanl\u0131k dal\u0131n\u0131 kapsamaktad\u0131r. Rayon say\u0131s\u0131 4500\u2019\u00fcn \u00fczerindedir. K\u0131rsal rayonlarda 40 bin kadar k\u0131rsal merkez (k\u00f6yler, kolhoz ve sovhozlar) bulunur.<\/p>\r\n\r\n\r\n\r\n<p><em>Oblast ve rayonlarda sa\u011fl\u0131k y\u00f6netimi b\u00f6l\u00fcmleri \u015funlar\u0131 i\u00e7erir;<\/em> Tedavi kurumlar\u0131, denetim, anne ve \u00e7ocuk bak\u0131m\u0131 (anaokullar\u0131, kre\u015fler), sanayi hijyeni ve i\u015fyeri hekimli\u011fi, \u00e7ocuk sa\u011fl\u0131\u011f\u0131 ve okul hijyeni, hijyenik ya\u015fam ko\u015fullar\u0131 (g\u0131da ve beslenme, bar\u0131nma, su ve at\u0131klar, epidemiyoloji<a href=\"#_ftn2\">[2]<\/a> ve enfeksiyonlar\u0131n \u00f6nlenmesi), bilimsel ara\u015ft\u0131rma, rasyonalizasyon (sorunlar \u00fczerinde \u00e7al\u0131\u015fma ve \u00e7\u00f6z\u00fcm bulma i\u00e7in \u00e7e\u015fitli kurumlarla i\u015fbirli\u011fi), planlama (finansman ve istatistik dahil), g\u0131da destek ve kurumlar\u0131n bak\u0131m onar\u0131m\u0131, in\u015faat.<\/p>\r\n\r\n\r\n\r\n<p>Rayonlar alt\u0131nda yer alan sa\u011fl\u0131k b\u00f6lgeleri <strong>U\u00e7astok<\/strong>lard\u0131r ve hizmetin u\u00e7 noktas\u0131ndaki ana birimlerdir. Birer pediatrist, eri\u015fkin genel pratisyen hekimi ve jinekolog ile, eri\u015fkin ve \u00e7ocuk hem\u015fireleri, \u00e7evre sa\u011fl\u0131k\u00e7\u0131lar\u0131 ve ebeler bulunur. U\u00e7astok b\u00f6lgesi ortalama \u00fc\u00e7 bin yeti\u015fkin ile on d\u00f6rt ya\u015f alt\u0131 1000 \u00e7ocu\u011fa hizmet verir.<\/p>\r\n\r\n\r\n\r\n<p>Ayr\u0131ca \u00fclkenin her yan\u0131na da\u011f\u0131lm\u0131\u015f halk sa\u011fl\u0131\u011f\u0131 merkezleri olarak i\u015flev g\u00f6ren Sanepid \u0130stasyonlar\u0131 bulunmaktad\u0131r. \u00d6nlenebilecek b\u00fct\u00fcn sa\u011fl\u0131k sorunlar\u0131n\u0131n denetiminden ve kontrol\u00fcnden sorumlu olan bu istasyonlar; \u00e7evre sa\u011fl\u0131\u011f\u0131, bula\u015f\u0131c\u0131 hastal\u0131klardan korunma, i\u015f sa\u011fl\u0131\u011f\u0131, epidemiyolojik \u00e7al\u0131\u015fmalar gibi konularda \u00e7al\u0131\u015fmaktad\u0131rlar. \u0130lk sanepid istasyonu 29 Ekim 1922 de kurulmu\u015ftur. T\u0131p fak\u00fcltelerinin bir b\u00f6l\u00fcm\u00fc bu istasyonlarda g\u00f6rev alacak hekimleri yeti\u015ftirmek i\u00e7in \u00f6zelle\u015fmi\u015ftir. \u0130stasyon \u00e7al\u0131\u015fanlar\u0131 iki y\u0131lda bir tazeleme kurslar\u0131na kat\u0131lmak durumundad\u0131rlar.<\/p>\r\n\r\n\r\n\r\n<p>1940 y\u0131l\u0131 sonuna kadar 1958 sanepid istasyonu kurulmu\u015ftur ve bu istasyonlarda 11.121 hijyen ve halk sa\u011fl\u0131\u011f\u0131 hekimi ile di\u011fer sa\u011fl\u0131k\u00e7\u0131lar g\u00f6rev yapmaktad\u0131r. 1950\u2019lerden sonra sanayile\u015fme ve kentle\u015fmenin geli\u015fmesiyle \u00e7evre sa\u011fl\u0131\u011f\u0131 sorunlar\u0131 daha \u00e7ok \u00f6ne \u00e7\u0131kar. Yine ayn\u0131 d\u00f6nemlerde meslek hastal\u0131klar\u0131 \u00e7al\u0131\u015fmalar\u0131 da yo\u011funla\u015fm\u0131\u015f, \u00e7al\u0131\u015fanlar\u0131n i\u015flevleri de buna g\u00f6re de\u011fi\u015fmi\u015ftir.<\/p>\r\n\r\n\r\n\r\n<p>\u00d6zel ama\u00e7larla kurulmu\u015f \u00f6zel \u00f6rg\u00fctler ve dispanserler de bulunmaktad\u0131r. En \u00f6nemlisi i\u015f\u00e7i sa\u011fl\u0131\u011f\u0131 \u00f6rg\u00fct\u00fcd\u00fcr. T\u00fcberk\u00fcloz, kanser, diabet, romatizmal kalp hastal\u0131klar\u0131, fizyoterapi gibi \u00f6zel dal dispanserleri t\u00fcm \u00fclkeye yay\u0131lm\u0131\u015ft\u0131r. \u00c7ocuklar i\u00e7in poliklinikler, hastaneler, kronik hastal\u0131k dispanserleri, s\u00fct merkezleri, kre\u015fler, yaz tatilleri i\u00e7in kamplar, g\u00fcnd\u00fcz ve gece bak\u0131m \u00fcniteleri gibi sa\u011fl\u0131k kurulu\u015flar\u0131 da bulunmaktad\u0131r. \u0130la\u00e7 \u00fcretimi ve da\u011f\u0131t\u0131m\u0131 da devlet eliyle yap\u0131lmaktad\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>SSCB sa\u011fl\u0131k y\u00f6netiminde \u201ci\u015f\u00e7ilerin sa\u011fl\u0131\u011f\u0131 i\u015f\u00e7ilerin ellerinde olmal\u0131d\u0131r\u201d ilkesi temel al\u0131nm\u0131\u015ft\u0131r. SSCB\u2019nin y\u00f6netim organlar\u0131 olan \u201cSovyet\u201dler i\u015fyerinden ve sorumlu oldu\u011fu b\u00f6lge insanlar\u0131n\u0131n sa\u011fl\u0131\u011f\u0131ndan da sorumludurlar. \u0130\u015fyeri veya b\u00f6lgelerinde g\u00f6revli hekimle i\u015fbirli\u011fi i\u00e7inde hareket ederek sunulan hizmetlerin geli\u015ftirilmesine \u00e7al\u0131\u015f\u0131rlar. Sosyal sigorta fonlar\u0131n\u0131n en iyi nas\u0131l kullan\u0131laca\u011f\u0131na karar vermek; hijyen ko\u015fullar\u0131n\u0131, sosyal hizmetleri, kre\u015f ve anaokullar\u0131n\u0131, okul \u00e7ocuklar\u0131na verilen hizmetleri denetlemek; kimin dinlenme evine, sanatoryuma, sa\u011fl\u0131k tatil k\u00f6y\u00fcne g\u00f6nderilece\u011fine karar vermek gibi konularda hekimin yan\u0131nda \u201cSovyet\u201dler arac\u0131l\u0131\u011f\u0131 ile i\u015f\u00e7iler de s\u00f6z s\u00f6yler. \u0130\u015f\u00e7ilerin sa\u011fl\u0131k hizmetlerine aktif kat\u0131l\u0131m\u0131yla \u00fclkenin sa\u011fl\u0131k sorunlar\u0131n\u0131n h\u0131zla \u00e7\u00f6z\u00fcm\u00fc m\u00fcmk\u00fcn olmu\u015ftur. Uzmanlar i\u015f\u00e7ilerin do\u011fru kararlar verebilmeleri i\u00e7in yol g\u00f6stermi\u015flerdir.Sa\u011fl\u0131k hizmetleri, eme\u011fin sa\u011fl\u0131k ihtiya\u00e7lar\u0131 dikkate al\u0131narak planlanm\u0131\u015f, dispanserler de bunu uygulam\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Hava kirlili\u011fi i\u00e7in ad\u0131m atan, atmosferik kirleticiler i\u00e7in azami kabul edilebilir yo\u011funluklar\u0131 belirleyen ilk \u00fclke de SSCB olmu\u015ftur. Bu alandaki \u00e7al\u0131\u015fmalar\u0131 D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) taraf\u0131ndan di\u011fer \u00fclkelere \u00f6rnek g\u00f6sterilmi\u015ftir.<\/p>\r\n\r\n\r\n\r\n<p><strong>SA\u011eLIK H\u0130ZMETLER\u0130N\u0130N SUNUMU<\/strong><\/p>\r\n\r\n\r\n\r\n<p>Sa\u011fl\u0131k \u00fc\u00e7 alanda yo\u011funla\u015fm\u0131\u015ft\u0131r; yeti\u015fkin emek\u00e7i sa\u011fl\u0131\u011f\u0131, ana-\u00e7ocuk sa\u011fl\u0131\u011f\u0131 ve hijyen.<\/p>\r\n\r\n\r\n\r\n<p>Sa\u011fl\u0131k hizmetinde izlenen s\u00fcre\u00e7 \u015fu \u015fekildedir;<\/p>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\">\r\n<li>\u0130\u015fyerlerinde emek\u00e7ilere, okullarda \u00f6\u011frencilere, b\u00f6lgelerde b\u00f6lge sakinlerine, orduda askerlere d\u00fczenli, periyodik sa\u011fl\u0131k muayeneler,<\/li>\r\n<li>Hastan\u0131n evinde bak\u0131m (hastalar\u0131n az bir k\u0131sm\u0131),<\/li>\r\n<li>Fabrikalar veya \u00e7al\u0131\u015ft\u0131klar\u0131 kurumlarda bak\u0131m,<\/li>\r\n<li>Dispanser ve polikliniklerde ayaktan bak\u0131m,<\/li>\r\n<li>Daha ciddi hastal\u0131klarda hastaneler veya di\u011fer yatakl\u0131 kurumlarda bak\u0131m (sanatoryum vb)<\/li>\r\n<li>Nekahat d\u00f6nemlerinde dinlenme evlerinde bak\u0131m.<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p>Tedavi kurumlar\u0131, genel dispanserler (t\u00fcberk\u00fcloz, ana-\u00e7ocuk sa\u011fl\u0131\u011f\u0131, cinsel yolla bula\u015fan hastal\u0131klar dispanserleri), poliklinikler, genel hastaneler, uzmanla\u015fm\u0131\u015f hastaneler (\u00e7ocuk, do\u011fum ve cinsel yolla bula\u015fan hastal\u0131klar i\u00e7in), sanatoryumlar, gece sanatoryumlar\u0131 (g\u00fcnd\u00fcz \u00e7al\u0131\u015fan, gece tedavileri s\u00fcren hastalar i\u00e7in), e\u011fitim hastanelerinden olu\u015fmaktad\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>1949 y\u0131l\u0131na kadar i\u015fyeri sa\u011fl\u0131k birimleri ile birlikte \u00e7al\u0131\u015fma ve ikamet b\u00f6lgelerinde de b\u00f6lge\/n\u00fcfus tabanl\u0131 dispanser ve polikliniklerde ayaktan bak\u0131m hizmeti verilmi\u015f, i\u015f\u00e7iler her ikisine de gidebilmi\u015flerdir. 1950 sonras\u0131 dispanser ve poliklinikler ile hastanelerin ayakta bak\u0131m birimleri birle\u015ftirilmi\u015f, hizmet b\u00fcy\u00fck sa\u011fl\u0131k komplekslerinde verilmeye ba\u015flanm\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Sa\u011fl\u0131k emek\u00e7ilerinin \u00e7al\u0131\u015fma s\u00fcreleri ve y\u00f6ntemleri de kapitalist sistemin o g\u00fcne kadar g\u00f6sterdiklerinden farkl\u0131d\u0131r. Polikliniklerde hekimler g\u00fcnde 6-6.5 saat \u00e7al\u0131\u015f\u0131rlar ve bir saatte en \u00e7ok alt\u0131 hasta kabul edebilirler, \u00e7al\u0131\u015fman\u0131n 5. g\u00fcn\u00fc tatil yaparlard\u0131. R\u00f6ntgen uzmanlar\u0131n\u0131n \u00e7al\u0131\u015fma s\u00fcresi 4 saat, di\u011fer sa\u011fl\u0131k emek\u00e7ilerinin \u00e7al\u0131\u015fma s\u00fcreleri t\u00fcm di\u011fer emek\u00e7iler gibi 7 saattir. Hekimler t\u00fcm \u00e7al\u0131\u015fanlar gibi y\u0131lda iki hafta izin kullan\u0131rken, r\u00f6ntgen uzmanlar\u0131 daha uzun izin kullan\u0131rd\u0131. K\u0131rsal kesimdeki hekimler ise \u00fc\u00e7 y\u0131lda bir daha uzun izin kullan\u0131rlard\u0131. Bir U\u00e7astok hekiminin mesaisi 6,5 saat olup, \u00e7al\u0131\u015fmas\u0131 3 saat poliklinik, 3 saat ev ziyareti ve yar\u0131m saat sa\u011fl\u0131k e\u011fitimi (bireylere, gruplara, geni\u015f topluluklara) olarak planlanm\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Fa\u015fizme kar\u015f\u0131 sava\u015f d\u00f6neminde, askeri sa\u011fl\u0131k hizmetleri \u00f6ne \u00e7\u0131km\u0131\u015ft\u0131r. Sa\u011fl\u0131k kaynaklar\u0131 da di\u011fer alanlarda oldu\u011fu gibi fa\u015fizmin yenilgisi i\u00e7in kullan\u0131lm\u0131\u015f, sa\u011fl\u0131k emek\u00e7ileri, yeni sa\u011fl\u0131k hizmeti ihtiya\u00e7lar\u0131 \u00fczerinden e\u011fitimden ge\u00e7irilmi\u015ftir. Bu d\u00f6nemde sava\u015f yaralar\u0131n\u0131 en aza indirmek, tetanoz ve kangreni \u00f6nlemek i\u00e7in tedavi teknikleri geli\u015ftirilmi\u015f, cerrahi bran\u015flarda \u00f6nemli birikim olmu\u015ftur. Yine o g\u00fcne kadar g\u00f6r\u00fclmemi\u015f kan transf\u00fczyonlar\u0131<a href=\"#_ftn3\">[3]<\/a> ve sulfanamid tedavisi<a href=\"#_ftn4\">[4]<\/a> ve vitamin yetersizli\u011fini \u00f6nleme \u00e7al\u0131\u015fmalar\u0131 yap\u0131lm\u0131\u015ft\u0131r. Fa\u015fizmin yenilgisi sonras\u0131 sa\u011fl\u0131k hizmetlerinin sava\u015f \u00f6ncesi d\u00f6neme ve daha iyisine kavu\u015fmas\u0131 i\u00e7in yap\u0131lacak \u00e7al\u0131\u015fmalar 4. be\u015f y\u0131ll\u0131k planla belirlenmi\u015ftir. D\u00fcnyadaki ilk kan transf\u00fczyon enstit\u00fcs\u00fc Moskova\u2019da kurulmu\u015f, sava\u015f sonras\u0131 400 t\u0131p ve bilimsel ara\u015ft\u0131rma enstit\u00fcs\u00fc a\u00e7\u0131lm\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p><strong>ANNE VE \u00c7OCUK SA\u011eLI\u011eI<\/strong><\/p>\r\n\r\n\r\n\r\n<p>Ana-\u00e7ocuk sa\u011fl\u0131\u011f\u0131 hizmetlerini anayasas\u0131na ge\u00e7iren ilk \u00fclkenin Sovyetler Birli\u011fi oldu\u011fu ba\u015flarda ifade edilmi\u015fti. Annelik ve \u00e7ocuk bak\u0131m\u0131 SSCB b\u00fct\u00e7esinin ilk \u00f6deme kalemlerinden kabul edilmi\u015ftir. Daha Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 kurulmadan Aral\u0131k 1917 tarihinde Ana-\u00c7ocuk Sa\u011fl\u0131\u011f\u0131 Departman\u0131 kurulmas\u0131na y\u00f6nelik kararname yay\u0131nlanm\u0131\u015ft\u0131r. Kad\u0131nlar \u00e7al\u0131\u015fmak istediklerinde erkeklerle e\u015fit haklara sahip olarak \u00e7al\u0131\u015fma ya\u015fam\u0131nda yer alm\u0131\u015flard\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Ana-\u00e7ocuk sa\u011fl\u0131\u011f\u0131 hizmetleri, \u00e7ocuklar\u0131 do\u011fumdan eri\u015fkinli\u011fe kadar izleme ve korumay\u0131 kapsarken, kad\u0131nlar\u0131 da izleme ve korumay\u0131 ama\u00e7lam\u0131\u015ft\u0131r. Her kad\u0131na do\u011fumda 200 ruble ve bebek 5 ayl\u0131k oldu\u011funda 50 ruble olmak \u00fczere 250 ruble do\u011fum yard\u0131m\u0131 yap\u0131lmaktad\u0131r. Ayda 50 rublelik yard\u0131m \u00e7ocuk 12 ya\u015f\u0131na kadar devam etmekte ve gerekti\u011finde art\u0131r\u0131labilmektedir.<\/p>\r\n\r\n\r\n\r\n<p>Ana ve \u00e7ocuk sa\u011fl\u0131\u011f\u0131 dispanserleri yan\u0131nda kre\u015fler, anaokullar\u0131 ve di\u011fer t\u00fcm \u00f6\u011fretim kurumlar\u0131nda okul hekimlikleri olu\u015fturulmu\u015ftur. 1931 y\u0131l\u0131nda 3 bine ula\u015fan ana-\u00e7ocuk sa\u011fl\u0131\u011f\u0131 dispanserlerinin \u00e7o\u011funda s\u00fct mutfaklar\u0131 bulunmaktad\u0131r. K\u0131rsal alandaki kolhoz ve sovhozlarda da bulunan bu dispanserlerde hekimler, hem\u015fireler, hukuksal dan\u0131\u015fmanlar g\u00f6rev yapmaktad\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Ana \u00e7ocuk sa\u011fl\u0131\u011f\u0131 hizmetlerinin temel \u00f6zellikleri<\/p>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\">\r\n<li>T\u00fcm anne-\u00e7ocuk sa\u011fl\u0131\u011f\u0131 hizmetleri \u00fccretsizdir,<\/li>\r\n<li>B\u00fct\u00fcn bireyleri kapsayacak \u015fekilde tasarlanm\u0131\u015ft\u0131r,<\/li>\r\n<li>\u0130dari bak\u0131mdan eri\u015fkin hizmetlerinden ayr\u0131 programlar olarak ele al\u0131n\u0131r,<\/li>\r\n<li>Bir hekimin de sorumlu oldu\u011fu birimlerde y\u00fcr\u00fct\u00fcl\u00fcr,<\/li>\r\n<li>\u00d6nleyici, klinik, e\u011fitimsel, toplumsal, hukuksal ve \u00e7evresel etkinlikleri i\u00e7eren kapsaml\u0131 programlar anne ve \u00e7ocu\u011fun sa\u011fl\u0131\u011f\u0131n\u0131 ve iyili\u011fini sa\u011flamaya y\u00f6neliktir,<\/li>\r\n<li>Polikliniklerde anneler, \u00e7ocuk bak\u0131m\u0131 konusunda e\u011fitilir,<\/li>\r\n<li>Temel program merkezi olarak planlanm\u0131\u015ft\u0131r, yerel ko\u015fullara uyarlanabilir.<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p>Bir ana-\u00e7ocuk sa\u011fl\u0131\u011f\u0131 merkezinde, bebek klini\u011fi, bir-\u00fc\u00e7 ya\u015f \u00e7ocuk klini\u011fi, hamile kad\u0131n klini\u011fi, t\u00fcberk\u00fcloz uzman\u0131 ofisi, cinsel yollarla bula\u015fan hastal\u0131klar uzman\u0131 ofisi, beslenme istasyonu, s\u00fct istasyonu, hukuksal dan\u0131\u015fmanl\u0131k ve dan\u0131\u015fma b\u00fcrosu b\u00f6l\u00fcmleri bulunur.<\/p>\r\n\r\n\r\n\r\n<p>1944 y\u0131l\u0131nda gebelere, evli olmayanlar dahil t\u00fcm annelere verilen hizmetlerin kapsam\u0131 geni\u015fletilmi\u015f, 25 Kas\u0131m 1947 Kararnamesi ile de \u00e7ok \u00e7ocuklu ve evli olmayan annelere verilen \u00f6demeler art\u0131r\u0131lm\u0131\u015ft\u0131r. Cumhuriyetlerin sa\u011fl\u0131k bakanl\u0131klar\u0131nda da ana ve \u00e7ocuk sa\u011fl\u0131\u011f\u0131 hizmetleri, eri\u015fkin sa\u011fl\u0131k hizmetleri, epidemiyoloji ve hijyen hizmetleri ayn\u0131 d\u00fczeydedir.<\/p>\r\n\r\n\r\n\r\n<p>3-4 bin kad\u0131n\u0131n bulundu\u011fu b\u00f6lgeye hizmet sunan Kad\u0131n Dan\u0131\u015fma Merkezleri, yayg\u0131n olarak \u00f6rg\u00fctlenmi\u015flerdir. Merkezde \u00e7al\u0131\u015fan avukatlar, baban\u0131n y\u00fck\u00fcml\u00fcl\u00fckleri ve anne-\u00e7ocuk haklar\u0131 konular\u0131nda dan\u0131\u015fmanl\u0131k verirler. Merkezlerde hizmet, annelerin \u00e7al\u0131\u015ft\u0131\u011f\u0131 dikkate al\u0131narak 08.00-20.00 aras\u0131 verilir ve bu nedenle hekimler iki vardiya olarak \u00e7al\u0131\u015f\u0131r. Hamile kad\u0131nlar ba\u015fka sa\u011fl\u0131k sorunu olmad\u0131\u011f\u0131 s\u00fcrece 8-12 kez evinde ziyaret edilir.<\/p>\r\n\r\n\r\n\r\n<p>Gebe evleri ve hastanelerikomplikasyonsuz do\u011fum yap\u0131lan hastanelerdir, ko\u011fu\u015flarda 6-10 aras\u0131 yatak bulunur. Bu kurumlarda yat\u0131\u015f s\u00fcresi 9 g\u00fcnd\u00fcr, gerekti\u011finde uzat\u0131labilir. T\u00fcm do\u011fumlar\u0131n gebe evlerinde yap\u0131lmas\u0131 i\u00e7in \u00e7abalanm\u0131\u015ft\u0131r. Bunun sonucu olarak 1913 y\u0131l\u0131nda bin do\u011fumda 10 anne \u00f6l\u00fcrken, 1959 y\u0131l\u0131na gelindi\u011finde binde 0,49\u2019a kadar gerilemi\u015ftir. Yine 1913 y\u0131l\u0131nda binde 275 olan bebek \u00f6l\u00fcm h\u0131z\u0131, 1960\u2019lara do\u011fru binde 40\u2019a geriletilmi\u015ftir. B\u00fct\u00fcn yatakl\u0131 tedavi kurumlar\u0131nda yataklar\u0131n %12,7 si gebeler i\u00e7in ayr\u0131lm\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>\u00c7ocuk hastaneleri i\u00e7inde yer alan \u00c7ocuk Dan\u0131\u015fma Merkezleri b\u00f6lgedeki kre\u015f, anaokulu ve okullardan sorumludur. \u00c7ocuklar do\u011fumdan itibaren pediatrik hekimlerin g\u00f6zetimine al\u0131n\u0131r ve 15 ya\u015f\u0131na kadar pediatrik hekimler taraf\u0131ndan takip edilir. Annenin 2 ayl\u0131k izni bitti\u011finde \u00e7ocuklar pediatrik hekimlerin de \u00e7al\u0131\u015ft\u0131\u011f\u0131 kre\u015flere kabul edilir. \u00c7ocuklar bir ya\u015f\u0131ndan itibaren y\u0131lda 4-5 kez fiziksel muayeneden ge\u00e7irilir. Emziremeyen anneler i\u00e7in s\u00fct mutfaklar\u0131 bulunur. Bir ya\u015f\u0131na kadar s\u00fct ve ek g\u0131dalar \u00fccretsiz olarak sa\u011flan\u0131r. Di\u015f hekimleri taraf\u0131ndan da a\u011f\u0131z sa\u011fl\u0131\u011f\u0131 hizmetleri verilir.<\/p>\r\n\r\n\r\n\r\n<p>Do\u011fum \u00f6ncesi izin alan emek\u00e7ilerin gebeliklerini ge\u00e7irebilmeleri i\u00e7in \u00e7o\u011funlu\u011fu sendikalar taraf\u0131ndan kurulmu\u015f gebe sanatoryumlar\u0131 da bulunmaktad\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>K\u0131rsal kesimdeki hastanelerde de kad\u0131n ve \u00e7ocuk dan\u0131\u015fma merkezleri, s\u00fct mutfaklar\u0131, daha az yatakl\u0131 gebe evleri bulunur. Ayn\u0131 zamanda rayon hastaneleri, b\u00f6lge hastaneleri, kolektif \u00e7iftlik gebe evleri, feldsher\/ebe istasyonlar\u0131 olu\u015fturulmu\u015ftur. S\u00fcrekli ve mevsimlik kre\u015fler ve anaokullar\u0131 da bulunmaktad\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>\u00c7al\u0131\u015fan kad\u0131nlara hamileli\u011fin 4. ay\u0131ndan itibaren fazla mesai verilmesi yasakt\u0131r, emziren kad\u0131nlar da gece \u00e7al\u0131\u015ft\u0131r\u0131lmaz. Kre\u015fler fabrikalarda ve yerle\u015fim yerlerindedir. \u0130\u015f\u00e7i kad\u0131n\u0131n bebe\u011fi emiyorsa, anne \u00e7al\u0131\u015fma saatleri i\u00e7inde iki kez, yemek izni s\u0131ras\u0131nda da bir kez kre\u015fe giderek bebe\u011fini emzirir. B\u00fct\u00fcn hamile kad\u0131nlar do\u011fum \u00f6ncesi ve sonras\u0131 56\u2019\u015far g\u00fcnden toplam 112 g\u00fcn \u00fccretli izinlidirler. \u00c7ocuklar\u0131na kendisi bakmak isteyen annelere ilaveten 3 ay izin verilir. Annelerin rahat seyahat edebilmeleri i\u00e7in demiryolu istasyonu kre\u015fleri, sosyal ya\u015fama kat\u0131labilmeleri i\u00e7in gece kre\u015fleri a\u00e7\u0131lm\u0131\u015ft\u0131r. Fabrikalardaki kre\u015f yatak say\u0131lar\u0131 1928 y\u0131l\u0131nda 33 bin, 1931 y\u0131l\u0131nda 130 bin, 1951 y\u0131l\u0131nda 1,5 milyona ula\u015fm\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Anne Dan\u0131\u015fma Merkezlerinde ve annelerin \u00e7al\u0131\u015fma saatlerine g\u00f6re hizmet veren Anne Okullar\u0131nda annelere kurslar verilir. Bu kurslara kat\u0131lamayanlara mektupla e\u011fitim, k\u0131rsal kesimlerde ebeler arac\u0131l\u0131\u011f\u0131 ile e\u011fitimler verilir. Bu e\u011fitimler kad\u0131nlar\u0131n e\u015flerine de verilir ve i\u00e7eri\u011fi hijyen, bebek bak\u0131m\u0131 ve beslenmesi \u00fczerinedir.<\/p>\r\n\r\n\r\n\r\n<p>SSCB de koruyucu sa\u011fl\u0131k hizmetlerine ve bunun i\u00e7in sa\u011fl\u0131k bilgisinin yayg\u0131nla\u015fmas\u0131na \u00f6zel \u00f6nem verilmi\u015ftir. Bunun arac\u0131 da topluma y\u00f6nelik sa\u011fl\u0131k e\u011fitimidir. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 d\u00fczenli ve sistematik sa\u011fl\u0131k e\u011fitiminden sorumlu olurken her cumhuriyette e\u011fitiminden sorumlu sa\u011fl\u0131k e\u011fitim dairesi olu\u015fturulmu\u015ftur. Sa\u011fl\u0131k e\u011fitimleri; sa\u011fl\u0131k kurumlar\u0131na gelenlere, ev ziyaretlerinde, Anne Okullar\u0131\u2019nda gruplarca, hastanelerde topluca konferanslar yoluyla, gazeteler ve radyolar kullan\u0131larak, k\u0131rsal kesimde sa\u011fl\u0131k kurumlar\u0131 ve gezici sa\u011fl\u0131k hizmetleri ile \u00e7ok \u00e7e\u015fitli bi\u00e7imlerde yap\u0131larak t\u00fcm topluma yayg\u0131n olarak ula\u015f\u0131lmas\u0131 hedeflenmi\u015ftir.\u00a0<\/p>\r\n\r\n\r\n\r\n<p><em>Moskova\u2019daki bir evlilik b\u00fcrosunun bekleme odas\u0131n\u0131n duvar\u0131na as\u0131lm\u0131\u015f tavsiye notunda \u015funlar yazmaktad\u0131r; <\/em><\/p>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\">\r\n<li>Bir \u00e7ocuk k\u00f6t\u00fc ko\u015fullar\u0131n ortas\u0131nda do\u011furulmamal\u0131d\u0131r,<\/li>\r\n<li>\u00c7ocu\u011funuzu fazla kuca\u011f\u0131n\u0131za almay\u0131n (resimlerde do\u011fru tutma metotlar\u0131 g\u00f6sterilir),<\/li>\r\n<li>Her aile t\u0131bbi acil yard\u0131m \u00e7antas\u0131 bulundurmal\u0131d\u0131r,<\/li>\r\n<li>E\u011fer aile kalabal\u0131k ise \u00e7ocuk iyi yeti\u015ftirilemeyecektir,<\/li>\r\n<li>Anne do\u011fumevinden ayr\u0131ld\u0131ktan hemen sonra il\u00e7esindeki Uzman Muayene Klini\u011fi\u2019ne gitmelidir.<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p>Kad\u0131nlar\u0131n \u00e7ocuklar ve sa\u011fl\u0131k i\u00e7in a\u00e7\u0131lan kurumlardan haberdar olmalar\u0131 ve \u00e7ocuklar\u0131n\u0131 d\u00fczenli olarak g\u00f6t\u00fcrmeleri i\u00e7in her kul\u00fcp, fabrika, sendika toplant\u0131lar\u0131nda, sinema ve tiyatrolarda s\u0131k s\u0131k yap\u0131lan duyurular\u0131n yan\u0131nda afi\u015flemeler de kullan\u0131l\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Devrim \u00f6ncesi k\u00f6ylerde kurumda yap\u0131lan do\u011fum oran\u0131 %7\u2019lerde iken, 1930\u2019lara gelindi\u011finde bu oran %20\u2019lere ula\u015fm\u0131\u015f, \u015fehirlerde %100 e yakla\u015fm\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Yine 1930\u2018larda gebe bir kad\u0131n do\u011fum \u00f6ncesi bak\u0131m merkezine gitti\u011finde verilen bir kartla \u015fu haklar\u0131 kullan\u0131r; 1)Tramvaylarda \u00f6ncelik ve korunakl\u0131 bir yer edinme hakk\u0131 2) D\u00fckkanlarda kuyru\u011fa girmeden al\u0131\u015fveri\u015f yapma 3) Destekleyici yiyecek karnesi 4) \u00c7al\u0131\u015ft\u0131\u011f\u0131 ofis veya d\u00fckkanda daha kolay i\u015flerde \u00e7al\u0131\u015fma izni 5) \u00dccret kayb\u0131 olmaks\u0131z\u0131n iki ay dinlenme hakk\u0131<\/p>\r\n\r\n\r\n\r\n<p><strong>\u0130\u015e\u00c7\u0130 SA\u011eLI\u011eI<\/strong><\/p>\r\n\r\n\r\n\r\n<p>Ba\u015fl\u0131 ba\u015f\u0131na ele al\u0131nabilecek i\u015f\u00e7i sa\u011fl\u0131\u011f\u0131 ve i\u015f g\u00fcvenli\u011fi uygulamalar\u0131na dair birka\u00e7 \u00f6nemli noktaya de\u011finmek bu yaz\u0131 \u00e7er\u00e7evesinde yeterli olacakt\u0131r. Sa\u011fl\u0131\u011f\u0131n temel ilkesi hastalanmadan \u00f6nlem almak ve hastal\u0131\u011fa zemin haz\u0131rlayan sosyal etmenleri ortadan kald\u0131rmakt\u0131r. \u0130\u015f\u00e7i sa\u011fl\u0131\u011f\u0131nda da ayn\u0131 ilkeye g\u00f6re davran\u0131lm\u0131\u015ft\u0131r.\u00a0 1918 y\u0131l\u0131nda \u00e7\u0131kar\u0131lan i\u015f\u00e7i sa\u011fl\u0131\u011f\u0131n\u0131 koruma yasas\u0131 t\u00fcm i\u015f\u00e7i ve emek\u00e7ileri kapsamas\u0131 ve di\u011fer \u00f6zellikleri ile d\u00f6neminin tek \u00f6rne\u011fi olmu\u015ftur. \u0130\u015f saati 8 saate d\u00fc\u015f\u00fcr\u00fcl\u00fcrken, baz\u0131 i\u015fkollar\u0131nda 7 saat ile s\u0131n\u0131rland\u0131r\u0131lm\u0131\u015ft\u0131r. 1936 y\u0131l\u0131nda ise herkes i\u00e7in 7 saate d\u00fc\u015f\u00fcr\u00fclm\u00fc\u015f, gece vardiyalar\u0131 6 saatle s\u0131n\u0131rlanm\u0131\u015ft\u0131r Haftada be\u015f g\u00fcn \u00e7al\u0131\u015fma, zorunlu \u00fccretli y\u0131ll\u0131k izin, 18 ya\u015f alt\u0131 gen\u00e7lerin tehlikeli i\u015flerde \u00e7al\u0131\u015ft\u0131r\u0131lmamas\u0131, 16 ya\u015f alt\u0131na \u00e7al\u0131\u015fma yasa\u011f\u0131, i\u015fyerlerinde koruyucu giysi giyilmesi, t\u00fcm i\u015f\u00e7ilerin periyodik muayenelerden ge\u00e7irilmesi yasal g\u00fcvence alt\u0131na al\u0131nm\u0131\u015ft\u0131r. Zamanla a\u011f\u0131r ve tehlikeli i\u015flerde \u00e7al\u0131\u015fanlar i\u00e7in i\u015fg\u00fcn\u00fc 6 saate, c\u0131va sanayi gibi i\u015flerde ise 4 saate kadar d\u00fc\u015f\u00fcr\u00fclm\u00fc\u015ft\u00fcr. Kapitalist sistemin aksine \u00e7al\u0131\u015fma saatleri d\u00fc\u015f\u00fcr\u00fcl\u00fcrken \u00fccretler asla d\u00fc\u015f\u00fcr\u00fclmemi\u015ftir.<\/p>\r\n\r\n\r\n\r\n<p>1922 y\u0131l\u0131nda kabul edilen i\u015f mevzuat\u0131, i\u015f\u00e7i sa\u011fl\u0131\u011f\u0131 ve g\u00fcvenli\u011fi alan\u0131ndaki d\u00fczenlemeleri de i\u00e7ermi\u015ftir. Sendikalar ve sa\u011fl\u0131k otoritelerinin onay\u0131 olmadan hi\u00e7bir sanayi tesisi veya i\u015fli\u011fin in\u015fa edilememesi, tadilat yapamamas\u0131, ba\u015fka yere ta\u015f\u0131namamas\u0131, tesislerin i\u015f ve hijyen m\u00fcfetti\u015fleri taraf\u0131ndan incelenmeden hizmete girememesi yasa ile belirlenmi\u015ftir. Ayn\u0131 y\u0131l i\u015f\u00e7ilerin sa\u011fl\u0131k muayeneleri yap\u0131lmaya ba\u015flanm\u0131\u015f, end\u00fcstriyel zehirlenme ve yaralanmalar kay\u0131t alt\u0131na al\u0131nmaya ba\u015flanarak bildirimi zorunlu hale getirilmi\u015ftir.<\/p>\r\n\r\n\r\n\r\n<p>Yine 1922 y\u0131l\u0131nda i\u015fyerlerinde \u201csa\u011fl\u0131k h\u00fccreleri, dispanserler ve poliklinik gruplardan\u201d olu\u015fan sa\u011fl\u0131k kompleksleri olu\u015fumuna gidilmi\u015ftir. Sa\u011fl\u0131k h\u00fccrelerinde, g\u00f6n\u00fcll\u00fc ve sa\u011fl\u0131k e\u011fitimi alan i\u015f\u00e7iler yer alm\u0131\u015f, onlar taraf\u0131ndan tespit edilen hasta i\u015f\u00e7iler, tedavi i\u00e7in ilgili yerlere y\u00f6nlendirilmi\u015ftir.<\/p>\r\n\r\n\r\n\r\n<p>\u0130\u015f\u00e7i sa\u011fl\u0131\u011f\u0131 ve i\u015f g\u00fcvenli\u011fi alan\u0131nda 1935 y\u0131l\u0131na kadar 40 bilimsel ara\u015ft\u0131rma enstit\u00fcs\u00fc kurulmu\u015ftur. Bu enstit\u00fclerin baz\u0131lar\u0131 oto-trakt\u00f6r sanayi, askeri sanayi, demiryollar\u0131 ve ula\u015f\u0131m alan\u0131 gibi alanlarda uzmanla\u015fm\u0131\u015ft\u0131r Enstit\u00fcde fizyoloji, hijyen, havaland\u0131rma, \u0131\u015f\u0131kland\u0131rma, psikoteknik ve bireysel y\u00f6ntemler \u00fczerine \u00e7al\u0131\u015fan b\u00f6l\u00fcmler bulunmaktad\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>\u0130\u015f\u00e7i sa\u011fl\u0131\u011f\u0131 alan\u0131nda standartlar\u0131n belirlenmesine ve uygulanmas\u0131na Sovyetler Birli\u011fi \u00f6nc\u00fcl\u00fck etmi\u015f, hava kirlili\u011fi standartlar\u0131 1920\u2019lerde kullan\u0131lmaya ba\u015flanm\u0131\u015f, i\u015f\u00e7i sa\u011fl\u0131\u011f\u0131na zararl\u0131 14 maddelik liste yay\u0131nlanm\u0131\u015ft\u0131r. Bu standartlar ABD de 1937 de, Almanya\u2019da 1938 de, \u0130sve\u00e7\u2019te 1969 y\u0131l\u0131nda kabul edilmi\u015ftir.<\/p>\r\n\r\n\r\n\r\n<p>1920\u2019li y\u0131llardaki Selmashstroy tar\u0131m makineleri fabrikas\u0131 \u00f6rne\u011fine bakal\u0131m. 18 i\u015flikten olu\u015fan fabrikada her bir i\u015flikte bin i\u015f\u00e7i \u00e7al\u0131\u015fmaktad\u0131r. Her i\u015flikte bir hekim ve ayr\u0131ca fabrikan\u0131n genel sa\u011fl\u0131k hizmetlerinden sorumlu bir hekim bulunmaktad\u0131r. Hijyen b\u00fcrosunca i\u015fe giri\u015fte i\u015f\u00e7iler muayene edilmekte, koruyucu a\u015f\u0131 yap\u0131lmaktad\u0131r. Sonras\u0131ndaki periyodik muayeneleri 3-4 ayda bir ger\u00e7ekle\u015ftirilmektedir. Hastalara t\u0131bbi bak\u0131m dispanserlerde, gerekti\u011finde hastanelerde yap\u0131lmaktad\u0131r. \u0130\u015flik hekiminin g\u00f6revleri; acil durumlarda ilk yard\u0131m, dispanser hekimlerinden rapor almak, hasta ve i\u015fe gelmeyen i\u015f\u00e7ilerin listesini y\u00f6netime bildirmek, evde dinlenen i\u015f\u00e7ilerin i\u015flik komitesinden bir i\u015f\u00e7i taraf\u0131ndan ziyaretini sa\u011flamak, hastal\u0131klar\u0131 g\u00fcnl\u00fck listelemek, diyet uygulayanlar\u0131 mutfa\u011fa bildirmek, i\u015f\u00e7ilere hijyen e\u011fitimi vermektir.<\/p>\r\n\r\n\r\n\r\n<p>SSCB de spor sa\u011fl\u0131kl\u0131 olman\u0131n arac\u0131 olarak ele al\u0131nm\u0131\u015f, bedensel sa\u011fl\u0131\u011f\u0131n aktivitelerle korunaca\u011f\u0131 ve geli\u015ftirilece\u011finden hareketle spora \u00f6zel bir \u00f6nem verilmi\u015ftir. Fabrikalarda, semtlerde, parklarda, salonlarda topluca spor yap\u0131lmas\u0131 \u00f6zendirilerek bu tarz spor yapma yayg\u0131nla\u015ft\u0131r\u0131lm\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p><strong>SA\u011eLIK EMEK\u00c7\u0130LER\u0130N\u0130N E\u011e\u0130T\u0130M\u0130 <\/strong><\/p>\r\n\r\n\r\n\r\n<p>T\u0131p e\u011fitiminde \u00e7evre sa\u011fl\u0131\u011f\u0131, sa\u011fl\u0131k e\u011fitimi ve koruyucu hekimlik \u00f6ncelikli olmu\u015ftur. Hekimler 1930 y\u0131l\u0131na kadar 10 y\u0131ll\u0131k temel e\u011fitim \u00fczerine 5 y\u0131l e\u011fitim al\u0131rlarken, 1947 den sonra 10 y\u0131l \u00fczerine 6 y\u0131l, eczac\u0131 ve di\u015f hekimleri 5 y\u0131l e\u011fitim al\u0131rlar. Hem\u015fireler yedi y\u0131ll\u0131k temel e\u011fitim \u00fczerine 3 y\u0131l, ebeler ise iki y\u0131l e\u011fitim al\u0131rlard\u0131. T\u0131p \u00f6\u011frencileri iki y\u0131ll\u0131k e\u011fitim sonras\u0131 genel t\u0131p, halk sa\u011fl\u0131\u011f\u0131-hijyen ve \u00e7ocuk gibi \u00fc\u00e7 temel b\u00f6l\u00fcmden birini se\u00e7erlerdi. M\u00fcfredat i\u00e7inde tarihsel materyalizm, sosyal ve politik bilimler gibi dersler de olurdu. Uzmanla\u015fmak isteyenler i\u00e7in 14 temel uzmanl\u0131k alan\u0131 bulunurdu. E\u011fitim s\u00fcresi boyunca \u00f6\u011frencilerin t\u00fcm masraflar\u0131 devlet taraf\u0131ndan kar\u015f\u0131lan\u0131rd\u0131. Hekimler 3 y\u0131l s\u00fcre ile k\u0131rsal b\u00f6lgede \u00e7al\u0131\u015f\u0131rlar, k\u0131rsal kesimdeki hekimler 3, kentlerde \u00e7al\u0131\u015fanlar ise 5 y\u0131lda bir e\u011fitime al\u0131n\u0131rlard\u0131. Sa\u011fl\u0131k emek\u00e7ilerinde emeklilik erkeklerde 60, kad\u0131nlarda 55 ya\u015f\u0131ndayd\u0131. Daha \u00f6nce doktorlar ayr\u0131, di\u011fer sa\u011fl\u0131k emek\u00e7ileri ayr\u0131 sendikalarda \u00f6rg\u00fctlenirken 1920 y\u0131l\u0131ndan itibaren sa\u011fl\u0131k emek\u00e7ileri sendikas\u0131 alt\u0131nda \u00f6rg\u00fctlendiler.<\/p>\r\n\r\n\r\n\r\n<p>1932 y\u0131l\u0131nda 36.00 t\u0131p \u00f6\u011frencisi bulunmaktad\u0131r ve 20 bin civar\u0131nda olan doktor eksi\u011finin 1937 y\u0131l\u0131nda giderilmesi hedeflenmi\u015f, 1000 ki\u015filik n\u00fcfusa bir doktor ideal say\u0131 olarak belirlenmi\u015ftir. Devrimden \u00f6nce Rusya\u2019da yakla\u015f\u0131k 26 bin doktor varken, 1931 y\u0131l\u0131nda bu say\u0131 76 bine ula\u015fm\u0131\u015ft\u0131r. Doktorlar\u0131n % 90\u2019\u0131 kamu kurumlar\u0131nda \u00e7al\u0131\u015fmaktad\u0131rlar, 1930\u2019lara gelirken \u00f6zel hekimlik yasaklanm\u0131\u015f oldu\u011fundan hemen hemen sona ermek \u00fczeredir.<\/p>\r\n\r\n\r\n\r\n<p>Yaz\u0131ya da kaynakl\u0131k eden K\u0131z\u0131l T\u0131p kitab\u0131n\u0131n yazarlar\u0131, daha \u00f6nce \u00c7ar 3. Aleksandr\u2019\u0131n ikametgah olarak kulland\u0131\u011f\u0131 K\u0131r\u0131m Livadya\u2019daki nekahat d\u00f6nemi evinde ba\u015fhekimlik yapan doktordan \u015f\u00f6yle s\u00f6z ederler; \u201cBa\u015fhekim, yeni rejime kar\u015f\u0131 en \u00e7ok duyguda\u015fl\u0131k hisseden ki\u015fiydi ve her ne kadar \u00f6nceki d\u00f6neme g\u00f6re maa\u015f\u0131 d\u00fc\u015fm\u00fc\u015f olsa da art\u0131k mali konular hastalar\u0131 ile kendisi aras\u0131nda bir mesele olmaktan \u00e7\u0131kt\u0131\u011f\u0131nda dolay\u0131 hastalar\u0131n iyili\u011fi i\u00e7in daha etkili olabildi\u011fini d\u00fc\u015f\u00fcn\u00fcyor.\u201d<\/p>\r\n\r\n\r\n\r\n<p>K\u0131z\u0131l T\u0131p yazarlar\u0131ndan Sir Arthur Newsholme, \u0130ngiltere h\u00fck\u00fcmetine yapt\u0131\u011f\u0131 sa\u011fl\u0131k ba\u015fdan\u0131\u015fmanl\u0131\u011f\u0131ndan emekli olmu\u015ftur ve Milbank Vakf\u0131 ad\u0131na Avrupa \u00fclkelerini gezerek sa\u011fl\u0131k sistemlerini incelemektedir. Di\u011fer yazar John Adams Kingsbury de Milbank Vakf\u0131 sekreteridir. \u0130kisi birlikte 1932 y\u0131l\u0131n\u0131n A\u011fustos ve Eyl\u00fcl\u2019\u00fcnde SSCB de alt\u0131 hafta s\u00fcreyle 15 bin kilometre yol kat ederek 14 kenti dola\u015f\u0131rlar ve sa\u011fl\u0131k hizmetleri de dahil bir\u00e7ok konuda g\u00f6zlem ve incelemelerde bulunurlar. 1932-33 y\u0131llar\u0131nda gezi notlar\u0131n\u0131 ve g\u00f6zlemlerini kaleme al\u0131rlar. \u0130zlenimlerinden baz\u0131 b\u00f6l\u00fcmleri k\u0131saltarak da olsa almak, sistemi anlamak a\u00e7\u0131s\u0131ndan yararl\u0131 olacakt\u0131r;<\/p>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\">\r\n<li>Tatar Cumhuriyeti n\u00fcfusunun yar\u0131s\u0131 Tatarlardan olu\u015fmas\u0131na kar\u015f\u0131n Sovyet iktidar\u0131 ilan edildi\u011finde Tatar n\u00fcfusa hizmet verecek hemen hi\u00e7 hastane yoktu, 1932 y\u0131l\u0131na gelindi\u011finde ise 20 b\u00fcy\u00fck hastane ve sanatoryum bulunmaktad\u0131r. 1932 k\u0131\u015f\u0131nda meydana gelen 15 \u00e7i\u00e7ek hastal\u0131\u011f\u0131 vakas\u0131 sonras\u0131 Kazan\u2019\u0131n t\u00fcm n\u00fcfusu 1932 Temmuz\u2019unda bir ya da birka\u00e7 kez a\u015f\u0131lanm\u0131\u015ft\u0131r. B\u00f6yle kitlesel bir \u00e7al\u0131\u015fma sonucu tif\u00fcs de yok edilmi\u015ftir.<\/li>\r\n<li>G\u00fcrcistan\u2018da ba\u015fka yerlerde oldu\u011fu gibi hepsi birbirine ba\u011fl\u0131 bir ayakta tedavi hizmetleri, poliklinikler, genel ve uzmanla\u015fm\u0131\u015f hastaneler zinciri bulunmaktad\u0131r.<\/li>\r\n<li>G\u00fcrcistan\u2019da kurulan 500 yatakl\u0131 demiryolu hastanesi, demiryolculara hizmet vermektedir. \u00c7ocuklar i\u00e7in oyun park\u0131n\u0131n da bulundu\u011fu \u00e7i\u00e7eklerle s\u00fcsl\u00fc bir bah\u00e7eye, m\u00fczik salonlar\u0131na, kul\u00fcplere ve a\u00e7\u0131k hava sinemalar\u0131na sahiptir.<\/li>\r\n<li>Batum\u2019dan K\u0131r\u0131m\u2019a kadar uzanan sahil \u015feridinde sa\u011fl\u0131k merkezleri ve dinlenme evleri bulunmaktad\u0131r. \u00d6nceleri zenginlerin kulland\u0131\u011f\u0131 saraylar, bak\u0131m evleri ve tatil tesisleri olarak kullan\u0131lmaktad\u0131r. K\u0131r\u0131m-Yalta\u2019da \u00c7ar\u2019\u0131n ve di\u011fer soylular\u0131n saraylar\u0131nda on binlerce i\u015f\u00e7i tatil yapmakta, sanatoryum ve nekahat d\u00f6nemi i\u00e7in dinlenme evleri olarak kullan\u0131lmaktad\u0131rlar.\u00a0<\/li>\r\n<li>Ukrayna\u2019da \u00f6zel hekimlik t\u0131p uygulamalar\u0131n\u0131n sadece y\u00fczde 10\u2019unu olu\u015fturmaktad\u0131r. Ukrayna Cumhuriyetinde 1920 den beri su\u00e7i\u00e7e\u011fi a\u015f\u0131s\u0131 \u00fclke genelinde uygulanmakta, 1930\u2019dan beri difteriye kar\u015f\u0131 a\u015f\u0131lama zorunlu tutulmaktad\u0131r. Di\u015f tedavisi de t\u00fcm okullarda zorunludur.<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p>Baz\u0131 de\u011ferlendirmeleri de \u015fu \u015fekildedir:<\/p>\r\n\r\n\r\n\r\n<p>\u201c \u2026Avrupa \u00fclkelerinden t\u0131bbi ve sosyal reformlar a\u00e7\u0131s\u0131ndan geri kalm\u0131\u015f ve halen yar\u0131 Asyatik ve Avrasyal\u0131 olan Rusya; \u015fimdi ba\u015fta \u015fehirlerinde olmak \u00fczere, neredeyse t\u00fcm halk\u0131na ba\u015fka hi\u00e7bir \u00fclkede olmad\u0131\u011f\u0131n\u0131 bildi\u011fimiz nitelikli, \u00fccretsiz ve k\u0131s\u0131tlamalar olmaks\u0131z\u0131n kolayl\u0131kla ula\u015fabilecekleri t\u0131bbi bak\u0131m hizmetlerini y\u0131ld\u0131r\u0131m h\u0131z\u0131yla kurmaktad\u0131r.\u201d \u201c\u2026 ziyaret etti\u011fimiz \u015fehirlerde bulunan ve i\u015flemekte olan bu d\u00fczenlemeler eksiksiz t\u0131bbi hizmetlerin birka\u00e7 y\u0131l i\u00e7inde Rusya\u2019n\u0131n hem k\u0131rlar\u0131nda, hem de kentlerinde verilebilece\u011fini g\u00f6stermektedir.\u201d (Sayfa 73)<\/p>\r\n\r\n\r\n\r\n<p>\u00a0\u201c &#8230;Daha \u00f6nce ara\u015ft\u0131rma yapt\u0131\u011f\u0131m\u0131z \u00fclkelerin hi\u00e7birinde g\u00f6rmedi\u011fimiz kadar kapsaml\u0131, b\u00fct\u00fcnl\u00fck i\u00e7inde planlan\u0131p b\u00fcy\u00fck \u00f6l\u00e7\u00fcde ba\u015far\u0131ya ula\u015fm\u0131\u015f, \u015fehirlerdeki Rus vatanda\u015flar\u0131n sa\u011fl\u0131k ve mutlulu\u011funu bolca e\u011flence ve spor ile korumay\u0131 ama\u00e7layan benzersiz bir kamu sa\u011fl\u0131\u011f\u0131 ve t\u0131p sistemine dair binlerce izlenim vard\u0131.\u201d (Sayfa 68-69)<\/p>\r\n\r\n\r\n\r\n<p><strong>SA\u011eLIKLI BARINMA<\/strong><\/p>\r\n\r\n\r\n\r\n<p>\u00c7arl\u0131k d\u00f6neminde i\u015f\u00e7iler, k\u00f6yl\u00fcler, yoksullar i\u00e7in \u00e7ok b\u00fcy\u00fck sorun olan konut sorunu devrimle birlikte ele al\u0131nm\u0131\u015ft\u0131r. 1914 y\u0131l\u0131ndaki ara\u015ft\u0131rmaya g\u00f6re Moskova\u2019daki b\u00fcy\u00fck sanayi \u015firketlerinin ko\u011fu\u015flar\u0131nda bulunan 27 bin odada 300 binden fazla i\u015f\u00e7i kal\u0131yordu. Ayn\u0131 tarihte Moskova da burjuvalara ait 5 bin adet geni\u015f, konforlu ev ve \u015fatolar bo\u015f duruyordu.<\/p>\r\n\r\n\r\n\r\n<p>\u0130\u00e7 sava\u015f y\u0131llar\u0131 istenilen d\u00fczeyde konut yap\u0131m\u0131n\u0131 engelledi, 1923 y\u0131l\u0131nda 1 milyon metre kare konut in\u015fa edildi. 1923-27 y\u0131llar\u0131 aras\u0131nda 12,5 milyon metre kare, 1927-31 y\u0131llar\u0131 aras\u0131nda da 28,5 milyon metre kare ya\u015fam alan\u0131 kuruldu. 1926-39 y\u0131llar\u0131 aras\u0131nda 213 \u015fehir ve 1323 yeni kent kuruldu. 1940 y\u0131l\u0131na kadar da konut stoku %130 artt\u0131r\u0131ld\u0131. 1950 y\u0131l\u0131na kadar her ailenin m\u00fcstakil konutu olmas\u0131 planlan\u0131rken fa\u015fizmin sald\u0131r\u0131s\u0131 bu alanda da kesinti yaratt\u0131 ve \u00fcst\u00fcne y\u0131k\u0131m\u0131 ekledi. Sava\u015f sonras\u0131 acil olarak konfordan uzak, ge\u00e7ici konutlar yap\u0131ld\u0131. Sonras\u0131nda yeniden konut \u00fcretimi s\u00fcrd\u00fcr\u00fcld\u00fc. Konut kiralar\u0131 ise metre kare ba\u015f\u0131na 14 kopekti (rublenin y\u00fczde biri) ve gaz, elektrik, konut gideri ile su ve s\u0131cak su i\u00e7in c\u00fczi \u00fccretler al\u0131n\u0131rd\u0131.<\/p>\r\n\r\n\r\n\r\n<p><strong>SSCB SA\u011eLIK S\u0130TEM\u0130N\u0130N SONU\u00c7LARINA DA\u0130R<\/strong><\/p>\r\n\r\n\r\n\r\n<p>Y\u00fcr\u00fct\u00fclen sa\u011fl\u0131k politikalar\u0131 SSCB halklar\u0131n\u0131n devrim sonras\u0131 y\u0131llar\u0131nda olumlu sonu\u00e7lar\u0131n\u0131 vermi\u015ftir. 1913-1940 y\u0131llar\u0131 aras\u0131nda \u00f6l\u00fcm h\u0131z\u0131 %40, \u00c7ocuk \u00d6l\u00fcm H\u0131z\u0131 (\u00c7\u00d6H) %50 oran\u0131nda azalm\u0131\u015ft\u0131r. 1913 y\u0131l\u0131nda binde 268,6 olan \u00c7\u00d6H 1960 y\u0131l\u0131na gelindi\u011finde binde 35,3\u2019e gerilemi\u015ftir. Bebek \u00d6l\u00fcm H\u0131z\u0131 (B\u00d6H) 1957 y\u0131l\u0131na gelindi\u011finde binde 45\u2019e, Anne \u00d6l\u00fcm H\u0131z\u0131 (A\u00d6H) 1954\u2019te y\u00fcz binde 54\u2019e kadar d\u00fc\u015fm\u00fc\u015ft\u00fcr.<\/p>\r\n\r\n\r\n\r\n<p>1928 y\u0131l\u0131na gelindi\u011finde difteri a\u015f\u0131s\u0131 olmayan \u00e7ocuk say\u0131s\u0131 %14\u2019t\u00fcr.<\/p>\r\n\r\n\r\n\r\n<p>Sa\u011fl\u0131k sisteminin sonu\u00e7lar\u0131n\u0131n en \u00f6nemli g\u00f6stergesi ya\u015fam beklentisidir. 1913 y\u0131l\u0131nda 32 y\u0131l olan ya\u015fam beklentisi, 1926-27 y\u0131llar\u0131nda erkeklerde 44 kad\u0131nlarda 47\u2019ye, 1968-69 y\u0131llar\u0131na gelindi\u011finde erkeklerde 70 kad\u0131nlarda 74\u2019e y\u00fckselmi\u015ftir.<\/p>\r\n\r\n\r\n\r\n<p>1927 den itibaren kolera g\u00fcndemden \u00e7\u0131km\u0131\u015f hi\u00e7bir vaka kaydedilmemi\u015f, \u00e7i\u00e7ek hastal\u0131\u011f\u0131n\u0131n g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131 1912 y\u0131l\u0131nda on bin hastada 5 iken 1929 da on bin hastada 0,37 vakaya d\u00fc\u015fm\u00fc\u015ft\u00fcr. 1920-1921 y\u0131llar\u0131ndaki tif\u00fcs salg\u0131n\u0131nda toplam 4 milyon vaka g\u00f6r\u00fcl\u00fcrken, 1925-29 aras\u0131nda y\u0131ll\u0131k ortalama vaka say\u0131s\u0131 k\u0131rk binin biraz \u00fcst\u00fcndedir. Ancak o y\u0131llarda ate\u015fli tifo, k\u0131z\u0131l ve difteri vakalar\u0131 hala sorun olmaya devam etmi\u015ftir.<\/p>\r\n\r\n\r\n\r\n<p>K\u0131z\u0131l T\u0131p yazarlar\u0131 1932 y\u0131l\u0131ndaki SSCB\u2019nin durumunu \u015f\u00f6yle ifade etmi\u015flerdir; \u201cSSCB\u2019nin durumu zaten g\u00f6r\u00fcld\u00fc\u011f\u00fc \u00fczere \u00e7ok \u00f6zeldir. T\u0131bb\u0131n toplumsalla\u015ft\u0131r\u0131lmas\u0131, baz\u0131 temel \u00f6zelliklerde t\u00fcm \u00fclkeleri a\u015fm\u0131\u015ft\u0131r. Doktoru parasal rekabet alan\u0131ndan neredeyse tamamen \u00e7ekmi\u015f ve b\u00f6ylece ba\u015fl\u0131ca yetersiz t\u0131bbi hizmet kayna\u011f\u0131n\u0131 ortadan kald\u0131rm\u0131\u015ft\u0131r. \u015ea\u015f\u0131rt\u0131c\u0131 bi\u00e7imde eksiksiz, kentsel n\u00fcfusun b\u00fcy\u00fck \u00e7o\u011funlu\u011fu i\u00e7in h\u0131zl\u0131ca ula\u015f\u0131labilir, k\u0131rsal Rusya\u2019ya s\u00fcratle geni\u015fletilmi\u015f, \u00fccretsiz (yani devlet taraf\u0131ndan \u00f6denen) bir sa\u011fl\u0131k hizmeti yaratm\u0131\u015f ve t\u0131bbi \u00f6nleyici hizmetlerle birlikte bu hizmetin tamam\u0131na sosyal a\u00e7\u0131dan takdire de\u011fer bir y\u00f6n vermi\u015ftir.\u201d (sayfa 262)<\/p>\r\n\r\n\r\n\r\n<p><strong>SOSYAL\u0130ZM SONRASI SA\u011eLIK<\/strong><\/p>\r\n\r\n\r\n\r\n<p>SBKP 20. kongresi ile a\u00e7\u0131\u011fa \u00e7\u0131kan revizyonizmin hakim oldu\u011fu y\u0131llarda sa\u011fl\u0131k hizmetlerinin \u00f6rg\u00fctlenmesi \u00f6nemli oranda ayn\u0131 kalsa ve koruyucu ve b\u00fct\u00fcnc\u00fcl sa\u011fl\u0131k hizmetleri s\u00fcrd\u00fcr\u00fclse de bu d\u00f6nemde tedavi edici hizmetlere y\u00f6nelim artm\u0131\u015ft\u0131r. Bu y\u00f6nelim toplumcu sa\u011fl\u0131k hizmetlerinden sapman\u0131n temelini olu\u015fturur. Sosyalist devrimle birlikte hayata ge\u00e7irilen \u00fccretsiz, b\u00fct\u00fcnc\u00fcl, merkezi planlamayla ve yerelin ihtiya\u00e7lar\u0131na g\u00f6re d\u00fczenlenmi\u015f sa\u011fl\u0131k hizmetleri ve herkesin sigorta kapsam\u0131nda olmas\u0131 gibi temel uygulamalar\u0131n tasfiyesi, kendilerini sosyalizmin savunucular\u0131 olarak g\u00f6steren revizyonist y\u00f6neticiler taraf\u0131ndan zamana yay\u0131lm\u0131\u015ft\u0131r.\u00a0<\/p>\r\n\r\n\r\n\r\n<p>1983 y\u0131l\u0131nda \u00f6zel poliklinik ve dispanser uygulamas\u0131 ba\u015flat\u0131lm\u0131\u015f, 1987 y\u0131l\u0131nda sa\u011fl\u0131kta da perestroyka uygulamas\u0131na ge\u00e7ilmi\u015f ve ayn\u0131 y\u0131l ilk paral\u0131 hastane a\u00e7\u0131lm\u0131\u015ft\u0131r. 1989 y\u0131l\u0131ndan sonra da sa\u011fl\u0131k sisteminde merkeziyet\u00e7i yap\u0131 yerine desantralizasyon, devlet finansman\u0131n\u0131n yerine \u00f6zel sa\u011fl\u0131k sigortac\u0131l\u0131\u011f\u0131, birinci basamak sa\u011fl\u0131k hizmetlerinin yerine aile hekimli\u011fi uygulamalar\u0131na ge\u00e7ilmi\u015ftir. B\u00f6ylece paral\u0131 sa\u011fl\u0131k hizmetleri uygulamas\u0131 ba\u015flam\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>1980\u2019li y\u0131llarda DS\u00d6 ile ba\u015flayan yak\u0131nla\u015fma D\u00fcnya Bankas\u0131 ile devam eder. DS\u00d6\u2019n\u00fcn, Do\u011fu Bloku \u00dclkeleri olarak tan\u0131mlanan \u00fclkelerin da\u011f\u0131lmas\u0131 sonras\u0131 getirdi\u011fi \u00f6neriler sigorta sistemi, aile hekimli\u011fi, katk\u0131 paylar\u0131n\u0131n artt\u0131r\u0131lmas\u0131 ve \u00f6zelle\u015ftirme olur. Aynen T\u00fcrkiye\u2019de de oldu\u011fu gibi.<\/p>\r\n\r\n\r\n\r\n<p>Kapitalist emperyalist sistemin m\u00fcdahaleleri, uluslararas\u0131 sermayenin yo\u011fun giri\u015fimleri zamanla daha fazla kar\u015f\u0131l\u0131k bulmaya ba\u015flad\u0131. SSCB\u2019nin resmen da\u011f\u0131lmas\u0131 ile birlikte Rusya ve eski cumhuriyetlerde sa\u011fl\u0131k hizmetlerinin \u00f6rg\u00fctlenmesi ve sunumunda k\u00f6kl\u00fc de\u011fi\u015fiklikler hayata ge\u00e7irildi. \u00d6ncelikle kamu sa\u011fl\u0131k harcamalar\u0131n\u0131n k\u0131s\u0131tlanmas\u0131 yoluna gidilmi\u015ftir. 1991 y\u0131l\u0131 \u00f6ncesinden ba\u015flayan \u2018sa\u011fl\u0131k reformu\u2019 denemeleri, bize de hi\u00e7 yabanc\u0131 olmayan sa\u011fl\u0131k sigortac\u0131l\u0131\u011f\u0131, hekimlerin hasta ba\u015f\u0131na para almas\u0131, d\u00f6ner sermaye uygulamas\u0131 giri\u015fimi, hastanelerin \u00f6zerkle\u015ftirilmesi, maliyet d\u00fc\u015f\u00fcr\u00fcc\u00fc \u00f6nlemler vb. uygulamalar olmu\u015ftur. Hastaya ve hastal\u0131\u011fa y\u00f6nelik modeller dayat\u0131lm\u0131\u015ft\u0131r.<\/p>\r\n\r\n\r\n\r\n<p>Rusya federasyonundaki uygulamalar sonras\u0131 bebek \u00f6l\u00fcmleri h\u0131zla artm\u0131\u015f, 1991 y\u0131l\u0131nda fazladan 1 milyon \u00f6l\u00fcm olmu\u015ftur. \u00d6l\u00fcm h\u0131z\u0131 \u00f6zellikle erkeklerin gen\u00e7 ve orta ya\u015f gruplar\u0131nda korkun\u00e7 boyutlara ula\u015f\u0131r. 1994 de Rusya\u2019da 100 kad\u0131na kar\u015f\u0131l\u0131k 89 erkek bulundu\u011fu ve \u2018kay\u0131p\u2019 erkek say\u0131s\u0131n\u0131n 5,9 milyona ula\u015ft\u0131\u011f\u0131 hesaplanm\u0131\u015ft\u0131r. \u00d6l\u00fcm nedenlerinin hepsinde y\u00fckselmeler olur ama en fazla artan neden %191 ile travma ve kazalard\u0131r (intiharlar, \u00f6ld\u00fcrmeler). 1991 y\u0131l\u0131nda 148 milyon 660 bin olan n\u00fcfus, 4 y\u0131l aradan sonra 1995 y\u0131l\u0131nda halen 148 milyon 400 bindir. Gelece\u011fe g\u00fcvensizlik do\u011fumlar\u0131 azalt\u0131r. Difteri, t\u00fcberk\u00fcloz, bo\u011fmaca, k\u0131zam\u0131k, kolera, brusella ve ba\u015fta sifilis olmak \u00fczere cinsel yolla bula\u015fan hastal\u0131klarda patlamalar g\u00f6r\u00fcl\u00fcr. Alkol al\u0131m\u0131 erkeklerde %136, kad\u0131nlarda %71 artar. Beslenme problemleri ba\u015f g\u00f6sterir ve buna ba\u011fl\u0131 olarak \u015fi\u015fmanl\u0131k artar. \u0130lkokul \u00e7ocuklar\u0131n\u0131n %53\u2019\u00fcn\u00fcn sa\u011fl\u0131\u011f\u0131 t\u00fckenir.<\/p>\r\n\r\n\r\n\r\n<p>DB, DT\u00d6 ba\u015fta olmak \u00fczere uluslararas\u0131 sermayenin Rusya Federasyonu ve eski Sovyet Cumhuriyetlerindeki \u2018reform\u2019 denemeleri o \u00fclkelerin halklar\u0131 i\u00e7in \u00e7ok pahal\u0131ya mal oldu. 1997 y\u0131l\u0131nda Rusya\u2019da ya\u015fayanlar\u0131n %41\u2019i, en alt gelir grubunun %50\u2019si ila\u00e7 \u00fccretlerini kar\u015f\u0131layamad\u0131\u011f\u0131n\u0131, n\u00fcfusun % 13\u2019\u00fc t\u0131bbi bak\u0131m \u00fccretlerini kar\u015f\u0131layamad\u0131\u011f\u0131n\u0131 belirtmi\u015ftir. En d\u00fc\u015f\u00fck gelir d\u00fczeyindekilerin %36\u2019s\u0131 ise ayaktan bak\u0131m hizmetleri i\u00e7in ba\u015fvurmay\u0131 dahi kesmi\u015ftir.<\/p>\r\n\r\n\r\n\r\n<p>\u2018Reform\u2019un temeli, sa\u011fl\u0131ktan kar elde edecek bir d\u00fczen yaratmak \u00fczerinedir. Daha \u00f6nce merkezi planlama ile y\u00fcr\u00fct\u00fclen, yerel \u00f6rg\u00fctlerine de uygulamada k\u0131smen \u00f6zerklik tan\u0131yan sistemin yerini tamamen yerelle\u015ftirme al\u0131r. Sa\u011fl\u0131k personelinde daralt\u0131lmaya gidilir.<\/p>\r\n\r\n\r\n\r\n<p>Bu t\u00fcr uygulamalar nedeniyle 1990\u2019l\u0131 y\u0131llardan itibaren eski SSCB \u00fclkelerinde sa\u011fl\u0131k hizmetlerine eri\u015fimde ve hizmet almada e\u015fitsizlikler derinle\u015fir. Rusya Federasyonunda 1994-95 y\u0131llar\u0131 aras\u0131nda gebe kad\u0131nlar\u0131n sadece %72 si do\u011fum \u00f6ncesi bak\u0131m alabilmi\u015ftir. A\u00d6H 1985 de y\u00fcz binde 54 iken 1990 da y\u00fcz binde 70\u2019e y\u00fckselir. Anne \u00f6l\u00fcmlerinin d\u00f6rtte biri k\u00fcrtaj nedeni ile olmu\u015ftur. \u00c7\u00d6H 1990-2001 aras\u0131nda 12 kat artm\u0131\u015ft\u0131r. 1998 y\u0131l\u0131nda bir ya\u015f alt\u0131 bebeklerde k\u0131zam\u0131k a\u015f\u0131s\u0131 olmayanlar\u0131n oran\u0131 \u00d6zbekistan\u2019da %8, Tacikistan\u2019da %20, T\u00fcrkmenistan\u2019da %34 olmu\u015ftur. Rusya federasyonunda k\u0131zam\u0131k a\u015f\u0131s\u0131 1989-1992 aras\u0131 %82 den %62 ye d\u00fc\u015fm\u00fc\u015ft\u00fcr.<\/p>\r\n\r\n\r\n\r\n<p>Henri Alleg\u2019in B\u00fcy\u00fck Geri S\u0131\u00e7rama adl\u0131 kitab\u0131ndan al\u0131nan anlat\u0131mlar \u2018sa\u011fl\u0131kta reform\u2019 denilerek yap\u0131lan uygulamalar\u0131n 1995-96\u2019l\u0131 y\u0131llardaki sonu\u00e7lar\u0131n\u0131 da g\u00f6stermektedir.<\/p>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\">\r\n<li>\u201c1995 y\u0131l\u0131nda Rusya\u2019da bula\u015f\u0131c\u0131 hastal\u0131klar (dizanteri dahil) tehlikeli bi\u00e7imde artt\u0131. 1994 y\u0131l\u0131na g\u00f6re %47,7\u2019den \u00e7ok (36.000 hasta ve 800 \u00f6l\u00fc say\u0131lm\u0131\u015ft\u0131r) art\u0131\u015f var. %26,6 art\u0131\u015f Hepatit B, %150 frengi vakalar\u0131ndad\u0131r. \u00c7ocuklarda bula\u015f\u0131c\u0131 hastal\u0131klar %150\u2019lik art\u0131\u015f g\u00f6stermektedir.\u201d (Sayfa 157)<\/li>\r\n<li>\u201cBak\u0131m g\u00f6rmenin giderek g\u00fc\u00e7le\u015fti\u011fi zay\u0131f d\u00fc\u015fm\u00fc\u015f poliklinik ve dispanserlerin \u201cyerini doldurmak\u201d \u00fczere \u00f6zel servis ve kurulu\u015flar do\u011fmu\u015f. Gereken parasal kayna\u011f\u0131 bulabilen hekimler ve di\u015f\u00e7iler bedelini \u00f6deyebilen bir hasta az\u0131nl\u0131\u011f\u0131 i\u00e7in kabin ve klinikler kurmak \u00fczere kamu hizmetlerinden ka\u00e7m\u0131\u015flar. Bir klinikte bir g\u00fcn kalmak i\u00e7in, cerrahlar\u0131n \u00fccretleri d\u0131\u015f\u0131nda, 500.000 ruble ve hatta daha fazlas\u0131n\u0131 \u00f6demek gerekiyor\u201d (Sayfa 22)<\/li>\r\n<li>\u201c\u2026 \u00c7o\u011fu, eczanelerde ve b\u00fcfelerde serbest\u00e7e sat\u0131lan ila\u00e7lar\u0131 re\u00e7etesiz sat\u0131n alarak, kendi kendilerini tedavi etmeye \u00e7al\u0131\u015f\u0131yorlar. E\u011fer kendilerini ger\u00e7ekten k\u00f6t\u00fc hissederlerse, belki de, hemen hemen paras\u0131z olduklar\u0131ndan, m\u00fc\u015fterilerini metro kalabal\u0131\u011f\u0131 i\u00e7inde aramak zorunda kalan t\u0131p profes\u00f6rleri ya da emekli uzmanlardan olu\u015fan \u015fu yoksul hekimlerinden birisine ba\u015fvuracaklar\u2026\u201d(Sayfa 22)<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p>B\u00fct\u00fcn bu \u2018reform\u2019 uygulamalar\u0131 halklar a\u00e7\u0131s\u0131ndan \u00e7ok ac\u0131 sonu\u00e7lara yol a\u00e7ar. Uluslararas\u0131 sermaye a\u00e7\u0131s\u0131ndan da sigorta sistemleri istedikleri gibi gitmez ve ba\u015far\u0131s\u0131z olur. 1999 y\u0131l\u0131nda DS\u00d6, AB ve D\u00fcnya Bankas\u0131, sa\u011fl\u0131\u011f\u0131n finansman\u0131 ve \u00f6rg\u00fctlenmesinde b\u00f6yle \u201cani de\u011fi\u015fiklik \u00f6nerilerinin\u201d yanl\u0131\u015f oldu\u011funu s\u00f6yleyerek Rusya\u2019n\u0131n sigorta hekimli\u011finden devlet sa\u011fl\u0131k hizmetine d\u00f6nmesini \u00f6nerirler. Ama bu d\u00f6nem Rusya\u2019da e\u015fitsizliklerin artt\u0131\u011f\u0131, sa\u011fl\u0131k g\u00f6stergelerinde ciddi bozulmalar\u0131n ortaya \u00e7\u0131kt\u0131\u011f\u0131 bir d\u00f6nem olur. Emperyalist kapitalist sistemin deneme tahtas\u0131 olarak kulland\u0131\u011f\u0131 bu d\u00f6nemde milyonlarca insan bunun sonu\u00e7lar\u0131n\u0131 sa\u011fl\u0131\u011f\u0131 ve hayat\u0131 ile \u00f6der.\u00a0<\/p>\r\n\r\n\r\n\r\n<p><strong>Kaynaklar <\/strong><\/p>\r\n\r\n\r\n\r\n<p>Dr. M. Akif Akal\u0131n, Toplumcu T\u0131p (Sovyetler Birli\u011fi Deneyimi), Yaz\u0131lama Yay\u0131nlar\u0131, 1. Bask\u0131, Kas\u0131m 2010.<\/p>\r\n\r\n\r\n\r\n<p>\u00d6zlem \u00d6zkan (Y\u00fcksek Hem\u015fire), \u2018Sovyet Sosyalist Cumhuriyetler Birli\u011fi\u2019nde Sa\u011fl\u0131k Hizmetleri\u2019, Toplum ve Hekim Cilt 18, Say\u0131 1, Ocak-\u015eubat 2003\u00a0<\/p>\r\n\r\n\r\n\r\n<p>Dr. Gazanfer Aksako\u011flu, Sosyalist \u00dclkelerde Sa\u011fl\u0131k \u00d6rg\u00fctlenmesi, Toplum ve Hekim Cilt 2, Say\u0131 7, Temmuz, 1978.<\/p>\r\n\r\n\r\n\r\n<p>Prof. Dr. Gazanfer Aksako\u011flu, Sovyetler Birli\u011fi \u00d6zelinde Sosyalist \u00dclkelerde \u201cSa\u011fl\u0131k Reformu\u201d, Toplum ve Hekim Cilt 18, Say\u0131 1, Ocak-\u015eubat 2003.<\/p>\r\n\r\n\r\n\r\n<p>Sir Arthur Newsholme-John Adams Kingsbury, K\u0131z\u0131l T\u0131p Sovyet Rusya\u2019da Toplumsalla\u015ft\u0131r\u0131lm\u0131\u015f Sa\u011fl\u0131k, \u00e7ev: Sel\u00e7uk G\u00f6rmez, Yaz\u0131lama Yay\u0131nlar\u0131, Birinci bask\u0131, 2015 (Yaz\u0131m tarihi 1932-33, \u0130lk Bas\u0131m tarihi 1933)<\/p>\r\n\r\n\r\n\r\n<p>\u0130smet Do\u011fan, SSCB de Bar\u0131nma: Hayal edin, ev sahibi yok, kira 28 lira, Ekmek ve G\u00fcl web, 22 Kas\u0131m 2017.<\/p>\r\n\r\n\r\n\r\n<p>Henri Alleg, B\u00fcy\u00fck Geri S\u0131\u00e7rama, \u00e7ev: Kerem Kurtg\u00f6z\u00fc, Evrensel Bas\u0131m Yay\u0131n, 2012<\/p>\r\n\r\n\r\n<hr class=\"wp-block-separator\" \/>\r\n\r\n\r\n<p><a href=\"#_ftnref1\">[1]<\/a> Sanitasyon: Ortam\u0131n hastal\u0131k yapan mikroorganizmalardan ar\u0131nd\u0131r\u0131lmas\u0131 i\u00e7in gerekli i\u015flemlerin sa\u011fl\u0131k ve temizlik kurallar\u0131na uygun olarak yap\u0131lmas\u0131 (G\u0131da, i\u015fyeri, g\u0131da d\u00fckk\u00e2nlar\u0131, i\u015fyerleri, \u00e7evre\u2026)<\/p>\r\n\r\n\r\n\r\n<p><a href=\"#_ftnref2\">[2]<\/a> Epidemiyoloji: Toplumdaki hastal\u0131k, kaza \u015fekli, etkiledi\u011fi pop\u00fclasyon, al\u0131nabilecek \u00f6nlemler, g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131, a\u015f\u0131lama ve etkisi, da\u011f\u0131l\u0131m ve da\u011f\u0131l\u0131m belirleyen etmenlerin bilimi<\/p>\r\n\r\n\r\n\r\n<p><a href=\"#_ftnref3\">[3]<\/a> Transf\u00fczyon: Kan veya kan \u00fcr\u00fcn\u00fc nakli<\/p>\r\n\r\n\r\n\r\n<p><a href=\"#_ftnref4\">[4]<\/a> Sulfanomid tedavisi: Enfeksiyon tedavisinde kullan\u0131lan antibiyotikler<\/p>\r\n","protected":false},"excerpt":{"rendered":"<p>\u015e\u00fckran Do\u011fan D\u00fcnyada ve \u00fclkemizde \u00f6zellikle 1980 sonras\u0131 h\u0131z kazanan neoliberal politikalar\u0131n bir par\u00e7as\u0131 olarak hayata ge\u00e7irilen \u00f6zelle\u015ftirmelerden, sa\u011fl\u0131k hizmetlerinin azade kalmas\u0131 m\u00fcmk\u00fcn olamazd\u0131, olmad\u0131 da. Sermaye a\u00e7\u0131s\u0131ndan ciddi kar kap\u0131s\u0131 olarak g\u00f6r\u00fclen sa\u011fl\u0131k hizmetleri alan\u0131nda \u00e7e\u015fitli y\u00f6ntemlerle s\u00fcrd\u00fcr\u00fclen \u00f6zelle\u015ftirmeler bug\u00fcn \u00e7ok ciddi boyutlara varm\u0131\u015f durumdad\u0131r. Kapitalizm ko\u015fullar\u0131nda zaten hi\u00e7bir zaman tamamen \u00fccretsiz verilmemi\u015f olan sa\u011fl\u0131k hizmetlerinin \u00f6zel sekt\u00f6re daha [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1087,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"categories":[507,421,392,353],"tags":[],"class_list":["post-1086","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-38-sayi-ocak-2020","category-devrimler-tarihi","category-saglik","category-sukran-dogan"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Sovyetler Birli\u011fi\u2019nde sa\u011fl\u0131k hizmetleri\ufeff<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri\ufeff\/\" \/>\n<meta property=\"og:locale\" content=\"tr_TR\" \/>\n<meta property=\"og:locale:alternate\" content=\"en_EN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Sovyetler Birli\u011fi\u2019nde sa\u011fl\u0131k hizmetleri\ufeff\" \/>\n<meta property=\"og:description\" content=\"\u015e\u00fckran Do\u011fan D\u00fcnyada ve \u00fclkemizde \u00f6zellikle 1980 sonras\u0131 h\u0131z kazanan neoliberal politikalar\u0131n bir par\u00e7as\u0131 olarak hayata ge\u00e7irilen \u00f6zelle\u015ftirmelerden, sa\u011fl\u0131k hizmetlerinin azade kalmas\u0131 m\u00fcmk\u00fcn olamazd\u0131, olmad\u0131 da. Sermaye a\u00e7\u0131s\u0131ndan ciddi kar kap\u0131s\u0131 olarak g\u00f6r\u00fclen sa\u011fl\u0131k hizmetleri alan\u0131nda \u00e7e\u015fitli y\u00f6ntemlerle s\u00fcrd\u00fcr\u00fclen \u00f6zelle\u015ftirmeler bug\u00fcn \u00e7ok ciddi boyutlara varm\u0131\u015f durumdad\u0131r. Kapitalizm ko\u015fullar\u0131nda zaten hi\u00e7bir zaman tamamen \u00fccretsiz verilmemi\u015f olan sa\u011fl\u0131k hizmetlerinin \u00f6zel sekt\u00f6re daha [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri\ufeff\/\" \/>\n<meta property=\"og:site_name\" content=\"Teori ve Eylem\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/teoriveeylem\/\" \/>\n<meta property=\"article:published_time\" content=\"2020-01-10T11:19:45+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-01-18T10:48:24+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/teoriveeylem.net\/wp-content\/uploads\/2020\/01\/4.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"664\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@teoriveeylem\" \/>\n<meta name=\"twitter:site\" content=\"@teoriveeylem\" \/>\n<meta name=\"twitter:label1\" content=\"Yazan:\" \/>\n\t<meta name=\"twitter:data1\" content=\"\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tahmini okuma s\u00fcresi\" \/>\n\t<meta name=\"twitter:data2\" content=\"35 dakika\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/#\\\/schema\\\/person\\\/413054853585ad4d138f2f331dfd177c\"},\"headline\":\"Sovyetler Birli\u011fi\u2019nde sa\u011fl\u0131k hizmetleri\ufeff\",\"datePublished\":\"2020-01-10T11:19:45+00:00\",\"dateModified\":\"2023-01-18T10:48:24+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/\"},\"wordCount\":8406,\"publisher\":{\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/teoriveeylem.net\\\/wp-content\\\/uploads\\\/2020\\\/01\\\/4.jpg\",\"articleSection\":[\"38. Say\u0131 \\\/ Ocak 2020\",\"Devrimler Tarihi\",\"Sa\u011fl\u0131k\",\"\u015e\u00fckran Do\u011fan\"],\"inLanguage\":\"tr-TR\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/\",\"url\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/\",\"name\":\"Sovyetler Birli\u011fi\u2019nde sa\u011fl\u0131k hizmetleri\ufeff\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/teoriveeylem.net\\\/wp-content\\\/uploads\\\/2020\\\/01\\\/4.jpg\",\"datePublished\":\"2020-01-10T11:19:45+00:00\",\"dateModified\":\"2023-01-18T10:48:24+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/#breadcrumb\"},\"inLanguage\":\"tr-TR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"tr-TR\",\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/#primaryimage\",\"url\":\"https:\\\/\\\/teoriveeylem.net\\\/wp-content\\\/uploads\\\/2020\\\/01\\\/4.jpg\",\"contentUrl\":\"https:\\\/\\\/teoriveeylem.net\\\/wp-content\\\/uploads\\\/2020\\\/01\\\/4.jpg\",\"width\":1200,\"height\":664},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/2020\\\/01\\\/10\\\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Anasayfa\",\"item\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Sovyetler Birli\u011fi\u2019nde sa\u011fl\u0131k hizmetleri\ufeff\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/#website\",\"url\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/\",\"name\":\"Teori ve Eylem\",\"description\":\"\u00dc\u00e7 Ayl\u0131k Sosyalist Teori ve Politika Dergisi\",\"publisher\":{\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"tr-TR\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/#organization\",\"name\":\"Teori ve Eylem\",\"url\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"tr-TR\",\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/teoriveeylem.net\\\/wp-content\\\/uploads\\\/2022\\\/12\\\/400x400-1.jpg\",\"contentUrl\":\"https:\\\/\\\/teoriveeylem.net\\\/wp-content\\\/uploads\\\/2022\\\/12\\\/400x400-1.jpg\",\"width\":400,\"height\":400,\"caption\":\"Teori ve Eylem\"},\"image\":{\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/teoriveeylem\\\/\",\"https:\\\/\\\/x.com\\\/teoriveeylem\",\"https:\\\/\\\/www.instagram.com\\\/teoriveeylem\\\/\"]},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/#\\\/schema\\\/person\\\/413054853585ad4d138f2f331dfd177c\",\"name\":\"admin\",\"url\":\"https:\\\/\\\/teoriveeylem.net\\\/tr\\\/author\\\/admin\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Sovyetler Birli\u011fi\u2019nde sa\u011fl\u0131k hizmetleri\ufeff","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri\ufeff\/","og_locale":"tr_TR","og_type":"article","og_title":"[:tr]Sovyetler Birli\u011fi\u2019nde sa\u011fl\u0131k hizmetleri\ufeff[:] - Teori ve Eylem","og_description":"\u015e\u00fckran Do\u011fan D\u00fcnyada ve \u00fclkemizde \u00f6zellikle 1980 sonras\u0131 h\u0131z kazanan neoliberal politikalar\u0131n bir par\u00e7as\u0131 olarak hayata ge\u00e7irilen \u00f6zelle\u015ftirmelerden, sa\u011fl\u0131k hizmetlerinin azade kalmas\u0131 m\u00fcmk\u00fcn olamazd\u0131, olmad\u0131 da. Sermaye a\u00e7\u0131s\u0131ndan ciddi kar kap\u0131s\u0131 olarak g\u00f6r\u00fclen sa\u011fl\u0131k hizmetleri alan\u0131nda \u00e7e\u015fitli y\u00f6ntemlerle s\u00fcrd\u00fcr\u00fclen \u00f6zelle\u015ftirmeler bug\u00fcn \u00e7ok ciddi boyutlara varm\u0131\u015f durumdad\u0131r. Kapitalizm ko\u015fullar\u0131nda zaten hi\u00e7bir zaman tamamen \u00fccretsiz verilmemi\u015f olan sa\u011fl\u0131k hizmetlerinin \u00f6zel sekt\u00f6re daha [&hellip;]","og_url":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri\ufeff\/","og_site_name":"Teori ve Eylem","article_publisher":"https:\/\/www.facebook.com\/teoriveeylem\/","article_published_time":"2020-01-10T11:19:45+00:00","article_modified_time":"2023-01-18T10:48:24+00:00","og_image":[{"width":1200,"height":664,"url":"https:\/\/teoriveeylem.net\/wp-content\/uploads\/2020\/01\/4.jpg","type":"image\/jpeg"}],"author":"admin","twitter_card":"summary_large_image","twitter_creator":"@teoriveeylem","twitter_site":"@teoriveeylem","twitter_misc":{"Yazan:":false,"Tahmini okuma s\u00fcresi":"35 dakika"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/#article","isPartOf":{"@id":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/"},"author":{"name":"admin","@id":"https:\/\/teoriveeylem.net\/tr\/#\/schema\/person\/413054853585ad4d138f2f331dfd177c"},"headline":"Sovyetler Birli\u011fi\u2019nde sa\u011fl\u0131k hizmetleri\ufeff","datePublished":"2020-01-10T11:19:45+00:00","dateModified":"2023-01-18T10:48:24+00:00","mainEntityOfPage":{"@id":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/"},"wordCount":8406,"publisher":{"@id":"https:\/\/teoriveeylem.net\/tr\/#organization"},"image":{"@id":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/#primaryimage"},"thumbnailUrl":"https:\/\/teoriveeylem.net\/wp-content\/uploads\/2020\/01\/4.jpg","articleSection":["38. Say\u0131 \/ Ocak 2020","Devrimler Tarihi","Sa\u011fl\u0131k","\u015e\u00fckran Do\u011fan"],"inLanguage":"tr-TR"},{"@type":"WebPage","@id":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/","url":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/","name":"Sovyetler Birli\u011fi\u2019nde sa\u011fl\u0131k hizmetleri\ufeff","isPartOf":{"@id":"https:\/\/teoriveeylem.net\/tr\/#website"},"primaryImageOfPage":{"@id":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/#primaryimage"},"image":{"@id":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/#primaryimage"},"thumbnailUrl":"https:\/\/teoriveeylem.net\/wp-content\/uploads\/2020\/01\/4.jpg","datePublished":"2020-01-10T11:19:45+00:00","dateModified":"2023-01-18T10:48:24+00:00","breadcrumb":{"@id":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/#breadcrumb"},"inLanguage":"tr-TR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/"]}]},{"@type":"ImageObject","inLanguage":"tr-TR","@id":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/#primaryimage","url":"https:\/\/teoriveeylem.net\/wp-content\/uploads\/2020\/01\/4.jpg","contentUrl":"https:\/\/teoriveeylem.net\/wp-content\/uploads\/2020\/01\/4.jpg","width":1200,"height":664},{"@type":"BreadcrumbList","@id":"https:\/\/teoriveeylem.net\/tr\/2020\/01\/10\/sovyetler-birliginde-saglik-hizmetleri%ef%bb%bf\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Anasayfa","item":"https:\/\/teoriveeylem.net\/tr\/"},{"@type":"ListItem","position":2,"name":"Sovyetler Birli\u011fi\u2019nde sa\u011fl\u0131k hizmetleri\ufeff"}]},{"@type":"WebSite","@id":"https:\/\/teoriveeylem.net\/tr\/#website","url":"https:\/\/teoriveeylem.net\/tr\/","name":"Teori ve Eylem","description":"\u00dc\u00e7 Ayl\u0131k Sosyalist Teori ve Politika Dergisi","publisher":{"@id":"https:\/\/teoriveeylem.net\/tr\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/teoriveeylem.net\/tr\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"tr-TR"},{"@type":"Organization","@id":"https:\/\/teoriveeylem.net\/tr\/#organization","name":"Teori ve Eylem","url":"https:\/\/teoriveeylem.net\/tr\/","logo":{"@type":"ImageObject","inLanguage":"tr-TR","@id":"https:\/\/teoriveeylem.net\/tr\/#\/schema\/logo\/image\/","url":"https:\/\/teoriveeylem.net\/wp-content\/uploads\/2022\/12\/400x400-1.jpg","contentUrl":"https:\/\/teoriveeylem.net\/wp-content\/uploads\/2022\/12\/400x400-1.jpg","width":400,"height":400,"caption":"Teori ve Eylem"},"image":{"@id":"https:\/\/teoriveeylem.net\/tr\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/teoriveeylem\/","https:\/\/x.com\/teoriveeylem","https:\/\/www.instagram.com\/teoriveeylem\/"]},{"@type":"Person","@id":"https:\/\/teoriveeylem.net\/tr\/#\/schema\/person\/413054853585ad4d138f2f331dfd177c","name":"admin","url":"https:\/\/teoriveeylem.net\/tr\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/teoriveeylem.net\/tr\/wp-json\/wp\/v2\/posts\/1086","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/teoriveeylem.net\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/teoriveeylem.net\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/teoriveeylem.net\/tr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/teoriveeylem.net\/tr\/wp-json\/wp\/v2\/comments?post=1086"}],"version-history":[{"count":3,"href":"https:\/\/teoriveeylem.net\/tr\/wp-json\/wp\/v2\/posts\/1086\/revisions"}],"predecessor-version":[{"id":3171,"href":"https:\/\/teoriveeylem.net\/tr\/wp-json\/wp\/v2\/posts\/1086\/revisions\/3171"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/teoriveeylem.net\/tr\/wp-json\/wp\/v2\/media\/1087"}],"wp:attachment":[{"href":"https:\/\/teoriveeylem.net\/tr\/wp-json\/wp\/v2\/media?parent=1086"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/teoriveeylem.net\/tr\/wp-json\/wp\/v2\/categories?post=1086"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/teoriveeylem.net\/tr\/wp-json\/wp\/v2\/tags?post=1086"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}