Public Health in Osijek: 1925th - 2005.
The beginnings of protection from epidemics
Protection from the plague epidemic and livestock diseases occurred in Osijek in the early 18th century. Since a large number of soldiers were stationed in the city, the military authorities had taken over the health measures to avoid any possible contamination, especially epidemic. Some of the epidemics, such as the plague epidemics in the years 1725 , 1738 , 1741 and cholera in 1805, decimated the population of Slavonia and Srijem including the population of Osijek, so considerable attention was devoted to these measures in Slavonia not only when it was an outbreak area, but also when it was thought that it could become an area from which, with the circulation of goods, livestock or passengers, contagious disease could be transferred to other parts of the Habsburg Monarchy. This means that the Habsburgs treated infectious disease, especially fever, as a threat, which in its effects and consequences was equal to the danger of war.
Creation of permanent protection from epidemics throughout the Habsburg Empire, and in Croatia - all for the purpose of regulating and organizing the plague gendarmerie - lasted from the time of Emperor Charles III. (1710-1740) and publishing of a series of health care provisions, regulations and laws to the standards of the time of Empress Maria Theresa (1740th-1780th), when the entire public health of the Monarchy was regulated by the "health regulations" of Gerard von Swieten int the year 1770.
However, substantial progress in epidemic protection on Croatian soil, and also in Osijek, had not been felt until 1850. (when a temporary constitution of public medical management was proclaimed). Only the "Law on the organization of health services in the Kingdom of Croatia, Slavonia and Dalmatia" of 15th of November 1874 achieved obvious improvement in the health care on Croatian soil, including Osijek. More significant advances were brought by the "Law on the organization of health services in Croatia and Slavonia" of 24th of January 1894, which continued the organization of health services, and some medical tasks were delegated to the municipalities. "The Law on Health" of 25th of March 1906 was significantly better in terms of epidemic control services since it was the first law to emphasize preventive measures that should be implemented in order to protect human health. However, despite these laws serious socio-hygienic efforts and the separation of the hygiene department from the health department will occur only after the First World War.
Reorganization of Health care
Separating the hygiene department from the health department
In the Kingdom of Serbs, Croats and Slovenes, created after the First World War, Ministry of Public Health was formed in December 1918, and was given the task of reorganizing and improving health care throughout the state. However, by the year 1921 nothing happened especially in terms of the reorganization since the individual health programs started showing their true results only after the establishment of counties, constituted on 23rd of February 1927, after the election that King Alexander announced in December 1926. Specifically, by the establishment of counties the government attempted to transfer all financing obligations to the counties and thus make it easier to reorganize health care. In carrying out the reorganization and improvement of health services Dr. med. Andrija Štampar was particularly noted, as the head of Social Hygiene of the Ministry of Public Health, in the period between 1921 and 1931, he thoroughly reformed public health, placing the main emphasis on the social and medical goals and separating hygienic service from general health services. During this period, the Ministry of Public Health had given major attention to social ills, networked the entire state with scientific and health institutions and organizations, which had the fundamental task of "free treatment in various dispensaries and infection control and testing, production of serums, and more." The result of these efforts was the establishment of public health centers across the country, including in Osijek. Using the model of md. Andrija Štampar and the regulations at that time the purpose of health centers was in outpatient work and promotion of public hygiene, the centers were active in one or more districts and they had several departments: clinic for mothers and children, school clinic, clinic for TB, bacteriological and epidemiological department, chemical department and Optional stations that were established to combat trachoma, venereal diseases and malaria, as well as general medical clinic for the treatment of underprivileged patients and an inpatient ward with 10 beds. Although in the decade after World War I health conditions had improved significantly all over the newly created state, it was felt in the cities that the need for hygiene education of the population was great, especially the youth and school children in the cities. Because in this post-war period there was no public health service in Osijek, in 1923 the Health Center at the General Hospital (today's Department of Neurology of the Clinical Hospital of Osijek) in the Lower Town was founded and opened.
Health Center in Osijek
Since there was no building in Osijek for the newly established health facility that would suit the purpose, it was decided in 1924 to build a two-story building for the Health Center "that would fully suit the purpose." Therefore, the mayor dr. ius. Vjekoslav Hengl received a notification in July 1924 from Andrija Štampar, the then chief of the Social Hygiene in the Ministry of Public Health, in which the Inspectorate of the Ministry assigned 600,000 dinars for the construction of the building "which would accommodate clinics for school children, dental clinic, clinic for mothers and infants, hospital for venereal diseases and a tuberculosis dispensary." Institution would be financed by the Ministry and the city council would have to give "a certain annual assistance." Since by the end of August that year, 300,000 dinars came from the ministry, Mayor Hengl at the city assembly on the 27th of August 1924 authorized experts regarding the construction. Almost simultaneously a letter arrived from Zagreb in which Štampar, "specifically wanted to put this building in the Upper Town or between the Upper and Lower Town in a beautiful location with plenty of space, so that a small park can be arranged around the building." Since the location in the then (and present) Krežma street no. 1 was chosen, the construction of the center was entrusted to the Juzbašić & Freundlich construction company from Osijek on the 27th September of that year, and the supervision was entrusted to the city engineer Dimitrije Popovic. It was not easy to raise the funds (total cost of construction amounted to 2,057.973,78 dinars) and the construction of the Health Center lasted longer than two years. The building was officially opened and dedicated for use on the 19th of December 1926.
The building is a detached two-story, built in the spirit of historicism, with a prominent central part of the tympanum and pilasters in the front. The facade is entirely made of plaster and stucco elements are formed in plaster and embedded in the facade. The windows are three winged with a window on top and the roof cornice is accentuated and cast in concrete and subsequently molded same as the pilasters. The capitals of columns and stucco facade (rosettes, cornices, and the brackets below the cornice) are casted in plaster and applied to the facade. Basement, ground floor, first floor and the mansard attic had the "floor space of 190 x 3, ie 570 m2." In front of the building, as well as today, is a beautiful iron fence. "As a part of the newly opened Public Health Center were the following departments: municipal and school Clinic, sanitary inspection, anti-TB and skin-venereal dispensary, anti-trachomatous and the anti-rabies station, baby clinic, dental department and the Epidemiological Institute", while the test animals, which where needed for the work of the bacteriological laboratories, were held - until the construction of a special backyard building for them (1958./1959.) - in the back building next to the building which is now the Department of Neurology, therefore,a part of the General Hospital. The work of the Osijek Health Center took place in full accordance with the social medicine program of that time promoted by md. Andrija Štampar. ( He stayed in Osijek several times until 1930. )
Bacterial station / Epidemiological Institute / Sanitary-Epidemiological Service (1925-1945)
With the opening of the Health Center with numerous services better health care was provided for the population in the city on the river Drava, especially with the outpatient and the anti-epidemic service. The health care system included, from the summer of 1925, just established bacteriological station, which was raised to the degree of institute and the name was changed into Epidemiological Institute. With the construction of the building of the Health Center in Krežma street no. 1 the Institute acted as an autonomous organization of the Health Center, and after the administrative reform at the state level and the adoption of "Regulation on the founding of the county Committee of Osijek County” of 1928, 8 departments were established for areas of particular interest to the community public life. One of the departments was the Department of Public Health which included the planning of medical services so the service received its basis by the adoption of the "Regulation of the organization of provincial medical management" and the "Regulation of the district Medical authorities", It was very fast because these regulations were passed as laws. Therefore, the Institute completely integrated in the work of the Center as its specialized sanitary-epidemiological service and acted thus until the end of World War II. Epidemiological Institute, ie sanitary-epidemiological service as a part of the the Community Health Center in practice exercised health care and resolved problems of health and disease with a curative, preventive and social point of view. Within Osijek Sanitary-Epidemiological Service were the following departments:
- Bacterial-epidemiological department,
- Chemical Division,
- Sanitary-technical department and
- Department of hygienic propaganda.
The Head of Public Health, MD. Slavko Hirsch founded the bacteriological station in 1925, and from that year on he performed along with his duty as the director, the job of the head of the bacteriological station, ie Epidemiological Institute, ie sanitary-epidemiological service in the Public Health Center. In the first years of operation md. Marija Belavić (medical and judicial chemistry) and engineer Jovo Dugošević (head of the Chemical Laboratory) worked in the Chemistry Department, and md. Marijan Banić worked as a field doctor in the bacterial-serological department.
Since 1930 md. Niktopolion Černozubov was the chief of the Bacteriological-serology department until 1940 when the department head becomes md. Jelena Cekić with Agata Simunovic as the lab technician. Md. Stjepan Ivić was a part of the division from 1935 to 1943 and md. Rafael Nahmijas (bacteriologist and serologist) led the newly opened anti-rabies station until 1941. From 1930 lab technician Vladislava Petrović worked in the Chemistry Department where the chief was the engineer Jovo Dugošević. Josipa Baić also worked in the institution as an auxiliary "helper" health professional (in the chemical and bacteriological laboratory) and nurses assistants Marija Leović and Fanika Golob, and in the war period Staža Ivanović and Barica Kovač. Medical hygienist Marko Vrbanić was in the sanitary-epidemiological service since 1939, a year later, md. Jelena Cekić, became the head of microbiological and serological diagnostics. Matija Knezevic, a medical hygienist, worked in the laboratory of the Bacteriological-serological department, also lab technician Jelka Orehovec who also ran all the books of the department. During this period "disinfectors" Pavle Dubovski, Ivan Lešnjaković, Dominik Kalamut, Grga Pezelj and Dragutin Lenner briefly worked in the Center, and Zdravko Ćupić, Ante Troha and Vasilije Petrović, worked long-term (from 193. until 1941).
Territory and scope of work
The Bacterial station, ie Epidemiological Institute, in the first three years of its existence covered the entire Slavonia region and most of Srijem acting to combat infectious diseases, detecting germ carriers and establishing epidemiological measures. Its professional employees were engaged in disinfestation, disinfection and pest control. Difficulties in conducting epidemiological measures, difficulties in combating infectious diseases and lack of exercise powers for hygienic and health care activities on such a large territory - all of this was evident immediately after the creation of the Bacteriological station, ie Epidemiological Institute. It was very difficult, almost impossible to professionally monitor and control the "situation on the ground" from Osijek. But regardless of this state, the responsibilities of the head of the Institute, were enormous. The most obvious example of this was the launch of a criminal liability suit against the head of epidemiological Institute md. Slavko Hirsch, on the 25th of July 1925 when he was "punished with a warning" by the decision of the Ministry of Public Health of Belgrade "that the same in late March of that year on the basis of a bacteriological finding gave his judgment on the quality of local water to the local military authorities in Brod na Savi (Slavonski Brod), and that water had not been chemically reviewed or sent to the local inspection and with such superficial work ", in the judgment of the then Standing epidemiological Commision, "proper judgment on the origin and development of the local epidemic was hindered." In fact, since the beginning of March until the end of June of 1925 there was an epidemic of typhoid fever in all the companies of Brodski garrison; 49 soldiers were affected and 8 died. Hirsch was charged, "that he and thus the Institute did not react on time to combat the epidemic." In order to explain the real situation in this "case," Hirsch in early July that year, sent all the documentation and a report "on the affair" to the Ministry of Public Health; he presented in detail the chronological and statistical data on the situation in the Brodski garrison, described the general (non) hygienic conditions - inadequate sewage systems, poorly implemented water supply system, the problem of germ carriers, problem "of vaccination" and other problems - and noted that "even after the expert opinion of Osijek epidemiological institute the military authorities in Brod had not done any epidemiological measures that could have prevented an epidemic of typhus." However, regardless of the above explanation, the Permanent epidemic Commission "delivered the opinion and decision on Hirsches responsibility expressing a reprimand." Since 1928 sanitary-epidemiological service was incorporated in Osijek Health Center and acted only in eastern Slavonia covering, from that time, towns and districts Našice, Donji Miholjac Podravska Slatina, Valpovo and Osijek. This is the period when the service, along with the aforementioned tasks, monitored the hygienic conditions and the health status of the population, and worked on improving the health and the hygienic conditions of life in this part of the Croatia.
Therefore, for example, the area of "disinfectors" (raskužitelja) except in the city was in the field, ie, "outdoor office." On average, one "disinfector" covered the area of two districts. Disinfectors had to complete a three-month training course. The training was practical and it included "the most basic concepts of hygiene and habits, the concept of infections and how to keep from them, performing funerary services, the terms of sterilization and disinfection, knowledge, preparation and use rodenticide solutions and resources, the way in which sanitation can replace or complement (thorough cleaning, scrubbing, use of liquor, ventilation, sun, etc.), handling of disinfecting devices, decontamination (haircuts, bathing, using different means).