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 APPROVED FOR RELEASE: 2009/06/16: CIA-RDP01-00707R000200070023-3

Polish Government to set up a venerological institute in January 1970 and to mount a greatly expanded program of preventive mass examinations.

Despite a steady improvement in the availability of medical care, the number of doctors and hospitals is still inadequate in most areas of the country outside of the major cities. While the ratio of medical personnel and facilities to the total population appears relatively favorable, their geographical distribution partially offsets their growing numbers; over 90% of all medical doctors, for example, live in cities and industrial areas, preferring to avoid the isolation and generally still primitive living conditions of the countryside. Since the Gierek regime came to power in December 1970, however, an increased effort has been underway to expand and improve the system of rural medical centers and consultation stations, as well as to develop a system of incentives that would induce fully trained medical personnel to practice in these areas.

Shortages of professional medical care in rural areas, however, have been mitigated to a large extent through the still widespread use of feldshers, i.e., trained medical assistants and technicians who are competent to deal with routine treatment or preventive health measures. This system, however, is being phased out in favor of professional care. Many peasants who are far from available medical facilities and personnel continue to rely on the traditional system of midwives not only in cases of childbirth but also for routine medical care of all members of the family. The shortage of professional medical care in rural areas was, until 1971, largely a result of the ineligibility of persons employed in private agriculture—about one-fourth of the population—to receive free medical care. The extension of this care to the private peasantry by the Gierek regime is likely to improve medical care in the countryside in the long run, but to cause short-term strains as the system seeks to overcome years of relative neglect in these areas.

Efforts are being made to remedy the existing maldistribution and quality of hospitals. Although the number of hospital beds may be comparable to or above the European average in metropolitan areas, hospitals in rural areas are undermaintained and understaffed, and equipment, facilities, and sanitary standards even in some city hospitals fall considerably below the Western European standard. Because of heavy wartime destruction, the number of hospitals—despite rapid postwar construction—was only 516 in 1950 compared to the 1938 total of 632, and reached the prewar total only in the late 1950's. Since then, state expenditures on medical plant have tended to be focused on existing facilities rather than constructing new ones. However, these funds have generally been insufficient in most cases even to maintain and refurbish aging and obsolescent facilities. The following tabulation shows the availability of medical personnel and facilities in 1970:

The above data for the number of hospitals and hospital beds included some 31 hospitals with 36,400 beds devoted exclusively to the care of mental illness, but excluded some 43 military hospitals and rehabilitation centers. The number of nurses includes 81,429 fully trained registered nurses, with the remainder being nursing assistants and student nurses. The overall trend in the availability of medical personnel and hospital facilities is shown in Figures 26 and 27, respectively.

The competence of professional physicians and their training are believed to be good by European standards, although their skill is often handicapped by the lack of specialized drugs and of modern diagnostic and other hospital equipment. The Polish Medical Society is a general professional association and there are also a large number of associations comprising members of the various medical specialties active in

'''FIGURE 26. Health personnel per 10,000 population (U/OU)''' (chart/graph)

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APPROVED FOR RELEASE: 2009/06/16: CIA-RDP01-00707R000200070023-3