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Divisão sanitária e organização dos serviços de saúde em Moçambique
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Neste trabalho, destacam-se a evolução e o desenvolvimento que os Serviços de Saúde sofreram nos últimos anos, através da expansão progressiva da ocupação sanitária do território, da criação de novos serviços, do equipamento em material e pessoal e da melhoria das instalações.
Novos serviços criados - A Estação Antimalária em 1937, que agora expande a sua atividade nos principais centros populacionais; - a Missão da Doença do Sono, 1939, hoje integrada na Missão de Combate contra as Tripanossomíases; - A Assistência Médica aos Indígenas e a Assistência Materno-Infantil, que se intensificaram desde 1943 com a construção de numerosos postos de saúde e maternidades rurais (fora das sedes) e com a criação de um serviço ambulatório para consultas, prospecções sanitárias, vacinações, inspeções e tratamentos - o número de postos de saúde aumentou de 137 em 1946 para 325 em 1950; o número de hospitais e enfermarias regionais, de 59 para 65; o número de maternidades (centrais, regionais e rurais) de 61 para 163; os dispensários e postos de puericultura de 4 para 43; a luta contra a tuberculose em organização, e o dispensário antituberculoso de Lourenço Marques deve ainda este ano começar a funcionar, iniciando a prospecção da doença por foto-radio-miniatura; a Inspeção dos Serviços de Assistência aos Trabalhadores Indígenas; - o Serviço de Combate à Lepra; o Serviço de Transfusão de Sangue e o Serviço de Radioterapia no Hospital Miguel Bombarda.
Pessoal - O número de médicos é hoje de 142; o de enfermeiros, incluindo o pessoal religioso, de 306; o número de auxiliares de enfermagem subiu para 661; 310 alunos frequentam escolas de enfermagem.
Atividade dos serviços - Ela se traduz nos seguintes números, referentes a 1946 e 1950: - pacientes hospitalizados - 44.298 e 56.367; consultas - 663.786 e 1.004.245; - tratamentos, incluindo injeções - 6.700.000 e 8.700.000; - operações - 39.600 e 67.800; exames laboratoriais - 114.480 e 170.877; mulheres grávidas atendidas - 14.233 e 30.080; crianças nascidas vivas em maternidades - 13.386 e 29.238; natimortos - 566 e 293; (42,2 e 31,5 por mil); crianças atendidas em dispensários - 5.477 e 12.189; o Serviço de Lepra, além dos doentes internados nas 7 leprosários existentes, supervisiona agora 15.299 doentes e suspeitos e as respectivas famílias.
Dotações - As dotações concedidas aos Serviços aumentaram de 57.652.860$00 em 1945 para 89.073.270$00 em 1950.
Incidência e distribuição das doenças endémicas - Com exceção da doença do sono, da lepra e das febres intermitentes tratadas especificamente pelos respectivos Serviços, são as úlceras venéreas com uma incidência de 62,5 por mil em relação ao total de casos de doenças, a bilharziose vesical com 25 por mil, a sífilis com 20 por mil, as doenças venéreas com 15 por mil, a ancilostomíase e a disenteria amebiana com 4 por mil e as febres recorrentes com 2 por mil, que constituem as endemias de maior extensão e que são mais fortemente combatidas.
Como resultado do aumento do número de doentes tratados anualmente, que passou de 551.053 em 1945 para 1.004.245 em 1950, o número de casos de doenças endémicas foi, respetivamente, de 229.044 e 367.677, representando 416 e 366 por mil do total de casos de doenças registados. mil no total dos casos de doenças registados.
Conclusões - O aumento do número de casos de doenças endémicas não pode ser considerado como um agravamento do estado sanitário, mas sim como resultado do desenvolvimento dos nossos serviços de assistência e da sua penetração na população indígena, e as percentagens acima indicadas mostram os bons resultados obtidos na sua luta. - A vantagem de criar, junto à Direção de Serviços, um departamento de profilaxia e combate às doenças endémicas e epidémicas. - A necessidade de aperfeiçoar a organização atual, constituindo brigadas equipadas com ambulâncias bem equipadas para atuar nas regiões mais atrasadas, realizando o estudo sanitário dessas regiões e intensificando o combate às endemias.
ln this paper it is pointed out the evolution and improvement which the Public Health activities have taken these last years as a result of the progressive enlargement of the sanitary occupation of the territory, of the creation of new services and of the improvement in the material and staff conditions of the already present settlements. New services settled: The Estação Anti-Malãrica (Anti-Malarial Post) in 1937, that at the present time extends its action to the main settlements; - the Missão da Doença do Sono (Sleeping Sickness Unit) in 1939, now integrated in the Missão de Combate às Tripanosomiases (Control of Trypanosomiasis Unit); - the Assistência Médica aos Indígenas (Medical Assistance to the Natives) and the Assistência Matemo-Infantil (Assistance to Mothers and Children) which are developing their activities since 1943, building a great number of health centers and rural maternities, and settling an ambulatory service for consultation, sanitary prospection, vaccinations, inspections, and treatments – the number of health centers passed from 137, in 1946, to 325, in 1950; the number of hospitals and regional infirmaries passed from 59 to 65; the number of maternities (central, regional. and rural maternities) passed from 61 to 163; the dispensaries and puericulture centers passed from 4 to 43; - the Combate à Tuberculose (Tuberculosis Control) in organization, hopes that the antituberculous dispensary of Lourenço Marques will start its -activities still this yar, as well as the prospection of this disease by microradiography; - the Inspecção dos Serviços de Assistência aos Trabalhadores Indígenas (Inspection of the Services of of Assistance to the Native Labourers) ; - the Serviço de Combate à Lepra (Leprosy Control Service) ; - the Serviço de Radioterapia (X-Ray Therapy Service) in the Hospital Miguel Bombarda. Staff - At the present time the number of physicians is 142; the number of nurses including the religious staff is 306; the number of aid nurses raised to 661; 310 students attend the courses of the nurses schools. Activity of the services - It is showed by the following numbers referred to 1946 and 1950; patients hospitalised - 44,298 and 56,367; consult visits - 663,786 and 1004,245; treatments including injections - 6700,000 and 8700,0J0; operations - 39,600 and 67,800; laboratory examinations - 114,480 and 170,877; anti-variolic vaccinations and other vaccinations - 719,529 and 1777,549: pregnant women assisted - 14,233 and 30,080; live-births in the maternities - 13,386 and 29,238; stillborn childr�n - 566 and 923 (42.2 and 31.5 per thousand); children observed in the dispensaries - 5,477 and 12, 189; besides the patients hospitalised in the seven leprosaries which exist the Serviço da Lepra (Leprosy Service) controls also 15,299 patients, suspected patients, and their families. Budgets - The budgets of the Services raised from 57,652,860$00. in 1945, to 89,073, 270$00 in 1950. Prevalence and distribution of the endemic diseases - Excepting sleeping sickness, leprosy, and malaria which are especially treated by the respective sevices the other endemic diseases are: yaws with a prevalence of 62.5 per thousand in relation to the total of the cases of the disease; vesical bilharziasis with 2.5 per thousand; syphilis with 20 per thousand; hookworm disease and dysenteric amoebiasis with 4 per thousand; recurrent fever with 2 per thousand. These diseases constitute the most widely spread endemies and are those mostly com bated. As a result of the increase of the number of patients treated each year which passed from 551,053, in 1945, to 10004,245, in 1950, the number of cases of the endemic diseases was respectively 229,004 and 367,677, representing 416 aind 366 per thousand of the total of the cases recorded. Conclusions - The increase of the number of cases of the endemic diseases cannot be considered as a more serious state of sanity but the result of the expansion of the assistance services and their penetration into the native population. The percentages mentioned above show the good results obtained with the fight against those diseases. .- Advantage of settling adjoining the Direction of the Services a «depart ment of prophylaxis and centrol of the eindemic and epidemie diseases». - - Necessity of improving the organization of the present time by means of brigades with well-equipped auto-ambulancies for acting in the more rudi mentary regions, and ,necessity of studying the sanity of those areas and intensifying the fight against the endemies.
ln this paper it is pointed out the evolution and improvement which the Public Health activities have taken these last years as a result of the progressive enlargement of the sanitary occupation of the territory, of the creation of new services and of the improvement in the material and staff conditions of the already present settlements. New services settled: The Estação Anti-Malãrica (Anti-Malarial Post) in 1937, that at the present time extends its action to the main settlements; - the Missão da Doença do Sono (Sleeping Sickness Unit) in 1939, now integrated in the Missão de Combate às Tripanosomiases (Control of Trypanosomiasis Unit); - the Assistência Médica aos Indígenas (Medical Assistance to the Natives) and the Assistência Matemo-Infantil (Assistance to Mothers and Children) which are developing their activities since 1943, building a great number of health centers and rural maternities, and settling an ambulatory service for consultation, sanitary prospection, vaccinations, inspections, and treatments – the number of health centers passed from 137, in 1946, to 325, in 1950; the number of hospitals and regional infirmaries passed from 59 to 65; the number of maternities (central, regional. and rural maternities) passed from 61 to 163; the dispensaries and puericulture centers passed from 4 to 43; - the Combate à Tuberculose (Tuberculosis Control) in organization, hopes that the antituberculous dispensary of Lourenço Marques will start its -activities still this yar, as well as the prospection of this disease by microradiography; - the Inspecção dos Serviços de Assistência aos Trabalhadores Indígenas (Inspection of the Services of of Assistance to the Native Labourers) ; - the Serviço de Combate à Lepra (Leprosy Control Service) ; - the Serviço de Radioterapia (X-Ray Therapy Service) in the Hospital Miguel Bombarda. Staff - At the present time the number of physicians is 142; the number of nurses including the religious staff is 306; the number of aid nurses raised to 661; 310 students attend the courses of the nurses schools. Activity of the services - It is showed by the following numbers referred to 1946 and 1950; patients hospitalised - 44,298 and 56,367; consult visits - 663,786 and 1004,245; treatments including injections - 6700,000 and 8700,0J0; operations - 39,600 and 67,800; laboratory examinations - 114,480 and 170,877; anti-variolic vaccinations and other vaccinations - 719,529 and 1777,549: pregnant women assisted - 14,233 and 30,080; live-births in the maternities - 13,386 and 29,238; stillborn childr�n - 566 and 923 (42.2 and 31.5 per thousand); children observed in the dispensaries - 5,477 and 12, 189; besides the patients hospitalised in the seven leprosaries which exist the Serviço da Lepra (Leprosy Service) controls also 15,299 patients, suspected patients, and their families. Budgets - The budgets of the Services raised from 57,652,860$00. in 1945, to 89,073, 270$00 in 1950. Prevalence and distribution of the endemic diseases - Excepting sleeping sickness, leprosy, and malaria which are especially treated by the respective sevices the other endemic diseases are: yaws with a prevalence of 62.5 per thousand in relation to the total of the cases of the disease; vesical bilharziasis with 2.5 per thousand; syphilis with 20 per thousand; hookworm disease and dysenteric amoebiasis with 4 per thousand; recurrent fever with 2 per thousand. These diseases constitute the most widely spread endemies and are those mostly com bated. As a result of the increase of the number of patients treated each year which passed from 551,053, in 1945, to 10004,245, in 1950, the number of cases of the endemic diseases was respectively 229,004 and 367,677, representing 416 aind 366 per thousand of the total of the cases recorded. Conclusions - The increase of the number of cases of the endemic diseases cannot be considered as a more serious state of sanity but the result of the expansion of the assistance services and their penetration into the native population. The percentages mentioned above show the good results obtained with the fight against those diseases. .- Advantage of settling adjoining the Direction of the Services a «depart ment of prophylaxis and centrol of the eindemic and epidemie diseases». - - Necessity of improving the organization of the present time by means of brigades with well-equipped auto-ambulancies for acting in the more rudi mentary regions, and ,necessity of studying the sanity of those areas and intensifying the fight against the endemies.
Descrição
Palavras-chave
Saúde pública Organização dos serviços de saúde Moçambique
Contexto Educativo
Citação
Editora
Instituto de Medicina Tropical