Georgia

This Republic in the Caucasus was a part of the Russian Empire until 1922 when it became a constituent part of the Soviet Union. It became an independent nation in 1991. It has a population of 4,694,000 (2004) and has 436 doctors and 474 nurses per 100,000 people.

While Georgia was a part of the Soviet Union, healthcare was extensive and coordinated from Moscow, the capital, which established the basic policies for the whole country, although these were implemented by the health ministries of the constituent republics. There were also regional and local health authorities which provided healthcare. The main problem faced by Georgia was that the Soviet Union wanted to set national standards of health care, along with quotas for patient visits, and the provision of treatment and hospital beds with not much consideration for the regional differences in the need for healthcare. Georgia also became a place to where many people from elsewhere in the Soviet Union went to for health cures in spa resorts. Many of these were restricted to people who worked in state enterprises throughout the Soviet Union, with access being regarded as a privilege.

Traditionally much healthcare was provided in the home, with people being treated by family members, and elderly people remaining at home rather than going to hospitals, as institutional nursing care was often poor. The system, which operated in Tbilisi, the capital of Georgia, and to a lesser extent in the rest of the country, saw emergency first aid provided by ambulance teams that were often well equipped by regional standards, although their equipment lagged considerably to that used in western Europe. As regular hospitals did not have emergency rooms, there were special emergency hospitals which dealt with people treated by ambulance teams. In remote parts of Georgia, the system was often haphazard because of the problems with communications and roads.

When the Soviet Union was dissolved, the responsibility for looking after the health services of Georgia fell to the Ministry of Health. At that time, the health-care of the population of Georgia had been exceedingly good. With Georgia having the highest number of doctors per capita, 59.2 doctors per 100,000 people, it also had more dentists per capita than any of the Soviet republics. Tuberculosis diagnoses, at 28.9 cases per 100,000 people, was the third lowest of any of the republics in the Soviet Union, and cancer, at 140.9 diagnoses per 100,000 people in 1990, was the lowest. However, there were problems with hospital bed availability which was low, and the rate of infant mortality was also high.

By this time, the healthcare system had become underfunded, and the decline in living conditions also led to the increased prevalence of some diseases. There were also more frequent problems of ill-health environmental hazards. These include some problems from nuclear waste left over from Soviet-era sites. A Georgian commission inquiry into radiation burns suffered by 11 soldiers in February 1997, concluded in November 1997 that there were 352 contaminated [Page 731]sites in the country. By contrast with the plight of the majority of the people in the country, the elite in Georgia continued to experience good healthcare having access to the best medical facilities.

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