The role of local authorities in solving medical and social problems in the east of Russia at the end of the 18th - early 20th centuries

In the late 18th and early 20th centuries, the political elite of Eastern Siberia was formed from appointees, natives of European Russia, who received their education and began their careers in the center of the Russian Empire. Regardless of the historical period, representatives of local authorities had to immerse themselves in a large-scale volume of specific problems. During the late 18th and early 20th centuries, medical and social problems in Eastern Siberia maintained their constancy and the deepest level of backwardness. In this article, using a rational approach, the authors examine the initiatives of regional officials in the field of public health, determine their motives, and draw cause-and-effect relationships of medical and social changes. The authors put forward the idea that representatives of regional authorities viewed healthcare from the perspective of the rational approach, and only personal qualities acted as an addition to managerial abilities. At different periods in the Yenisei and Irkutsk provinces, Yakutsk and Transbaikalian regions, the region was headed by political leaders who came up with the idea of transforming the medical sphere. The basis for significant changes was laid by the program documents of M.M. Speransky, N.N. Muravyov-Amursky, A.D. Goremykin and others. The authors of the publication believe that a large number of works have been accumulated covering the activities of representatives of regional authorities in the East Siberian region. However, there is a gap in the study of the factors that prompted representatives of the local political elite to carry out medical and social transformations, as well as to implement measures to increase the network of hospitals, resolve personnel issues, and change the system of medical care to the population.