348 



per bed in obstetric and children's departments is from 2.5 to 4 square meters, while the 

 standard requirement is 7-10 meters. Of the total number of medical facilities, 24.5% 

 have furnace heating, 66% of medical facilities have no hot water and depend on trucked 

 water. Over 70% of hospitals have no indoor plumbing. Running water exists in 53.8% 

 of central and rayon hospitals, and 18% of central and rayon hospitals depend on 

 trucked water. 



In recent years the birth rate in the republic has decreased significantly (Figure 

 2). As for the life expectancy of the northerners, it is connected directly not only with 

 the medico-biological problem, but also with many social and hygienic problems of 

 health protection of the northern peoples. 



Life expectancy figures for northerners are given in Figure 3. During the last 30 

 years, the life expectancy of northerners has been significantly below that of the Russian 

 Federation. This is particularly true for small ;thnic groups living in Yakutia. 



In our opinion the concept of the demographic development of the northern 

 peoples should contain the requirements needed to implement a transition to an 

 intensive type of reproduction of the population: 



1. Increasing the average life expectancy of northern peoples. 



2. Stabilizing a high birth rate. 



3. Reducing infant mortality. 



4. Reducing mortality in the working-age population, particularly from 

 exogenous causes, and also in the elderly population. 



The demographic policy of the government and the regional demographic policy 

 in areas populated by northern peoples must help to solve these problems. 



Medical care is provided by 8 central hospitals (411 beds), 29 rayon hospitals (450 

 beds), 5 outpatient clinics, 28 paramedical midwife stations, and paramedical stations. 



Of the rayon hospitals, approximately 60% were buih during 1930-1950 and their 

 degree of dilapidation is from 40% to 100%. All these medical institutions are located 

 in converted buildings. 



In 1991, the general morbidity of the adult population was 714.7 per 100,000. In 

 the hierarchy of morbidity, the dominant components are common colds and diseases of 

 the female organs, 29.0%; complications in pregnancy and delivery, 18.9%; 

 gastrointestinal diseases, kidney diseases, and dental caries. The infant mortality index in 

 1990 was 45.0%. 



-5- 



