Background

Throughout the 20th century, there have been significant changes in children’s health and enormous gains in paediatric healthcare because of systematic healthcare development including public health interventions. Recognising the importance of children’s health currently, countries have agreed to develop independently their own strategies, plans and programmes for sustainable development. According to WHO/Europe, infant mortality is associated with an increase in infectious diseases and adverse living conditions.1 The achieved improvements in children’s health are largely attributable to the reduction of infectious diseases prevalence.

Many historical studies of children’s morbidity and mortality concentrated either on Western countries or on metropolitan locations in non-Western settings. This paper extends the discussion by focusing on a relatively remote and peripheral urban location in the Russian Empire, the city of Tomsk in Western Siberia. According to some estimates, at the end of the 19th century in the Russian Empire, infant mortality reached 250 cases per 1000 children and was one of the highest in Europe.2

Tomsk is a city located in the Western Siberia with the climate being characterised by cold and prolonged winters. According to official sources, the population of Tomsk in 1897 was 52 430 people. Average life expectancy was 29 years for men and 30 years for women.3 There was a high birth rate in comparison with other cities, 48 per 1000 inhabitants, along with the high mortality rate of children.4 The sanitary setting of the city was in bad condition. People were forced to drink river water, and the first water supply in Tomsk was opened only in 1905.5

The first Western-style medical faculties began to appear in Russia …