Natural medical resources and preformed means

The formation of the national policy of Ukraine concerning the development of the recreational sector and health resort and recreational nature management is an extremely urgent problem in connection with the necessity of the nation mass health improvement; and it is the basis for the constructive interaction between the public authorities of Ukraine and its entities concerning the ensuring of the complex usage of the natural recreational resources and potential of the recreational sector. The preservation and development of the health resort industry should become an constituent of the public policy in the protection and promotion of the population health; it should become priority line in the formation  of the social programs providing the realization of the citizens’ right to rest, to treatment, to favourable environment, the rights of future generations to usage of the recreational natural and resource potential for the purpose of the high life quality maintenance, and solution to the current problems of the mass citizens’ health improvement and the inseparable connection with the implementation of the adequate measures concerning the  preservation and renovation of the natural recreational resources.

The resort complex of Ukraine is presented by the huge reserves of the natural medicinal resources with modern medical equipment, the network of the sanatorium-and-health-improving institutions and the reserve of the experienced cadre potential. Thus, the natural and recreation complexes of Ukrainian coasts of the Black Sea and the Sea of Azov, the Carpathian region, Polissya (woodlands) and other regions of Ukraine are of great regional, national and international importance for the system of the mass citizens’ health improvement in Ukraine, CIS and other countries; and for stabilization of the economy and socio-economic progress, for Ukraine’s integration in the global economic system.
Among the natural resources of the country a special place is occupied by the naturalmedicinalrecourses through their economic and social value. On the basis of these resources the sanatorium-and-spa branch (an important branch of the health protection system) and the bottling in the food industry are operating and successfully developing.
In 2000 the Law of Ukraine “On Resorts” entered into force. This Law determines the legal, organizational, economic and social principles of the resort development in Ukraine. It seeks to provide the usage of the natural medicinal resources (NMR), natural areas of the resorts for the purpose of people’s treatment and health improvement; and to protect these resources and resorts. According to the Article6of this Law “Natural Medicinal Resources”the natural medicinal resources are mineral and thermal water, therapeutic muds and ozocerite, brine of limans and lakes, sea water, natural objects and complexes with the favourable climatic conditions for the treatment, that are suitable for the usage for the purpose of the treatment, rehabilitation and preventive health care.
According the order of the Ministry of Health of Ukraine of 02.06.2003 No.243 "On the Approval of the Order of Medical and Biological Assessing of the Quality and Value of the Natural Medicinal Resources, of the Determination of Their Usage"(is registered in the Ministry of Justice 29.08.03 No.752/8073), the basic notions and terms are defined:
Mineral natural water is the natural underground mineral water of the objects (deposits) that are characterized by the certain and stable physical and chemical composition, by the content of biologically active components and compounds in accordance with the standards, which are set for every object (deposit), that is used without additional processing, which may influence on the chemical composition and microbiological properties. The criteria of mineral water for drinking and external usage are determined in Appendix 1 to the Order.
Packed natural underground mineral water (medicinal and table, medicinal water) is mineral water, which is bottled into the hermetic tares for sale.
Packed natural underground mineral medicinal-and-table water is natural underground mineral water of the objects (deposits) with medicinal properties, that is characterized by the mineralization of 1.0 to 8.0 h/dm3, the stability of physical and chemical composition, the content of biologically active components and compounds, which is lower than the accepted balneal standards according to the requirements of the standards, which are set for every object (deposit), that is used without additional processing that may influence on the chemical composition and microbiological properties, according to medical (balneal) conclusion. Mineral natural medicinal-and-table water is used as medicinal on doctor’s orders and as table beverages during an unsystematic taking for not more than 30 days with the interval of 3-6 months.  
Natural underground mineral medicinal water is natural underground mineral water of the objects (deposits) with the marked medicinal and prophylactic action on the human, that is characterized by the mineralization of more than 8.0 h/dm3 or less, with the content of biologically active components and compounds, which is not lower than the accepted balneal standards (Appendix 1) according to the requirements of the standards, which are set for every object (deposit), water of which is used without additional processing that may influence on the chemical composition and microbiological properties, according to medical (balneal) conclusion.
Mineral natural medicinal water is used only for the purpose of treatment on doctor’s orders according to the medical indications. Water with the mineralization of 1.0 to 1.5 h/dm3 is tested for the biological activity for the identification of their type: table or medicinal-and-table water.
Diluted mineral water is water that is obtained by diluting of natural underground mineral water with natural underground mineral water with the mineralization under 1.5 h/dm3 that allows their usage in the resort and off-resort practice.
Therapeutic muds (peloids) are peat, sapropelic, silt sulfide, freshwater clayey silts, hill hydrothermal silts that consist of mineral and organic substances, that were under the multiple transformations through the physical and chemical, chemical, biochemical processes and that are homogeneous fine-dispersed plastic mass, and which in hot state are used in the mud treatment. The main types of the therapeutic muds are determined in the Appendix 2.
Sea water is earth surface water in the seas. It is characterized by the stability of the correlation of basic ions concentrations regardless of their absolute concentrations, the total mineralization of 6 to 18 h/dm3, the permanent saline composition in which 80% is sodium chloride, 20% - calcium, magnesium, potassium, bromine salt etc.
Ozocerite (mountain wax) is a group classification name of bitumen, an oil part of which is generated from solid hydrocarbons, mainly of paraffin series (ceresin).
Brine is saturated salt-water of salt lakes (limans), hollow spaces and interstice of the bottom sediments.
Bischofite is a final product of the easily soluble salts deposition (halogenez) formation process; that is generated at the last stage of the sulfate type salts, rich of magnesium, deposit formation.
Preformation agents are preparations based on the natural medicinal resources: water with alimentary and herbal admixtures, mud solution, differently soluble mud extracts, mud masses with admixtures of inorganic, organic compounds and biologically active components with the therapeutic or preventive action on the human on internal or external application.
Medical and biological assessment of the natural medicinal resources quality and value is a research and development substantiation of the effectiveness and safety of the natural medicinal resources, including preformation agents, the possibility of their usage for the purpose of treatment, medical rehabilitation and preventive health care.
Medical (balneal) conclusion is a conclusion on the basis of complex medical and biological and other special researches of the structure and properties of the natural medicinal resources, including preformation agents, in regard to the possibility of their usage for the purpose of treatment, medical rehabilitation and preventive health care; a document that regulates the quality of the natural medicinal resources as well as the conditioned composition of healthy and unhealthy components for the human.
Medical (balneal) conclusion is due to be reviewed if during its action there were the following changes of:
  • the current legislation of Ukraine;
  • the operative conditions of the natural medicinal resources deposits;
  • the key components of the composition, including biologically active;
  • the indications and contraindications for the application;
  • the introduction of new methods of analysis of the natural medicinal resources, including the preformation agents;
  • the medicobiological substantiation of expiry dates;
  • the production techniques.

Climatological research is a study of the characteristic features of the climate, its formation and geographical area.

Geological and hydrological research is a geological, hydrogeological and hydrological study of the natural medicinal resources, their origin, conditions of occurrence, physical and chemical properties, interaction with rocks, atmospheric and surface waters, objective laws of phenomena and processes in them, as well as possibilities of their practical usage.

Balneological research is a study of the action of the naturalfactorscomplex, that are characteristic for this area, in regard to giving the status of the resort (the characteristic of landscapes, climate, engineering and geological conditions, natural medicinal resources, the possibility of their usage for the purpose of treatment, rehabilitation and preventive health care, the identification of the methods their usage, etc.).

Researches (tests) are the experimental determining of quantitative and / or qualitative features of the object of research properties. The tests are:

  • researching (defining) that are held to analyze certain characteristics of the object properties;
  • comparative – for comparison the features of the object;
  • checking – for determination of the object compliance with the standard requirements.

Preclinical researches of the natural medicinal resources, including preformation agents, are the complex of hydrogeological, physical, chemical, microbiological, sanitary-and-epidemiologic, physiological and other researches in the process of which their effectiveness and safety are grounded.

Clinical trials of the natural medicinal resources, including preformation agents, are the study of their effectiveness and safety on the human for the purpose of the determination or confirmation of the balneological and other properties, possible adverse reactions on the application.

By 01.01.2009 during last three years the Ukrainian Research Institute of Medical Rehabilitation and Balneology has conducted a complex of preclinical researches and clinical trials and published medical (balneal) conclusion for53 packed mineral medicinal-and-table waters, 32 mineral medicinal waters, that are used in the sanatorium-and-spa industry on the internal and external  application, and 8 therapeutic muds (peloids). During this time it has been also prepared the certificates of condition for20 deposits of mineral waters, 5 deposits of therapeutic muds, which are necessary for confirmation of their reserves in the State committee of mineral deposits of Ukraine. State cadastre of the natural medicinal resources (DKPLR), which in fact should be carried on together with State cadastre of the natural areas of the health resorts, should become an information base for effective management of the natural medicinal resources (PLR).

According to the decree of the Cabinet of Ministers of 26.07.2001 No.872 "On the Approval of the Order of Establishment and Conduct of State Cadastre of the Natural Medicinal Resources", the Cadastre is used for effective current and prospective usage of PLR in the sanatorium-and-spa treatment, medical rehabilitation, recreation of population; ensuring of the reasonable  production, usage and protection of PLR; the arrangement of the favorable conditions for treatment, the  preventive health care and recreation; the improvement of the nature-conservative system, the creation of districts and areas of the sanitary (mining and sanitary) protection of the resorts; the solutions to other matters, that are connected with the usage of PLR. The modern solutions to the determined tasks must be conducted with the help of the geographic information technologies in the way of the DKPLR management automated system creation.

In fact, the decree of the Cabinet of Ministers of 23.05.2001 No.562 approved the "The Order of Establishment and Maintenance of State Cadastre of Natural Resort Areas". The analysis and systematization of the information and the results of research about health resort and recreation regions concerning the natural medicinal resources are extremely necessary. It is also necessary to know the level of the anthropogenic impact on hydromineral resources of the deposits, which are used, that brings up the question of the urgency of the monitoring. And with it, in the state administration there is often no information about the ecological conditions of the natural medicinal resources, which are in the regions where in some cases the special assessment is necessary. Thereby, the important tasks in this direction are the determination of the reasonability of the primary operation of this or that mineral water deposits or the implementation of their exploration final stages; the assessment of the mineral water usage direction and the potential of the health resort recreation in the concrete regions.

In the Ukrainian Research Institute of Medical Rehabilitation and Balneology one has argued the conception of the monitoring of Ukraine natural medicinal resources: the methodology (ideological and scientific foundations) and methods (organization, structure and program in general
form), one has developed the mineral waters and therapeutic muds quality assessment criteria.

The complex researches of various natural medicinal resources, the assessment of their current condition cause the development of various specializations resorts. The following stages are to be made:

  • to make a full environmental-and-economic assessment and certification of recreational resources of Ukraine;
  • to go over from the partial and separate researches of  some problems of the recreational infrastructure and the departmental usage of the recreational resources to the complex researches and the processing of the corresponding programs on a scale of the separate regions;
  • to ensure the full financing of scientific researches of the aforesaid issues.

It is obvious, that the preservation of the natural medicinal resources should, primarily, be based on the protection of the health resort and recreation areas. In spite of the obvious economic reasonability and the urgent necessity of the development of the health and recreational complex, today in Ukraine, with minor exceptions, it is not established the boundaries of the conservation zones of all types (the zones of the resort sanitary control, of the coastal protective strips along the seas, etc.); it is almost not defined the indicators of reserve areas for the development of the resorts even for the nearest future. Therefore the complex of the issues of the sanitary control of resorts and natural medicinal resources deposits requires a special attention. The development of the regulated activities within the zones of sanitary protection of the resorts and the control of the natural medicinal resources quality are of great importance. Thus, according to the Articles 30-33 of the Law of Ukraine "On Resorts", oneregulates the requirements as to the three zones of the resort sanitary control: the first zone is a zone of the strict routine; the second zone is a zone of restrictions; the third zone is an area of observation. The realization of the concrete aspects as to the given requirements is set out in the relevant normative-methodological documents, which are at the different stages of the processing and approval.

The state data report about the natural medicinal resources and the objects of the resort infrastructure is necessary for the modern assessment of the natural potential of the resorts and ensuring of the constant health resorts development. And according to the Law of Ukraine "On Resorts", this is the main task of establishment of the state cadastres of the natural resort areas and natural medicinal resources. In addition, the results of ecological, economic and socio-economic assessment of the resorts and the objects of their infrastructure natural potential should be taken into account while declaring the natural area to be a resort area and conducting the special economic measures.

As it was mentioned above, the designing of the resort development conception should be the primary task of the public policy formation in the field of the resort functioning. This conception would determine the types of the sanatorium-and-spa institutions, the directions of their specialization and the programs of the resort functioning coordination irrespective of the departmental subordination and patterns of ownership; and it should cover the basic following issues:

  • efficient usage of the natural medicinal resources and their protection;
  • following the unified state standard methods of treatment u1110 and medical rehabilitation;
  • following the scientifically grounded terms of treatment and rehabilitation in the resorts;
  • development of the Statute of the protection of resorts, deposits of natural medicinal resources, routines and areas of sanitary control;
  • establishment and maintenance of the State cadastre of the natural medicinal resources;
  • development of the system of the State monitoring of the natural medicinal resources and areas;
  • development of economically reasonable standards of the pay for the usage of the natural medicinal resources;
  • preparation of the list of the resorts of the state and local value.

The developed infrastructure of the resort areas (the transport, the communications, the communal services), which will be in conformity with the world standards, favour the competitive recovery of the Ukraine health resort and rehabilitation complex. The development of this infrastructure requires the solution to the territorial-and-functional, social-and-economic, environmental problems and tasks. They are connected with the distribution and measurement of the priority directions of the territorial resources usage and the search of the ways of the interindustry interests balancing; the solutions to the health resort, residential, social, engineering-and-transport, municipal and other types of construction placement, the reproduction of the cultural and historical heritage, the protection and enrichment of the health resort natural environment. Therefore, the existence of the unique natural medicinal resources, the information regarding their current conditions, the well-developed infrastructure of the sanatorium-and-spa institutions are the base potential, against the background of which the state attitude to the efficient usage of the recreational resort areas facilities should be formed, and this attitude causes the further development of the health resort industry in Ukraine.

K.D. Babov, T.A. Zolotariova, B.F. Ometsynskyi