Until the early 80s of the XIX century, almost all doctors in Western Siberia lived in cities. District doctors went to rural areas only to fight epidemics, but often appeared in villages after typhus or cholera had stopped. There were few free-practicing doctors, mostly from exiles with medical education. Although the regulations of March 12, 1882 prohibited exiled doctors from practicing medicine, there were frequent violations. Thus, medical student N. Dolgopolov, exiled to Tyukalinsk, established himself as a doctor who treated peasants without any remuneration. He cured the wife of the mayor Balakin, for which, contrary to logic, he was first imprisoned in the Tyukalinsky district prison, then exiled to Yakutia.

Significant changes in the situation of rural medicine occurred in 1888. According to the new staffing table, 42,000 rubles were allocated for medicine, 840 rubles for each hospital, and 100 rubles for the purchase of medicines. These measures have made it possible to increase the number of medical personnel. So, in the Tobolsk province, 8 rural doctors, 40 paramedics, 40 midwives and midwives were invited. However, this number of doctors was insufficient due to the huge area of the province. In 1888, only 23 thousand people were able to seek medical help.

The opening of local educational institutions, such as the Tobolsk Midwifery School, made it possible to increase the number of medical personnel. In 1897, the number of medical personnel in the province amounted to 237 people. There were still not enough doctors and paramedics. There was an acute need for medical staff in rural areas. On average, one rural doctor accounted for 12 thousand square miles, 130 villages and 47 thousand inhabitants.

At the beginning of the twentieth century, the number of medical personnel continued to grow. In 1904, 283 medical employees worked in Tobolsk province, 383 in 1911, and 470 in 1913. Doctors of such specialties as pharmacists and dentists appeared. Quite complex surgical operations were performed. In 1913, there was 1 doctor for 2,199 people in the cities, and a paramedic for 1,374 people. Thus, the urban population was provided with medical care. There were still not enough medical personnel in rural areas: 1 doctor accounted for 47,813 people, a paramedic for 10 951 people.

In the second half of the 19th century, Siberian doctors and paramedics began an active struggle against quackery. "It has been positively proven," it was stated in the Journal of the Tobolsk District Committee of Public Health, "that healers and horse doctors, cutting through tumors or performing bloodletting to humans or animals, do not observe proper cleanliness, do not clean their tools and spread the infection to other villages…"

The success of scientific knowledge in the early twentieth century caused changes in the worldview of the people. The younger generation no longer believed in the idea of diseases as living beings. But the practice of folk medicine continued to exist and even competed significantly with official medicine, whose authority was not high. For example, in 1912, a woman bitten by a snake was brought to the village of Bryantseva in the Kugaevsky parish of the Tobolsk district of the Tobolsk province. The paramedic, after examining her, gave the order to take the patient to the city, but the woman ordered to take her back to the village, to the healer.

In the 1930s, an orphanage for street children was established in the Tyumen region. The first mention of it dates back to 1935. In 1939, three orphanages were already listed on this territory, which were structural divisions of the Verkhny Bor orphanage. At the Verkhny Bor orphanage there was a subsidiary farm engaged in animal husbandry and crop production, mechanical workshops, a school, and a medical center.

In 1944, the Verkhny Bor orphanage was reorganized into the Verkhny Bor children’s bone tuberculosis sanatorium of the Tyumen Regional Department of Social Security.

In the 1940s, the institution was named in different ways: "Verkhny Bor Orphanage", "Verkhny-Bor Children’s Sanatorium", "Verkhney-Bor Children’s Home for disabled children with bone tuberculosis", "Children's Bone Tuberculosis Home", etc.

At the end of 1947, there were 163 children in the sanatorium, 87 of them aged 7 to 12 years, 61 children aged 12 to 16 years. Four of the children were under 7 years old, and 11 were 16 years old and older.

In 1949 The Verkhny Bor Children’s Bone Tuberculosis Sanatorium was renamed the Verkhny Bor Children’s Home for the disabled of bone tuberculosis children of the hospital type. In March 1962, the Verkhny Bor orphanage was reorganized into a sanatorium for preschool and school-age children with tuberculosis with 75 beds.

Throughout the entire period of activity, the Verkhny Bor children’s sanatorium provided sanatorium treatment for children with tuberculosis, as well as medical care in the areas of phthisiology, pediatrics, otorhinolaryngology, medical massage, physiotherapy, functional diagnostics, radiology, medical statistics, medical rehabilitation, etc.

In 2020, the institution was reorganized by joining another institution — the State Autonomous Healthcare Institution of the Tyumen Region "Nadezhda Children’s Medical Rehabilitation Center".

One of the most dangerous diseases was smallpox. Although the first experiments on smallpox vaccination were carried out in Siberia in the second half of the XVIII century, vaccination entered the life of the population very slowly.

In 1879, smallpox vaccination began in the Tobolsk province. In the first year, 28,638 infants were vaccinated with smallpox, which was 41.19% of the total number of children born in the province in 1879. Smallpox vaccinators worked one or two people per parish.

At the end of the XIX century to combat smallpox, an attempt was made to prepare smallpox vaccinators from peasant boys, who were then sent to villages. However, they could not gain the trust of their fellow villagers. The peasants preferred to vaccinate themselves, transferring the liquid from the smallpox vesicles from a sick child to the body of a healthy one.

Smallpox vaccination primarily affected the urban population. The nomadic foreign population continued to suffer from smallpox. So, in 1891, the Berezovsky District Committee of Public Health recorded an epidemic among the Khanty and Nenets, but no measures were taken, at least to weaken the epidemic, "in view of the nomadic lifestyle, the dispersion of the population and the lack of smallpox lymph …".

Midwives provided obstetric care to women in the village.

In 1878, a midwifery school was opened in Tobolsk. It was the second educational medical institution for women in Russia after the school for paramedics in St. Petersburg. The base for training was the provincial hospital.

In August 1878, 62 girls applied to the school, 48 were admitted to the exams, and 30 girls were accepted to the school.

The school taught the Law of God, the Russian language, arithmetic and penmanship. In addition, in the second half of the year, the students were practically engaged in the art of childbirth, handing out brochures to pregnant women and women in labor.

Since the opening of the school, the duties of the director and teacher of obstetrics have been assigned to the inspector of the Medical Board, Mavriky Lukyanovich Petrazhkevich. The teachers of the Law of God in the first half of the year were the priest of the Tobolsk Theotokos-Nativity Church Alexei Mikhailovsky, in the second — the priest of the cathedral Nikolai Skosyrev. Elizaveta Krasnopevtseva, who holds the title of a home teacher, taught Russian, arithmetic and penmanship. The midwife of the school was the midwife Claudia Protopopova.

Before the construction of its own building, the Tobolsk midwifery school was located in the mountainous part of the Belyankin house for a fee of 250 rubles per year, the boarding school and the apartment of the midwife-supervisor were located in the same building.

On August 1, 1879, the school was transferred to another house, hired under a contract for 300 rubles per year from Korolkova. This building was located near the hospital, but it was cramped and not adapted.

In 1884, 26 girls studied at the midwifery school, 8 of them peasant, 5 noblewomen and daughters of officials, 4 petty bourgeois, 4 soldiers, 3 clergy, 1 honorary citizen, 1 merchant. In 1886, 25 girls studied at the midwifery school, in 1887 — 20 girls.

In 1895, the paramedic-midwifery school was transformed into a paramedic-midwifery school. The school was located in a spacious wooden building on Ilyinskaya Street.

At the end of the XIX century, women from 18 to 30 years old with an education of at least the 4th grade of a gymnasium or gymnasium, as well as having certificates for the title of domestic or rural teachers, were admitted to the paramedic-obstetric school.

In 1913, the Tobolsk obstetric and paramedic school served: director, collegiate adviser Grzhegorsky Olgerd Viktorovich; Law teacher Archpriest Nikolai Pavlovich Bellavin; Teachers: Ivan Arsentievich Burtsev, Ivan Ivanovich Pokrovsky, Maria Alekseevna Giganova, Alexander Nikolaevich Genke, Vladimir Karlovich Lindeberg, Arkady Nikolaevich Nelyubin, Konstantin Nikolaevich Splenderov, Georgy Nikolaevich Egorov, Mikhail Mikhailovich Makarevich. In 1913, 108 girls studied at the obstetric and paramedic school.

On May 5, 1913, construction began on a spacious two-story brick building at the corner of Ilyinskaya Street and Aptekarsky Lane. Although the bulk of the work was completed in 1914, the full completion of construction took place in 1915.