Notions of social reform and social medicine that evolve from the 19th century onwards have been discussed by scholars especially in relation with the advent of cholera and industrial societies. However, the relevance of social reform has long been demonstrated by scholars such as Alain Roussillon for the MENA region, regardless of an industrialization process occurring there.
This panel aims at filling a gap between social histories of medicine in the Middle East that have focused, from below, and a more institutional approach that has dwelled on the social engineering of medicine as a state-building/ empire-building tool. Focus on social reform and social medicine requires a "meso" approach, between the macro and the micro levels, and which by implication has to do with construction of norms, low-level actors of policy-making, enquiry processes, petitioning and local mobilization, in particular at the emergent municipal level.
This panel agrees that war was iteratively a trigger for policy making on social and health issues. These would not only build on the shifting conceptions of nationalism that characterized the era but also enhanced the role of local actors, experts and cause entrepreneurs. This connection can also be evidenced by growing social concerns in the aftermath of the Arab revolutions and especially as a consequence of refugees from Syria, Iraq or Yemen.
Wars and social problems are mutually interconnected through links such as the global impoverishment induced by the concentration of resources in the war effort, the heightened difficulty to face issues that are already hard to cope in peace time such as epidemics and starvation, and the multiplications of the various victims of war. Household with reduced workforce, citizens submitted to rationing, dependent people deprived as the state resources are allocated in priority to the military, and last, but not least, refugees are some of the other topics that need to be further enquired to build on the relationship between war, social reform and social medicine.
Finally, social medicine as an approach of healthcare has been vastly understudied in the MENA region, being overshadowed by insights into anti-epidemic control, military medicine which deals with healthcare in social and spatial enclaves, and into global health, especially in its preventive and healthcare-building dimensions.
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Gulhan Balsoy
This presentation discusses an almost unknown topic for women’s history, the case of Kırmızı Kışla (The Red Barracks). Although this name evokes militaristic connotations, Kırmızı Kışla was actually a shelter for refugee women and their children who fled to Ottoman
Istanbul in early 1890s from wars and other social turmoil. Since those women who found their ways in this shelter were almost unexceptionally widows, this institution was also called the Widow’s House (Dulhane). Despite the important function it fulfilled and its
peculiarity, Kırmızı Kışla is completely absent in the secondary literature thus making it important to shed light to the presence of this institution in history. This institution, which was established in the last decade of the nineteenth century, targeted mainly the relief of emigrant widows and orphans; yet it also hosted destitute women and orphans of the capital. In this presentation after trying to reconstruct the everyday workings of this institution, I will specifically focus on the sanitary conditions and issues related with health. The sanitary conditions at the Widow’s house were very poor. There was almost no irrigation and as a result the women and their children were constantly exposed to microbes and contagious diseases. The food was always very scant and under-nutritious. The number of beds were not enough for the residents and many women had to sleep on bare floor. As a result of such conditions, there was a huge need for midwives and doctors. Since the institution had a very central location in the city, the unhealthy conditions were not only threatening the lives of the women being sheltered at the Widow’s House, but also the residents of the city in general, as well, according to the doctors. In this presentation, building upon this preliminary framework I will try to handle the case of Widow’s House to discuss the relationship between war, social medicine, and public health.
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Ms. Seyma Afacan
Through an unusual love story between an old homosexual couple, who just decided to fight jealousy together, Baha Tevfik rewrote the rules of love in Love, Egoism (Aşk, Hodbinî): ‘Now I understand that real love starts after the age of 80, a type of love that is beyond lust, passion and jealousy...” His childhood friend and one of the first authors who wrote short stories about Darwinism, Ömer Seyfettin, told the story of a monkey afflicted with love sickness. When the poor monkey starves itself to death for its young womanizer owner, he concludes: ‘Animals tend to be affected by some irrational emotions deeply’. Pathological love was a popular subject as well as a burning problem in this era according to Nazım Şakir, the author of Pathological Love (Aşk-ı Marazî). One of the most cutting edge perspectives to love came from psychology whose authoritative voice in emotional matters was heard most clearly in Baha Tevfik’s studies, which this paper deals with primarily.
Starting with the stigmatization of emotions at the medical school in the late 19th century by ‘materialist circles’ ending with Baha Tevfik’s use of ‘self control’ as a new method of cognitive psychology in 1910, this paper treats a selection of understudied psychological writings in relation to the late Ottoman intellectual currents. Hitherto we don’t know much about the changing discourses of what to feel and how to feel in the second constitutional era, except for the dominance of nationalist/war literature. How do we make sense of the rising interest in the rhetoric of self-control? What was ‘the main reason’ for ‘materialist circles’ to stigmatize emotions? Can we think of one particular dominant ideology coloring all intellectual productions? Baha Tevfik was an outcast who openly criticized nationalism and praised anarchism in the time of rising nationalism and state control. He was once called ‘a fantasizer with great potential but no purpose’ by Ömer Seyfettin as someone who had just found his life purpose in Turkish nationalism. This paper suggests looking closely to the process of defining, understanding and shaping ‘the Ottoman individual’ as part of the process of medicalizations of emotions and the liberal and -to some extent - individual centered spirit of the post 1908 period with a complex web of motivations and opinions. This complexity can be best seen in intellectual history of medicine wherein political and ideological dominant trends did not necessarily play primary role.
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Social medicine, one of the major trends of global health in the first half of the twentieth century, seems to be out of place when one considers the Middle East. Major epidemics in the nineteenth century, plague and cholera in particular, induced strict control procedures on transportation but remained on the surface of Ottoman society. As evidenced by Sandy Sufian and Timothy Mitchell, in the most systematic health policies, macro-environmental changes were preferred to the socio-economic transformations promoted by partisans of social medicine. However, this was not for lack of interest for social medicine : Ceren Ilikan was able to show that the early Turkish Republican state harnessed anti-tuberculosis mobilizations dating back to the late Ottoman period, into enforcing its social project of shaping a modern, healthy Turkish citizenry.
This paper aims at tracking and questioning social medicine approaches in the Arab Levant, from the late Ottoman period to the mandates, through the lens of anti-TB policies. The establishment of the mandate implied that improving health was an international obligation for the colonial powers. It attracted the attention of the League of Nations' Health Organisation, in whose midst partisans of social medicine were very active. Multiple plans for relief and healthcare development were formulated in the immediate aftermath of the war, to deal with greatly enhanced epidemiological problems in a hard-hit region. However, the mandatory were short of cash and largely subcontracted healthcare to voluntary religious institutions, and, in Palestine, to Zionist organizations. Did these institutions stick to their earlier approach, aimed at extending beneficence and providing healthcare mostly within sectarian bounds without engaging social structures ? Or was there room, in the new political system, for social medicine ?
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Mr. Hratch Kestenian
On April 24, 1915, Ottoman authorities arrested Dr. Avedis Nakashian in Istanbul along with some 250 other Armenian doctors, pharmacists, politicians, intellectuals and leaders of Istanbul’s Armenian community. The arrest and the imprisonment of these personnel, which coincided with the Gallipoli landings, marked the beginning of the Ottoman Empire’s systematic attempt to eliminate the Armenian people from Anatolia—a campaign that continued through World War I and the fall of the empire. While much has been written about political aspects of the Armenian Genocide, few studies have analyzed the social and medical aspects of the genocide. It is my intention to focus on the experiences of Armenian doctors and nurses during the war, by analyzing the difficulties faced and the challenges encountered.
During the war, diseases and epidemics became a major threat to the empire’s health concerns; after all, more Ottoman soldiers died from lethal microbes and bacteria than from battlefield wounds. Armenian deportees who survived the Syrian Desert, and reached Aleppo and Beirut, contributed to the dissemination of infectious diseases such as cholera, typhus, and syphilis. The outbreak of such epidemics, obliged even Ottoman officials to facilitate the opening of hygienic centers in Aleppo in order to prevent the spread of disease to troops and civilians. In such circumstances, only doctors and nurses were capable of saving thousands and controlling epidemics, and Armenians were a large number of them. Many of these Armenian doctors were serving as captains in the Ottoman army, some answering their medical call while others under duress. It is my interest to study how medicine during WWI was militarized, politicized, and abused, how some doctors used medicine as a survival strategy, while others tried to abuse it for national and personal gains. By combining military history with medical history, I strive to establish a relationship between wars, epidemics and modernization theories during the period concerned.