Page 256 - ירושלים: גיליון רפואי

Palestine was established, the Pasteur Institute, which also conducted research on local diseases
and prevention, and manufactured rabies and smallpox vaccines.

With the outbreak of World War I in 1914, the population’s condition deteriorated. Basic food
products were unattainable, and many families suffered from starvation, aggravated in 1915 by
massive locust swarms that damaged most of Palestine’s agricultural produce. The first attempts
to establish a proper sewage system were abandoned, and ideal conditions were created for
outbreaks of various intestinal diseases. During the same period, most of the hospitals and
medical services in the city were closed down, and doctors who were nationals of hostile
countries were compelled to leave the city. Others were recruited by the Turkish army, which
confiscated all the available medical equipment and drugs. During the war, sick and injured
Turkish and Austrian soldiers occupied the few available hospital beds, also bringing various
diseases with them.

In 1916, a typhus epidemic broke out in Jerusalem and, together with other diseases rife at
the time, was responsible for over 40,000 deaths. A contagious disease caused by a microbe
known as Rickettsia, typhus is transmitted by the body louse. Substandard living conditions,
congestion, and poor sanitation all create the ideal conditions for lice to transmit the infectious
agent. The typhus epidemic lasted a number of weeks and caused widespread morbidity and
mortality. Immediately following this occurrence, the city suffered another blow. In May 1916,
large numbers of Turkish forces gathered in the city prior to an offensive against the British
forces in the Sinai desert. The Turkish units included Austrian recruits exposed to outbreaks of
cholera while on the east European front, and cholera immediately broke out in Jerusalem. For
the first time, the Turkish authorities forced the population to be vaccinated against cholera,
yet in spite of these measures, many fell ill. Patients with the epidemic were hospitalized at
Misgav Ladach and other hospitals, including one adjacent to Shaare Zedek.

On the eve of the British occupation of Jerusalem in December 1917, the greatly-depleted
population numbered only 50,000. When the British occupied Jerusalem, most of the population
was in dire economic straits, often suffering from starvation and malnutrition, and extremely
vulnerable to illness. A hint as to why morbidity was rampant among the Jerusalemites can
be found in articles printed at the time lamenting the widespread crime of prostitution, while
noting steps taken by the British army to prevent its troops from consorting with prostitutes.

The British military government dealt with the sanitary and health conditions with
determination, professionalism, and an admirable degree of efficiency. The authorities brought
food to Jerusalem and enforced army regulations on troops and citizens alike, improving the
nutrition of the population and eliminating sexually-transmitted diseases. Cisterns were
gradually sealed as a water-delivery system was constructed. Thus, the scourge of malaria and
intestinal infections was eliminated from the city. At the end of the war, physicians and medical
and health practitioners returned, significantly improving the situation of the population.

Epidemics in Jerusalem from the Nineteenth Century to the Period of the British Mandate ■ 47e