LaVerne Kuhnke - Lives at Risk: Public Health in Nineteenth-Century Egypt (Comparative Studies of Health Systems and Medical Care)
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Lives at Risk: Public Health in Nineteenth-Century Egypt (Comparative Studies of Health Systems and Medical Care)
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Lives at Risk describes the introduction of Western medicine into Egypt. The two major innovations undertaken by Muhammad Ali in the mid- nineteenth century were a Western-style school of medicine and an international Quarantine Board. The ways in which these institutions succeeded and failed will greatly interest historians of medicine and of modern Egypt. And because the author relates her narrative to twentieth-century health issues in developing countries, Lives at Risk will also interest medical and social anthropologists. The presence of the quarantine establishment and the medical school in Egypt resulted in a rudimentary public health service. Paramedical personnel were trained to provide primary health care for the peasant population. A vaccination program effectively freed the nation from smallpox. But the disease-oriented, individual-care practice of medicine derived from the urban hospital model of industrializing Europe was totally incompatible with the health care requirements of a largely rural, agrarian population.
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COMPARATIVE STUDIES OF HEALTH SYSTEMS AND MEDICAL CARE
General Editor John M. Janzen
Founding Editor Charles Leslie
Editorial Board
Don Bates, M.D., McGill University
Frederick L. Dunn, M.D., University of California, San Francisco
Kris Heggenhougen, University of London
Brigitte Jordan, Michigan State University
Patricia L. Rosenfield, World Health Organization
Paul U. Unschuld, University of Munich
Francis Zimmermann, Centre National de la Recherche Scientifique, Paris
For a complete list of titles in this series, please contact the
Sales Department University of California Press 2120 Berkeley Way Berkeley, CA 94720
Page iii
Lives at Risk
Public Health in Nineteenth-Century Egypt
LaVerne Kuhnke
Page iv
University of California Press Berkeley and Los Angeles, California
University of California Press Oxford, England
Copyright 1990 by The Regents of the University of California
Library of Congress Cataloging-in-Publication Data
Kuhnke, LaVerne. Lives at risk: public health in nineteenth-century Egypt / LaVerne Kuhnke. p. cm.(Comparative studies of health systems and medical care; no. 24) Includes bibliographical references and index. ISBN 0-520-06364-3 (alk. paper) 1. Public healthEgyptHistory. 2. Medical careEgypt History. 3. EpidemicsEgyptHistory. I. Title. II. Series. RA549.K83 1990 614.4'0962'09034dc20 89-33122 CIP
Printed in the United States of America
9 8 7 6 5 4 3 2 1
The paper used in this publication meets the minimum requirements of American National Standard for Information SciencesPermanence of Paper for Printed Library Materials, ANSI Z39.48-1984
Page v
To Bob, George, and Elizabeth
Page vii
Contents
Acknowledgments
ix
Introduction: Evolving Concepts of Disease and Medicine
1
1 Muhammad Ali and the Egyptians
17
2 Response: Establishment of the Egyptian School of Medicine
33
3 Cholera: The Epidemic of 1831 and Later Invasions
49
4 The Plague Epidemic of 1835: Background and Consequences
69
5 The International Quarantine Board
92
6 The Conquest of Smallpox: Variolation and Vaccination
111
7 Women Health Officers
122
8 Urban and Rural Health Programs: Hospitals, Clinics, and Provincial Health Centers
134
9 The Continuing Evolution of Concepts of Disease and Medicine
153
Appendix l: A Public Health Establishment in Egypt, 18251850
167
Page viii
Appendix 2: Medical-Pharmaceutical Personnel in the Public Health Service in Egypt, 1851
168
Notes
179
Index
231
Page ix
Acknowledgments
This study has undergone a long evolution, and I have accumulated many debts of appreciation for inspiration and support from many people. William R. Polk, Lester S. King, and William H. McNeill encouraged my initial efforts at the University of Chicago. Generous grants from the American Research Center in Egypt and the Center for Middle East Studies at the University of Chicago provided the means to pursue extensive research abroad at the outset, and another liberal award from the National Library of Medicine (LM03172-01) enabled me to complete the work.
Many librarians, archivists, and scholars on three continents extended invaluable assistance for my research. Hoda Banhawi and Jean Catafago at the Egyptian National Geographic Society in Cairo were indefatigable in locating publications needed. Cynthia Nelson and Aida Sourial at the American University in Cairo stimulated and seconded my investigations. At Cairo University, Dr. Ferdos Labib opened new avenues of inquiry and contributed a twentieth-century perspective to my nineteenth-century public health data. Lewis Halim and Muhammad Qadri unfailingly came to the rescue to interpret technical or archaic terms in Arabic documents.
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