SPECIAL ARTICLE Polish medicine in 1918 Marek Przeniosło1, Małgorzata Przeniosło2 1 Institute of History, Jan Kochanowski University of Kielce, Kielce, Poland 2 Institute of School Education, Jan Kochanowski University of Kielce, Kielce, Poland Health condition of the society After the outbreak troops. The increasing number of deaths partic- of World War I in 1914, the quality of health care ularly affected children. That was the case in pri- clearly deteriorated on Polish lands. Many doctors vate homes and various types of care facilities. A were mobilized and some of the existing health drastic example may be the situation in the City care infrastructure was taken over by the fight- Orphans’ Home in Vilnius, run by the local gov- ing troops (FIGURE 1). In addition to the difficult -ac ernment, where mortality among children exceed- cess to medical care, there were also other factors ed 90% over the entire war period.1 that influenced the decline of public health. The During World War I, Polish lands became the war caused a deterioration of housing and sani- theater of military operations. In fact, only the tary conditions (destruction of residential build- western part (the area of the Prussian Partition) ings, forced lodgings). Also, there was a serious was not affected by war. In the other areas, espe- problem with food supply due to the insufficient cially in the first year of the conflict, there were amount of food on the market. The conditions regular clashes between the German and Aus- of war were conducive to the spread of epidem- tro-Hungarian armies on one side and the Rus- ics, not only due to the worsening living condi- sian army on the other. From the second half of tions and difficult access to medical care, but also 1915, the front became stabilized. Some of the because of the mass movement of civilians and Polish territories formerly under Russian rule, Correspondence to: Prof. Marek Przeniosło, MA, PhD, Institute of History, Jan Kochanowski University of Kielce, ul. Świętokrzyska 15, 25-406 Kielce, Poland, phone: +48 41 349 73 06, email: [email protected] Received: August 27, 2018. Revision accepted: August 28, 2018. Published online: October 18, 2018. Conflict of interest: none declared. Pol Arch Intern Med. 2018; 128 (11): 693-700 doi:10.20452/pamw.4348 Copyright by Medycyna Praktyczna, FIGURE 1 Military hospital in Warsaw in 1914 or 1915 (photo courtesy of the Central Medical Library in Warsaw, Kraków 2018 Poland) SPECIAL ARTICLE Polish medicine in 1918 693 including Warsaw, were taken over by the troops In the Tłumacz county, the typhus epidemic deci- of the Central Powers. mates the population. Only one doctor, a dentist, The German and Austro–Hungarian military works for 108 000 people in the county; no disin- authorities made efforts to improve medical care fectants, no medicines.6 in the occupied territories. They monitored the The situation was slightly better in the Stani- health situation on a regular basis, especially ep- sławów county: idemiological threats, and supported health-re- Typhus in the city and the surrounding area; though lated initiatives of local governments and var- the city has enough doctors (15), there are none in ious social organizations. The occupation au- the countryside. Patients remain in hospitals and thorities organized various projects in order to at home; no disinfection is carried out due to the support the search for solutions to improve the lack of funds.7 health situation. An example could be the na- tionwide German congress of doctors, with rep- After the war, the situation was similarly tragic resentatives of the Polish medical community, in north-eastern Poland. An example report from organized in Warsaw in 1916.2,3 Unfortunately, that area reads as follows: the actions undertaken resulted in no signifi- The sanitary situation in the Borderlands is sim- cant improvement. ply terrifying. The number of people suffering from During the war years, the number of civil- typhus and black smallpox goes beyond imagina- ian deaths increased markedly. The rising death tion. The American Red Cross has taken action to toll was accompanied by a decrease in the num- combat this epidemic, but it is insufficient in the ber of births, which further aggravated the de- face of its scale.8 mographic situation. Some data regarding the Tuberculosis was also a major problem in Po- Catholic population in the Kingdom of Poland land at that time. Numerous cases had already illustrate the problem well. In 1918, compared been recorded before 1918. In 1916, in Warsaw, tu- with 1913, the number of births dropped by 36% berculosis caused the highest number of deaths.9 while the number of deaths rose by 40%. In 1915, The military authorities attached great impor- compared with 1913, the number of deaths in- tance to preventing the spread of venereal diseas- creased by 42%. As for the births, the situation es because they were a great threat to soldiers. A was particularly grim in cities where, in 1918, higher incidence of venereal diseases during the 4 60% fewer children were born than in 1913. The war was associated with a significant increase in decrease was influenced by the significant dete- prostitution caused by difficult economic condi- rioration of living conditions, a circumstance in tions. This increase was noticeable not only in Po- which families preferred to limit the number of land but also in the whole war-torn Europe. Af- offspring. There was also a temporary decrease ter the war, the threat of venereal diseases did in the number of young men (some were called not diminish. In December 1918, the Polish au- up by the army). thorities set up Sanitary-Moral Offices (in Polish, Both during and after the war, it was a big chal- Urzędy Sanitarno-Obyczajowe) to supervise pros- lenge to prevent and fight epidemics, especially titution and combat venereal diseases. They em- typhus, and, from 1918, also the so called Span- ployed doctors to search for susceptible individ- ish flu. Even international organizations joined uals, organize free medical examinations, encour- the fight against the epidemics. In March 1919, age treatment (compulsory for prostitutes), and in connection with the alarming epidemiologi- take measures to prevent the spread of venereal cal situation in Eastern Europe, the Internation- diseases—by raising awareness, giving away bro- al Red Cross set up the Central Epidemiological chures, or giving official readings to the public.10,11 Bureau for Eastern Europe, which included del- During and directly after World War I, special egates from Poland. The Red Cross mission in social aid organizations were established to rem- Poland mostly focused on the fight against epi- edy the tragic situation of the population on the demics.5 For instance, in 1918 and 1919, the epi- Polish lands. They provided food aid on a mass demiological situation was very difficult in East- scale as well as established orphanages and nurs- ern Galicia. There are reports from the area, writ- ing homes for the elderly. They also aimed to im- ten in 1919 by the inspectors of the Central Wel- prove the health of the population. The organizers fare Council (in Polish, Rada Główna Opiekuńcza of the aid were primarily representatives of the in- w Warszawie), a social organization that provid- telligentsia, mostly doctors, clergy, teachers, and ed help to the needy. Here are some quotes (our civil servants. Landlords and industrialists were translation): also active. The largest aid organizations estab- lished in Poland after the outbreak of World War Typhus in the Bohorodczany county; 31 municipali­ I were: the Central Citizens’ Committee in War- ties are visited by only one doctor who acts as the saw (Centralny Komitet Obywatelski w Warsza- county physician.6 wie; it operated in the years 1914–1915), Central The typhus epidemic in the Buczacz county has be- Welfare Council in Warsaw (1915–1921), Main come so large that it cannot be suppressed before Rescue Committee in Lublin (Główny Komitet winter, and the lack of doctors, hospitals and med- Ratunkowy w Lublinie; 1915–1918), and Duke- ical resources is very conducive to its expansion.6 Bishop’s Committee in Kraków (Książęco-Biskupi 694 POLISH ARCHIVES OF INTERNAL MEDICINE 2018; 128 (11) FIGURE 2 The Central Welfare Council’s hospital for children in Warsaw in 1918 (photo courtesy of the Polish Central Archives of Modern Records in Warsaw, Poland) FIGURE 3 Medical clinic for mothers and children in Sambor in 1919 (photo courtesy of the Polish Central Archives of Modern Records in Warsaw, Poland) Komitet w Krakowie; 1915–1919). These organiza- (in Polish, Komitet Generalny Pomocy dla Ofiar tions undertook very intensive actions aimed at Wojny w Polsce), established in 1915, in Switzer- improving public health, for example, they set up land. Its first president was Henryk Sienkiewicz. and financed their own small hospitals and health As for other foreign assistance, the Poles could centers (FIGURES 2 and 3), organized a medical con- also count on the American government and or- sultation system, financed the purchase of med- ganizations, especially from 1918. In the postwar icines for the poorest, and organized vaccination period, the most significant help from the Unit- campaigns. They also took action to improve the ed States came from the American Relief Admin- level of hygiene and made efforts to raise public istration.12 Established in November 1918, it was awareness, for example, by disseminating infor- headed by Herbert Hoover (FIGURE 4), who attempt- mation on the ways to avoid infectious diseases. ed to organize help for Poland as early as in 1915. The aid organizations which operated on Polish Some of the aforementioned physicians who lands were financially supported by the General engaged in the work of social aid organization Relief Committee for the Victims of War in Poland represented the medical scientific community.