UNIVERSITY OT LONDON University College London Marcella Simoni “Germs know no racial lines” Health policies in British Palestine (1930-1939) Thesis submitted for the degree of goctor of Philosophy 2003 ProQuest Number: U642896 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest. ProQuest U642896 Published by ProQuest LLC(2016). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. Microform Edition © ProQuest LLC. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 Abstract In mandatory Palestine, Zionist civil society proved to be a powerful instrument for institution- and state-building. Civil society developed around four conditions: shared values, horizontal linkages of participation, boundary demarcation and interaction with the state. These four 6ctors were created and/or enhanced by the provision of medical services and by the organization of public health. In Jewish Palestine, these were developed - especially in the 1930s - by two medical agencies: the Hadassah Medical Organization and Kupat Cholim. First of all, Zionist health developed autonomously from an administrative point of view. Secondly, it was organized in a network of horizontal participation which connect different sections of the (Jewish) population. In the third place, medical provision worked as a connecting element between territory, society and administratioiL Lastly, the construction of health in mandatory Palestine contributed to create a cultural uniformity which was implicitly nationalistic. Zionist medical provision in mandatory Palestine also responded to two of the main ideological strongholds of Zionism. The Zionist movement saw the introduction of science and rationality into Palestine as a mission of civilization. Zionism also aimed at the regeneration of the Jews after centuries of physical and spiritual oppression in the Diaspora. The introduction of medical provision along western standards during the mandatory years had a number of important consequences for the future of Palestine/Israel. It improved the country’s sanitary, medical and hygienic standards. However, it also contributed to draw a boundary between the Jewish and the Arab communities. Different approaches to illness and disease, diverse availibility of medical structures for the two population groups, distinct levels of sanitation between Arab and Jewish towns and separate attendance in medical structures were ail indicators of the division which, by 1939, had drawn apart these two communities. The 1930s stand out as the decade in which the Zionist network of medical provision consolidated the process of civil society formation, of institution- and of state-building. During this decade such civil society became gradually more exclusive, as it became healthier and stronger. Contents List o f lllîistrations. ............................................ p. 4 List o f Graphs. p. 4 Acknoyvledgements. .......................................................................................... p. 6 List o fAbbreviations. ....................................................................................... p. 8 Introduction p. 10 1. The British and the Zionist in Palestine. Different implications of medical provision and public health. p. 13 2. Urban Palestine p. 17 3. Civil society p. 20 5 The British mandate in historiography (1960-2002) p. 25 5. Outline of the dissertation p. 31 Chapter I Administration p. 34 1. The British administrative structure of health provision., p. 37 a) Delegation. ...................................................................... p. 38 b) Decentralaation. .............................................................. p, 41 c) Legisiarton. p. 45 2. The Zionist administrative structure of health provision., p. 52 a) Kupat Cholim and Hadassah Medical Organization. ................... p. 54 b) Decentralization. ........................................................................... p. 56 c) Delegation. p. 57 3. The beginning ofthe British (administrative) surrender., p. 64 a) The Zionist administrative networkfh>m municipality to nation. p. 65 b) The Peel Commission on administration and hecdth. ........................ p. 68 c) From private to public. p. 72 Chapter n Society p. 78 1. Networking in territorial terms. p. 82 a) Medical coverage. ............................................................. p. 85 b) The hierarchy o f metücal provision. ................................................ p. 90 c) The eqxmsion o f medical coverage between territory and society... p. 93 2. Networking in society p. 99 a) Organization from above. ............................................................... p. 101 b) Mobilization frtm below. .................. p. HO 3. Networking the nation p. 115 a) The HU~HadassahHospitalinJeruscdem and the German alyia..... p. 116 b) The Beilinson Hospittd. p. 118 Contenir Chapter n i ^ Ideology .................................................................... p. 121 1. Prevention, p. 126 a) Educating Jews ta health, p. 129 b) Uving in healthy Jewish cities p. 138 2. Civilization. ............................................................... p. 142 a) Defeating the Evil Eye. p. 145 b) Attempts to r^orm unhealthy families...... p. 154 c) Claiming Mizrahim to civil society. p. 159 Conclusions ................................... p. 164 Appendix. ....................................................................................... p. 170 Diagram I. The administrative structure of Knesset Israel with regard to health. ....................................................... p. 171 Diagram 2. Diagram of Jewish Political Parties ............................ p. 172 Who’s who ......................................................... p. 173 Glossary of Hebrew T^nns ............................................................. p. 178 References p. 180 List of illustrations I. Public Health Administrative Divisions ..................... P 33 2. Infent mortality in Palestine per 1000 births .............. p. 104 3. Patients in Ha&tssah Hospitals in 1928 according to scale of fees ............................... ..................... ......... P- 146 4. “Conditions: ‘Poor”’ ................................................. P 148 5. “Conditions: ‘Ideal’” ................................................ P 148 6. Active Trachoma in government schools and in schools afSliated with the Palestine Zionist Executive. P 151 7. Blind Jews at the Western Wall (1935)........... .......... P 152 List ofCraphs 1. Percentage of totaKiovemment expenditure for medical e?q)enses (1921-1936)................................... P 39 2. Number of licenses tiy the Palestine Administration to male and female pharmacists prior to 1935 ................. P- 48 3. Nuinber of licenses granted to nadwives classified by nationality prior and during 1935 ............................... P 49 4. Percentage of licenses granted by the Palestine Admiitistration to midwives prior to 1935 classified by nationality ........................................................... P 49 5. Number of licenses granted by the Palestine Administration to male and female doctors in 1935, by Conteras. nationality:. ......................... p. 51 6. Total Expenses by the Department of Health in £P , (1921-1936).................................................................. p. 59 7. Jewish infant mortality per thousand births ( 1925- 1931) p. 103 8. Jewish immigrants by age group (1928-31) p. 130 9. Jewish immigrants by age group (1932-39) p. 130 10. Out-patients attendance in Oovemment Hospitals and in Voluntary Organizations classified by religion (1938) ........................................................................... p. 133 11. Number of visits in Jewish Hospitals classified by religion (1938) ............................................................. p. 133 12. Number of visits in Government Hospitals classified by religion (1938) ......................................................... p. 134 13. Number of visits in Missionary Hospitals classified by religion (1938) .............................................................. p. 134 Acknowledgements As this research was protracted through the years, my debt has grown towards all those who helped me at different times. First of all, I would like to thank Professor Paul Oinsborg at the University of Florence for sparking my interest in social and cultural history, for always offering enlightening suggestions and helping advice, for rea ^ g and commenting this manuscript and for his friendship throughout these years. Many thanks also to my supervisor at UCL, Professor John ICiier, who read and conected this work twice. My gratitude goes to Professor Samuel Kottek for allowing me to participate in his seminar on the history of medicine at die Hebrew University, to Dr. Shifira Shvarts for giving me very useful insights about the role of Kupat Cholim, to Dr. Risa Domb for supporting my work and for her enthusiasm, and to Professor Derek Hopkins for his patient tutoring while spending a term at St Antony’s College, O^ord. Professor Lea Campos Boralevi and Professor Emanuela Tievisan Semi helped me