Health, Hygiene and Eugenics in Southeastern Europe to 1945

Introduction: Framing Issues of Health, Hygiene and Eugenics in Southeastern Europe

2 INTRODUCTION of the national community figures prominently in leading medical discourses from the late nineteenth century onwards. Annexed to various forms of nationalism and concepts of society, health and hygiene became central components of larger biopolitical agendas; that is, the creation of a eugenically healthy nation and society. During the interwar period this agenda served as the progressive vehicle for transmitting a biological message transcending both specific political differences and generally opposed ideological camps. Second, health, hygiene and eugenics were complexly linked to political processes and state policies. Like elsewhere at the time, in Southeastern Europe the health of the collective body (defined either as the nation or society) became synonymous with the health of the state, and this political concern with health and hygiene, in turn, took several forms. One was the dominant role the state was asked to play in the expansion and administration of the collective body. New regimes of health and hygiene were instituted, especially after 1918, within which state intervention was normalized. It was assumed that with the help of experts, society and the state could be shaped and controlled by means of systematic regulation. This form of scientific management through medical education and schemes of hygiene and public health became central to the professionalization of medicine in Southeastern Europe, a process that only matured during the 1930s and 1940s. Comparing and contrasting various case studies in this region therefore provides the opportunity to delve into the archives in an attempt to redefine the wider debates on health, hygiene and eugenics within the broader European context of the late nineteenth and twentieth centuries.2 This volume also aims to explore the possible integration of the social history of medicine and health into broader Southeastern European studies . It thus raises questions about common regional patterns in various developments in health, hygiene and eugenics in Southeastern Europe. Of particular interest are the ways in which national states and emerging professional elites addressed (Ottoman and Habsburg) imperial legacies while at the same time contributing to the creation of new political and national systems based on the principle of national uniformity and centralism. 2 For a discussion of recent historiography, see Marius Turda, “Focus on Social History of Medicine in Central and Eastern Europe,” Social History of Medicine 21, 2 (2008): 395–401 and “Focus on Austria and Germany,” Social History of Medicine 23, 2 (2010): 408-412 3 Framing Issues of Health, Hygiene and Eugenics in Southeastern Europe Two interrelated assumptions therefore guide this volume’s conceptual unity: first, health, hygiene and eugenic policies in their various permutations were instruments of state building as expressed in professional networks and encompassing various social and political agendas. Second, in such agendas the idea of the nation was particularly salient, and, crucially, such nationalist narratives relied on biological metaphors of belonging and identification. It hardly needs emphasizing that these debates about health, hygiene and eugenics were conterminous with the wide-ranging effort to consolidate the Southeastern Europe nation-states and their societies . Once these dimensions have been fully appreciated, we can turn to examine how health, hygiene and eugenic projects were implemented and understood in their local contexts. Health and Hygiene in a ‘Backward’ Region Before 1945, Southeastern Europe was frequently viewed as a “backward” region. For example, one encounters arguments over unhygienic conditions in commentaries written by visitors to the region during the late nineteenth and early twentieth century. In 1909, the English traveler Mary Edith Durham (1863–1944) depicted the situation in Albania (then still under Ottoman rule) as dreadful: “No words can tell the misery of the sick in these lands, who, swarming with lice, rot helpless on a heap of ferns or filthy rags in a dark corner till death releases them. No doctor has penetrated these wilds, nor any teacher save the Franciscans, whose medical knowledge is usually of the slightest.”3 Paul Dudley White (1886–1973), the prominent cardiologist working for the American Red Cross, alerted his readers to the fact that: “On the old battle-scarred valleys and mountains of Eastern Macedonia lurk some of the most dangerous of the world’s diseases. The wars, which have been waged over this territory almost constantly since 1912, have exposed to broad day the menace of this land to the world’s health.”4 Local authorities in Southeastern Europe were equally unflattering. A Bulgarian sanitary report describes the poor health of the 3...