Bedouin Health Services in Mandated Palestine

Abstract

During four centuries of Ottoman rule in Palestine (1516-1917), the natives relied mainly on traditional medicine including herbal medicine, bone-setting, cauterization, blood-letting, leeching, cupping, as well as amulet writers, midwives and male religious healers. Based on their patterns of life, these Palestinians belong to three distinct ethnic groups: peasants (fallahin), the urbanized (hadar) and nomads and semi-nomad Bedouin tribes (badu). The years of the First World War exacerbated health conditions in Palestine. Many health institutions, especially those that offered free treatment, shut down or limited their operation drastically due to lack of resources and budgetary constraints. Arabs relied primarily on their traditional medicine. The population of Palestine was reduced and exhausted by famine, disease and displacement.' After the First World War, Palestine was divided by the British Mandate into four health care districts: Jerusalem, Nablus, Haifa and Jaffa. These districts were further divided into 18 sub-districts. A senior health care officer, usually British, headed each region and was assisted by a junior officer, usually an Arab Palestinian. The senior health care officers were responsible for the administration and supervision of the health care activities while the Arab Palestinian officers usually acted on these tasks.2 The problematic health care situation was predominantly a result of water scarcity and source contamination. The British Mandate focused on the eradication of contagious diseases, constructed the sewage and drainage systems, invested in drying up swamps and education for hygiene. Granting permits for sthe upply of food and drugs, it focused on nutrition issues, infant mortlity rates, hospital equipment and investments in the health care system, as well as enforcement of quarantine regulations.3 Even though the health care system focused initially on preventative measures, it shifted to clinical treatment. There was a growing demand for clinics and hospitals. State hospitals that treated mostly Arab population in urban areas were scarce at first, but during the mandate the system was expanded due to demand from the local Arab population.4 Where access to state hospitals was problematic, the Arab population depended on the Christian missionary health services. These institutions were part of an integrated medical, cultural and religious framework. The missionary institutions introduced into Palestine western health practices.5 Arabs of the Middle East suffered from poor health due to diseases and environmental health conditions, inadequate hygiene, malnutrition, mosquitoes and other parasites. In addition to other diseases, the rate for contracting eye diseases was high.6 Palestine, also suffered from various diseases during recent centuries.7