Infectious Diseases and Public Health in Southeast Europe

This project will provide for a hitherto lacking history of epidemics and widespread infectious diseases in Southeast Europe (SEE) from the Russo-Ottoman war of 1828-1830 to the First Balkan War of 1912-1913. The evaluation of hitherto rarely used published and archival sources (mainly in the Austrian State Archives in Vienna and in national and regional archives of SEE) will be undertaken with a focus on the interaction between diseases and preventive strategies. This project treats epidemics and infectious diseases as historical agents of their own which are not limited to states and whose reach extends via communication lines across borders. This allows for supra-national correlations and for the determination of the geo-epidemiological position of SEE. The mapping of epidemics and disease incidence in local areas on the other hand, requires the reflection of contemporary diagnostic capabilities together with the diseases` relations to concrete socioeconomic and environmental factors. Finally, preventive doctrines may also affect the appearance or course of an epidemic. The project proceeds from the assumption that the Habsburg Monarchy was an important centre of medical education for the region. Its institutions of public health became role models for their pendants in the Ottoman Empire and its successor states. The Habsburg sanitary cordon vis-à-vis the Ottoman Empire forms a starting point to examine whether the whole region subsequently worked as an anti-epidemic "tampon zone." Regional public health initiatives, in turn, were often considered "national" achievements against the pending Ottoman legacy of lacking health and hygiene. In this period, which witnessed the transition from the pre-bacteriological age to germ theory, medicine and hygiene became attributes of governmental power that even reached desolate villages and stock breeding upland communities which were otherwise untouched by the modern state (such as the vaccination of analphabetic citizens). Quarantines were apt for the policing of migrants like Muslim pilgrims and seasonal workers. Thus different religious as well as cultural attitudes have to be considered, when preventive measures were at stake. Topics of research are (1) plague and cholera epidemics; (2) the role of quarantine regimes; (3) discourses on urban and rural sanitation for preventing plague, cholera, typhoid, smallpox, malaria and syphilis; and (4) national and regional case studies on disease prevention. The results will be published in a monograph and an edited volume. The project will also provide for a commented edition of an unpublished 1830-report on the Austrian sanitary cordon. The results may offer new insights into demographic and social developments. They may confirm questions about the region`s modernisation, since Western views on the history of this region often tend to disregard them in favour of evoking images of archaic communities.

The main goal of the project was to examine the spread and control of selected epidemic diseases plague, cholera, typhoid, smallpox, malaria and syphilis in Southeast Europe from the Congress of Vienna (1815) to the First World War. Since the mid-19th century the Balkan Peninsula formed a tampon zone between Austria, respectively, Austria-Hungary and the Ottoman Empire which was still considered a hotbed of various epidemic diseases. To understand the intermediary role the Balkans played for the spread and control of epidemic diseases one has to consider the geographic neighborhood toward the main dissemination channels of cholera which ran across the Russian landmass and the Black Sea from the East to the West. The international sanitary councils in Egypt and the Ottoman Empire, on the contrary, were mainly successful to seal off the possible southern gateway of cholera and plague across the Eastern Mediterranean. The direct influence of the Western Great Powers on the sanitary affairs of the Ottoman Empires was also perceptible in its successor states on the Balkan Peninsula (Greece, Serbia, Romania, Bulgaria, Montenegro). They formed an additional safety buffer zone against the introduction of plague and cholera to Central Europe. Since the transmission of cholera in 1865 from Egypt to Constantinople, the Western Great Powers considered the Muslim pilgrims to Mecca a particular risk group, since they communicated with their peers from the contaminated areas of India and Southeast Asia during their stay at the holy sites of Islam in the Arabian Peninsula. For Austria-Hungary, which from 1878 governed the former Ottoman province of Bosnia-Herzegovina with its considerable Muslim population, the annual pilgrimage to Mecca was a serious sanitary problem despite the repeated quarantining of the Bosnian pilgrims on their return. The Balkans were otherwise the scene of exotic diseases which were deemed extinct in Central Europe, as was the case with leprosy, or which manifested themselves in unique variants, like Skerlievo in the Western part of the Balkan Peninsula; the latter was an endemic form of syphilis whose transmission was not limited to sexual intercourse. In rare cases such a setting allowed for the establishment of internationally accepted medical schools like that one around the bacteriologist Victor Babes (1854-1926) in Bucharest, while the Austro-Hungarian physicians in Bosnia-Herzegovina at least until the turn of the century found themselves in a situation, surrounded by massive manifestations of archaic diseases, which reminded on that one of colonial doctors. In several cases one can observe a mixing of preventive measures with prejudices against the Orient and Muslim communities. Thereby not the measures themselves have to be questioned primarily, but their disproportionate application.