Category Archives: disease

Population, Industry, and World War I

From Russia’s Last Gasp: The Eastern Front 1916–17, by Prit Buttar (Osprey, 2016), Kindle Loc. 169-95:

A combination of industrialisation and major improvements in public health in the second half of the 19th century led to large increases in the population of Europe, rising from about 200 million in 1800 to double that figure by 1900. The experiences of war during the 19th century resulted in most large nations adopting systems of national service followed by a variable period as a reservist; as a result, when the continent plunged over the precipice into war in the summer of 1914, all the Great Powers had the ability to field forces on a scale that dwarfed anything that had gone before.

The same industrialisation that helped increase the population of Europe also provided arms and munitions on a scale to match the huge armies that were sent into battle. Yet despite the enormous stockpiling and production of guns, bombs and shells, all armies found themselves struggling to cope with the huge consumption of resources that followed. Every army that fought in 1915 was forced to moderate its military ambitions to live within the limitations imposed by ammunition shortages, and it was only at the end of the year that all sides could begin to look forward to a time when they might have sufficient matériel to cope with the demands of modern warfare.

In the west, the terrible irony of the ‘mobilisation’ of 1914 was that hundreds of thousands of men were left facing each other in almost static front lines, subjecting each other to bombardments and assaults that left huge numbers dead or maimed without any prospect of ending the war. In many respects, the fighting on the Eastern Front was very different, with the front line moving back and forth as the vast spaces of Eastern Europe allowed armies to exploit weaker areas. However, the very space that allowed for such movement also made a conclusive victory almost unachievable. As early as October 1914, the Germans had correctly calculated that it was impossible for armies to maintain operations more than 72 miles (120km) from their railheads, and both sides rapidly realised that there were few if any strategically vital objectives within such a radius. Consequently, although there were major advances by all sides, it was not possible to advance sufficiently far to force the other side out of the war.

The Great Powers entered the war with a clear idea of how they intended to win. Germany wished to avoid a prolonged two-front war, and opted to concentrate most of its strength against France, intending to send its victorious armies east after defeating its western opponents. Russia believed in the irresistible might of its vast armies, and anticipated a steady advance that would roll over the German and Austro-Hungarian forces, while the armies of the Austro-Hungarian Empire calculated that their best hope was to draw the full weight of the tsar’s armies onto themselves, giving the Germans every opportunity to win the war in the west before the Russians could put enough forces into the field. When these initial plans failed, senior commanders struggled to come up with alternative strategies, trying usually without success to learn from the errors of the opening campaigns. To a very large extent, the one shining victory of the opening phases of the war – the German triumph at Tannenberg in September 1914 – left commanders on all sides attempting in vain to recreate the great encirclement. They repeatedly saw the endless stalemates as anomalies; the reality was that it was Tannenberg that was the anomaly, achieved at a time when there was still open ground between formations, allowing corps and armies to be outflanked – by the time they became aware of German movements, it was too late for the Russians to react. As the war continued, the density of troops prevented any such advantage being achieved.

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Filed under Austria, Britain, disease, France, Germany, Hungary, industry, military, nationalism, Russia, war

Germany’s ‘White Bread Division’, 1944

From Defeat in the West, by Milton Shulman (Secker & Warburg, 1947; Dutton, 1948; Arcadia, 2017), Kindle Loc. 4344-67:

After five years of nervous tension, bad food, and hard living conditions, the Wehrmacht found itself swamped with soldiers complaining of internal gastric trouble. Some of these were real, others were feigned. It was difficult to check.

As defeat became more and more imminent and life at the front more dangerous and more uncomfortable, the rise in the number of men reporting themselves as chronic stomach sufferers became alarming. With the staggering losses in Russia and France, it was no longer possible to discharge this huge flood of groaning manpower from military service. On the other hand their presence in a unit of healthy men was a constant source of dissatisfaction and unrest, for they required special food, constantly asked to be sent on leave, continually reported themselves to the doctor, and grumbled unceasingly about their plight. It was thus decided by the Supreme Command to concentrate all these unfortunates into special Stomach (Magen) battalions where their food could be supervised and their tasks made lighter. It was originally intended to use these troops for rear-area duties only, but as the need for additional men became increasingly critical these units were sent forward for front-line duty as well.

On Walcheren Island, following the Allied invasion, it was decided to replace the previous normal infantry division with a complete division formed from these Stomach battalions. By the beginning of August 1944, the transformation was complete. Occupying the bunkers of the polderland of Walcheren Island and pledged to carry on to the very end were stomachs with chronic ulcers, stomachs with acute ulcers, wounded stomachs, nervous stomachs, sensitive stomachs, dyspeptic stomachs, inflamed stomachs — in fact the whole gamut of gastric ailments. Here in the rich garden country of Holland, where white bread, fresh vegetables, eggs and milk abounded, these men of 70 Infantry Division, soon nicknamed the ‘White Bread Division,’ awaited the impending Allied attack with their attention nervously divided between the threat of enemy action and the reality of their own internal disorders.

The man chosen to lead this formation of convalescents through their travail was the mild-looking, elderly Lieutenant General Wilhelm Daser. His small, peaked nose, his horn-rimmed glasses and his pink, bald head effectively hid his military identity. Only a firm, loud voice accustomed to giving orders betrayed it. Like the other fortress commanders he was chosen for his final military role because he could easily be spared, not because he had any particular qualifications for the task. The tremendous wastage of senior officers incurred by the Wehrmacht in Russia and North Africa was the prime reason for Daser’s being called out of semi-retirement in February 1944, to take over a static coastal division in Holland. His last active field command had been in 1941 when he had been sent back to Germany because of heart trouble. The years between had been spent as a military administrator of civilians in occupied territory. Now, at sixty years of age, he had neither the enthusiasm, the zeal nor the ability to make of Walcheren a memorable epic of German arms — but neither had most generals of the Wehrmacht in the declining months of 1944.

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Filed under Britain, Canada, disease, food, France, Germany, labor, military, Netherlands, USSR, war

Broad Scope of Missionary Work

From Protestants Abroad: How Missionaries Tried to Change the World but Changed America, by David A. Hollinger (Princeton U. Press, 2017), Kindle Loc. 224-61:

Missionaries established schools, colleges, medical schools, and other technical infrastructures that survived into the postcolonial era. Missionaries were especially active in advancing literacy. They translated countless books into indigenous languages, produced dictionaries, and created written versions of languages that had been exclusively oral. Some missionary institutions became vital incubators of anti-imperialist nationalisms, as in the case of the American University in Beirut, founded in 1866, and the alma mater of several generations of Arab nationalist leaders. Christianity itself has assumed shapes in the Global South quite different from the contours designed by European and American evangelists. Religious voices purporting to speak on behalf of indigenous peoples have occasionally claimed that the missionary impact was beneficial for endowing local populations with Christian resources that proved to be invaluable. Feminist scholars have called attention to the ways in which African women were able to use Christianity—for all the patriarchal elements in its scriptures—as a tool for increasing their autonomy, especially in choosing their own spouses.

Scholars continue to inquire just where and how the actions of missionaries affected the subsequent histories of the societies they influenced. That inquiry is an important and contested aspect of today’s discussions of colonialism and the postcolonial order that is largely beyond the scope of Protestants Abroad. But not altogether. As scholars come to recognize the interactive dimensions of the missionary project, we can comprehend that project itself as a genuinely global, dialectical event. Missions were part of the world-historical process by which the world we call modern was created.

This book’s cast of characters was involved with missions in three different capacities. The first of these was service abroad as a missionary. People routinely classified as missionaries included not only evangelists, but teachers, doctors, nurses, YMCA leaders, university professors, and social service workers affiliated in any way with institutions and programs sponsored by missionary societies, churches, and missionary-friendly foundations. All were understood to be part of the greater missionary enterprise, even though some would say, “I wasn’t really a missionary,” by way of explaining they were not directly involved in evangelism. A second order of involvement was to grow up as the child of missionaries, often spending many years in the field. The third capacity was the least direct: to be closely associated with missionaries, typically through missionary support organizations.

Although there were persons of both sexes in all three of these categories, the gender ratio was different in each case. In the field, about two-thirds of missionary personnel were women, either unwed or married to male missionaries. Missions afforded women opportunities to perform social roles often denied to them in the United States. Glass ceilings in the mission field were higher and more subject to exceptions than in most American communities. By the 1950s, nearly half of the missionary physicians in India were female. Women led many colleges in China. These included one of the most famous missionaries of all time, Minnie Vautrin, who turned the campus of Ginling College into a fortress during the Nanking Massacre of 1937 and 1938. She is credited with saving several thousand Chinese women from rape and murder at the hands of marauding Japanese soldiers. Women were sometimes allowed to preach in the mission field, even though Paul the Apostle had told the Christians of Corinth, “Let your women keep silent in the churches: for it is not permitted unto them to speak; but they are commanded to be under obedience.” While home on furlough, female preachers were often prohibited from speaking from the pulpits of their own denominations, sometimes even in their home congregations.

Among missionary children, there were of course equal numbers of males and females. In missionary support organizations, women were very prominent. Most denominations had women’s missionary boards that exercised strong influence in church affairs and stood among the largest women’s organizations in the United States in the late nineteenth and early twentieth centuries. These women’s missionary boards were often active on social issues, urging their denominations to take more vigorous stands, especially against racism. A group of 150 women from the various denominational missionary boards picketed a Washington, D.C., hotel in 1945 to protest its refusal to serve black members of the United Council of Church Women.

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Filed under Africa, China, disease, education, Japan, Korea, language, Latin America, Middle East, nationalism, religion, South Asia, Southeast Asia, U.S.

Logistics of Penal Migration

From The House of the Dead: Siberian Exile Under the Tsars, by Daniel Beer (Knopf, 2017), Kindle Loc. 715-748:

The European empires all struggled with the formidable logistical problems of penal migration. Britain’s transports to its Australian penal colonies in the late eighteenth century were dreadful ordeals for the convict passengers. Prisoners languished in the ships’ holds, “chilled to the bone on soaked bedding, unexercised, crusted with salt, shit and vomit, festering with scurvy and boils.” Of the 1,006 convicts who sailed on the Second Fleet in 1790, 267 died at sea and at least another 150 after landing. The British government took swift and decisive action to curb the lethal excesses in transportation because the organized and efficient transfer of healthy convicts was understood to be necessary to the wider project of penal colonization. It bombarded the private contractors responsible for transportation with demands for improvements in conditions, and deferred payment for each convict until he or she disembarked in decent health. A naval surgeon was placed on board each vessel and was answerable to the government, not to the contractors. Negligence and abuse still continued on some ships but, by 1815, the death rate in the transports had fallen to one in eighty-five. By the end of transportation in 1868, it was only one in 180.

The deportation of convicts to Siberia presented logistical difficulties not less (and possibly even more) daunting than those of the roiling waters of the Atlantic and Indian oceans. The annual deportation of thousands of unruly and sometimes violent convicts several thousands of kilometres across the most inhospitable territory would have taxed the resources of any contemporary European state. The Siberian continent boasted only the sketchiest network of roads, and rivers that flowed unhelpfully south to north and north to south, rather than west to east, and turned each winter into a hazardous ocean of snow.

When compared with its European rivals, the tsarist empire’s state machinery was primitive and already creaking under the weight of its administrative burdens. St. Petersburg’s remit did not run as deep as that of London or Paris. Even within European Russia, the state had little direct contact with its own population. It devolved governance onto the landed nobility, the Church, merchant guilds and village assemblies. The Imperial Army was the only direct and sustained confrontation with state power that most Russian subjects—the peasantry—ever experienced. The enormous distances separating Siberia’s administrators from their masters in the capital amplified the effects of this bureaucratic weakness. Under-resourced and virtually unaccountable, officials manoeuvred within the deportation system for private gain, neglecting, exploiting and robbing the convicts in their charge.

After several months, sometimes years on the road, convicts who had departed hale and hearty from European Russia finally reached their destinations in Eastern Siberia as ragged, sickly, half-starving mockeries of the robust penal colonists envisioned by officials in St. Petersburg. The deportation process itself thus frustrated the state’s wider strategic ambitions for the penal colonization of Siberia. The downcast and desperate figures trudging eastwards in marching convoys were indictments of the imperial state’s weakness and incompetence. The boundary post was not so much a symbol of the sovereign’s power as a marker of its limitations.

At the beginning of the nineteenth century, exiles almost all made the journey to Siberia on foot. They would set out from one of five cities in the empire: St. Petersburg, Białystok in the Kingdom of Poland, Kamenets-Podolsk and Kherson in Ukraine, and Tiflis in Georgia. Most were funnelled through the Central Forwarding Prison in Moscow, from where they and their families would march eastwards through the town of Vladimir that gave its name to the road that wound its way eastwards. Synonymous with Siberian exile, the Vladimirka gained such notoriety over the nineteenth century that Isaak Levitan’s eponymous landscape painting from 1892, which today hangs in Moscow’s Tretyakov Gallery, seemed to echo to the clumping steps of exiles marching eastwards.

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Filed under Australia, Britain, Caucasus, disease, labor, migration, military, Poland, Russia, slavery, Ukraine

Addiction Treatment Culture

From Hillbilly Elegy: A Memoir of a Family and Culture in Crisis, by J. D. Vance (Harper, 2016), pp. 114-117:

On designated weekdays and weekends, we visited our mother at the CAT [Center for Addiction Treatment] house. Between the hills of Kentucky, Mamaw and her guns, and Mom’s outbursts, I thought I had seen it all. but Mom’s newest problem exposed me to the underworld of American addiction. Wednesdays were always dedicated to a group activity—some type of training for the family. All of the addicts and their families sat in a large room with each family assigned to an individual table, engaged in some discussion meant to teach us about addiction and its triggers. In one session, Mom explained that she used drugs to escape the stress of paying bills and to dull the pain of Papaw’s death. In another, Lindsay and I learned that standard sibling conflict made it more difficult for Mom to resist temptation.

These sessions provoked little more than arguments and raw emotion, which I suppose was their purpose. On the nights when we sat in that giant hall with other families—all of whom were either black or Southern-accented whites like us—we heard screaming and fighting, children telling their parents that they hated them, sobbing parents begging forgiveness in one breath and then blaming their families in the next. It was there that I first heard Lindsay tell Mom how she resented having to play the caretaker in the wake of Papaw’s death instead of grieving for him, how she hated watching me grow attached to some boyfriend of Mom’s only to see him walk out on us. Perhaps it was the setting, or perhaps it was the fact that Lindsay was almost eighteen, but as my sister confronted my mother, I began to see my sister as the real adult. And our routine at home only enhanced her stature.

Mom’s rehab proceeded apace, and her condition apparently improved with time. Sundays were designated as unstructured family time. We couldn’t take Mom off-site, but we were able to eat and watch TV and talk as normal. Sundays were usually happy, though Mom did angrily chide us during one visit because our relationship with Mamaw had grown too close. “I’m your mother, not her,” she told us. I realized that Mom had begun to regret the seeds she’d sown with Lindsay and me.

When Mom came home a few months later, she brought a new vocabulary along with her. She regularly recited the Serenity Prayer, a staple of addiction circles in which the faithful ask God for the “serenity to accept the things [they] cannot change.” Drug addiction was a disease, and just as I wouldn’t judge a cancer patient for a tumor, so I shouldn’t judge a narcotics addict for her behavior. At thirteen, I found this patently absurd, and Mom and I often argued over whether her newfound wisdom was scientific truth or an excuse for people whose decisions destroyed a family. Oddly enough, it’s probably both. Research does reveal a genetic disposition to substance abuse, but those who believe their addiction is a disease show less of an inclination to resist it. Mom was telling herself the truth, but the truth was not setting her free.

I didn’t believe any of the slogans or sentiments, but I did believe she was trying. Addiction treatment seemed to give Mom a sense of purpose, and it gave us something to bond over. I read what I could on her “disease” and even made a habit of attending some of her Narcotics Anonymous meetings, which proceeded precisely as you’d expect: a depressing conference room, a dozen or so chairs, and a bunch of strangers sitting in a circle, introducing themselves as “Bob, and I’m an addict.” I thought that if I participated, she might actually get better.

At one meeting, a man walked in a few minutes late, smelling like a garbage can. His matted hair and dirty clothes evidenced a life on the streets, a truth he confirmed as soon as he opened his mouth. “My kids won’t speak to me, no one will,” he told us. “I scrounge together what money I can and spend it on smack. Tonight I couldn’t find any money or any smack, so I came in here because it looked warm.” The organizer asked if he’d be willing to try giving up the drugs for more than one night, and the man answered with admirable candor. “I could say yes, but honestly, probably not. I’ll probably be back at it tomorrow night.”

I never saw that man again. Before he left, someone did ask him where he was from. “Well, I’ve lived her in Hamilton for most of my life. But I was born down in eastern Kentucky, Owsley County.” At the time, I didn’t know enough about Kentucky geography to tell the man that he had been born no more than twenty miles from my grandparents’ childhood home.

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Filed under Appalachia, disease, drugs, education

Alternatives to Domestic Service, 1800s

From Servants: A Downstairs History of Britain from the Nineteenth Century to Modern Times, by Lucy Lethbridge (Norton, 2013), Kindle Loc. 1362-91:

Elizabeth Banks was inspired to undertake her 1892 investigation into service to find an answer to the question that vexed the English middle classes: why was it that many girls would do almost anything, even if it meant living off ‘porridge in the morning and watercress in the evening with no midday meal’, rather than undertake the work of cleaning someone else’s home? She visited a young seamstress living in terrible conditions – ‘the unwomanly rags, the crust of bread, the straw and the broken chair’ – in a lodging-house in Camberwell on eighteen pence a week. When the dismayed Elizabeth offered to find her a job as a housemaid, ‘with a nice clean bedroom, plenty to eat, print dresses in the morning, black stuff in the afternoon, with white caps and aprons and collars and cuffs’, she was astounded by the girl’s outrage at the suggestion: ‘“Did you come only to insult me?” she demanded, stamping her feet. “I go out to service! I wear caps and aprons, those badges of slavery! No, thank you, I prefer to keep my liberty and be independent.”’

The servant-employing classes struggled to grasp why so many girls did not appear to be grateful for the opportunity to get their feet under a more comfortable table than the one they had come from. Was not the home a haven both moral and practical, a place of safety? The nineteenth century had been haunted by the spectre of the lost child of the Industrial Revolution: the chimney sweep, the crossing-sweeper, the pickpocket, the match-seller, the five-year-old child who had gone blind sorting buttons in a sweatshop. In the popular imagination they were perceived as orphaned (even if this were not in fact the case), adrift, alone and prematurely aged by malnutrition, poverty and abandonment. The social reformer Edwin Chadwick’s 1842 descriptions of the ‘rookeries’ or London tenements in The Bitter Cry of Outcast London almost single-handedly sparked an age of public health reform. Chadwick’s picture of a world of struggle, suffering and hopelessness was entirely cut off from the comfortable family world of the prosperous; nineteenth-century London, he wrote, was a labyrinth of filthy box-like slums, leading one from the other and ‘reeking with poisonous and malodorous gases rising from accumulations of sewage and refuse scattered in all directions’.

According to Henry Mayhew, in 1868–9 there were 17,000 known tramps in England and Wales and 17 per cent of them were under sixteen. In 1889, of the 192,000 registered inmates of workhouses, 54,000 were under sixteen. Dr Thomas Barnardo, the most celebrated of all Victorian philanthropists and a fiery street preacher, was moved to set up his first home for children when he discovered eleven young boys, barely clothed, sleeping along an iron gutter open to the elements. The annual accounts of Dr Barnardo’s children’s homes contain fearful catalogues of the ailments suffered by those picked up on the streets and given refuge: rickets, knock-knees, goitre, spinal paralysis, deaf and dumbness; and lung diseases like consumption, bronchitis, pneumonia and asthma, which were the legacy of the dust inhaled while working long hours in factories. In 1906, Edith, a five-year-old girl, ‘nobody’s child’, was found by Thomas Barnardo wandering the streets apparently completely unwanted – absolutely nothing at all could be discovered of her origins or parentage. Another, a crippled boy of ten, was referred to Barnardo’s after the boy’s mother, a rubbish-picker, was burned to death by an upturned paraffin lamp.

Efforts were made to contain these wandering, vagrant children by the institution of industrial schools, but the focus of the schools was largely penal and the pastoral work of caring for ‘waifs and strays’ was left to private charities and individual philanthropic endeavours. By 1878, in London alone, there were fifty philanthropic societies dedicated to the welfare of children.

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Filed under Britain, democracy, disease, economics, labor

Soviet Veterans and PTSD

From Afgantsy: The Russians in Afghanistan 1979-89, by Rodric Braithwaite (Oxford U. Press, 2011), Kindle Loc. 5393-5420:

Though there was no nationwide study, individual regions, local veterans’ organisations, and local newspapers began to set up their own websites about their young men who had served in Afghanistan. The newspaper Voronezhskaya Gazeta reported there were 5,200 Afghan veterans in Voronezh. By the summer of 1996 seventy-five had died, half as a result of accidents, one-third had been struck down by illness, and one in seven had committed suicide. Twelve years later, more than five hundred had died – one-tenth of all those who had returned from the war. The paper claimed that the young men died not so much because of what they had been through in Afghanistan, but because no provision had been made for their psychological rehabilitation, because they had been unable to afford proper medical treatment, because many of them had been unable to find work or a decent place to live.

But the amount of psychological rehabilitation available for the soldiers was limited partly by the lack of resources and partly because the concept of trauma was alien. If the soldiers who fought against Hitler could survive without going to the shrink, why should the Afgantsy be different? ‘Trauma’ was an alien, perhaps an American idea.

Nevertheless, a thin but native Russian tradition did exist. The first work on soldiers suffering from psychological trauma was done in Russia after the Russo-Japanese war in 1904–5 by psychiatrists in the Academy of Military Medicine. The results were largely ignored in the Soviet period and the 40th Army took no psychiatrists with them when they went into Afghanistan. The first specialists went there in the mid-1980s. The symptoms they found among the Afgantsy were much the same as the Americans had identified after Vietnam: a sense of guilt at what they had done, a horror at what they had seen, the same self-reproach that they had survived while their comrades had died. Some specialists reckoned that as many as one in two Afghan veterans needed some sort of help. At first the symptoms were psychological: irritability, aggressiveness, insomnia, nightmares, thoughts of suicide. After five years many would be suffering from physical as well as psychological consequences: heart disease, ulcers, bronchial asthma, neurodermatitis.

The trouble was that, compared with the United States, there were nothing like the facilities available in Russia to treat the traumatised veterans. There were only six specialised rehabilitation centres for the whole of Russia, and these had to deal with people traumatised not only by Afghanistan, but by their experiences of dealing with the nuclear accident in Chernobyl in 1986, and by the fighting in Chechnya, and other places of violent conflict.

One of those who tried to explain the phenomenon scientifically was Professor Mikhail Reshetnikov, the Rector of the East European Institute for Psychoanalysis in St Petersburg. He had himself been a professional military medical officer from 1972 and was posted to Afghanistan in 1986. He sent a paper to the General Staff, based on interviews with two thousand soldiers, which set out the problems from which the 40th Army was suffering: from the inadequacy of the army’s supply system to the moral and psychological training of the soldiers. The report had no effect, and he was asked by his superiors why he had deliberately set out to gather facts which brought shame on the Soviet Army. From 1988 to 1993 he directed several programmes for the Ministry of Defence on the behaviour of people affected by local wars, and man-made and natural catastrophes. After retiring from the military he became a member of the Association of Afghan Veterans.

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