Erken Cumhuriyet Döneminde Sağlıklı Bireyin İnşası: Pronatalist Politikalar, Çocuk Sağlığı ve Verem
Ceren Gülser İlikan RasimoğluBu makale, Erken Cumhuriyet dönemi Türkiye’sinde nüfus meselesini çocuklara ve çocukların sağlığına atfedilen anlamlar üzerinden değerlendirerek incelemektedir. Makalede pronatalist politikalar ile vatandaşlık eğitiminin iç içe geçtiği bir halk sağlığı anlayışı anlatılmakta; verem konusu özelinde dönemin sağlık sorunlarına üretilen çözümler tartışılmaktadır. Hekimler tarafından dönemin sağlık propagandası dergilerinde kaleme alınan yazılar üzerinden 20. yüzyıl ile beraber halk sağlığı uygulamalarının temel odak noktasında yaşanan dönüşüm, kişisel hijyenin sosyal sorumluluk alanına itilişi ve modern tıp tarafından sınırsız bir müdahale alanına dönüştürülmesi konu edilmektedir.
Constructing the Healthy Individual in the Early Republic: Pronatalist Policies, Child Health, and Tuberculosis
Ceren Gülser İlikan RasimoğluThis article studies the issue of population in Turkey during the Early Republican Period by assessing the meanings attributed to children and children’s health. The article discusses the approach to public health, wherein pronatalist policies and citizenship education are intertwined, and deliberates the solutions produced for the health problems of the period by focusing on the case of tuberculosis. By examining articles physicians wrote in health propaganda journals of the period, this article discusses how the focus of public health practices transformed in the 20th century, the direction personal hygiene took towards an area of individual responsibility, and how modern medicine was transformed into an unlimited field of intervention.
As in many other countries, public health practice during Turkey’s Interwar Period was focused on children. The result of socially redefining the body since the late 18th century had positioned health policies at a leading position. The influence of positivism in every field resulted in glorifying the sciences that study society and paved the way for interventions in areas such as crime, poverty, and productivity. In addition, this interest was taken over by the republic and reshaped in the context of constructing the nation and citizenship.
This article explores the relationship between pronatalist policies and citizenship education in the Early Republican Period. It analyzes the meanings attributed to the children of the country and reveals the relationship between the fight against tuberculosis and these meanings. The study has not considered childhood experiences from an insider perspective nor has it included children’s voices as a source. Instead, the article focuses on the meanings and biopolitical discourses adults and physicians in particular imposed on children in the Late Ottoman and Early Republican Periods, historicizing these starting from the Late Ottoman Period.
The main sources used in the article are texts that discuss the population problems of the period which physicians produced in the first quarter of the century. In this period, physicians occupied an important place in state cadres and played a decisive role in producing health and population policies. Therefore, the texts written by the members of this profession provide information on how the population problem was handled in the eyes of the state. The texts generally include articles on health, epidemics, and children deaths, as well as chapters prepared for children to read in publications from the Istanbul Society for the War against Tuberculosis.
The article discusses the impact of the idea of biopolitics on the newly founded Turkey in terms of children’s health and tuberculosis. It establishes on a historical basis the process of modern medicine’s expansion into areas that intervened in individuals’ daily lives and its engagement in population debates. For this purpose, the study first discusses the theoretical framework of the relationship between the national population problem and children’s health, then describes the course of concrete discussions about children’s health in the Late Ottoman and Early Republican Periods, and lastly explains the place tuberculosis occupied in the field of children’s health, the forms of health propaganda, and the discourse produced over the citizen child.
In the Early Republican Period, population policies were shaped to support pronatalism and these policies were able to be implemented with the support of the educated elites of the period, especially physicians. Physicians and bureaucrats attributed as much importance to propaganda as they did to inaugurating a national health system because they believed that health propaganda could prevent epidemics and decrease child death rates. But health propaganda, rather than mere health, also included the discourse produced for realizing the civilization project that was envisioned as an inherent part of nationalization. In other words, being able to behave healthily also became one of the basic skills expected of a responsible citizen.
Three elements have been found that made this transformation possible: medical, scientific, and political. The medical aspect involved transitioning from an understanding of public health based on sanitary conditions to one based on personal hygiene. New public health practices spread the idea of the risk of transmitting diseases from a particular area to all areas, and thus the area medical knowledge was able to reach became unlimited. Observation and intervention in the field of the infinite danger zone included new administrative techniques and discourses; as a result, citizenship education was able to be included in health education.
Secondly and scientifically, although germ theory had been produced in the previous century, it had only been able to become widespread in the 20th century; after this, the transfer of hygienic practices to all strata of society could finally be expected and targeted. The presence of microbes provided and justified scientific grounds for suggesting compliance with personal hygiene rules to prevent diseases, as in the case of tuberculosis. In this way, the social causes of the disease were rendered invisible and a significant part of the fight against tuberculosis could be transferred away from the responsibility of the state to individual responsibility and institutional volunteerism.
Thirdly and politically, the overlap of nationalist and political propagandas had a historical background. Insufficiency of the population since the 19th century had been considered as the crucial concern the ruling elites had to concretely solve in terms of security and labor shortages in the Interwar Period. After the demographic transformation and destruction of fundamental institutions such as family and education that had been provoked by the cultural crisis, physicians found a domain where they could impose their power of knowledge to restore these institutions.
In this context, the solution to the population and cultural crises brought the new family and new woman forward and at the same time produced a language based on the understanding of the citizen child: healthy children were indispensable for maintaining the regime and nation. In this sense, pronatalist policies merged with eugenics through the fear of degeneration, at least in the eyes of physicians and bureaucrats. Parents who could not provide children with the environment and knowledge necessary for a healthy life were accused on a scale that ranged from neglect of national duty to murder. In the case of tuberculosis, both adults and children were expected to educate each other. Only then could current or future adults become citizens who were healthy-bodied, healthy-minded, moral, and civilized.