Cumhuriyet Dönemi Trahom Mücadelesi ve Malatya ÖrneğiGülten Dinç
Trahom, Türkiye tıp tarihi açısından önemli bir halk sağlığı sorunu yaratan bulaşıcı bir göz hastalığıdır. Birinci Dünya Savaşı’na kadar Güneydoğu Anadolu’da endemik olarak görülen trahom, savaş sırasında ülkenin her yerine yayılmış ve insanda görme kaybına ve körlüğe neden olmuştur. Trahom ile mücadele, ilk kez Cumhuriyet’in ilanından sonra gündeme gelmiştir. Sağlık Bakanı Prof. Dr. Refik Saydam, ülkenin sağlık alanındaki gereksinimlerini belirlemek için yaptığı listeye diğer bulaşıcı hastalıkların yanı sıra trahomu da eklemiştir. Zira 1923 yılında ülkede üç milyon trahomlu hasta vardır. Böylece, Sağlık Bakanlığı ve Hıfzıssıhha Dairesi tarafından sıtma, verem, frengi ve trahom gibi bulaşıcı hastalıkları ortadan kaldırmak için büyük bir mücadele başlatılır. Konu hakkında şimdiye kadar yapılan yayınlar sadece genel bilgiler içerdiğinden, bu makalede dönemin gazeteleri incelenmiş ve Malatya tarihini çalışan araştırmacılarla görüşülerek bölgedeki trahom mücadelesi ve mevcut kurumlar hakkında bilgi toplanmıştır. Bu kapsamda makale, Cumhuriyet döneminde özellikle Malatya’da yapılan trahomla savaş faaliyetlerini ortaya çıkarmayı amaçlamaktadır.
The Fight Against Trachoma During the Turkish Republic Era: The Case of MalatyaGülten Dinç
Trachoma is an infectious eye disease and a significant public health issue in terms of the history of Turkish medicine. Trachoma was endemic to Southeast Anatolia until World War I, when it then spread all over the country and caused vision loss and blindness in many people. The fight against trachoma went on the government’s agenda only after the proclamation of the Turkish Republic. Due to the country having three million trachoma patients in 1923, the Minister of Health Dr. Refik Saydam added trachoma to the list of infectious diseases to be fought. As a result, the Ministry of Health (Sağlık Bakanlığı) and the Department of Public Hygiene (Hıfzıssıhha Dairesi) instigated a great initiative to eradicate infectious diseases such as malaria, tuberculosis, syphilis, and trachoma. The present article focuses on the fight against trachoma in the city of Malatya. As only general information is available about the trachoma initiative conducted in the region, the present article examines new sources in order to study it in detail. The study has obtained new detailed information by going through newspapers of the period and interviewing researchers specialized in the history of Malatya, revealing the work undertaken in the fight against trachoma in Malatya during the Republican era.
Trachoma is an infectious eye disease and was a significant public health issue in terms of the history of Turkish medicine. Trachoma was endemic to Southeast Anatolia until World War I, when it then spread all over the country and caused vision loss and blindness in many people. The Turkish Republic had three million trachoma patients (70% of the population) when it was founded in 1923. Although the Ottoman government had listed trachoma among the diseases to be reported since 1915, the systematic fight against trachoma in the country didn’t begin until after the proclamation of the Turkish Republic. Starting in 1925, the Ministry of Health and the Department of Public Hygiene initiated work to eradicate trachoma as well as other infectious diseases such as malaria, tuberculosis, and syphilis. The Trachoma Control Program was implemented first, and laws and regulations to fight trachoma were also enacted. Due to the success of this program, trachoma cases decreased in number over the years, and the work of the institutions diminished with time.
The region including Adıyaman and Malatya, was one of the areas with the greatest number of trachoma cases, which made the struggle most difficult. For this reason, the war against trachoma was started in 1925 by establishing trachoma hospitals in Adıyaman (20 beds) and Malatya (10 beds), as well as opening dispensaries in both cities. At the same time, specialist doctors, nurses, secretaries, health officers, and caregivers were appointed. Treatment included both surgical interventions and medication.
After the decision was made to combat trachoma, ophthalmologist Dr. Vefik Hüsnü Bulat was sent to the region to conduct an inspection. Vefik Hüsnü prepared a report on trachoma that he then presented at the National Turkish Congress of Medicine in Ankara in 1927. The report included information about the spread of the disease in Türkiye, its characteristics, and the ways through which it had entered the country.
The fight against trachoma was given a prominent place in the Public Health Law of 1930. The fight continued in the 1930s with the creation of institutions, including the trachoma institute, hospitals, dispensaries, and village treatment houses. Mobile teams consisting of physicians and health officers who traveled in the region first on horseback and later on motorized vehicles carried out highly efficient work to eradicate the disease. The number of hospitals, dispensaries, and beds in affected regions gradually increased, with the number of hospitals and dispensaries growing to 120 by 1933.
Separate schools were established for children infected with trachoma. Between 1933 and 1934, 25 such schools were found across the country that educated students with trachoma. Efforts were also made to inform the public about the measures to be taken in order to avoid the disease. Free movie viewings were organized, informative posters and brochures were distributed, and books and magazines were published.
The trachoma war zone expanded over the years to include nine provinces. By 1950, 16 trachoma hospitals with a total of 225 beds had been placed into operation, as well as 40 trachoma dispensaries and 115 trachoma village treatment houses. During this time, the World Health Organization (WHO) occasionally sent experts to help prepare annual work programs, with UNICEF also contributing in the fight against trachoma by sending motor vehicles, drugs, and other materials. In Malatya, the combat against trachoma continued intensively through hospitals, dispensaries, and courses, until the end of the 1930s when positive results began being obtained.
In 1951, the fight against trachoma was run by three regional directorates situated in Adana, Diyarbakir, and Malatya. The provinces of Malatya (Adıyaman), Bingöl, Erzincan, Erzurum, and Tunceli were affiliated with the Malatya regional directorate. As a result of these establishments, trachoma gradually ceased being a serious health problem, especially in the city center of Malatya with the development of urbanism and social life. In 1966, one dispensary was closed due to the decreased rate of trachoma in the city. The Malatya regional directorate for trachoma continued to function until the early 1980s, with the last hospital and dispensary closing in 1984.