Journal - International Society for the History of Islamic Medicine

CONTROL PROJEST OF BEJEL (ENDEMIC SYPHILIS)
DISEASE IN IRAQ
America, but Iraq is took over the administration of
the Institute for the subsequent years (4). The
Institute staff was comprised of a director, six assistant
doctors, six nurses, six dressers and a number of
laboratory technicians and X-ray staff. From these
personnel three teams were organized. The first team
was stationed in the northern area, the second team
was stationed in the middle area and the third team
was in the southern area. They were provided with
transport, often a car, but in the Western desert horses
and camels were used, boats were used in areas
where rivers made water transport preferable. The
Institute also ran two V.D. dispensaries in Baghdad.
Specimens from the field were sent to a modern laboratory
so the serological analysis could be carried
out (4,9).
Foreign Medical Advisers For the Project
At the suggestion of WHO and the request of the
Iraqi government, the first adviser to the Bejel project
was Dr. Hudson who took up his residence in
Baghdad in October 1950. After preliminary
research, field work started on January 1st, 1951. The
first two months were spent on the Euphrates River,
then a few weeks with the nomads of the Western
Desert. After that, two months were spent in the
marsh area in the south. On June 1st, 1952, the teams
began work on the northern part of the Tigris River.
Dr. Hudson left Iraq in mid-June, and replaced by Dr.
G.W. Csonka as Adviser for project. During that time
he investigated 3000 cases and published his results
in two papers, the first entitled ‘Bejel. Childhood
Treponematosis’ and the second entitled ‘Clinical
Aspects of Bejel (10,11). He was followed by Dr.
L.G.G. Jones who became Chief Adviser for the
WHO project in 1953. He reported a very rare case
caused by Bejel (12) .disease under the name
‘Mutilating Bejel
Achievements of the Institute
The Institute discovered that the best way for
controlling Bejel was by attending the patients in
their own remote districts, in spite of the great difficulties
confronting the traveler, due to the very poor
roads. On their visits to a village the teams considered
the following:
JISHIM 2004, 3
Kathem K. AL-RUBIAY
1. Clinical cases of Bejel
2. Contacts
3. Infected pregnant women
During the early days of the project the team met
with many difficulties due to the ignorance of the
patients and their disgust at giving away some of
their blood for the purpose of serological examination,
and because of their attitude towards Bejel,
which they considered a. simple matter requiring no
treatment (4). Those difficulties were eventually
overcome. As a result, a large number of patients
were cured. The normal treatment was penicillin, 1.2
mega units in a single injection for the early stage,
but a double dose for the late stages (10). The
Institute, apart from treating Bejel. also treated venereal
diseases and other skin diseases. The Institute
expanded gradually and in later years it became a
place for teaching medical students. After the
Revolution of July 14, 1958. The Institute was
renamed the Unit of Dermatology and Venereology
after the control project and was attached to the main
hospital (9). The people however, still called it the
Bejel Institute.
Results of the Project
During 1951 the investigation and control measures
were restricted to certain Liwas (provinces).
Work in other cities started in 1952 when three teams
were formed. The control project started in early
1953 and continued until the end of 1955. It covered
11 province in Iraq except few provinces which were
to be included in the control program of 1956. The
team found the incidence of the disease to be very
high (between 60 to 90%) especially 1n the villages
near Deir-Ez-Zor -such as Tala’aFar and Sinjar (4,9).
In 1956 there was a follow-up of the same villages,
and the incidence was found to be greatly
reduced. In 1957-1958 the teams doing the control
and follow-up operation covering all the villages,
including cottages, and schools, found that the number
of active cases became less, especially in schools.
Factors contributing to the eradication in active cases
included the opening of new schools, dispensaries,
widespread ownership of radio, propaganda campaigns
and large companies all influenced people to
become more health conscious. The total number of
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