Journal - International Society for the History of Islamic Medicine

The Story of Bejel Disease in Iraq: Bejel (Endemic
Syphilis) Disease Among the Euphrates Arab Bedouins*
Kathem K. AL-RUBIAY*
* DHM, DTMH MSc. PhD., Department of Dermatology, Collge of Medicine, University of Basrah - Basrah, Iraq Po. Box. 289
e-mail : kadhim1000@yahoo.com
This paper is primarily intended for the historical aspect of Bejel (endemic syphilis) disease in Iraq. Bejel (the Arabic word for
the disease) is an infectious disease a form of endemic syphilis which is not sexually transmitted and occurs in children. It was most
commonly found in the Middle East (Syria, Saudi Arabia, Iraq), Africa, central Asia, and Australia. This disease was prevalent among
the Bedouins of the West Desert and the peasants people of villages of the Tigris and Euphrates Rivers prior to the 1951 WHO campaigns
in Iraq also among Bedouins of Syrian Desert. Bejel has many synonyms as sibbens (Scotland), radseyege (Scandinavia), siti
(Gambia), therlijevo (Croatia), njovera (Southern Rhodesia), frenjak (Balkans), dichuchwa (Bechuanatand). The disease has other colloquial
names in Arabic local languages as Bishal, Lowath, Balash and Jirdam, but amongst the medical profession it was known as
"non-venereal syphilis" or "endemic syphilis".
The organism that causes bejel belongs to the same family as the that causes syphilis, named the treponema Bejel is characterized
by the skin and bones lesions that begin in the mouth and progress gradually to the late stages which are the most severe. The disease
is usually occur in childhood and spreads in a non-venereal way. It was believed that when the disease entered a village it spread, to
all occupants of the village, suggesting an easily communicable disease. The Bedouins description of the disease was similar to
measles (a common childhood disease). If a child escaped infection, then the likelihood of contracting it in adulthood was almost certain
and the Bedouins were able to distinguish the Bejel eruption from those of chicken pox, small pox or measles. Dr. Hudson, who
has the first notified of this disease in medical literature in 1928 from the city of Deir-Ez-Zor in Syria. Also it was widely believed
that the disease was transmitted from Syria to Iraq.
I hope it will be of value to overview the historical story of this disease which is considered to have been theoretically and practically
eliminated from Iraq as previous observers and writers have concentrated mainly in the clinical features, diagnosis and treatment
of Bejel disease.
Key Words; Historical Aspect of Bejel, Endemic Syphilis, Iraq.
Background
This background information is necessary
because Bejel is considered to be found mainly
amongst the Arab Bedouins and has certain geographical
distribution, climatic conditions, and life
style considered to be important factors in the spread
of the disease.
Iraq is situated on the South-western part of Asia
and occupies the north eastern part of the Arab
Homeland. Bordered by Turkey to the north; Iran to
the east; Jordan, Saudia Arabia and Syria to the west;
Kuwait and Saudia Arabia to the south. Mountains
are in the north and north-east, while the south is
mainly marshland. Western desert in the west (forming
60%) expanding towards the Syrian Desert and
the Arab Peninsula. The climate of Iraq is hot and dry
64
Summary
in summer; cold and wet in winter. The two largest
rivers are the Tigris and the Euphrates. The Euphrates
passes through the Syrian Desert before entering Iraq
through the West Desert to reach to the south of Iraq.
The peasants in the marsh area of Iraq at the
beginning of this century were poor, simple and predominantly
farmers and fishermen, boats are the
main method of transport. They build their houses
which were usually cottages or mud huts along the
bank of the small rivers. On the other hand the
Bedouins lived in 'black-tents' mainly in the Western
Desert. They were poor; camels being the main form
of transport. Drinking water came from the rivers or
wells; their lifestyle differed radically from townspeople.
There was no veneral disease as was in the
towns, due to their customs and the fact that they
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