T he poverty and hardness of life inmost countries of Southeast Europein the 19th and 20th centuries

meant that virtually the entire populationlived in unhealthy conditions. That had aparticular impact on the health of children,who are most susceptible to diseases, not yetbeing strong enough to fight them. Babiesand infants were at the greatest risk as theirfamilies lived in unhygienic, poorly heatedrooms, and they were often without suffi-cient parental care as their mothers had tostart working again soon after the baby’sbirth, leaving children with inadequate care.That was why it was often the case that onlya small number of children reached adoles-cence, despite the high birth rate.

Besides poor living conditions, anothersignificant reason for the high child mortal-ity rate in the past was the lack of knowledge

about many diseases. There were neither suf-ficient medicaments nor sufficient knowl-edge about how to treat many diseases anddisorders. Before the discovery of penicillin(1929), many diseases were incurable, andone of the most common causes of deathamongst children was pneumonia, as well asother respiratory diseases. Unhygienic con-ditions and malnourishment often led tostomach infections and many at that timeincurable parasitic diseases. Many childrendied from diseases that are cured today in afew days, thanks to modern medicine.Communicable diseases such as scarlet fever,measles, chickenpox, diphtheria, typhoid,tetanus, infantile paralysis... were also com-mon causes of death among children. Eveninfluenza took the lives of huge numbers ofpeople; in the large-scale epidemic thatspread through war-aff licted Europe in

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Children and Health

Children s hospital, Yugoslavia, after the Second World War

1918, 44,000 children died in one month inHungary alone. Besides those diseases,which are today treated and cured relativelyeasily with antibiotics, there were also anumber of today virtually unknown diseasesthat struck in the form of epidemics andcaused the death of enormous numbers ofchildren. In the 19th century children weredying of cholera, pellagra, smallpox, andeven the plague.

The most dangerous incurable diseasewas tuberculosis, for which a cure was notfound until 1944. Up until then, tuberculo-sis had been incurable and, to make matterseven worse, it was believed that people suf-fering from tuberculosis needed sea air, thesun and heat. Medicine later proved that thetreatment of tuberculosis requires just theopposite, that is rest in fresh mountain sur-roundings. And that is how the disease istreated today. Before 1914, one death in fivewas due to tuberculosis. For Hungary, wehave the figure that between 40,000 and50,000 people were dying every year oftuberculosis at the end of the 19th century.

In addition to medicine not knowing thereal causes of disease until the 20th century,one of the significant factors leading to thehigh child mortality rate was the lack ofstate welfare support. Although vaccinationstarted among children, the first laws onhealthcare passed and the first dispensarieswere opened in the middle of the 19th cen-tury (in Bulgaria, the first case of vaccina-tion was recorded in 1845, and systematicvaccination against communicable diseaseswas introduced in the 1890’s; in Bosnia andHerzegovina, systematic healthcare startedafter 1878 within the Austro-Hungarianhealth system; in Hungary, the first nation-al council for healthcare was formed in1868, and larger-scale vaccination started atthe beginning of the 1860’s; in Greece, thefirst children’s hospitals and orphanageswere opened and laws passed providing for alarger-scale struggle against communicablediseases, mainly typhoid and smallpox, inthe 1850’s), those measures could notencompass the entire child population. Thatis why the death rate amongst children invirtually all countries was very high.Statistics from all countries show that new-

born babies and infants up to the age ofthree were at the greatest risk. Figures forAthens tell us that almost half the childrenwere dying before the age of ten in the1890’s, which is slightly higher than inHungary where, at the beginning of the 20thcentury, slightly more than 600 per 1,000children reached the age of ten. The situa-tion improved somewhat between the twoworld wars. In Romania, 20.5 children per1,000 died in that period before the age ofone, while in Bulgaria, on the eve of theSecond World War, child mortality had fall-en to 136 per 1,000.

It was not until after the Second WorldWar that measures for the systematic moni-toring of children’s health, free vaccinationand all-encompassing social and medicalinsurance were introduced. And those meas-ures, and their regular implementation, werewhat led to a fall in the child mortality rate,the prevention of large-scale epidemics andquicker and more effective treatment andcure. In the 1970’s, for example, the infantmortality rate had halved in Bosnia andHerzegovina (32.4 per 1,000), while inBulgaria that rate had fallen to 27 per 1,000,and, in Romania it had reached 20 per 1,000.Infant mortality rate had reached 41.8 per1,000 at the beginning of the 1990’s inAlbania.

D.S.

Save the Children

The Union for Child Protection inBulgaria strives for the unification of allsocial powers, organizations, associations,and people. The care for children findsexpression in the Geneva declaration and inthe resolutions and wishes at the first inter-

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● 10.1. Learn about the various types ofdiseases in history.10.2. How did those diseases affect peo-pleís lives? How were cures found for someof the most lethal diseases of the past?

QQ uu ee ss tt ii oo nn ss

national congress for childprotection held in August1925 in Geneva.

In order to reach itsgoal, the Union tries toestablish regional branchesin villages and towns,which will take care of chil-dren. The first and primaryconcern of childrenremains mainly to parents.Children, however, cannotalways enjoy their parents’care because very oftenthey are deprived of it andare left to the care of theirclosest relatives. Because ofthe migration and movingof the population and thehard economic conditions,parents turn out alone, so,deprived of parents’ carechildren are also deprivedof the care of close rela-tives, and these children aremany. These children andbabies are left at the help ofmerciful people who canreplace the mother, theparents, or the relatives.Here is a case, in whichmercy for children may beexpressed.

The mother dies, thebaby and the other chil-dren remain at theirfather’s care; but the fatherdoes not know and cannotfeed and take care of thechildren; besides, if he stays at work or isabsent the children are left without hiscares, as well. There are children with suchfate in every town and village.

In a certain village, the mother gives birthto twins and dies of fever. The babies aregiven to neighbors, but they do not knowhow to feed them neither have a possibilityto raise them. A teacher-counselor asks theUnion to put them in a kindergarten or anorphanage.

The mother gives birth to a baby, she hasbigger children, as well; she gets ill; the

father goes to work; the helpless ill motherbecomes twice ill because there is nobody tolook after her children.

Mother or father in prison or in an asy-lum, or unable, or uncaring, and childrenremain without supervision, upbringingand even without nourishment.

Poor parents with many children inunfertile years, earthquake, fires, unemploy-ment are not able to either feed or raise theirchildren and they remain deprived of careand attention.

The municipal councils and the police

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Sheer luxury, a slice of bread and jam, a photograph taken during the war.

often find abandoned or neglected children,they don’t know what to do with them andturn to the union for finding a place forthem.

The children themselves, being babies,bigger children, or pupils may get ill, as well.With ill or unable parents, who cannot lookafter their ill children, the last should begiven to the cares of doctors and nurses andthis could be done only in a hospital. Ill chil-dren having tuberculosis, whooping-coughor often-dangerous infectious decease, diph-theria, scarlet fever, measles should be sepa-rated from the healthy ones and treated inhospitals.

Many children are born with brain dam-age, or after birth become ill, have tempera-ture and syncope. These should be treatedquickly in hospitals because otherwise a bigpart of them remain crippled, mentallydefective, develop slowly, often have syn-cope, become violent, make troubles. Suchchildren must be put in orphanages, so theywill not be a burden to the parents, who goto work, and not make harm to society andtogether with that - be trained for any kind

of work which could help them nourishthemselves.

In the whole territory of Bulgaria we haveonly one kindergarten in Sofia and one hos-pital for children - the university child clinic- and this is the only choice for accepting,giving shelter or treating the unfortunatechildren, who are often refused becausethere is no place available.

From 1925 till 1928, 91 small childrenwere accepted in the kindergartens and 485babies were refused to be accepted. 43 men-tally ill children were treated at the childclinic in 1928, 17 of whom from South-west-ern Bulgaria, 18 from Southern Bulgariaand 8 from Northern Bulgaria, who alsoneed an orphanage where they will be raised,educated and trained to do some work.

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● Devote one class to the history of health.By doing so, show to what extent medicalprogress has changed everyday life and, asa result, the history of mankind.

RR ee cc oo mm mm ee nn dd aa tt ii oo nn

Village soup kitchen, Bulgaria

There is a certain number of boardinghouses and orphanages for the blind, thedeaf and the dumb, for the orphans inschools but there is no orphanage, no socialcare for the unfortunate babies and smallchildren-orphans, crippled, mentally ill, andfor the ill children – no child hospital. Thecharity organizations on the other hand,having no funds, can do nothing beneficialfor the miserable children, which is the dutyof the municipalities, the district councilsand the state.

All civilized countries have laws for childprotection, which assure for their materialsupport. Hungary has a law for 30 yearsalready, according to which all children in apre-school age, orphans, abandoned, crip-pled, mentally ill belong to the state whichtakes care of their health, nourishment andeducation; there are doctors, nurses, kinder-gartens, and orphanages.

The human duty, as well as the Genevadeclaration, necessitates that we take care oforphan babies and small children in a pre-school age, of the ill, crippled, mentally ill,neglected and abandoned children.

We stretch out our hand, we beg mercyand ask for help in order to build and main-tain kindergartens, orphanages and hospi-tals, in which all unhappy children, futurecitizens may find merciful care, nourish-ment and education.

Babies cry – let’s give them mother’s care.Children get ill, moan, and want to live –let’s shelter them in hospitals. Children arehungry – let’s feed them. Save the children!

by Prof. Stoyan Vatev, MDpublished in "Child's Day", issue 1/08.05.1927,

Journal of Union for Child Protection in Bulgaria

Summer StudentColonies

Twenty three years ago the school physi-cians drew the public attention to the unsat-isfactory condition of students' health;according to the reports from 1904-1905 weconclude that there were 28 death cases, 174- tuberculosis, and also other various healthproblems due to school environment among

14000 examined stu-dents. That fact causedconcern about stu-dent's health and in1904 the Ministry ofNational Educationsent 40 physically weakstudents from Sofia tospend their holidays inthe open mountain air

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An illustration taken from aBulgarian publication between thetwo world wars. Part of a cam-paign against charlatans.

of Chepino; and this initiative laid thebeginning of the summer student colonies.

The promising results of the stu-dents' health in this first colony, drew soci-ety's attention, which did not hesitate tosupport this good initiative and "Zdravets"association for summer student colony wasfounded. The association used the moneycollected to buy a plot in the village ofPancharevo and in 1907 constructed abuilding. Since then in 20 years, the associ-ation has accepted 120 physically weak poorstudents per year, because of the good nour-ishment and cares they added weight andwere able to continue their education with-out problems. "Zdravets" associationtrustees still saw the necessity for childrento spend in the colony not only the summertime but to be there throughout the wholeyear. For this purpose we collected muchmore money and a building for a permanentstudent colony will be constructed soon,such as the ones in Lovech and Nova Zagora,where the physically weak, exhausted orweakened by sickness students will have theopportunity to take shelter for severalmonths throughout the whole year and con-tinue their education without missing thewhole school year.

Society started to realize the necessi-ty for students' health protection and thisconsciousness started to develop also inother towns and summer student coloniesnear the towns, in mountains, or on seasidewere established. Thereby step by step, espe-cially during the recent years after the worldwar, summer student colonies were foundedalmost in every town. There have been 60colonies with 5000 settlers in 1926. But justa little number of students could enjoy thesesummer student colonies, and all physicallyweak students need to improve their healthin such colonies. Therefore, it is necessarysummer colonies for all students to beorganized, and such ones could be foundednear every town or village, by taking the chil-dren out every day during the summer holi-day to play and party in the open air andsun, under the supervision of teachers orwell-wishers of the children. This will leadnot only to improving the health of the stu-dents, but will contribute to their moralstrengthening also.

by Tsevatana Vateva(President of "Zdravets" Associations)

published in "Child's Day", issue 1/08.05.1927,Journal of Union for Child Protection in Bulgaria

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Organised nourishment in the war.

Proper Food forStudents

Children's food for lunch and dinner hasto be always varied and should includemainly:

1. Proteins: meat, eggs, milk; 2. Fats: milk butter, vegetable oil; 3. Carbohydrates: bread, rice, potatoes,

beans, lentils, sugar, bee-honey, etc; 4. Vegetables: onion, leeks, cabbage,

dock;5. Fruits: apples, oranges, watermelons,

pears, cherries, wal-nuts, etc.

At home childrenhave the opportunityto eat whatever theywant and wheneverthey want. But inboarding-houses or insoup-kitchens, wheremany children, manytastes and wishes aregathered, we have tokeep in mind that thefood must be variedevery day and everySunday and complete-ly in accordance withthe seasons. Furthe-rmore the food shouldbe selected not only byits quality and quanti-ty, but also by itsnutritive value.

U n i v e r s i t yChildren's Clinic hasalways been helpfuland will be in thefuture giving informa-tion to all soup-kitchens, boarding-houses, orphanages,which would like toknow the nutritivevalue of the food theyoffer to their inmates.

As the nutritivevalue of the food

stuffs and their cost are well-known, one caneasily prepare nutritious meals and at lowcost.

A lunch with nutritive value of 1250-1540calories costs 5.05-10.35 leva in Sofia soup-kitchen. A lunch with nutritive value of1070-1700 calories costs 3.80-10.20 leva inLovech soup-kitchen. The food per day,3200 calories costs 28 leva in UniversityChildren's Clinic. The food per day costs8.40-12.40 leva in Kjustendil orphanage.

By calculating the calories one can fixmeals sufficiently nutritious and at low cost,which fact has a great economic significancewhen feeding so many children in soup-

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Having a bath, 1912

kitchens, boarding-houses, and orphanages.If in such institutions children learn how tokeep an account of food, and along withthat girls learn how to cook as the childrendo so in Lovech soup-kitchen, in that way weeducate them how to keep house and bethrifty.

In Lovech soup-kitchen for poor studentsa rule is introduced that every student mustpay for the meal even a small sum. The chil-dren in charge keep account of receivedmoney all by themselves, put them in thebank and later they use the interest and thegrant from the bank for common benefits.In that way children learn how to live not oncharity and mercy, but by using their ownfunds. This initiative contributed to themoral of both children and mothers.

Soup-kitchen must be established atevery village and town school. Children willlearn how to eat properly and sufficiently,and when they cook and keep account of thefood cost they will learn to keep house andbe thrifty.

by Prof. Vatev, MD(President of Union for Child Protection in Bulgaria)

published in "Child's Day", issue 2/29.04.1928,Journal of Union for Child Protection in Bulgaria

Five-Years oldDesajda Suffersfrom Leukemia

The young mother: ”Please help mydaughter. Perhaps, a miracle can happenif we go to Italy!“

A little girl cries in the arms of her moth-er. As it is not hard to understand, she isafraid to pass the door that she has passed ahundred of times by now. The little girl suf-fers from leukemia, a terrible disease. Onlythe ”strongest“ can resist it. The sick girlwalks inside, while Majlinda, her mother,stays out of the door, tears in her eyes. Itaches to the 27-year old mother to see herdaughter having an injection in the spine.The girl will lay in her bed for a couple ofhours.

”We are from very far away, from Skrapar.We are here with our sick child for one anda half month. This is the second time ofhospitalization.“

Little Desajda stares at us. She doesn’tspeak. Her mother, Majlinda, tries to hideher tears. ”Desajda became sick all of a sud-den. At the beginning she lost her appetite,than became pale and her glands grew“.

”We took her to the doctor of the districtwhere we live, but we were sent to Berat andfrom there urgently to Tirana. From the verybeginning the doctors informed us for theterrible disease, lymph plastic acuteleukemia“.

In fact this disease causes a high level ofleukocyte.

”The first curing cycle happened last yearfrom June to September. After 45 days wecame again, from October till December.When we left hospital at that time, we neverthought that our daughter would need to behospitalized again, the mother says.

She stops for a while to take a breath andmention to us the fact that a six year old boyfrom Kukes died last week from the samedisease. She talks about the possibility tosend these children abroad to be cured inorder to help them enjoy the life that theyhave just began.

”I, Majlinda continues, am ready to givemy life to save the life of my daughter. I wantto send her to Italy to be cured there. I heardthat another child that was sent to Italycame back quite in good condition. Doctorstold me that the disease is curable and Ihope“.

”The people in white blouses, continuesthe mother of Desajda, have told me thateven in Italy, the process of injection in thespine is difficult. In many cases children dieduring the intervention process. It dependsa lot on the condition of the sick child in themoment of intervention. My daughter hasreacted positively towards the curing processand this gives me hope. I have never beenpessimistic, but I can not accept to loose mydaughter, who together with my one yearold son, are all I have in this world“.

The sick children are sent abroad if thesymptoms are repeated. They are some 20children each year.

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”Some similar cases with that my daugh-ter are cured, I am told. We know someonefrom our hometown who was cured with theattention of Anila Godo, the doctor, andthe former patient is studying medicinenow“.

The girl that survived is called Aurora,and she studies in the fourth year of theschool of Medicine of Tirana University.

We see Desajda trying to move in her bedwanting to draw some flowers. She has aneedle in her right arm, but she behaves as ifit is part of her body. Desajda knows allmedications she is taking. She was injectedin the spine more than 30 times now. Shehas become a doctor of herself.

( The article was written by L. Kondi)SHEKULLI , Albania, 28/09/2000

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Organised provision of food for children

CIP - Katalogizacija u publikacijiNarodna biblioteka Srbije

316.356.2-053.2(4-12)“18/19“(082.2)

CHILDHOOD in the Past: 19th and 20thCentury: Additional, Teaching Materials forSecondary Schools / Milan Ristović, DubravkaStojanović (eds.) ; [Translation from Serbian Linda Luise Krstajić]. - Beograd :Udruženje za društvenu istoriju, 2001(Beograd : Čigoja Štampa). - 100 str. :ilustr. 21 cm

Tiraž 10001. Ristović, Milan 2. Stojanović, Dubravka

ISBN 86-83227-05-7

ID=907125588

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