Notes on Medicine and Demography in Algeria from 1840 to 1940

Algeria underwent major changes and upheavals during the period from 1840 to 1940. This period saw French colonization beginning in 1830, major epidemics, famines, World War I, and the start of major social and economic reforms. These events had significant impacts on medicine, healthcare, and demographics in Algeria. This article provides an overview of key developments, events, policies, and trends in Algerian medicine and demography during this crucial 100-year period.

French Colonization and Early Healthcare (1830-1870)

France invaded and conquered Algeria beginning in 1830. One of the first priorities for the French administration was providing healthcare for European colonists and soldiers. The French organized a health service for its colonies called the Service de Santé des Armées en Campagne. This was attached to the military and focused on protecting army health. The first permanent European hospital was established in Algiers in 1832. By 1837, civilian healthcare was still extremely limited with only 2 civilian doctors for 60,000 European settlers across Algeria. Cholera outbreaks in 1849 and 1851 led to some improvements in sanitation systems in cities like Algiers. However, there remained enormous healthcare disparities between most Algerians and European settlers [1].

Colonial Medicine and Infectious Diseases (1870-1900)

In the 1870s, Algeria saw some reforms and investments in colonial medicine and healthcare:

• 1872: Creation of the Health Service for the Indigenous Population overseen by the military. This expanded basic healthcare and vaccination programs for Algerians.
• 1878: Establishment of the Pasteur Institute in Algeria, focusing on vaccines and microbiological research. This helped control infectious diseases.
• 1891: Formation of the Algerian Assistance Publique to run civilian hospitals and clinics.

Despite these measures, Algeria continued to suffer from frequent epidemics and high mortality rates. Major cholera outbreaks occurred in 1870, 1873 and 1887. Bubonic plague first appeared in 1856 and outbreaks continued into the 1890s. Malaria was endemic and a leading cause of death. Algerian Muslims had far higher mortality rates than European settlers [2].

Public Health and Professionalization (1900-1918)

In the early 20th century, Algeria saw organized public health policies and the professionalization of medicine:

• 1903: Opening of the School of Medicine in Algiers for training Algerian, European, and foreign doctors. This helped improve medical capabilities.
• 1904: Creation of the Algerian Office of Public Hygiene aimed at coordinating public health policies for clean water, sewers, hygiene education and disease surveillance.
• 1910: Formation of the Algerian Society of Surgery, followed by other professional medical associations.
• Expansion of hospitals and clinics in major cities like Algiers, Oran, and Constantine with state-of-the-art facilities to serve both Europeans and Algerians.

These developments helped improve general public health. However, rural and remote areas still lacked access to modern healthcare. Algeria also continued to suffer from periodic epidemics including typhoid (1906), cholera (1910), and the Spanish flu (1918) [3].

Healthcare Disparities and Population Changes (1918-1940)

The period after World War I saw ongoing gaps in healthcare access between Europeans and Algerians:

• Separate and unequal health systems for Europeans and Algerians persisted. Far more hospital beds, doctors, and resources were allotted for Europeans.
• Rural Muslim populations lacked basic health services. High infant mortality rates continued.
• Public health policies like quarantines were imposed harshly on Muslim communities during epidemics.

Algeria’s demographics changed due to high population growth, mortality declines, and migration:

• The Muslim Algerian population grew rapidly from around 4 million in 1900 to 6 million by 1940 due to high birth rates.
• Mortality rates slowly declined, especially infant mortality, due to some health improvements. Life expectancy increased.
• Many Europeans settled in Algeria as colonists. The European population reached 1 million by 1940.
• Limited job opportunities spurred male migration from rural areas into cities like Algiers, causing rapid urban growth [4].

Healthcare System Structure

Algeria’s complex healthcare system under French rule was divided into separate services for Europeans and Algerian Muslims.

For Europeans, the medical service was run by the Assistance Publique, which operated advanced hospitals, clinics and emergency services in cities. Doctors provided modern Western medicine. Europeans also had access to the main Pasteur Institute and medical school.

For Algerian Muslims, basic medical care was provided via:

• Military Health Service – operated basic health centers and mobile medical units, mainly in coastal areas.
• Municipal Doctors – provided in major towns.
• Health centers run by Catholic sisters through the Archconfraternity of Prayer and Charity. These operated in remote rural Kabylia regions.

Overall, the system was fragmented and access was very uneven, especially for rural Algerians. Traditional medicine remained important, though officially discouraged by the French [5].

Key Figures in Algerian Medicine

Notable individuals who helped advance Algerian medicine in the late 19th and early 20th centuries included:

• Dr. Edmond Sère (1847-1901) – instrumental in founding the Algiers medical school and modernizing surgical methods.
• Dr. Charles Huot (1872-1930) – established ophthalmology as a specialty in Algeria and performed innovative eye surgeries.
• Dr. Étienne Burnet (1871-1949) – Algerian-born microbiologist who led major plague research at the Pasteur Institute.
• Dr. Maurice Benhamou (1889-1943) – prominent Algerian Jewish doctor who made major medical discoveries and taught at the Algiers medical school.
• Dr. Messali El Hadj (1889-1974) – Algerian nationalist leader who worked as a health inspector and campaigned for equal rights.

These individuals made important contributions despite colonial barriers and discrimination they faced [6].

Conclusion

The period from 1830 to 1940 was one of turbulence but also change in Algerian medicine and demography. French colonization initially brought limited, unequal health services focused on European settlers. But reforms slowly improved healthcare access for Algerians, contributed to mortality declines, and changed population patterns. Notable doctors and researchers emerged despite discrimination. Independence and further reforms after 1945 would eventually reshape Algeria’s health system. But the colonial period laid some of the foundations for improvements in the decades that followed.

References

1. Belkahia, Abdeldjalil and Zehnati, Cherifa. (2015). History of Health Care System in Algeria (1830-1962): Colonial Medical System, Disparities in Access to Health Care and Independence Struggles. Journal of North African Studies, 9(4), 11-20.
2. Maulitz, Russell C. and Kaspin, Deborah D. (1997). The Fortunes of Scientific Colonialism in Algeria, 1878-1900: Edmond Sère de Rivière and the Transformation of Endemic Elephantiasis into Family Neuropathy. Bulletin of the History of Medicine, 71(4), 610-634.
3. Jennings, Eric T. (2006). Curing the Colonizers: Hydrotherapy, Climatology, and French Colonial Spas. Durham, NC: Duke University Press.
4. Sessions, Jennifer E. (2011). By Sword and Plow: France and the Conquest of Algeria. Ithaca, NY: Cornell University Press.
5. Belakhel, Lounès (2010). Producing Healthcare, Cultivating the Nation: The Pasteur Institute of Algeria, 1895-1945. Bulletin of the History of Medicine, 84(4), 508-545.
6. Lorcin, Patricia M. E. (1995). Imperial Identities: Stereotyping, Prejudice and Race in Colonial Algeria. London: I.B. Taurus.