Iran in the age of epidemics. Nationalism and the struggle for public health: 1889--1926.

다국어 초록 (Multilingual Abstract)

The evolution of public health in Iran is an important reflection of the milestones and setbacks that have ultimately shaped its contemporary institutional landscape. This work investigates Iran's unique encounter with epidemics and its national quest for the institutionalization of public health. More broadly, it looks at the ways in which cholera, plague, and influenza outbreaks changed Iranian society between 1889 and 1926.
The initial sanitary improvements and the growth of European medicine in Iran occurred as part of its drive for military modernization. The creation of Iran's first secular academy of higher learning, coupled with the influx of European physician-instructors, played an important role for the eventual hegemony of European medical theories among the Iranian population. However, faced with civic shortcomings, administrative decentralization, and financial paralysis the Iranian government was unable to establish a viable sanitary regime and faced recurrent epidemics throughout the nineteenth and twentieth centuries. In addition to the severe mortality brought about by these outbreaks, the recurrent epidemics also halted trade activities and contributed to the general degradation of Iranian economy. These dramatic and devastating plagues became an impetus for the evolution and acceptance of new medical knowledge, such as the germ theory of disease. Increasing awareness of the etiology of these illnesses, coupled with an understanding of how best to prevent them, contributed to the patriotic and radical rhetoric of reform in Iran.
During the first decade of the twentieth century, Russian and British meddling in Iran's quarantine establishment paralyzed Iranian sanitary institutions. This situation was worsened by instability and destruction brought about by the First World War, worsened the situation, culminating in the 1918–1919 influenza pandemic, the deadliest outbreak in the Iran's history. The trauma of influenza, coupled with the demise of the Qajar and rise of the Pahlavi dynasty, launched a period of progress for Iran's sanitary establishment through new organizations, such as the Pasteur Institute, and expansion of previously existing public health programs. Reza Shah's success in establishing law and order, a healthy fiscal policy and a nationalist program of revival allowed Iranians to harness indigenous medical resources and break free of foreign sanitary restraints and, through effective administration and funding, a national public health program was established.