Epidemics in the Holy Land 100 Years Ago

During the World War I campaign in the Middle East, more soldiers died from epidemic diseases than from bullets. Louse-borne typhus, cholera from contaminated water, and malarial mosquitos were often the lethal agents, but not the only ones.

How did the epidemics affect civilians? One-third of Jerusalem’s population died from the epidemics that struck well before the 1918 influenza pandemic. Hundreds of Jews from Jerusalem, Hebron, and Gaza worked or served in the Turkish army base in Beer Sheva. When they returned to their homes, the plagues spread like wildfire.

This chapter is an excerpt of Lenny Ben-David’s forthcoming book, “The Secrets of World War I in the Holy Land Revealed in Photographs.”

A group of the orphans in Jerusalem in 1918. “Their fathers and mothers had died from typhus, dysentery, malaria and exhaustion.” (Red Cross, Library of Congress). When the British army entered Jerusalem in 1918, they found 2,700 orphans wandering the streets.

Several years before the catastrophic influenza pandemic struck the world in 1918, calamitous plagues were killing millions in the Middle East. After 1914, the region suffered from malaria, typhus, cholera, dysentery, smallpox, and venereal disease. The disastrous locust plague that struck the Holy Land stripped the land of all crops and fruit. What food the civilians had hoarded was looted by Turkish soldiers.  Tens of thousands of civilian residents died of hunger, “exhaustion,” or disease.

Turkish troops forcibly conscripted Jerusalemites into the army and looted Old City homes. (Ottoman Imperial Archives)

When World War I erupted in Europe, Turkey allied itself with Germany and dispatched its army to the four corners of the Middle East — to Arabia, Mesopotamia (Iraq), Palestine, and the Sinai. From there, the Turks, encouraged by Germany, sought to seize the Suez Canal from British control, and tens of thousands of Turkish soldiers flooded into Palestine and the Sinai. The Suez Canal was essential for the United Kingdom for protecting its empire, particularly the route to India from where the British secured resources and manpower, including soldiers.

The Ottoman army was abysmally prepared for the disease and public health challenges it was unleashing. According to Prof. Melanie Schulze-Tanielian of the University of Michigan,  “Widespread epidemics consumed Ottoman soldiers and civilians alike during the Great War…. Typhus, malaria, and relapsing fever, transmitted via disease-infected lice, mosquitoes, and ticks were the deadliest assailants, followed by bacterial diseases like dysentery and typhoid.”

Prof. Schulze-Tanielian continued:

“The [Ottoman] empire’s poor infrastructure contributed to the spread of disease. Limited trains to and from the fronts were often packed to capacity, meaning that common soldiers and microbes were crammed under unsanitary conditions into freight cars over long stretches of time… The fact that soldiers often had to march to and from the front made it difficult for Ottoman sanitary officials to maintain adequate hygiene.  It was during these marches that soldiers would at random mingle with civilians, picking up or leaving behind germs and microbes…”

Among the civilians mingling with Turkish soldiers were Armenian refugees fleeing for their lives and wracked by disease. The fly-infested corpses on the sides of the roads accelerated the spread of disease.

The German army medical corps attempted to improve health conditions in Turkish camps, even preparing a hygiene booklet for the soldiers, but many Turks were illiterate.  German General Otto Liman von Sanders examined Turkish bases at the start of the war:. According to Prof. Schulze-Tanielian, he found:

“[P]oor or even non-existing hygiene, vermin infestations, and rampant sicknesses among the troops. There were no bathing facilities in the barracks; military hospitals were in an appalling state. A permeating stench and overwhelming dirt met him as he entered overcrowded hospital rooms. There was no separation between patients with physical injuries and those infected with diseases; men slept in the same beds or crowded on the floor. Sanders reported the misery to the Ottoman military command and issued suggestions to improve the state of affairs. His propositions were ignored, evaded, or met with outright resistance from higher officers of the military.”

Photographs of Turkish troops on the move

The Turkish army gathering in the Galilee before heading south for the attack on the Suez Canal, 1914. (Library of Congress)

Ottoman troops departing from Jerusalem’s Old City for the Suez front. 1914. (Ottoman Imperial Archives)

Ottoman troops leaving Jerusalem’s Lions Gate, heading for the Gallipoli front in 1915. (Ottoman Imperial Archives)

Note in all the photographs the Ottoman troops were traveling great distances. Schulze-Tanielian pointed out., “Military transfer centers were a particular challenge for Ottoman health officials. Here soldiers slept crowded on the floor, making it nearly impossible to prevent louse-borne diseases, such as typhus.”

According to an account by a German medical officer, “Of the 10,000 troops serving in the Ottoman division that set off from Istanbul, only 4,635 could make it to Palestine. The rest either became ill or deserted. The ones who reached Palestine were ill and had lost their strength.”

Ottoman soldiers being deloused at Jerusalem’s Shaarei Tzedek hospital in 1914. (Cathedra Quarterly – A journal for the history of Eretz-Israel, Yad Izhak Ben-Tzvi, “Causes for death among Jerusalem residents during World War I,” by Zalman Greenberg.)

The German troop in Palestine may have suffered less than their Turkish allies because of their sanitary standards, but they, too, suffered from the diseases and parasitic illnesses such as cutaneous leishmaniasis — caused by the bite of a sandfly. The disease afflicted soldiers on both sides of World War I in Palestine.

A German soldier suffering from the “Jericho buttons” of leishmaniasis, 1917 (Library of Congress)

A medical report of all nine [Ottoman] armies and enlistment stations, Schulze-Tanielian wrote, “shows the total number of military casualties of the Ottoman army as 771,844; 466,759 of whom died of illnesses and 68,378 from battle wounds.”

The spread of diseases to the civilian residents

When the war began in the Middle East, Turkey streamed soldiers into bases in locations such as Nazareth, Jerusalem, and Beer Sheva. The latter, on the Egyptian front, rapidly grew from a sleepy village of 1,000 to a town of 3,000. The economically depressed region suddenly provided employment for hundreds of Jews in the army bases working as carpenters, cooks, teamsters, builders, shoemakers, tailors, millers, bakers, civilian quartermasters, and more. Jews helped build and manage the Ottoman rail system, a factor that would have important implications as the war continued. Some of the Jews were soldiers in the army, some contractors, and others forced laborers who worked to avoid serving in the military. Among the Jews employed in Beer Sheva were 78 who were sent from Jerusalem in June 1916 by a Jewish employment agency. Others came from Gaza or Hebron. The town had an estimated 50 permanent Jewish residents and 150 temporary

Beer Sheva, photographed  circa 1916 by a German officer who was taken captive by British forces.(NSW Museum)

workers, according to researcher Ilan Gal-Farr, writing for Ben Gurion University’s Journal.

In early 1917, a British air raid hit the rail yard in Beer Sheva, killing 16 Jews who were waiting in a

A Jewish tailor (right) in the Turkish army uniform factory in Beer Sheva. (Library of Congress)

railroad car for a train to evacuate the town after wave of illnesses hit the town. They sought to return to their homes, especially when the Turkish army was relocating its resources as the British forces moved north. The Jewish laborers were buried in a common grave in a Jewish cemetery in the town. The cemetery had to secure special Turkish permits since the law prohibited Jewish purchases of land. It was sorely needed by 1916 when a typhus epidemic hit and killed Jewish soldiers and approximately 100 of the Jewish laborers.  By March 1916, six Jews were dying a week, according to Gal-Farr.

Tombstone of Eliezer Rivlin, a Jewish Turkish soldier from Jerusalem who died in the Beer Sheva epidemic.(Israeli Tombstones Blogspot)

One of the Jewish soldiers was Eliyahu Rivlin, a pharmacist in the Turkish army who died in May 1916 from cholera. His gravestone was found only in the 1980s embedded in a wall of an old building being renovated. The stone had been used for secondary construction. It served as evidence of the Jewish cemetery’s destruction in the 1929 Arab riots.

The epidemics hit the city of Jerusalem like an army of Angels of Death. Some Jewish villages were burned down by Turkish authorities because of their infestation of disease-carrying agents. In 1918, when British, Indian, Australian, and Jewish forces pushed north and east toward Damascus, malaria was so rampant that just several more weeks of fighting would have rendered the forces powerless.