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How was malaria of 100 years ago eradicated in Palestine/Israel? And without vaccine?

May 21, 2012 - 09:55 -- Anton Alexander

How was malaria of 100 years ago eradicated in Palestine/Israel? And without vaccine?

The desperate state of the Holy Land 100 years ago may be appreciated upon reading the following:

"I have referred to the question of heat as one too often forgotten, but there are at the present time still great dangers in this semi-tropical region. Palestine suffers severely from that great scourge of the tropics - malaria .............

..........where open water or irrigated land is abundant there is less hope of eradicating this disease, and those who live in such places will always have to do so with precautions - which must be enforced - for the sake of themselves and the community.

In some of the Jewish colonies which I have visited, all precautions have been neglected, and the severest malaria and blackwater fever were frequent."

(19th March 1917 - Palestine: Its Resources and Suitability for Colonization by Dr EWG Masterman, read at the Meeting of the Royal Geographical Society).

"The determined attempt by communities of Jews to colonize in Palestine might almost have been doomed at its inception, and, indeed, because of the prevailing hyperendemic conditions  might have proved a most disastrous failure, had it not been for the particularly able manner in which defensive measures [against malaria] were gradually introduced. In the near future it will be no empty claim that country wide malarial control has been established. ........ The Jewish colonists [had previously] most frequently settled in the neighbourhood of that precious commodity, water, with the result that in a very short time malaria was rife, and, as in the village of Hulda, the settlement could only be maintained by annual replacement of part of the population."

(21st November 1931 - The British Medical Journal - Control of Malaria in Palestine)

And for an overview of the shocking severity of the disease in Palestine and also of  the method that was used to control and eradicate malaria, see www.eradication-of-malaria.com .

But for a more detailed explanation of the method then used to eradicate malaria, I have now scanned the book by Dr I Kligler, the man responsible for the eradication method, published in 1930 under the title “The epidemiology and control of malaria in Palestine”, and which may be read at www.kligler1930.com so that this will now be available to everyone.

At page 135 of this book, Dr Kligler wrote

“We have come to realise that malaria is eminently a local problem, and that a successful attack is possible only after a careful study of the local conditions combined with systematic experiments with the method or methods most likely to give the desired results.

In the course of our work during the last five years, various methods of control have been tested. Antimosquito measures as well as quininization have been experimented with under different conditions. The results will be presented in the subsequent chapters. Before discussing the results, however, it is desirable to describe the general procedure followed in the organisation of the control areas and the antilarval and antimosquito measures employed in our work.

In 1925, the Malaria Commission of the League of Nations, having read Dr Kligler’s progress report, visited Palestine to study what could be done against malaria in the way of an anti-larval campaign. “The League of Nations Malaria Commission – Reports on the Tour of Inspection in Palestine in 1925” was published and may be read (in English and French) at http://whqlibdoc.who.int/hist/malaria/malaria51-54.pdf .  This merits reading to provide inter alia details of the ordinances and regulations to oblige and enforce, if necessary, co-operation with the control and eradication methods, and also an idea of the manpower employed or engaged in the antilarval and antimosquito measures referred to above.

Different countries, different areas, provide different problems, and Kligler did not suggest a particular way that should be blindly followed. He did however suggest a principle and it is worth repeating, namely that malaria is eminently a local problem, and that a successful attack is possible only after a careful study of the local conditions combined with systematic experiments with the method or methods most likely to give the desired results. He was at pains to also stress the importance of the organisation of the control areas, and equally of the education of the population in the benefits to be derived from the assistance and co-operation with the anti-malaria methods.

100 years ago, Palestine was very thinly populated, uninhabitable in many areas. Today, Israel is approximately the 30th most densely populated country in the world. In the 1920s, 1930s and 1940s, Kligler’s ‘old’ method worked (and without vaccines, without reliance on bednets), yet other areas elsewhere in the world still struggle under the harsh disease of malaria.

Kligler died in 1944 and was then forgotten, his contribution overlooked. His above book was also overlooked, and was hardly available anywhere. Hopefully this is now remedied, and it can be seen by all who are interested.

Depending upon the interest shown in the above by readers of MalariaWorld, it may be possible to make available more articles by Kliger, and perhaps you may wish to add your interest or comments below.

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