AMERICA'S RELIEF EXPEDITION TO ASIA MINOR UNDER THE RED CROSS
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REPORT OF DR. IRA HARRIS,
OF TRIPOLI, SYRIA, PHYSICIAN IN CHARGE OF THE FOURTH FIELD EXPEDITION FOR
THE RELIEF OF MARASH AND ZEITOUN.
Dr. Ira. Harris, resident American physician at Tripoli, Syria, a gentleman of high attainments, Christian character, scholarship and service, who directs a large private hospital and practice of his own, honored the Red Cross and contributed largely to the beneficence of his and our own people's efforts to relieve and rebuild the people of Asia Minor, by accepting a commission to command an expedition for the relief of the fever-stricken thousands, residents and refugees, crowded into the cities of Marash and Zeitoun. The reports received from consuls and missionaries presented a terrible condition of affairs, threatening the lives of thousands by pestilence and hunger, more rapidly than the Circassian knife and the Kourdish spear and bullet had done. Our own special agbnts were all in charge of difficult and distant fields, and none could be spared to this section. After various disappointments, aided by the Rev. Dr. Post at Beyrout Dr. Ira Harris was reached and asked to aid in organizing and forming a relief expedition at once. Besides himself as director, six other physicians and two pharmacists were required. Dr. Harris, though burdened with hospital patients and promised operations, finally decided to proceed to Beyrout and meet Dr. Post, taking with him his own assistant and pharmacist. Dr. Hubbell had already been Dr. Harris' guest and this fact aided the latter's acceptance. At Beyrout time was spent in examining medical applicants, most of whom withdrew however on learning of the dangers before them. Two Protestant doctors were secured on the second day, and so with half the needed medical force at hand, the supplies and stores were quickly purchased and packed for travel. Arrangements at Tripoli for the care of Dr. Harris' own patients were then made, and upon the third of April our fourth expedition was under way. A route was chosen via
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Mersene and Adana. At the latter city some delay was occasioned by the rumors of incursions of bandit tribes to neighboring towns and villages and an insufficient military escort available. After trying in vain two or three days, to influence the local authorities Dr. Harris telegraphed to Red Cross headquarters for assistance. The matter was immediately brought to the attention of the Porte, through the U. S. Legation, and within an hour an imperial order was sent to the Governor of Adana. As fine a mounted Turkish soldier guard as ever escorted an expedition was at once found, and Dr. Harris with his corps of assistants, hastened on to Marash, where he was welcomed by Dr. Hubbell of our first expedition, on the eighteenth of April, after five days' of severe travel. Dr. Harris' report was embodied in a letter, After enumerating the trials at Adana, from which he was so quickly freed by the order from the Porte, the doctor continues:
We found that the medical work was being cared for by native physicians, and the missionaries and their wives were caring for the other relief work, one feature of which seemed to me very valuable indeed, i. e., the making of clothing by poor women from the material sent by you from Constantinople or purchased by Dr. Hubbell in Marash. I wish the dear people in America who gave of their means, could see with their own eyes the condition of thousands in these districts alone. The hundreds of women, almost destitute of covering, and that a mass of rags. It does not require much thought to realize the value of good clothing at such a time.
A consultation was held and our party decided to proceed to Zeitoun, just as soon as our weary bodies were rested. Unfortunately the day after we arrived I had a severe chill and fever which prostrated me for several days. As the symptoms seemed to resemble typhus fever the doctors remained with me until a clear diagnosis was made by the fever leaving me on Thursday. The next day the party went to Zeitoun with Mr. Macallum, I following three days later.
I have witnessed scenes of suffering, both in the United States and the Orient, but never, to my dying day, will I be able to dismiss from my mind the horror of the pinched, haggard faces and forms that gathered about me that first day. Before we left the tent one of the doctors said: "we will now see the place is full of walking skeletons." This expressed fully their condition. Just imagine a place having a normal population of 12,500 living all told in 1,403 houses, you can see there is not much cubic space to spare; then imagine 7,000 or more refugees to be provided for in the town also. Some of the Zeitounes gave shelter to a small number, but the greater majority lived on the street, under the houses, in many instances too vile to be of use to its owner; in cow and donkey stables with the animals; in spaces in close proximity to water closets; in fact not a place that even suggested shelter was unoccupied. The smell and presence of
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human excrement were everywhere, and this, added to divers other odors made the air a fit place for the culture of disease germs. So much for the hygienic conditions of the place.
DISEASES. I regret that I am unable to give the exact number of those afflicted with each individual disease; to ascertain this would have taken too much valuable time. We found it a difficult task even to make a true estimate of the number ill with acute diseases. Our first estimate sent you, viz: 1,400 dysentery and diarrhoea, 600 typhus fever, afterwards proved nearly correct, i. e., if we take about 300 from the typhus and add to the dysentery. These were-acute cases. Of the refugees, ninety-eight per cent, complained and were treated for diseases such as chronic dysentery, diarrhoea, dropsy (usually those recovering from typhus), rheumatism, bronchitis, dyspepsia, malaria; all were suffering from anaemia and debility. CAUSES. Overcrowding and bad air; but that condition bordering on starvation was the principal cause of all the sickness. I should add, many of the cases of diarrhoea were caused from eating a soup made from grass, weeds, buds and leaves of shrubs and trees. In fact anything green that could be gathered in the fields was boiled in water to which a small quantity of flour was added. This diet was especially dangerous to children.
TREATMENT. We were soon convinced that if we expected to gain the upper hand of all this sickness and save even a remnant of the refugees, we must first feed the sick, and then when they were well—to give the former every possible chance to get well, and to prevent the well from becoming ill. Second, we must try in every way in our power to get the refugees to return to their homes, or at all events to camp out in the fields. The first day we filled the hospital opened by consul Barnum with cases off the street, and from that time on we increased hospital facilities as fast as possible. We engaged two men and one woman to care for the hospital; four interpreters and one assistant for the pharmacist. We then divided the town into districts so as to systematically get at every sick person. Then we hired (for we could get nothing without a system of bargaining as to price) two large copper kettles used to make grape molasses, and purchased two hundred pounds of beef and made a strong, rich soup. We then strained every nerve to get a soup ticket into the possession of every sick person. We did not waste time by trying to cull out the impostors; in fact there were very few of this class, all the refugees were needy and hungry. The second day we added three kettles, and to supply the number we served at 10 o'clock clear meat broth; at 4 o'clock thick soup of beef and rice. By the end of the third day every sick person was receiving food. Then all complaints of vomiting the medicine ceased.
The problem then to be met was—how to get the people to go outside the town. We suggested that if they would, we would place a soup kettle
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out in the open fields to the south, north and east, and in addition to the soup we would give them flour. This had a very decided effect, for 1,000 went the first day. The moving continued until every person living on the streets and in cow stables had built for themselves shelters of twigs and leaves. Now the butchers saw a chance of applying the plan of putting up the price of meat from seven to fourteen piasters per oke (2 3/4 lbs.). But we had anticipated this and sent men to a friendly Moslem village to purchase cattle. So their scheme failed. By the end of the second week there were no hungry people in Zeitoun.
RESULTS. The typhus cases began to recover, the new cases took on a mild form, the same could be said of dysentery. The new cases of both became less and less until they almost disappeared. The most marked improvement was the rapidity which the daily funerals in the three burying grounds decreased. I watched these places with deep interest, for they were a thermometer to gauge the success of our work, and it was with deep gratitude to God that we saw the daily burials reduced from fifteen to none. So much for the acute cases. The first week the chronic cases took the entire time of one doctor, each taking our regular turn. Tonic treatment and food so reduced the number that sixty became the daily average at the end of the second week. At the end of the third week, fell to ten. Our pharmacist, Shickri Fakhuri, proved as he always has, a jewel. His hands were full to prepare the prescriptions of three doctors. At first it was necessary for one of us to give him assistance of an hour or so daily. On the 20th of May, we felt we could leave the town free of acute typhus and dysentery. We gave to the committee selected by Mr. Macallum, funds enough to keep the soup kettles going for one week, and 200 liras ($880) worth of flour, which would suffice for at least six weeks, and by that time it was hoped that all the refugees would have departed for their homes. On our return to Marash we remained four days superintending the work of relief of the native doctors, and performing surgical operations. We then started for the coast. We chose a shorter and less expensive route than that by which we came. We were able in several places on the road to give needed relief, although to a limited amount. The lessons learned by our experience have been many:
1st. The value of keeping well, for obviously, success depends upon this. It is evident to us the way to reduce the danger of infection to a minimum for medical men, is to eat and sleep outside the infected town. This plan may present difficulties, but if possible, it is best. The dreadful mortality among doctors and nurses in the epidemics of typhus fever is well known. The query is, could not this mortality be reduced by the plan suggested ? It proved so in our case at least.
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2d. The food supply is of first importance, especially for epidemics caused by lack of food.
3d. The utter worthlessness of medication without it.
4th. Pure air. It is much better for people to risk possible exposure out in the open air, than risk contagion in vile unwholesome shelter in an overcrowded town.
Lastly, I am more than ever convinced that small doses of medicine oft repeated give better results in typhus and dysentery than those usually recommended in text books. I, at least, had ample opportunity to test this to my satisfaction.
In conclusion, I wish to express my hearty approval of the methods pursued by yourself and associates, especially as applied to the giving relief to the suffering people. The distribution of your forces was admirable, and the way they grasped the situation and the needs of the people of each particular place should excite the admiration of all who have the relief of this afflicted people at heart. Instead of scattering the money here and there in an aimless way, food, medical and surgical supplies, clothing, seed, cattle, farming utensils, simple cooking vessels, were systematically distributed, thus putting all in the way of providing for themselves in the future and becoming independent again. It is very easy to pauperize the people of the Orient, but your methods prevent this.
Again, the non-sectarian aspect of your work has made a favorable impression. It eliminates all religious prejudices from the minds of all, especially the religious heads. Therefore no ungenerous remarks as to the ulterior motives of your relief. On the contrary we heard nothing but words of commendation.
No one but yourself and your associates and those who have lived in Turkey for a number of years, can appreciate the difficulties and perplexities under which you have labored from the very first.
I am sorry that this report ends my official relations with you, but believe me, dear Miss Barton, my wife and I shall hold yourself and your associates always in interested remembrance.
Truly and sincerely yours,
Tula, Mt. Lebanon, August 15, 1896.
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| Pages 1, 2 | Executive
Report by Miss Clara Barton
Financial Report by George H. Pullman | Financial Balance Sheet | Map Of Asia Minor
Pages 57, 58 | 1st Expedition Report | 2nd Expedition Report | 3rd Expediton Report
4th Expedition Report | Telegrams | Red Cross Principles | In Memoriam
Contents (as in the book) | Illustrations
Source: Clara Barton. America's relief expedition to Asia Minor under the Red Cross. Journal Publishing Company, Meriden, Conn. 1896.
Provided by: Sona Tumanyan