BBS

CHILDHOOD, HEALTH AND DISEASE (1900-1939)

At the beginning of the 20th Century children mortality rates were terrifying 28,9/1000; one out of five children born in Spain died in the first year of life and almost two of five children didnt live more than five years. However during the following three decades medicine progress, hygiene and living conditions improvements and other factors made possible a decrease of children mortality rates to 16,83/1000. The cause of these high rates of children mortality is a set of social, economical and health factors that I will develop individually. Regarding economical factors, most of Spanish population lived in terrible conditions. The agriculture crisis and the industrial expansion in the cities had caused an unbalance development between rural and urban areas. While cities economy improved rural society could hardly survive. In addition, this industrial expansion caused a lot of people to migrate to the cities where bad hygienic, labour and living conditions produced a deterioration of health and lots of families lived in poverty. Social disparities were also significant between that working class and a high class who had no problem to access food and medical facilities. That environment of poverty complicated the situation of children as most families couldnt guarantee a proper nutrition to their children. Also women had to work in order to feed the family so breastfeeding period was too short and not properly done. Lack of money was related also to lack of medical assistance as they couldnt pay a doctor. In addition, hygienic conditions were terrible and infectious diseases were one of the main causes of children mortality. Therefore economic factors had a direct relation to health aspects of this period, for example important diseases in children as diarrhoea and bronchitis were linked to bad nutrition and living conditions. Regarding social factors, children mortality was directly linked to children abandonment, a situation very usual those days. Poverty and illegitimate pregnancy were some of the reasons for abandonment. Most of those children were newborn and they were left in the street or in Casas Cunas. The future of those children was terrible; most of them died and if they fortunately survived theyd probably beg for money at streets, be exploited and abused, and turn into criminals or prostitutes due to the few options they had. Its also important the concept that society had of children, they were considered as a being that had to be educated, tamed and controlled and not as human individuals that had to be discovered. This conception changed throughout the 20th Century, when the child is considered a person with individual rights. I must highlight that the weight and characteristics of these factors were different in rural and in urban area. In rural areas children lived in a more stable environment that was characterized by an early initiation in the labor world. Since very young children accompanied their parents to their jobs in agriculture, stockbreeding and industry, and they learned the job by observation and imitation therefore they could help their parents although they had no more than 6 years. At the beginning the job wasnt very hard but as they grew up the quantity of work increased and children of 10 years worked the same hours as their parents instead of

going to school. Training of children in a job started very early and they had no choice but to accept the fate of working all their life in the position their parents had chosen. In urban areas, however, the problem of child exploitation coexisted with the problem of abandonment and children delinquency. Streets were full of children suffering many negative situations: parents abandonment or carelessness, poverty, rebellious attitudes, exploitation by adults that forced children to beg for money, etc. Governments didnt know how to deal with this plague of street children and measures such as reformatories and law punishments had uncertain efficiency. All these factors lead to such a high infant mortality that the problem couldnt be ignored by society any longer. A new perception of children as the future wealth of the nation appeared and an idea that the situation of children was an indication of the level of development and progress of a society contributed to the creation of policies and movements to protect children and improve their living conditions. The government developed in the 20th Century some strategies to protect abandoned children, to help mothers with no means of support, to improve hygienic and health conditions of children and families, to regulate child and female labor, etc. It also created reform schools for children who had been abandoned or were criminals, those children had to be reformed and protected as their bad behaviour was sometimes caused by adults that exploded them. Also, there was a change in traditions and habits of society which influenced on the consideration of the child as a person with self status. Improvements in education and the role of the child in the family where the origin of the model of middle-class family in which the mother had the responsibility to create a home where the child was loved and protected and the father to protect and to provide the family. Severity was replaced with affection. Also the medical society played an important role in this fight against children mortality. As a consequence of the necessity to stop the loss of that national wealth that represented children, a medicine specific for children appeared, on one hand Paediatrics as clinical speciality and on the other hand Childcare with a hygienic-social perspective. The first measures that doctors took focused on hygienic conditions of homes, bad nutrition habits, the lack of childcare due to maternal work, the situation of misery and pathological heredity. First doctors tried to educate population about hygiene and children diseases because ignorance, some traditions and superstitions were so established in the lowclass and rural society that it was very difficult for doctors to intervene in the care of children. This lead to the publication of childcare education books for schools and families, public campaigns to inform society about children health and the establishment of the SchoolMedical Inspection, which allowed a better control of childrens health conditions. The main objectives of the School Medical Inspections were three: inspection of the childs health previously to the admission in the centre, the isolation of children with infectious diseases and the detection of abnormal children. Secondly doctors focused on the nutrition problem related to misery and the problems resulting from breastfeeding. Natural breastfeeding was a practice that mothers left in wet nurses hands, a practice that doctors advised against due to hygienic and moral reasons. Doctors recommended mothers to breastfeed their own children and in case they needed a wet nurse to select her carefully. Governments created laws to control and reduce this activity in order to protect childrens health and those women who had to abandon

their own children to feed other womens children. Another practice doctors fought was the use of bottles of animal milk to feed children, which lead to numerous digestive disorders. It was also very common in low-class families to start to feed children with solid food too early, so doctors initiated a campaign to educate population about when and how change the childs diet. An important initiative was the creation of specialized hospitals and dispensaries for children along with the consolidation of learning and professional institutions focused on childrens health, specialized magazines and specialist societies. All this lead to a better understanding of childrens health and improved the measures to treat them. Another model of institution was the sanatoriums and colonies. Children that due to their social status were exposed to diseases and had weak health were sent to those institutions to improve their health and prevent them from getting sick. Moreover specialized schools were created for those children who were abnormal (mental deficiencies, bad personality and behaviour, sensory dysfunction). To conclude with, the period of 1900-1939 witnesses many social, economical and scientific changes that allowed an improvement in the situation of children. Before the 20th Century children were invisible, just living beings that had to be trained to be productive in a future, an idea that nowadays seems horrible and cruel but that was very real at that time and that is still real these days in many countries and social sectors. Although throughout these years governments and society has tried to protect children they still face many threats in their daily life (family, health, school, work, etc.), the responsible of them being adults. So, although great improvements have been done, as we have seen through this paper, we still have to work a lot to protect childrens rights in the present.