in: Uluslar ve Alanlararası Bakışla Salgınlar Tarihi (History of Epidemics from International and Interdisciplinary Perspectives), Arın Namal,M. Kemal Temel,Ayşegül Erdemir,Bozena Płonka-Syroka,Burak Kazan, Editor, Platanus Publishing, Ankara, pp.93-102, 2023
Introduction
Trachoma is a sight-threatening
disease caused by ocular infection with Chlamydia trachomatis, strains of
which also cause infections involving other parts of the human body, including
urethritis, epididymitis cervicitis, salpingitis, lymphogranuloma venereum, and
pelvic inflammatory disease. It can be spread by sexual contact, vertical transmission,
and contact with fomites (contaminated objects) as well as with disease vectors,
most notably the housefly. While the sexually transmitted C. trachomatis infections
are generally referred to as chlamydia, the infection of the eye is termed as trachoma.
The most common sexually transmitted bacterium, C. trachomatis is also the
most common infectious cause of sight loss as an outcome of poorly treated
trachoma (CDC, 2014; Nunes & Gomes, 2014).
Analyses found that the ocular
strains of C. trachomatis diverged from the genital strains about two to
five million years ago (Taylor, 2009). Also known as “Egyptian ophthalmia”,
ocular chlamydial infection has a millennia-long history in the Middle Eastern
territories surrounding Türkiye. The earliest records of the disease in the region
date back to the Ebers papyrus from Egypt circa 1550 BCE, with the presence of
even earlier findings in the remains of Egyptian mummies and cities of ancient Mesopotamia
(Taylor, 2008; Temel, 2015; Temel, 2019). The later records include the
descriptions found in Hippocratic, Alexandrian, and Roman writings from
classical antiquity. With the Nile Basin having been a traditional hotbed of
trachoma, the disease became rampant on the other side of the Mediterranean Sea
in modernity, particularly the 19th century, as a result of military
movements in the Napoleonic campaign in Egypt and wars across Europe.
Until only about a century ago,
trachoma remained a widespread malady, against which there was no adequate
remedy. Unlike preventive medicine, therapeutic interventions, both medical and
surgical, generally failed to achieve satisfactory outcomes, let alone cure the
disease. This began to change only after the preliminary use of antibacterial
drugs derived from sulfonamides in the late 1930s, and more so after the
clinical introduction of antibiotics in the late 1940s and the correct
identification of the trachoma pathogen as a bacterium (and not a virus) in the
late 1960s (Tower, 1963;
Moulder, 1966; Feibel, 2011; Barış, Temel, & Ertin,
2020).
The campaign
against trachoma in the Republic of Türkiye until the 1970s
The Turkish War of Independence, fought against the occupying Allied Powers of World War I (WWI) between May 1919 and July 1923, resulted in the abolition of the Ottoman Sultanate in November 1922 and, finally, establishment of the Republic of Türkiye in October 1923. From the mid-1920s to the late 1930s, a series of political, legal, sociocultural, and economic reforms were implemented under the leadership of Mustafa Kemal Atatürk, who also led the War of Independence before becoming the first president of the new, unitary country. In line with the revolutionary spirit of the period, national-scale programs were initiated also in the field of healthcare, to address problems that had long been plaguing the Turkish people, such as epidemic diseases. […]