Plagues and Pestilence
The most obvious single difference between traditional and modern societies in the pattern of disease is the virtual disappearance of infectious diseases as a cause of disability or death. The Yemenite Jewish experience is a good example of this process, and in this chapter we will map the details of this change, which occurred very soon after immigration to Israel.
A general overview of the situation in Yemen is given by an Australian general practitioner, Dr. Peter Underwood, who spent three years ( 1975-77) studying health and culture in Raymah, a rural region in the north. He concludes that:
the physical health of the people of the Yemen is one of the worst in the world. . . . The major causes of the high mortality rate are undernutrition and infectious and parasitic disease. . . . Children and women are the most vulnerable groups. . . . The depredations of infections, particularly gastro-intestinal and respiratory infections, contribute significantly to the poor growth and high mortality of children in Raymah.
( Underwood 1983)
We repeatedly observed the effects of epidemics of measles, pertussis and gastroenteritis . . . on individual child growth.
( Underwood and Margetts 1987a)
An anthropologist who visited a primary health care project in Tihama in 1984 reported fever, vomiting, and diarrhoea as the diseases that kill most children ( Hebert 1984). The project therefore concentrated all its efforts on immunization, oral rehydration therapy for diarrhoea, and treatment of malaria and tuberculosis ( Feilden 1985). In 1975, 30% of admissions to hospitals in Yemen were for parasitic diseases: 84% of healthy subjects had parasites in their stools;