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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 fivechildren 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, forexample 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 hadto 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 quantityof work increased and children of 10 years worked the same hours as their parents instead of

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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 low-

class 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 School-

Medical 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 andreduce this activity in order to protect childrens health and those women who had to abandon

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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.