Health conditions among the Syrians

Midwife Malake Nafash, ca. 1910, courtesy Renee Hoenig.
Midwife Malake Nafash, ca. 1910, courtesy Renee Hoenig.

Health

As in all urban slums, health conditions among the Syrians were deplorable. The lack of fresh air and light in their tenements, the crowded conditions, the dampness caused by the periodic flooding of the Hudson River, which inundated the basements, all contributed to debilitating and sometimes mortal illness. Poverty was also a primary cause, with people dying of conditions related to malnutrition. The Syrian quarter had one of the highest per capita rates of tuberculosis in the city, unsurprising given the conditions they lived in (the map below shows TB cases in 1913). Some of this misery was alleviated by the three Syrian midwives, who not only delivered babies but provided general care for families. 
The midwives were helped and eventually supplanted by western-trained Syrian doctors, some of whom offered free or low-cost care to their compatriots. Two were specialists in tuberculosis. 
But it wasn't until the Syrians began to improve their economic circumstances and moved to Brooklyn, that their health outcomes significantly improved.
Tuberculosis cases in the Syrian neighborhood, 1913.
Tuberculosis cases in the Syrian neighborhood, 1913.
The Syrians living on Washington Street lived in crowded and unsanitary conditions, causing debilitating diseases and high infant mortality rates.(Linda Jacobs, Afikra Conversations, 2021).

In a territory largely inhabited by Syrians...there were in the eight years from 1894 to 1902, 200 deaths from the disease [tuberculosis].

New York Times, 2 August 1903.
Maronite midwife Mannie Shahdan, 1897. Courtesy Matt Williams.
Maronite midwife Mannie Shahdan, 1897. Courtesy Matt Williams.
When reading the hundred death certificates of the members of the community (filing death certificates in New York City was not compulsory until the twentieth century), one is struck first by the number of infant deaths: forty-five are for children under the age of two. They died mostly of poverty: "marasmus" and "inanition," both illnesses related to malnutrition; lung diseases related to the conditions in which they lived; and some common childhood diseases like gastroenteritis and measles, which today would not be a death sentence and even then were probably not death sentences for children of wealthy parents. 

Adults faced tuberculosis, or consumption, related to the crowded and unsanitary conditions in which they lived. Tuberculosis was rampant in the Washington Street neighborhood, and despite the city's efforts at prevention it remained a scourge for decades. Other lung diseases, such as bronchitis and pneumonia were common killers. 
Women and children's care was in the hands of three Syrian midwives: Malake Nafash, Mannie Shahdan, and Barbara Sirgany, who home-delivered most of the babies in the community in the early days. None were qualified to treat serious illnesses, and all death certificates were signed by male doctors, many of them western-trained Syrian doctors who had come to the United States with medical degrees from Syrian Protestant College (now the American University of Beirut), or had earned degrees at American medical schools. They soon supplanted the midwives in even the most basic health care, delivering babies and providing reproductive care to women. But as the doctors moved to Brooklyn along with other prosperous Syrians, the colony in Manhattan remained poor and underserved. The Brooklyn community though was much better off, having more light and air in their homes, more space, and cleaner conditions in general. Their health and life spans improved.
Malake Nafash, Orthodox midwife, ca. 1908. Courtesy Renee Hoenig.
Malake Nafash, Orthodox midwife, ca. 1908. Courtesy Renee Hoenig.
Dr. A.G. Mussawir and his bride, Julia Maloof, 1902.
Dr. A.G. Mussawir and his bride, Julia Maloof, 1902.
Dr. Rizk Haddad, who treated many members of the Brooklyn community. Courtesy Zelfa Hourani.
Dr. Rizk Haddad, who treated many members of the Brooklyn community. Courtesy Zelfa Hourani.
1910 advertisement for Malake Nafash, Midwife. Courtesy Khayrallah Center.
1910 advertisement for Malake Nafash, Midwife. Courtesy Khayrallah Center.