The Organisation of the Health Front Aus - História (2024)

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216Austro-Hungarian Occupation Regimes in the Balkans (1916-1918): Organizing the ‘Health Front’Tamara ScheerIntroductionAustria-Hungary pursued its economic, geopolitical, and cultural interests in the Balkans from the mid of the nineteenth century, but the acquisition of new territories occurred only in the context of a slight weakening of the Ottoman Empire and with support from the European powers. At the same time, the Kingdoms of Serbia and Montenegro became more active internationally and domestically, consolidating themselves as independent national and political entities. The following years, the Austro-Hungarian Monarchy pursued a policy that aimed at preserving its territories and a status quo. Nevertheless, under the pretext of establishing peace in the Balkans, the Monarchy planned to extend its influences. Its opponents were the young national states that were striving, in the late nineteenth century after centuries of Ottoman rule, to develop their own armies and administration structures.1The first two years of the First World War added to the devastation left behind by the two Balkan Wars (1912/13). After September 1914 the war campaigns contributed to the outbreak of several epidemics in Serbia, Montenegro and Albania. In addition, these campaigns caused a shortage of medical assistance due to the fact that the local physicians either died during the army’s withdrawal or fell captive to the new occupation forces. The Austro-Hungarian soldiers, for years exposed to anti-Serbian propaganda and having the experience of the first two years of the war, together with the physicians and nurses, took over the administrative tasks.2 1 On the interests during the 19th century, see: Arnold SUPPAN, Zur Frage eines österreichisch-ungarischen Imperialismus in Südosteuropa. Regierungspolitik und öffentliche Meinung um die Annexion Bosniens und der Herzegowina. In: Adam Wandruszka, Richard G. Plaschka, Anna M. Drabek (eds.), Die Donaumonarchie und die südslawische Frage von 1848 bis 1918. Texte des ersten österreichisch-jugoslawischen Historikertreffens Gösing 1976 (=Veröffentlichungen der Kommission für die Geschichte Österreichs 8, Wien 1978), 103-129. Robin OKEY, Taming Balkan Nationalism (New York 2007). Tamara SCHEER, Occupation and its Impact on Society: Austria-Hungary’s Military Presence in Sandžak Novi Pazar/Plevlje (1879-1908). In: Der Donauraum49, H. 1-2 (2009), 129-137.2 On the Austro-Hungarian occupation in the Balkans, see: Tamara SCHEER, Zwischen Front und Heimat. Österreich-Ungarns Militärverwaltungen im Ersten Weltkrieg (=Neue Forschungen zur ostmittel- und 217Long before the outbreak of the First World War, the Austro-Hungarian public had become aware of the stringent necessity to improve sanitary measures. Insalubrities conditions and poor water supplies were widely seen to favour the spread of epidemics. The creation of sewage and central water supply systems, the organization of waste disposal, and the control of slaughterhouses and marketplaces financed by the communities were commonly regarded as measures that could help in the improvement of hygiene.3 Considering this, many soldiers, especially officers and civil servants, physicians and nurses, also interpreted their duty in the Balkans as a civilizing mission.4 In this sense, an Austrian army physician stated that “the sanitation is a criterion for a country’s cultural status”.5 Robin Okey summarized the strategic and personal ambitions going so far as to claim that the aim of the occupying forces “was to südosteuropäischen Geschichte 2, Frankfurt 2009); see epecially Brigitte FUCHS’s paper in this volume and, for the Serbian case, Jonathan E. GUMZ, The Resurrection and Collapse of Empire in Habsburg Serbia, 1914-1918(Cambridge 2009). For a good general view on Serbia during the First World War, see: Andrej MITROVIĆ, Serbia’s Great War 1914-1918 (London 2007) and Holm SUNDHAUSSEN, Geschichte Serbiens 19.-21. Jahrhundert (Wien 2007); Jovana Knežević discussed the reactions of the local population in Belgrade. Nevertheless Knežević did not address the medical and hygiene measures taken by the occupation power: Jovana KNEŽEVIĆ, The Austro-Hungarian Occupation of Belgrade during the First World War: Battles at the Home Front (Diss. Yale University 2006). Already during the war or soon after its conclusion, there were international studies on the spread and combat of epidemics: Richard STRONG, Typhus Fever with Particular Reference to the Serbian Epidemic (Cambridge, Mass. 1920); and the Serbian military physician: V. SOUBBOTITCH, A Pandemic of Typhus in Serbia in 1914 and 1915. In: Proceedings of the Royal Society of Medicine 11 (1917/18), 31-37. Soubbotitch’s article is very biased; he calls the lice in Albania ‘Albanian lice’ (page 31). In his study published in 1917, the future Chief Sanitary of the General Military Commando in Serbia Jakob Lochbihler, mentioned the foreign assistant missions which were active not only during the Balkan Wars and but also in the 1914 at the beginning of First World War. His instructions were based on the information supplied by the Serbian physician Milan P. Jevremovic, who was Sanitary Inspector at the Interior Ministry and Sanitary Major. ÖStA/KA/AOK, Qu. Abt., San. Chef, Kt. 2318, Sanitätsgeschichte L-Q, Bericht Jakob Lochbihler, Juni 1917, 10f and 17. This, unlike the next magazine article, was a report on the intern situation. It often presents drawbacks and problems. 3 Beate WITZLER, Großstadt und Hygiene. Kommunale Gesundheitspolitik in der Epoche der Urbanisierung(=MedGG-Beihefte 5, Stuttgart 1995), 10-12. See also Jörg VÖGELE, Wolfgang WOELK, Stadt, Krankheit und Tod: Geschichte der städtischen Gesundheitsverhältnisse während der Epidemologischen Transition. Eine Einführung. In: Jörg VÖGELE, Wolfgang WOELK (eds.), Stadt, Krankheit und Tod: Geschichte der städtischen Gesundheitsverhältnisse während der Epidemologischen Transition (vom 18. bis ins frühe 20. Jahrhundert (= Schriftenzur Wirtschafts- und Sozialgeschichte 62, Berlin 2000), 11-34, here 18. The authors refer to the cooperation between communities and society culture, a collaboration which existed in the occupied territory.4 Diana REYNOLDS, Kavaliere, Kostüme, Kunstgewerbe. Die Vorstellung Bosniens in Wien 1878–1900. In: Johannes FEICHTINGER, Ursula PRUTSCH, Moritz CSAKY (eds.), Habsburg postcolonial. Machtstrukturen und kollektives Gedächtnis (=Gedächtnis – Erinnerung – Identität 2, Innsbruck et al. 2003), 249. After 1879, the Habsburg monarchy and the Austro-Hungarian Army extended their own bureaucratic system in Bosnia-Herzegovina, including not only the healthcare and sanitary systems, but also the education system. The same approach was used in the administration of the occupied countries during the First World War.5 Eduard MILOSLAVICH, Schlusswort. In: Der Militärarzt 51 (14.4.1917), 119. After 1918, Miloslavich worked first as a university professor in Milwaukee, and afterwards in Zagreb. During the war, he was director of the Imperial Army’s Department of Pathology in Belgrade. Österreichisches Staatsarchiv [ÖStA]/Kriegsarchiv [KA]/Nachlasssammlung [NL], B/41, No. 2, Johann Steiner, Erinnerungen aus dem großen Krieg 1914-1918 (in manuscript), Bl. 83.218show the Serbs how much better the Habsburg administration was than their own”.6 This attitude influenced the health measures taken into the occupied territory. The assurance of specialised medical services became important during the war due to the fact that longer periods were marked by improvisation, lack of personnel, materials and information on patients.The health front reconstructionbecame a result of both the occupation policies and annexation strategies of the Balkans forged in Budapest and Vienna. The bureaucratisationwas carried out along similar lines to those promoted in the Habsburg Monarchy. The occupation regime (or the so called ‘back area’, to use the military term) had three main tasks focussing on support of the war machinery: to ensure stability behind the frontline, exploit local resources (including the human workforce), and the maintenance of communication. The sanitary measures were made comprehensible on the basis of the abovementioned tasks. Consequently, the army and the military medical personnel were assigned extended tasks. They were different from those which they had had previously during peacetime. The civilian physicians’ sphere of action was also extended due to the fact that they carried out both military duties and private medical practice outside the civil institutional control.7Taking these into consideration, the following questions arise: Who was responsible for implementing the health measures in the region? Who were the medical personnel working in the occupied territories and what were their nationalities? The occupying power was mainly interested in its own war commandment and staff. The population in the occupied territories played only a passive role. In this way, the former was interested in having a healthy population that could work hard; the population had to be obedient, work and accept the sanitary measures. Consequently, this chapter discusses the framework in which Austria-Hungary implemented health measures in the region, the restrictions to which the local population was subjected, and the possibilities which were granted to them by the system. This historical-military approach offers a picture of the occupation regime during the First 6 Robin OKEY, A Trio of Hungarian Balkanists: Béni Kállay, István Burián, and Lajos Thallóczy in the Age of High Nationalism. In: The Slavonic and East European Review 80/2 (2002), 234- 266, here 258.7 This conclusion was also reached by Christoph Roolf, who approached the role of German scientists in occupied Belgium: Christoph ROOLF, Eine "günstige Gelegenheit"? Deutsche Wissenschaftler im besetzten Belgien während des Ersten Weltkrieges (1914-1918). In: Matthias BERG, Jens THIEL, Peter Th. WALTHER (eds.), Mit Feder und Schwert. Militär und Wissenschaft - Wissenschaftler und Krieg (=Wissenschaft, Politik und Gesellschaft 7, Stuttgart 2009), 137-154. Jonathan Gumz disputed the argument of military necessity in the case of the Austro-Hungarian occupation power.219World War. At the same time, this chapter pursues a historical-medical approach as well. It will show that the doctors’ ethnical, religious, cultural and social origins were important and advantageous in their enterprise to implement health measures among the occupied population.In order to reconstruct the medical strategies and their implementation, this chapter evaluates specific types of sources and literature including the archival collections of the Sanitätschef[Chief Sanitary Officer] of the k.u.k. Armeeoberkommando [Imperial Army Headquarters], reports and daily orders, journals and post-war memoirs. The Sanitätschef received reports from the front and gave further instructions on many issues. It was also his duty to inspect the medical establishments of the occupation regime and give recommendations concerning their improvement. The reports and (daily) orders of the Austro-Hungarian government, as well as army and district headquarters, offer insights into the everyday organizational problems, such as the permits for the selected pharmacies that could sell prophylactics, and the decisions concerning the opening hours of public baths.8 The orders are rich in detail and for this reason they offer important information on the justification of the actions. Journals are another salient category of source material. They show how the occupying forces – in spite of strict censorship – promoted their health care measures and how they tried to educate the local population. These were the two official newspapers of the occupation regimes in Montenegro and Serbia. The Belgrade and the Cetinje News were published in German, ‘Serbo-Croat’ and Hungarian, and they were the only newspapers allowed to circulate in those countries. Nevertheless, they were also read in the neighbouring territories of the monarchy, which were inhabited by Slavic peoples and Albanians. Another periodical, Der Militärarzt [The Military Physician] was published in Vienna. It included reports of physicians who worked in the occupied countries and wrote about the problems that they faced every day.9 These articles are important for their content as well as shedding light on their authors - who were civilian or military physicians - and the working environment (district or hospital physicians). The articles also offer additional insight into the physicians’ personal engagement in the occupation regime with a latent pro-Austrian propaganda. The 8 Sources from all levels of the occupation regime can be found in all archives of the former occupied countries, (e.g. Arhiv Srbije in Belgrade), but many sources, fortunately from all levels of administration, are available in the Austrian State Archives (War Archive) and some of them in the Hungarian War Archive [Hadtörténelmi Levéltár] as well.9 The journal Der Militärarzt (1867-1917) was published in Vienna as a supplement to the Wiener Medizinische Wochenschrift.220authors realistically reported about sanitary problems, including venereal diseases, contagious diseases, etc. on the occupied territories. While the Belgrader and Cetinjer Nachrichten were addressed to the larger public (literate), the Militärarzt published medical studies and wasused mainly by physicians.The post-war Memorialistik reflects the experiences of those individuals who were engaged either in the military campaigns, or were participating in the organization of the ‘health front’. These biographies are always subjective; they follow different strategies, such as self-adulation, justification, excuse, accusation or anything else. Considering the subjectivism of the authors, my chapter offers a critical reading of these sources. Johann Steiner, as Chief Sanitary Officer, worked at the planning level. He was assigned to the Section of the Quartermaster of the Army Headquarters (initially in Vienna and afterwards in Baden). His diary, written during the military campaigns, is an important source on the networks and connections within the medical profession. Subordinates who acted in the field were Hugo Kerchnawe and Julius Roksandić, who were both commissioned in an organisation who worked for the Austro-Hungarian army. The latter titled his book Sanitäre Wacht an der Pforte des Orients und Occidents [Sanitary Supervision at the Gates of the Orient and Occident], which offers an interesting view on how the local sanitary level was perceived by the Austro-Hungarian officials. It becomes obvious from the title where the Balkans were geographically located.10Albeit this topic has received little attention, there is a nascent secondary literature. Božica B. Mladenović, for example, focused on the organization of in the cities of the occupied Serbia, referring to the medical facilities which were implemented by the Austro-Hungarian forces. Furthermore, there is already certain secondary literature on the cases of Albania and Montenegro.11 Thus the present chapter will fill the gap in the existing historiography and 10 Julius ROKSANDIĆ, Sanitäre Wacht an der Pforte des Orients und Occidents. Kriegs-Sanitäres aus demk.u.k. Militärgeneralgouvernement in Serbien (Belgrad 1918).The title was very popular; it referred to an inscription on a table, which Austro-Hungarian soldiers brought from the railway bridge of Semlin (it belonged to Hungary) to Belgrade; Another physician entitled his book: Friedrich WALLISCH, Die Pforte zum Orient. Unser Friedenswerk in Serbien (Wien 1917).11 Special thanks to Božica B. Mladenović, who after fruitful discussions intorduced her book to me. See Božica B. MLADENOVIĆ, Grad u Austrougarskoj Okupacionoj Zoni u Srbiji od 1916 do 1918 godine (Belgrade 2000), 233. For the Albanian case there is an older doctoral thesis available, but without mentioning the ‘health front’ as it is discussed in this article: Helmut SCHWANKE, Zur Geschichte der österreichisch-ungarischen Militärverwaltung in Albanien (1916−1918) (phil. Diss. Wien 1982). On the Montenegrin case Heiko Brendel at the University of Mainz is working on his doctoral thesis: Besatzungsherrschaft zwischen Intention und 221will analyze the specific example provided by Austro-Hungarian occupation regimes in the Balkans and the way in which the political-strategic interests were implemented through the medical personnel. The personnel were influenced to a high degree by propaganda and different advantages and their actions were marked by their personal ambitions. Strategies and Structures Serbia had been occupied by Austria-Hungary in December 1915. Montenegro and Albania followed in early 1916.12 One of the important consequences was the creation of governments in Serbia and Montenegro. This did not apply to Albania, which remained under the control of the respective frontline army corps. In the first two cases, the whole government and the administration were taken over by Austro-Hungarians. New occupation regimes, including civil responsibilities such as the healthcare system, hygiene measures, water supply, market supervision and waste disposal were consequently implemented.13 Albania slightly differed, because the local notables were integrated into the organization activity. On the other hand, annexation plans (or at least the plans that aimed to make the countries in question economically and politically dependent after the war), were drafted for all three occupied countries in the Balkans. The annexation plans influenced the occupation policy: ‘scorched earth’ had to be avoided and the Austrian administration system needed to be implemented. Nevertheless, there was no consensus on this issue within the Monarchy, as it transpires from the discussion held in the Cabinet. The Hungarian Prime Minister István Tisza declared Serbia under the Hungarian zone of influence. Therefore substantial Hungarian occupation forces were sent to Serbia and in this way the annexation was rejected. Had they followed the Austrian Prime Minister Karl Graf Stürgkh, the Montenegrins would have “withdrawn into their mountains […] and their country would have been treated as an American nature park”.14 Situation: Kontrolle und ‘Kolonisierung’ im österreichisch-ungarischen Militärgouvernement Montenegro, 1916–1918. 12 Besides Albania, Montenegro, and Serbia, Austria-Hungary occupied Northern Italy, Ukraine, Poland, and Romania, sometimes together with its German ally, which also influenced the organization manner. Several regions from South Europe were under the exclusive authority of Austria-Hungary. For further information see: SCHEER, Zwischen Front und Heimat and Brigitte Fuchs’ paper in the volume.13 The hygiene surveillance was carried out by salubrity commissions: ÖStA/KA/AOK, Qu. Abt., San. Chef, Kt. 2318, Sanitätsgeschichte L-Q, Bericht Jakob Lochbihler, Juni 1917.14 Miklos KOMJÁTHY, Protokolle des Gemeinsamen Ministerrates der Österreichisch-Ungarischen Monarchie (1914−1918) (=Publikationen des Ungarischen Staatsarchivs, II. Quellenpublikationen 10, Budapest 1966), 50, 222However, Northern Albania, Montenegro, and Serbia remained a part of the “back area”, which served as the militarised zone between the frontline and the hinterland. It had to ensure stability behind the frontline and to exploit local resources (including the human workforce). “Back area” rules stipulated engagement not only with medical institutions from the homeland, but also those of the enemy state, if possible.15 The maintenance of communication was the third task of the occupation regimes,16 which included medical care for wounded and ill soldiers and horses. Or as the rear area’s rules stipulated: “Keeping away and eliminating unhealthy impacts”.17 This framework included a collection point for all those wounded in the front-line, whom they transited to Austria-Hungary, with the few exceptions of prolonged cases of contagious diseases, especially venereal diseases.18 Those suffering of venereal diseases were kept in the territory until they were healed. Only afterwards were they were allowed to take leave [urlaubsfähig] and could depart to their home countries.19 The occupied territory functioned as well as a sanitary cordon, as the Turkish replace troops were sent through Serbia to the Eastern front.20 The importance of the occupied territory as quarantine facility in order to prevent the spread of contagious diseasesin Austria-Hungary was recurrently emphasized by Austro-Hungarian physicians.21 The physician Friedrich Wallisch briefly summarized who benefited from the involvement in the ‘back area’: It is obvious that the economic work that we carry out in the land has in view the interests of the people only secondarily, as it is carried out for the use of the land for our need, or at least aims at the self-sufficiency of the occupied territories so that they do not become a burden to the Monarchy.22 365-370. On the issue previously mentioned, Tisza took a public position: Polen: Wochenschrift für polnische Interessen 51 (17.12.1915), 353.15 ÖStA/KA/Mil. Impressen, Kt. 493, Etappenvorschrift, Entwurf, E-57, Wien 1915, 277.16 ÖStA/ KA/Mil. Impressen, Kt. 493, Etappenvorschrift, E-57, Entwurf, Wien 1915, 40.17 ÖStA/KA/Mil. Impressen, Kt. 493, Etappenvorschrift, Entwurf, E-57, Wien 1915, 277.18 ÖStA/KA/NFA, Armeeoberkommando [AOK], Sanitätschef, Kt. 2317, Tätigkeit, Erlebnisse und Erfahrungen bei der Armee im Felde geschildert von Oberstabsarzt Dr. Alois Karschulin.19 ÖStA/KA/NFA, Kt. 1629, Konv. MGG/S, Reservat-Befehle, 10.6-5.10.1918, No. 35, 5.9.1918. A similary order was earlier released: ÖStA/KA/NFA, Kt. 1629, Reservat-MGG-Befehl No. 57, 17.12.1917.20 ÖStA/KA/NFA, MGG/M, Kt. 1720, Reservat-Verlautbarungen, 23.4.1917, No. 37, Weitergabe eines AOK-Befehls vom 17.3.1917. Although the military administrations implemented a veterinary service, on account of there being many injured horses, this article stresses human medicine.21 ÖStA/KA/AOK, Qu. Abt., San. Chef, Kt. 2318, Sanitätsgeschichte L-Q, Bericht Jakob Lochbihler, Juni 1917, 43.22 WALLISCH, Die Pforte zum Orient, 144-145.223Before going into detail, it is necessary to point out that the regions under discussion were inhabited by a mixed population – a mixture of nationalities, cultural backgrounds (Serbs, Turks, Albanians, and Montenegrins), and denominations (Muslims, Orthodox, Catholics, and Jews). Furthermore, they had different political ambitions (e.g. ‘austrophile’ Serbs and cooperative Muslim Albanians, Bosnians and Turks). However, the population of an occupied country consisted not only of locals, but also of a high percentage of foreign soldiers, civil servants (including women)and Prisoners of War (POWs). Austria-Hungary was also multiethnic and multi-confessional. There were Austrians/Germans, Czech, Slovaks, Hungarians, Romanians, Serbs, Croats, Ruthenians, etc. belonging to different Christian and non Christian denominations including Catholic, Evangelical, Greek-Catholic and Orthodox, Jews and Muslims. There were situations when Orthodox Serbs from Hungary and Bosnia-Herzegovina employed in the Austria Hungary army were sent into Serbia where they ‘occupied’ other Orthodox Serbs. These circ*mstances encouraged fraternization, a phenomenon which the occupation power had already foreseen. The composition of the occupied population had a direct impact on how orders were carried out and how they treated the respective population. The Austro-Hungarian army system, comprising reserves and landsturm, was of additional importance.23 Former heads of medical departments were conscripted either as reservists or landsturms and they worked very often together with younger and less experienced military physicians. The temporarily-formed society of an occupation regime can be characterized as a mixture of a huge number of people, who had not lived there before (the occupying personnel and local refugees) or had left the country even before the occupation started - like most of the local male population eventually did. According to the census carried out by the occupying forces, in June 1916, the local civilian population of Belgrade was roughly comprised of 17,600 men and 30,330 women.24 In Serbia and Montenegro approximately 23 A Reservist was most of the time a younger person, well educated, who stayed a longer time in the army. Landsturm were all elder men, older than 40, from the peasant to the university professor, who were mobilized after all younger personnel had been sent to the frontlines.24 ÖStA/Haus-, Hof- und Staatsarchiv [HHStA]/PA I, Kt. 975, Konv. Einzelne Verwaltungsmaßnahmen, fol. 41 f., 31.12.1916. In comparison to January 1916, when the military administration was set up, 23,000 more people lived in Belgrade: Der Militärarzt 51 (3.2.1917), 99.22440,000 soldiers were engaged in each country. In Albania, there were 3,500 imperial Austrian gendarmes in addition to the troops.25The occupation regimes in Montenegro and Serbia were headed by governors while Albania remained under the control of the respective army corps commander. In all three cases the administrative organization had both civil and military responsibilities. The head of the sanitary branch was an officer subordinated to the chief-of-staff. The next administrative level was the Kreiskommando [county’s command]. A physician and a veterinarian were employed in every county. From each county, physicians were sent to communities, e.g. as sanitary consultants.26 County headquarters were supported by Bezirkskommandos [district headquarters] that were in charge of the Sanitary Police [Sanitätspolizei],27 forensic examinations and the surveillance of prostitution. Most communities were obliged to hire physicians of their own (in towns they were called k.u.k. Stadtarzt). These physicians had to offer free medical assistance to the poor. Many people had official papers to prove their degree of poverty. In April 1917, the Belgrader Nachrichten [Belgrade News] announced that “every child who has a poverty certificate could receive free medical assistance from 8 to 10 am by a Dr. Natalie Davidović-Nikolajević”.28 Belgrade serves as a significant example.29 In all occupied countries communities had been assigned extended sanitary and medical tasks. They delivered certificate papers, which gave ‘their’ poor access to medical treatment and medicine free of charge. However, the occupying forces had decided that communities had to pay for these services.30 They had also to finance the building of one Isolierhaus [isolation house] per community for the poor and for those suffering from contagious diseases. All in all, medical and sanitary facilities were spread all over the regions, countries and towns, to the benefit of both soldiers and locals. 25 Peter BROUCEK (ed.), Theodor Ritter von Zeynek. Ein Offizier im Generalstabskorps erinnert sich(=Veröffentlichungen der Kommission für Neuere Geschichte Österreichs 101, Wien 2009), 311–312.26 The locals remained to lead the communities. These were the only administrative structures where locals still remained on duty. The military sanitary consultants supervised the fulfilment of the sanitary orders. See Milan FIGATNER, Die Reorganisation des Sanitätswesens im Bereiche des k.u.k. Militärgeneralgouvernements Serbien. In: Der Militärarzt 51 (1917), 36.27 There were seven command districts in Montenegro and thirteen Serbia districts commands. Cf. SCHEER, Zwischen Front und Heimat, 27f.28 Belgrader Nachrichten (28 April 1917).29 Mathias PÖCHMÜLLER, Belgrad in sanitärer und hygienischer Beziehung. In: Der Militärarzt 51 (1917), 94. 30 ÖStA/KA/NFA, Kt. 1689, MGG/M, Verlautbarungen, 10.7.1916, No. 35. This order was released again:ÖStA/KA/AOK, NFA, MGG M, Kt. 1720, Verlautbarungen des k.u k. MGG M, 5.2.1917, No. 11.225Examples from Belgrade reveal the wide scope of medical and hygienic facilities, which were implemented in all three occupation regimes.31 In most cases, medical establishments were within or around cities. The county hospitals were built for the army and POWs, although as long as the hospitals existed they were also used by civilians.32 In the case of medical establishments, they often resorted to the pre-existing military infrastructure, albeit it was in a disastrous condition due to the many battles. Other establishments were organised in school buildings and barracks.33 In Skhodra, they resorted to the former Italian embassy or missionary houses, after Italy became a war enemy of the Central Powers.34 An article in DerMilitärarzt, written in March 1917 (almost a year after the beginning of the occupation) summarized what controlled the regime in Belgrade. There were two military hospitals (Reservespital ‘Brčko’, Reservespital II ‘Brünn’). A mobile surgery unit from Budapest (k.u.k. Mobile Chirurgengruppe der III. Chirurgischen Universitätsklinik) was subordinated to the latter. The imperial reserve hospital Brčko in Belgrade had a department for internal medicine and surgery, and also one for ophthalmology, obstetrics, otology, gynaecology, neurology, skin and venereal diseases. It also contained a private sanatorium for officers. This hospital provided a space also for the department of pathology (k.u.k. Kriegsprosektur), which not only determined causes of death but also investigated pathology throughout Serbia and reported findings on Syphilis’. After the occupation of Belgrade the civil hospital (k.u.k. Zivilspital) had remained under Serbian directory. After a few months it was put under economic and administrative surveillance, while some of the Serbian medical personnel were taken into prison.35 Moreover, there was a department for ear, nose and larynx illnesses, whose ambulance was also used by Serbian citizens.36 The paediatricians were assigned to 31 Lochbihler minutely refers in his report to all buildings, personnel and duties. ÖStA/KA/AOK, Qu. Abt., San. Chef, Kt. 2318, Sanitätsgeschichte L-Q, Bericht Jakob Lochbihler, Juni 1917, 40f.32 ÖStA/KA/AOK, Qu. Abt., San. Chef, Kt. 2318, Sanitätsgeschicht L-Q, Bericht Jakob Lochbihler, Juni 1917, 42.33 ÖStA/KA/NL, B/41, Johann STEINER, No. 2, Erinnerungen aus dem großen Krieg 1914-1918 (handschriftl. Manuskript), 93 und 137. See also the presentation of writers' experiences during wartime, especially of those who studied medicine: WALLISCH, Die Pforte zum Orient. UnserFriedenswerk in Serbien, 15: ‘I do not know how many inhabitants has this or that city. But it is a city. It has big and well built schools and large hospital buildings. […] Hospitals and barracks – and schools: the marks of the Serbian city […].’34 The official department of the Austro-Hungarian hospital was located in the former Italian seminary. In Skodhra, there was a hospital for prostitues. ÖStA/KA/NL, B/41, Johann STEINER, No. 2, Erinnerungen aus dem großen Krieg 1914-1918 (manuscript), 137. Valid also for Belgrade: ÖStA/KA/NFA/AOK, Qu. Abt., M.V. S, Index Proprien- und Materienregister 1917, Stichwort: Einquartierung.35 ÖStA/KA/NFA, Kt. 1629, Reservat MGG Befehl No. 57, 17.12.1917.36 Franz ZINNER, Das k.u.k. Reservespital Brünn. In: Der Militärarzt 51 (14.4.1917), 112. Similar institutions, with the exception of a war department of pathology, were also implemented in Cetinje. ÖStA/KA/NL, B/41, Johann STEINER, No. 2, Erinnerungen aus dem großen Krieg 1914-1918 (manuscript), 136. 226give medical assistance and to examine the school children.37 The data resulting from the examinations and measurements (weight and height) were centralised.38 Everyday life in these establishments was characterized by overcrowding and constant material shortages. The medical staff was constantly instructed how to save on or replace the scarce materials.39The military regime registered all the resources spent for the treatment of civilian Serbs. They hoped to claim the reimbursem*nt of the expenses at the end of the war. In Montenegro and Serbia medical structures and treatment were financed through fines, which had beencollected as Strafgeldfonds [Penalty funds]. In Albania, this measure was called the Landeskrankenhausfonds [hospital fund].40 When withdrawing from Serbia, the occupation powers left behind goods. Among these goods one can find “sanitary materials and the pieces of clothes and beds.”41 Hasty discussions in the army superior headquarters/ command establishing what was to be picked up or to be abandoned did not change the fact that Serbian, Montenegrin and Albanian people were confronted with new ravages during retreat.42About health structure which lasted almost three years, Dr. Lochbihler wrote: “Concerning politics and administration, the management of the military general governments is equal to that of the Austrian Crown lands”.43 Examples of bureaucratization in accordance with the Austro-Hungarian model can be seen on the health front for the case of the locals but also the personnel. This concerned not only the administration of districts and counties, but also the communities’ responsibilities and service regulations for the personnel. In Austria-Hungary, the tendency was to impose the costs on the communities, so they implemented a familiar 37 ROKSANDIĆ, Sanitäre Wacht, 154.38 WALLISCH, Die Pforte zum Orient. Unser Friedenswerk in Serbien, 60.39 An instruction of the Army Headquarters stipulated: “Concerning army garrisons and sanitary establishments, one has to take as many austerity measures as possible. Among them, there are those advocated by famous authors, including the recommendations not to waste bandages in the treatment of open wounds […] and to replace them as often as necessary. One has to pay particular attention to the collection and removal of bandaging materials.” ÖStA/KA/NFA, MGG M, Kt. 1720, Verlautbarungen des MGG/M, 16.3.1917, No. 27.40 Hugo KERCHNAWE, Die Militärverwaltung in Montenegro und Albanien. In: HugoKERCHNAWE (ed.), Die Militärverwaltung in den von den österreichischungarischenTruppen besetzten Gebieten (=Carnegie-Stiftung für internationalen Frieden, Abteilung Volkswirtschaft und Geschichte, Wien 1928), 298–301.4142 ÖStA/KA/AOK, Qu.Abt., Kt. 2581, Schreiben der liquidierenden Gruppe für das MGG/S, 16.6.1919, and ÖStA/KA/NL, B/41, Johann STEINER, No. 2, Erinnerungen aus dem großen Krieg 1914-1918 (handschriftl. Manuskript), 195.43 ÖStA/KA/AOK, Qu. Abt., San. Chef, Kt. 2318, Sanitätsgeschichte L-Q, Bericht Jakob Lochbihler, Juni 1917, 4.227system on the occupied Balkans.44 The occupation personnel received free care from the public health officers and thus were not assigned to private physicians. For instance, a physician working for the government had consultation hours during his office hours. Sick people had to present a medical certificate for diseases which last longer than three days.These regulations were typical for civil servants in Austria as well.45There was an inter-institutional exchange of scientific data from the frontline respectively occupied countries to the homeland, from the highest level through the office of the Chief Sanitary Officer to the occupation administration and vice versa. The Chief Sanitary officerreceived reports on new methods and experiences from the physicians working on the front. He authorized research trips as well. Steiner, the Sanitätschef im Armeeoberkommando, was involved in organizing conferences on military medicine, which were attended by the representatives of the Central Powers and occupation administrations. A permanent inter-allied contact took place. A significant example was the Congress of Internists in Warsaw, which outlined the duties of an occupied territory. Steiner saw, during his visit in Warsaw, the facilities built by his German colleagues, including the laboratory, in which they used Wassermann reaction and the department for the transport of invalids.46 The Militärarztpublished an official report on this Congress. Moreover, Steiner’s activity in the occupied Balkans also offered him an image of neighbouring Bulgaria, which ruled over Macedonia and Eastern Serbia. He often travelled to that area and reported his impressions to the army’s command.In order to strengthen cooperation on the local level the military administration organized militärärztliche Referierabende [scientific meetings and lectures]. Many of the lectures would take the form of an evening entertainment, which were announced in advance in the Belgrader or Cetinje News. Officers and civil servants together with their wives were invited. Sometimes there was an additional remark that the incomes were for the benefit of the 44 Reichsgesetzblatt für die im Reichsrath vertretenen Königreiche und Länder, No. 68 (1870), Instruction concerning the organization of the public sanitary service. The instruction prescribed the communities stronger competences which were closely connected to higher expenses. 45 ÖStA/KA/NFA, MGG/M, Kt. 1720, Konv. Interne Befehle 1917/18, No. 40, 3.8.1918.46 ÖStA/KA/NL, B/41, No. 2, Johann STEINER, Erinnerungen aus dem großen Krieg 1914-1918 (manuscript), 84. MGG/S was represented by Jakob Lochbihler, Chief Sanitary Officer. ÖStA/KA/NFA, AOK, Qu. Abt., M.V. S, Index Proprien- und Materienregister 1916, Stichwort: Sanitätswesen.228Austrian and Hungarian widows and orphans.47 Colonel Dr. Friedrich Justian, the president of the Verein der Militärärztlichen Vortragsabende [Association of Lecture Evenings on Military Medicine], in 1916 opened a meeting by claiming: “these demonstrations present the cases exactly as we encounter them every day.” 48Medical Personnel and DiseasesThe longer the war lasted, the fewer soldiers were employed. They were sent to the front and replaced by civilians and women from the hinterland, especially in Montenegro and Serbia. A military order from April 1917 forbade employing soldiers for specific works which could also be performed by Austro-Hungarian or local civilians.49 In the end, for every female nurse in the sanitary establishments one soldier had to be sent to the front. 50 The longer the war lasted, the higher the percentage of local personal and women became.The ethnic composition of the medicalpersonnel was mixed. It was made up of female doctors from Austria-Hungary and civil or military Serbian physicians. The latter were examined to see whether they were ‘politically inoffensive’. If not, they had to be imprisoned or detained on the territory of the Danube Monarchy. However, due to the fact that the number of medical personnel was deficient some of these physicians had to be released.51 In March 1917, there were one hundred and forty-five Austro-Hungarian, fifty Serbian, eight Greek, and three other-nationality military physicians working in Serbia.52 However, Austro-Hungarian physicians were not put on an equal footing with their foreign counterparts, although they still had to cooperate in their daily work. The status of foreign physicians was quite visible, although the occupation force took care of their clothes, accommodation and food, and they received remuneration. According to a decision issued by the office of the quartermaster of the Imperial Army, a Serbian physician was not allowed to accompany the 47 Belgrader Nachrichten (1.4.1917). As intern order for the officers: ÖStA/KA/NFA, MGG/M, Kt. 1720, Konv. Interne Befehle 1917/18, No. 50, 7.4.1917, von Kanzleidirektor des MGG M.48 Bericht über den Vortragsabend: Der Militärarzt (1.1916), 47.49 ÖStA/KA/NFA, Kt. 1629, Reservat MGG Befehl, No. 21, 26.4.1917.50 ÖStA/KA/NFA, MGG/M, Kt. 1720, Konv. Interne Befehle 1917/18, Interner Befehl No. 67, 6.6.1917, von Kanzleidirektor des MGG M, Weitergabe eines AOK Befehls.51 ÖStA/KA/AOK, Qu. Abt., San. Chef, Kt. 2318, Sanitätsgeschichte L-Q, Bericht Jakob Lochbihler, Juni 1917, 41. ÖStA/KA/NFA, AOK, Qu. Abt., M.V. S, Index Proprien- und Materienregister 1916, Rücksendung serbischer Zivilärzte aus Kriegsgefangenenlagern in Böhmen und Ungarn nach Belgrad.52 FIGATNER, Die Reorganisation des Sanitätswesens, 36.229Austrian one, when the latter had to inspect the occupied territory. Moreover, after work, foreign physicians returned to the detention centres or prison camps. 53The involvement of locals in the medical activity was presented to the public by means of propaganda articles published in the Belgrader and the Cetinjer Nachrichten. Naturally, no conflicts were presented to the public, the emphasis being laid on how cooperative the Serbian social and intellectual elites were. Despite many conflicts, involvement often led to cooperation. For instance, an Austrian and a Serbian military (POW) physician published an article together in Der Militärarzt. They reported on a new examination method for malaria54, a disease that Serbian physicians experienced in practice more often than their colleagues from the Austro-Hungarian Monarchy. The Austro-Hungarian army had a strong interest in this disease because many soldiers, unlike the locals, fell sick. Unsurprisingly, conflicts frequently appeared between Austro-Hungarian and local personnel, but also between the occupiers. One reason was that many civilian physicians were mobilized as reservists and integrated into military structures, which meant a complete change of the working environment. Sometimes a famous surgeon was subordinated to a young and inexperienced military physician due to his low reserve-rank. In turn, social rank, which varied much among the reservists given the difference between their former daily jobs and the current military ones, influenced hospital work.55 In nursing, the gap between educated and experienced nurses and inexperienced military personnel was even deeper. The many disciplinary undertakings and lawsuits are clear evidence of this. An example in this respect is an educated nurse’s outrage at the order of a sanitary non-commissioned officer (NCO), which she considered nonsensical. As a result, a huge conflict ensued between the two.56 53 ÖStA/KA/NFA, AOK, Qu. Abt., M.V. S, Index Proprien- und Materienregister 1916, Schlagwort: Sanitätswesen, Gehalt griechischer Ärzte in Serbien. See also: ÖStA/KA/NFA, AOK, Qu. Abt., M.V. S, Materienregister, No. 761, angefangen 1.9.1918, Stichwort „Ärzte“. The Greek physicians had worked in Serbia before the ocupation and they could continue their work. See: ÖStA/KA/AOK, Qu. Abt., San. Chef, Kt. 2318, Sanitätsgeschichte L-Q, Bericht Jakob Lochbihler, Juni 1917, 17-18. 54 D. ANTIĆ, S. NEUMANN, Urobilinogenurie bei Malarie. In: Der Militärarzt 51 (1917).55 If it occurs that a younger officer address informally and [the person] greeted is a true older man, who has a higher position, without author [in brief: na], Offizier und Politik, in: Danzers Armeezeitung 13 (27.3.1913), 2-3, here 2. 56 The NCO called the nurse ‘beast’: ÖStA/KA/Militärgerichtsarchiv [MGA], Gericht des k.u.k. Brückenkopf-und Stadtkommandos Belgrad, Kt. 5422a, Konv. E.N. 1785/17, 1917. Special thanks to the organizers of the conference ‘Medizin und Krieg’ (Dusseldorf 2009), hosted by the Deutsch-Polnische Gesellschaft für Geschichte der Medizin where an interesting discussion took place, which made it possible for me to compare my findings with those on the working environment in the German lazarettos during the same war. Obviously, 230Simultaneously, the number of inexperienced and less educated voluntary nurses constantly increased. Under these circ*mstances there are reports of physicians who complained that the new nurses hired in 1917 were unprofessional, despite being well-educated. The chain of command dictated “who was bound by instructions to whom.” Several attempts were necessary to improve discipline and order among the heterogeneous medical personnel.57Considering the very often hostile environment, it was often reported, that the Austro-Hungarian military personnel had the feeling that they had to make their duty ‘equivalent’ to those on the frontline. An officer wrote in Der Militärarzt: “The sacrificial endeavours of the physicians working in the rear area, […] are deservedly on the same level as the work of their peers on the battlefields”.58 This remark was made after an evaluation by the army’s commander to detect “Drückeberger”. For this reason, one can conclude that the medical personnel employed in the occupied territory saw the discussions regarding their responsibilities as very important. They tried to have their duties in the occupied countries considered as being on par with those performed by the medical personnel working on the frontline.59 Many members of the occupation medical staff lost their lives due to diseases, but not in the frame of the field operations. 60The Austro-Hungarian medical personnel were responsible for evaluating the medical and hygienic situation in the Balkans. Very often, the medical corps and establishments in the occupied territories were considered to be in a poor state. Only seldom was it mentioned that the local medical institutions were manifold. In this latter case, it is stated that local doctors were employed and the institutions of the occupied territories were used as well. This can be especially noticed in the intern reports. The Chief Sanitary Officer of the General Military Government, Jakob Lochbihler, claimed in an article on epidemic diseases the following: “the contaminated ailing Serbia underwent its rebirth in the framework of the imperial military the conflicts were similar. The following presentation depends on a work-in-progress doctoral dissertation: Petra PECKL, Lazarettalltag im Ersten Weltkrieg: Ein Blick auf die Hauptakteure in den deutschen Lazaretten.57 ÖStA/KA/NFA, MGG/S, Kt. 1629, Reservat-MGG-Befehl No. 18, 7.4.1917.58 FIGATNER, Die Reorganisation des Sanitätswesens,40.59 A part of each edition of Der Militärarzt listed victims of the physicians. 60 ÖStA/KA/NL, B/41, Johann STEINER No. 2, Erinnerungen aus dem großen Krieg 1914-1918 (manuscript), 132. This became obvious from the reports of the doctors on war experiences which AOK ordered in Marche 1918: ÖSTA/KA/AOK, San. Chef, Kt. 2317.231orders.”61 The term ‘rebirth’ suggests that before the advent of the occupation the existing institutions were destroyed during the previous conflicts, namely the Balkan wars and from July 1914 onwards. Franz Zinner from the Brünn hospital in Belgrade noticed that Serbia “remained half-Asiatic in spite of the painstaking work.”62 Apart from this, it is interesting that censorship did not view such articles as having a potential long-term negative effect on diplomatic affairs e.g. with the Turkish ally, or the local population, given that even Serbs from Austria-Hungary could read them.Opinions were influenced by a negative propaganda towards Serbs. Doctor Miloslavich, the head of the Army’s department of pathology in Belgrade,63 thoroughly condemned the Serbs for their hygienic situation: “this country, a source for the most dangerous and frightening epidemics, has decayed due to its utterly insufficient sanitary provisions”.64 Besides the Serbs, there were also other recurrent causes of disease and poor hygienic situations. Some physicians considered the danger for the spread of contagious diseases as being external and possibly coming from transiting troops, such as the Orientkorps, or peasants emigrating from other parts of the occupied countries.65 Kilhof considered that Jews were also responsible for transmitting diseases. He mentioned that not only in Belgrade but also all over in the occupied territory country there existed Jewish quarters suspected of “bad sanitary conditions”.66 This was also the case for the Gypsies’ (Roma) quarters, whose women were very often negatively mentioned.67An important issue revealed by the sources was relations between physicians and patients during wartime. “And I believe that behind some of the friendly Serbian smiles, one could detect concealed hatred.” These words were written by an Austrian physician, Friedrich Wallisch, who suspected in the eyes of the Serbs: “I still have for you, Schwaba, a good 61 Charasterist is by comparision the already mentioned report and article by Lochbihlers article: Jakob LOCHBIHLER, Rückblick. In: Der Militärarzt 51 (3.3.1917), 33.62 Original quotation in German: “Trotz aller Ententetünche doch halbasiatisch gebliebenen”. Franz ZINNER, Das k.u.k. Reservespital Brünn. In: Der Militärarzt 51 (1917), 116.63 MILOSLAVICH later became university professor in the USA and returned in the interwar period in the Kingdom of Yugoslavia and worked as a professor in Zagreb.64 MILOSLAVICH, Schlusswort, 119.Otto SCHWEEGER, Die Typhusepidemie in Belgrad im Jahre 1916 und die früheren Endemien daselbst. In: Der Militärarzt 51 (1917), 104.65 Otto SCHWEEGER, Die Typhusepidemie in Belgrad im Jahre 1916 und die früheren Endemien daselbst. In: Der Militärarzt 51 (1917), 104.66 M. KILHOF, Das k.u.k. Epidemiespital Belgrad. In: Der Militärarzt 51 (3.2.1917), 72.67 The Authors quotes an officer: “It was notorious, that without exception, the Gypsy girls were luetic.” Magnus HIRSCHFELD, Andreas GASPER (eds.), Sittengeschichte des Ersten Weltkriegs (Hanau 1998), 66.232bullet”.68 The long years of propaganda directed against the Serbs as well as the popular armed resistance during the war campaigns and the occupation, left its mark. Many physicians were the victims of armed attacks by the Serbians in the Balkans. Thus, certain Austro-Hungarian physicians approached their patients with fear.69As this shows, Austria-Hungary’s occupation regime had to implement health care measures in foreign hostile countries, some of the officers and physicians, who were part of the invading forces, were familiar with the societies (people and customs) from Balkan countries. There were many Muslim Bosnians and Orthodox Serbs living in the Dualist Monarchy. Thus, sending a female physician to examine Muslim ladies was not something new70 for people living in Austria-Hungary. However, in this case it was not exclusively a humanitarian action. The occupation regime was afraid of the spread of diseases and perceived the refusal of Muslim women to be examined by male physicians as a ‘red light’. This was especially true for the Sandžak region and Albania, where the Austro-Hungarian governor recommended “taking into account the particular customs and religious views”.71One group of diseases that perfectly matches all examples mentioned, were the venereal diseases. The mechanism to deal with this threat typically illustrates how the Austro-Hungarian occupation fulfilled its military tasks: bureaucratization according to its own model, and implementation through coercion. In parallel it served the Muslim population, because it took into consideration their cultural profile as it was implemented for Bosnia after 1878. It also shows the exceptional position of the officers and clerks in the society.72 “The fight against venereal diseases”73 became an important challenge. Thus, one important task of the occupation regime was to hinder the spread of venereal diseases in the home country. Regulating prostitution in brothels was supposed to bring about security because illegal prostitution was perceived as being connected to sexually transmitted diseases. On average, brothels were established for each district. They were supposed to ‘serve’ the military 68 WALLISCH, Die Pforte zum Orient. Unser Friedenswerk in Serbien, 39.69 WALLISCH, Die Pforte zum Orient. Unser Friedenswerk in Serbien, 39. ROKSANDIĆ, Sanitäre Wacht, 35, 109.70 Beginning with 1891, Austria-Hungary employed female public health physicians in Bosnia-Herzegovina. See: Martina GAMPER, Ärztinnen für Arbeiterinnen. Die Unterstützung weiblicher Ärzte durch die sozialdemokratische Arbeiterbewegung am Beispiel der Arbeiterinnen-Zeitung. In: Sonia HORN, Ingrid ARIAS(eds.), Medizinerinnen (=Sozialgeschichte der Medizin, Wiener Gespräche 3, Wien 2003), 71-88, here 72.71 ROKSANDIĆ, Sanitäre Wacht, 35, 109.72 Waldemar FINK Das Zivilspital in Belgrad. In: Der Militärarzt 51 (1917), 58.73 ÖStA/KA/NFA, Kt. 1629, Reservat-MGG-Befehl No. 57, 17.12.1917.233personnel and thus avoid illegal prostitution. Better facilities, undoubtedly, for the use of officers, had ten beds, but others had as many as seventeen rooms. They were equipped in accordance with the instructions of the garrison’s chief physician. In addition, they were under medical supervision.74The intention to eliminate illegal prostitution brought prejudices for the women who held specific jobs. Dr. Glück identified three categories of Weibern [prostitutes]. The first category worked in brothels, whereas the second one, albeit being ‘professional’ prostitutes, worked from home. Both categories were examined once a week and placed under police surveillance. According to Lochbihler, in the most contagious regions of Serbia, Belgrad, Šabac and Valjevo, “the compulsory examinations of all women” were ordered. The reason for this was that to protect the deployed military troops. According to him, the infected women represented the “source of contamination”.75 The third category, the Geheimprostituierte [secret prostitutes] were “mainly supplied by waitresses and housemaids” as a colleague wrote.76 The Chief Sanitary in Serbia added to this list the cashier women. The intention to eliminate illegal prostitution had the negative effect that some women’s jobs were labelled as prone to prostitution.77However, when he was on ward round, Waldemar Fink, head of the civilianhospital in Belgrade, reinforced his impression that most women suffering from venereal diseases did not look like prostitutes. In his opinion, the mothers were forced into prostitution when they actually had to take care of their children. He argued his opinion by providing the example of those women who offered to make baskets for hospitals.78 However, no report mentions precisely that it was the soldiers who, after being released from hospital, infected cured women. Nevertheless, most measures focused on instructing soldiers and civil servants. At the same time, local women were criminalized. Booklets were handed over to soldiers, e.g. 74 ÖStA/KA/NFA, Kt. 1613, No. 122295, 14.11.1916 ÖStA/KA/NFA, Kt. 1613, No. 122295, 14.11.1916. Original quotation in German: “[…] especially their support from the status of waitresses and servant girls.” GLÜCK, Über die Bekämpfung der Geschlechtskrankheiten, 410.75 ÖStA/KA/AOK, Qu. Abt., San. Chef, Kt. 2318, Sanitätsgeschichte L-Q, Bericht Jakob Lochbihler, Juni 1917, 35.76 Original quotation in German language: “[…] generally their supply [comes] from the estate of the waitresses and servant girls.” GLÜCK, Über die Bekämpfung der Geschlechtskrankheiten, 410.77 In the military archival fund [Militärgerichtsarchiv] there are many examples on punishments. They indicate the complex construction of the occupation society in matters of love. For instance: ÖStA/KA/MGA, Gericht des k.u.k. Brückenkopf- und Stadtkommandos Belgrad, Kt. 5422b, E 1157/17.78 FINK, Das Zivilspital in Belgrad, 58–59.234under the caption How to prevent syphilis or instructions with similar contents were put on brothel walls. The booklet had twelve pages with no pictures, and was written in German. Thus, they could not be understood by most soldiers who were actually the target of these publications. It was urgently warned that “all prostitutes and women […] they will come close to you all under the gleaming clothes of clean ladies or simply under the working clothes of a waitress or housemaid or under the coloured clothes of our county girls”.79Venereal diseases could also be transmitted other than sexually. The occupation power knew this very well. The booklet described the histories of those returning home, and how fathers were infecting their children.80 Milan Figatner wrote about his duty to ensure a sanitary environment in the occupied countries, because it was important to the state of health of the population of the Monarchy.81 The situation became even more complicated when an increasing number of young female nurses fell ill. They came from the hinterland to work for the occupation regimes after 1917. Regulations ordered the detection of the sources of the diseases, and in December 1917, compulsory examinations were introduced for all female employees at hotels, coffee-shops, and taverns, as well as for suspected local women.82 An order issued to nurses stipulated that: “Women who do not comply with these norms must be urgently compelled.” Austro-Hungarian nurses and female teachers were discretely notified of intern orders concerning examination times. Moreover it was necessary that employees displayed their “modest lifestyle”.83 Other women, especially local ones, were taken from the streets and brought in for investigations, which was actually a common occurrence in Western Europe in those days.84 However, in the small towns and villages in the Balkans, these measures were perceived differently. For instance, because his thirteen year old daughter was forced to undergo an examination for venereal disease, a Montenegrin father threatened with vendetta if the occupational court failed to find the defamer. This file was closed after the judges found out that the girl was accused by a spy who was sent by the occupation regime to detect secret prostitutes.85 79 Emanuel FREUND, Wie bewahrt ihr euch vor Syphilis (Graz 1916), 11.80 FREUND, Wie bewahrt ihr euch vor Syphilis, 6-7.81 FIGATNER, Die Reorganisation des Sanitätswesens, 40.82 ÖStA/KA/NFA, MGG/S, Kt. 1629, Reservat-MGG-Befehl No. 57, 17.12.1917.83 ÖStA/KA/NFA, MGG/S, Kt. 1645, Interner Befehl, 27.9.1917.84 Manfred VASOLD, Grippe, Pest und Cholera. Eine Geschichte der Seuchen in Europa (Stuttgart 2008), 225.85 ÖStA/KA/MGA, Akten des Gerichts des Kreiskommandos Podgorica, Kt. 5561, K 339/17. See also: ÖStA/KA/NFA, MGG/S, Kt. 1629, Reservat-MGG-Befehl No. 55, 8.12.1917.235Constraint was a part of most measures, but it was ambivalent because in the end, it could serve the population as well. In the course of compulsory vaccination the physicians and soldiers had to cope with superstition. Stories were circulating among the population that the occupying forces tried to inject diseases (because they got fever due to a vaccine). Locals considered that this occurred when compulsory vaccination was introduced by the military administration.86 On the other hand, in the same region, a medical article mentioned around only 1,700 first vaccinations as opposed to 44,200 boosters.87More dreadful must have been forced relocations, which the occupying forces called “evacuations”, out of the regions that had been declared areas affected by malaria.88Moreover, local culture was disregarded in the implementation of the Austro-Hungarian hygiene rules. Traditional graveyards were no longer allowed to be built next to houses; moreover, the dead had to be buried in common cemeteries on the outskirts of villages as it was common in Austria-Hungary since 18th century.89 A central topic in memoirs is the requirement to use public bathes and delousing facilities. The locals had to take a bath once a week, free of charge, and had to go through delousing – insofar as it was necessary. Soldiers were also required to bath regularly. As a matter of fact, delousing certificates were compulsory in daily life, as it was required to have them for travel by train or tram. Everyone had to bear them: from the noble woman to the male peasant. Public baths were maintained and spread all over the countries, which corresponded to the increasing modernization process. Often, military staff faced resistance, mainly from the elderly, who refused to cooperate. According to a report, an old lady had to be escorted by two soldiers, undressed by a lady, and driven into the pool as if she were cattle.90 86 Hugo KERCHNAWE, Die k.u.k. Militärverwaltung in Serbien. In: Kerchnawe HUGO (ed.), Die Militärverwaltung in den von den österreichisch-ungarischen Truppen besetzten Gebieten (=Carnegie-Stiftung für internationalen Frieden, AbteilungVolkswirtschaft und Geschichte, Wien 1928), 203−211. Colonel Hugo Kerchnawe was during almost the whole period chief of staff of the military government of Serbia, and consequently the superior of Jakob Lochbihler. Siehe auch: ÖStA/KA/AOK, Qu. Abt., San. Chef, Kt. 2318, Sanitätsgeschichte L-Q, Bericht Jakob Lochbihler, Juni 1917, 20.87 PÖCHMÜLER, Belgrad in sanitärer und hygienischer Beziehung, 94.88 1917 For the Italian case, which is also relevant for the occupied Balkan countries, see: Hermann LEIDL, Die Verwaltung des besetzten Gebietes Italiens (November 1917 bis Oktober 1918). In: Hugo KERCHNAWE (ed.), Die Militärverwaltung in den von den österreichisch-ungarischen Truppen besetzten Gebieten (=Carnegie-Stiftung für internationalen Frieden, Abteilung Volkswirtschaft und Geschichte, Wien 1928), 336.89 KERCHNAWE, Die k.u.k. Militärverwaltung in Serbien, 208.90 KERCHNAWE, Die k.u.k. Militärverwaltung in Serbien, 222−223.236The manner in which new measures were announced could be seen as either arrogant or the most pragmatic way to administer what was essentially an order. In April 1917, the readers of the BelgraderNachrichten were notified: “The date for the free vaccination in the ambulance of the community was extended, but everybody was notified that in case of absence, they will be punished”.91 Another way to communicate measures was during a community meeting, where officers and physicians instructed local officials how to implement the new sanitation laws. Very often, they talked to them in a depreciatory way. For example, an officer stated during a meeting: “[…] as primitive as local circ*mstances are […] it is not necessary to empty one’s bowels everywhere”.92 On the other hand, the occupation authorities realized that the spread of venereal diseases could not be prevented without cooperation. Once, a local major asked how he should cooperate, when his people would declare everyone who was found ill as “immoral”.93 The military official answered that if accusations were made, they should be justified. In this case, foreign officials expected the population to take attitude. At the same time, venereal diseases were not discussed publicly in Austria-Hungary.Conclusions The Austro-Hungarian occupation regimes of the Balkans (Serbia 1915-1918, Montenegro and Northern Albania 1916-1918) were part of the militarized zone between the frontline and the homeland, termed the ‘back area’. This situation required the occupation administrations to keep a firm hold on the territories in order to exploit the local resources for the war economy, and to maintain communication. The rear area also represented a communication junction among the frontline, homeland, and cordon sanitaire. The military administrations did not face only military defaults. Political debates were held on the future of these territories, and their annexation was discussed as well. The composition of the medical personnel followed the construction of the Imperial Army, which included reservists and was ethnically heterogeneous. ‘South-slav’ personnel were specially employed despite all fears of fraternization. Starting with 1917, the number of local and female personnel rose considerably. 91 Belgrader Nachrichten (5.4.1917).92 ÖStA/KA/NFA, Kt. 1700, MGG/M, Pol 470, 1917.93 ÖStA/KA/NFA, Kt. 1700, MGG/M, Pol 470, Protokoll, 1917.237The implementation of the precepts in daily life was influenced not only by the origin of the groups, but also by the various benefits they carried for them. This was felt within the occupation power, together with the strife to avoid front service. They also faced a hostile population, overcrowded conditions, material deficiencies, austerity measures, and improvisation. While certain diseases that appeared were partially combated, this did not really apply to venereal diseases. There was an increase in the number of those affected by them. This engendered discussions on moral issues, extramarital relationships, and the costs of the military organization, as well as dangers for the families at home as well. The measures were meant to instruct soldiers and stigmatize certain jobs for women. The implementation of the anti-venereal disease measures as well as the other hygiene measures required coercion and efficiency from the Austro(-Hungarian) bureaucracy.