The Improvement of Offspring

A country's wealth is its people, and its worth lies in their numbers, their state of health, and their capacity for mental and practical production. Growth in population is measured by the excess of the annual birth rate over the death rate — provided that deaths fall mostly among the old and least among children; and the rate of deaths among children is the index of a country's advancement, government and people alike.

The child has no say in the matter of his health, nor in the matter of deaths in the first years of his life; that depends on the health of his parents, on what he inherits from it, and on the healthy surroundings which they, and which society, prepare for him so that he may grow up sound, well, and vigorous. Society, through the laws it enacts, is alone responsible for the choice of the child's parents. Before they proceed to marry, they must be sound and free of the diseases that may be a cause of the child's death in his first years, or a cause of some mental or bodily infirmity that would make him a burden upon his surroundings or a danger to them. In the hope of averting this danger, the custom has arisen for the applicant for marriage to present a health certificate to the responsible authorities. But this law, in its present form, is a general one and binds the physician to nothing; so every physician has come to exercise a judgment of his own. Some believe that the presence of venereal diseases is sufficient ground to prevent marriage; some think that the chronic diseases — diseases of the heart, the lungs, the kidneys, and the circulatory system, which may bear down harder on the sufferer after marriage — are an essential ground for preventing marriage; and so on through the range of opinions. Would that a committee were formed of those whom the matter concerns — from the Ministry of Health, from the spiritual authorities, and from specialists in the science of eugenics — to study the diseases and the mental conditions that have their effect on the health and soundness of offspring, and that the results of their researches and their decisions were placed in the hands of physicians, to guide them whenever an applicant comes to them for a health certificate for the purpose of marriage.

This is the first aspect of the improvement of offspring; it is still a general theory in its earliest days, and years may pass before society profits from scientific progress in the two branches of heredity and sociology.

The second aspect is the care of the pregnant woman throughout the days of her pregnancy, at delivery, and throughout the period of nursing. And though talk on this subject has become commonplace, the matter has not yet reached the level that befits it: it is still confined to one particular class of the people, and some of the health centers set up for the purpose lack a great deal in the way of modern examinations.

Every institution that takes upon itself the care of the pregnant woman must be equipped with a laboratory for biological examination and for X-ray photography; the work must be carried on by a physician, a nurse, and a clerk to keep the records; and it must have connection with a hospital where the woman will find all she needs should she fall ill during pregnancy or should her delivery prove difficult. The record clerk enters in a special register, for every woman, her health history: what her diet was as a child and in what year of her life she walked; what her family's material condition is; if she has been pregnant before, how that pregnancy ended and how her previous deliveries went; whether she was stricken with puerperal fever; whether she nursed her child, or suffered an inflammation of the breasts. Then comes the physician's turn to perform his professional duty toward her, letting nothing great or small pass without the attention it deserves: he treats when treatment is called for, and supplies the woman with what she must know about her food, her work, her dress, the care of her teeth, and the rest of the elementary directions that everyone knows. Of late, however, calcium preparations and vitamins have multiplied in the hands of physicians, thanks to the publicity carried on by the commercial houses, and the pregnant woman has received a large share of these substances.

A country like Lebanon — with its temperate air, the warmth of its sun, the abundance of its foodstuffs, and the spaciousness of its houses, into the humblest of which air and sun find their way — has no problems of nutrition; natural foods contain all the substances the body needs.

The pregnant woman needs protein and iron, which are found in meat, egg yolk, brown bread, cereals, and vegetables; she needs iodine, which is found in fish; calcium is plentiful in milk, which also contains vitamin D and phosphorus.

If a woman's diet were of milk, eggs, meat, fish, vegetables, and fruit — and all of these are abundant among us — she could do without all the tonics that are given by injection into the vein or under the skin.

In the wake of the first world war, woman went down into the field of labor, and in the course of this war her footing there was made firm; her ability to do the work that men do is a settled matter. But her entry into the field of labor has not kept her from marriage and pregnancy. The question today is: shall the pregnant working woman be permitted to continue at her work? The answer is no, from both the health and the economic standpoints, for the pregnant woman needs rest. True, the pregnant woman works in her house and in her field; but that work is according to her own will — she works as much as she is able, and at the hour she chooses. The hired working woman, however, owes a duty to the employer, and he may show no mercy.

He may consent to keep her on, because the wage he pays her is less than what he pays a man; were wages equal, the competition between the sexes would lessen. And were the labor unions to enact a rule forbidding the pregnant woman to work, this would yield an economic gain: first, it would open the field to men, and unemployment would lessen; and second, the pregnant woman needs compulsory rest for a month before delivery and another month after it, and this is not in the interest of the work. It may be said that this may hold true in the countries of the West, but that among us the number of working women is very small. That may be so now; but industry among us is in its infancy, its growth is on the increase, and the number of working women grows year by year — so why not provide for the matter before it comes to pass?

The third aspect of the improvement of offspring — and in it, too, the child has no say — is that the child should find, after his birth, healthy surroundings that help him to grow and keep from him the fatal diseases and the diseases that leave in him infirmities preventing him from doing his duty as a useful member of the social body: blindness, rickets, chronic tuberculosis, and the rest. I shall pass over the fatal diseases — the fevers and the contagious diseases — and content myself with pointing to the diseases carried by the air, by flies, and by polluted water, all of which are easy to overcome by following the noble verse, 'Cleanliness is of faith.' Unfortunately, filth is general in Lebanon: in the cities and the villages, in the streets and the alleys, in the gardens and in the fields, in the tramway cars and in the shops. The man seated in his motorcar and the man going on foot spit where they please; the son of the city and the son of the village relieves himself in any place; the refuse of the houses and their drains are cast out and lie open in the roads and the gardens, and there the fly finds its food and a fit hotbed for laying its eggs, and carries on its feet all the microbes contained in this filth, to deposit them in the eyes of children, who are stricken with trachoma, and in food, where they cause infections of the stomach; and what the flies do not carry, the air carries once it has dried, and the microbe of consumption works its havoc. Who, then, is responsible for the spread of this filth? Government and people equally. The health laws of this country are such as the most advanced countries might envy us; but the weakness is in enforcement. If favoritism may pass in appointment and promotion, in the war on filth it is a crime; were the law applied to the letter against every offender, filth would not be what it now is.

And upon the people rests a duty no less than the government's, for the government cannot station in every house a policeman to restrain people from acts contrary to public decency and public health. We need discipline and training in cleanliness, and it is as necessary in the primary schools as national instruction itself.

It may be asked: what is the object of inking this article, when all that is in it is commonplace, known to the elite and the public alike? True — the object is not to spread information; the object is a hope and a plea addressed to the women's associations in this country, which labor in every field of our social life: that they take the lead in the movement for the care of the pregnant woman and for child welfare. If they turned their scattered efforts to this one field alone, they would render the country a service that no one else is able to render. In every one of Lebanon's great cities there is a women's association gathering to itself the choicest of women in patriotism, in learning, and in devotion; if each one of them adopted the project of protecting the pregnant woman and caring for the child, and founded a health center to carry on this work, nourishing it with its mighty effort and with the money it gathers, its labors would bear good fruit. And they have today a strong weapon for spreading their message: the women's paper, The Woman's Voice. If they carry this banner in their hand, all the people will march behind them. The benefit of it is general, beyond any price; and this is the least that we can do for our children, the men and women of tomorrow.