The Great War and the other war

Maryline Alhajj
Beirut, Lebanon


Lebanon World War I

Starving man and children in Mount Lebanon. 1915–1918. Unknown photographer. Via Wikimedia. Public domain due to age.  

The reverberations of October 29, 1914 would carry throughout the lands of the Ottoman Empire and serve as an ominous premonition of disastrous years to come. On that day, following a surprise attack on Russia’s Black Sea coast,1 the Empire entered World War I. It was the beginning of the end, as the four long years of the Great War would eventually prove fatal for the already weakened “Sick Man of Europe” (as was then the nickname of the crumbling Empire).2 The Sick Man would labor desperately through his final, ragged breaths before being put to rest in defeat and collapse.3 For the Empire’s occupied nations, the war was far from painless, and it left behind a gaping wound that has not fully healed.

Far removed from the bloody and gruesome battlefront is the often forgotten reality of the Ottoman home front. In Lebanon particularly, the Great War was a demographic and economic catastrophe. It is estimated that more people died in Greater Syria during the war than anywhere else in the world, as a proportion of the total population.4 This occurred because of an almost apocalyptic convergence of factors that caused an onslaught of tragedy and misfortune. Some of these factors include forced mass conscriptions, an influx of refugees, an economic siege, and a locust invasion “in biblical swathes” – leaving more than 200,000 dead in the region.5

But perhaps the aspect that dominates the Lebanese people’s perception of the war is widespread famine. Its repercussions were so severe that for generations to come, the Great War would come to be known as the “War of Famine” (or ḥarb al-majā’ah).6 Starving and desperate, people resorted to eating grass and leaves. After the locust invasion effectively eliminated that option, they moved on to the carcasses of dead animals.7 Most horrific of all, there have even been reports of cannibalism, of parents eating their own children.8

There was also another war, one against disease. This is what French official George Cahen referred to as the “Other War” or “l’autre guerre.” The challenge was to respond to and contain the growing menace of epidemics such as cholera, plague, malaria, and typhus.9

“So here is the complete triad: pest, famine, and war,” stated Louis Cheikho, a Jesuit priest and one of Beirut’s leading intellectuals at the time.10 Indeed, the long war and rampant famine that gripped the Ottoman Empire created the perfect breeding ground for the spread of infection and disease. With multiple epidemic outbreaks, Beirut and Mount Lebanon faced a four-year medical emergency.11

This already precarious situation was exacerbated by the Ottoman War Ministry mandating that all civilian doctors, pharmacists, and dentists in good health could be conscripted for health services to the military.12 Even medical and pharmaceutical students were recruited into the army.13 Bayard Dodge, American scholar of Islam and then-president of the American University

in Beirut, reported that cases of malaria had spun out of control in the mountain districts because “all of the doctors had gone off to serve in the military hospitals.”14

In the midst of this humanitarian crisis came an unexpected beacon of hope: an initiative by the Lebanese public health sector to fight the Other War. Several plans of attack were laid out, the execution of which created a surprisingly successful, well-oiled machine that came as a breath of fresh air in a scorching desert of despair.

To begin with, the physicians who were exempt from conscription prolonged their work hours and often held office hours in different locations. Also, municipalities imposed mandatory hours of weekly volunteer work for all practicing physicians.15

There was also an urgent need to educate people about disease types, prevention, symptoms, natural history, modes of transmission, and infectivity. For this purpose, health officials initiated an education campaign to mold what anthropologist Charles Briggs called a “sanitary citizen.” Ideally, such a citizen placed the well-being of the community ahead of personal needs and recognized the importance of isolation and quarantine when needed.16 The health commission also pushed for the publication of “advice” pieces devoid of medical jargon in local journals. These strategies were relatively successful,17 as there was a notable decrease in typhus cases following a terrible outbreak in the years 1916 and 1917. Hūsni Bey, a high-ranking Ottoman official tasked with overseeing the region, attributed this to increased civilian awareness and improved precautionary measures.18

The next step was to establish a public health administration. The hierarchical organization assigned division of labor and delineated responsibilities for members. Military personnel were also mobilized to aid in the fight, reinforcing lockdown and quarantine measures. This can be viewed as a militarization of public health, which allowed an unprecedented intervention of municipal and military authority into the daily lives of civilians.19

By the fall of 1915, the coordination of efforts was proving to be impressive. One example is the well-documented story of Ahmed Dandan and his family, who had been found to be infected with plague. Appropriate measures were taken almost immediately to quarantine their home city of Antelias, with the public health administration operating like a highly organized beehive to effectively contain the threat.20

Owing to the combined efforts of the Ottoman State, the local medical community, and the military, a war-torn Lebanon was able to rise against adversity and begin to build the secure foundations of its contemporary healthcare system. The Lebanese people and medical community fought tirelessly to establish this safe and reliable footing, urgently responding to a devastating humanitarian crisis.

The Great War eventually ended with the demise of the Sick Man of Europe. The “Healthier Man of Lebanon,” much like a phoenix recreating itself from the ashes of a difficult trial of fire, today proudly soars towards its future and gratefully remembers its past.



  1. “Ottoman Empire Enters the First World War,” New Zealand History, accessed August 28, 2021,
  2. “Lawrence of Arabia . Emerging Middle East . OTTOMAN: Sick Man of Europe,” PBS (Public Broadcasting Service), accessed August 28, 2021,
  3. “Ottoman Empire at War,” New Zealand History, accessed August 28, 2021,
  4. “WW1: The Famine of Mount Lebanon,” BBC News (BBC), accessed August 28, 2021,
  5. “Six Unexpected Ww1 Battlegrounds,” BBC News (BBC, November 26, 2014),
  6. Melanie Tanielian, “The War of Famine: Everyday Life in Wartime Beirut and Mount Lebanon (1914-1918),” Escholarship (UC Berkeley Electronic Theses and Dissertations, 2012),
  7. Melanie Tanielian, “The War of Famine: Everyday Life in Wartime Beirut and Mount Lebanon (1914-1918),” Escholarship (UC Berkeley Electronic Theses and Dissertations, 2012),
  8. “Six Unexpected Ww1 Battlegrounds,” BBC News (BBC, November 26, 2014),
  9. Catherine Rollet, “The ‘Other War’ I: Protecting Public Health,’ in Capital Cities at War,” in Capital Cities at War (Jay Winter, University of Cambridge, Jean-Louis Robert, 1997), p. 142.
  10. Louis Cheikho, in Diary of Father Loius Cheikho, p. 149.
  11. Melanie Tanielian, “The War of Famine: Everyday Life in Wartime Beirut and Mount Lebanon (1914-1918),” Escholarship (UC Berkeley Electronic Theses and Dissertations, 2012),
  12. Ittiḥād Al-‘Uthmānī, November 20, 1914, (Beirut: American University of Beirut).
  13. “Letter from Howard Bliss to Minister of Education Shukri Bey Dated June 29, 1916,” in Bliss Collection (Beirut: American University of Beirut).
  14. “Report of the Soup Kitchens in ‘Abeih and Souk al-Gharb,” in Bliss Collection (Beirut: American University of Beirut).
  15. Ittiḥād Al-‘Uthmānī, February 27, 1915, (Beirut: American University of Beirut).
  16. Briggs, “Why Nation-States and Journalists Can’t Tell People to be Healthy.”
  17. Ittiḥād Al-‘Uthmānī, March 15, 1915, (Beirut: American University of Beirut).
  18. Melanie Tanielian, “The War of Famine: Everyday Life in Wartime Beirut and Mount Lebanon (1914-1918),” Escholarship (UC Berkeley Electronic Theses and Dissertations, 2012),
  19. Ittiḥād Al-‘Uthmānī, October 6, 1915, (Beirut: American University of Beirut).
  20. Ittiḥād Al-‘Uthmānī, October 6, 1915, (Beirut: American University of Beirut).



MARYLINE ALHAJJ, B.S in Biology, is a medical student and researcher at the Lebanese American University in Beirut, Lebanon. She aspires to be at the forefront of various contributions to healthcare research and practice, and to improve understanding and accessibility of medical advances to the public eye. She is a published author, with projects on COVID-19, inflammation, diabetes, and trauma response, especially following crises such as the 2020 Beirut explosion.


First prize winner of the Glory of Lebanon Contest, in collaboration with the Lebanese American University Gilbert and Rose-Marie Chagoury School of Medicine

Winter 2022  |  Sections  |  Asia