Spread of Syphilis and Health Inequality of Patients in Montenegro at the beginning of the 20th century (Preprint)

Abstract

Syphilis is an acquired or congenital sexually transmitted infection caused by the pale spirochete bacterium (Treponema pallidum). The Principality of Montenegro was a small underdeveloped Balkan state that was trying to build institutions and thus a health care system. The sources that were the subject of our analysis show that syphilis appeared and spread in Montenegro at the beginning of the 20th century and that it threatened the health of the population.

The key goals of our work were to show the state of public health in Montenegro at the time of the spread of syphilis. To show how patients were treated unequally. To show the hard struggle in Montenegrin public health for its modernization.

In the research we have used the original archival material of the state authorities of Montenegro, which is kept in the State Archives. These are documents from the period of the spread of syphilis, which originated in the correspondence of the main state authorities in the field of health. Following the principles of scientific methodology, we have selected official documents that give the most accurate picture of the spread of syphilis, health policy, and discrimination against those affected at that time.

From the documents of state authorities that were the subject of our analysis, we conclude that people suffering from syphilis were discriminated and that there were cases of them becoming homeless. In some cases, the presence of health inequality and the refusal of certain health institutions to accept them for treatment can be seen. Also, funds were not allocated for the treatment of syphilis patients, and institutions avoided treating them. However, due to the prevalence of syphilis and the danger of uncontrolled spread, the state was forced to provide free treatment to all patients in state hospitals and clinics. The Ministry of the Interior ordered to regulate the issue of prostitution because it estimated that the spread of the infection came from people who were engaged in the oldest trade in the world.

The spread of syphilis in Montenegro at the beginning of the 20th century threatened the public health of the population of this small and underdeveloped European country. Syphilis spread mainly due to disorderly conditions related to prostitution and inadequate education and health culture of the population. The health care system of the small, underdeveloped Montenegrin society was weak and unable to properly deal with the emergence of this dangerous disease.