The State of Public Health in Iran during the Reign of Naser al-Din Shah Qajar from the Perspective of Foreign Travelers

Abstract

The reign of Naser al-Din Shah in Qajar history represents an important yet highly challenging phase for Iran’s public health and medical system; a period in which initial efforts were made to organize health and medical services, while at the same time, general sanitary conditions—according to the accounts of foreign travelers—were characterized by a combination of inadequate urban infrastructure, the absence of systematic waste disposal and sewage management, and the widespread prevalence of infectious diseases. Many travel writers of this period described narrow and dusty alleys, the accumulation of garbage in public spaces, and the presence of stagnant water as major factors contributing to the spread of disease. They also pointed to the shortage of trained physicians, the widespread reliance on traditional medicine and popular beliefs, and the lack of adequately equipped hospitals. Diseases such as smallpox, plague, and typhus occurred periodically, reflecting the weakness of the health system. Nevertheless, limited governmental measures—such as the establishment of the Dar al-Funun School, the founding of medical education, the employment of European physicians, and the creation of early medical clinics—were also undertaken during this period. Taken together, these accounts indicate that the health situation in Iran during the Naseri era was in a transitional state. In general, Western travelers who visited Iran viewed the issue of public health in the country from a critical perspective. How foreign travel writers during the reign of Naser al-Din Shah assessed the state of health in Iran is the central question examined in this article. Using a descriptive–analytical method, the present study reviews documentary evidence and travel narratives to provide a comprehensive assessment of the socio-economic impacts of health-related developments of that period on the population and the governing system, while also reflecting the limited role of the central government in responding to public health needs. The findings of this study indicate that, despite initial steps in the field of public health, the reign of Naser al-Din Shah continued to reflect unfavorable conditions and an urgent need for extensive reforms in the health system, the effects of which remained evident until the beginning of the modern era.