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THE HUMAN COSTS
OF THE WAR

HOMER FOLKS

ORGANIZER AND DIRECTOR OF THE DEPARTMENT OP

CIVIL AFFAIRS OF THE AMERICAN RED CROSS IN

FRANCE AND LATER SPECIAL COMMISSIONER

TO SOUTHEASTERN EUROPE

Illustrated with Photographs by
LEWIS W. HINE

American Red Cross
Special Survey Mission

HARPER fie BROTHERS PUBLISHERS

NEW YORK AND LONDON

THE HUMAN COST OF THE WAR

Printed in the United States of America

Published May, 1920

E-U

To the Memory oj

L. F.
1893—1915

43542

CONTENTS

CHAP. PAGE

PREFACE xiii

I. INTRODUCTORY 1

A unique survey: Europe's woes at the war's end;
experience in France; assistants; itinerary; transpor-
tation difficulties; with refugees in an JSgean storm;
Saloniki, cross-roads of the world; through Serbia as
freight; Serbians, near- Americans; Belgrade, not
dead, but convalescent; in a Serbian hospital; the
home-coming of war's exiles in Belgium and France;
limitations of present estimates; disasters dimly seen,
but terrifying; not an account of American Red Cross '
work.

II. SERBIA: THE COST OF ASPIRATION 28

Paralyzed Serbia; the people and the country; a
glorious war history; non-existent transportation;
everybody going somewhere; Serbia's boys die on
Albanian mountains; displaced peoples; a whole
country three years under enemy armies; sent into
slavery in enemy territory; from bad to worse after
the armistice; short rations of food, fuel, and clothing;
"a new kind of poor."

HI. SERBIA: THE COST OF ASPIRATION (Continued) . . 65
Health: the Serbian disease, tuberculosis; the slaughter
of the innocents; the older children; syphilis; typhus;
typhoid; influenza; "Wanted, Babies"; total human
losses; pre-war health agencies; organized medicine;

CONTENTS

CHAP.

the new Public Health Ministry; war orphans and
widows; soldiers' families; cripples and prisoners;
devastation; impressions of the Serbians.

IV. BELGIUM: THE COST OP DECISION 98

Belgium's material losses; military losses relatively
small; four waves of devastation; results of rationing;
tuberculosis doubled; birth-rate halved; infant mor-
tality; unemployment; exiles in Holland, France, and
England; reconstruction beginnings.

V. FRANCE: HER SUPREME SACRIFICE 119

The French; the exoduses of 1914 and 1918; repatria-
tion; under the enemy army; how devastation came
about; how much is thereof it?; her soldier dead; crip-
ples; widows' veils; fatherless wards of the nation;
soldiers' families; general conditions; huge excess of
deaths over births; intensive survey of a typical French
community after four years of war by Mr. and Mrs.
Basil de Selincourt; population; prices; wages; labor;
some family groups; refugees; health; government.

VI. ITALY: WAR WIPES OUT Two MARGINS . . . .168
Pre-war Italy; exiles after Caporetto; the occupied
Veneto; devastated Italy; a hungry nation; from
deprivation to disease — slipping back into the plagues;
tuberculosis; the return of malaria; child mortality;
typhoid; "flu"; military losses; total human losses;
war orphans; cripples; the return of the prisoners;
soldiers' families.

VII. GREECE: THE COST OF INDECISION 199

Pre-war Greece; the futility of a glorious past; Greece's
war history; fleeing from the Turk and the Bulgar;
refugees from earlier wars and fires; under Bulgar rule;
sentenced to slavery; destroyed villages; the fire in
Saloniki; nation-wide hunger: a virgin field for sanita-

CONTENTS

CHAP. PA<3E

tation; tuberculosis; typhoid; Greece's malaria menaces
Allied success; infant mortality.

VJLLL WAR AND THE CHILDREN 229

"The scenes of my childhood" in war; Semendria;
the obstinate optimism of childhood; "Dad" and big
brother go away; will they return?; no more goodies —
malnutrition; the refugee child; disillusionment of
home-coming; war as childhood's background; war
deficit of babies.

IX. WAR EXILES AND HOME-COMINGS 249

Homelessness no light matter; continuing tides of
refugees; refugees everywhere; leave-taking; refugee
"adjustment"; refugee "prosperity" and "morale";
the call of home; war zone after the war; cave-dwell-
ings; repairing the irreparable; other makeshifts;
temporary houses; more aid and less pity; immaterial
ruins; substandard living; Germany's devastated area;
community * * adoption. ' '

X. WAR, BEST FRIEND OF DISEASE 277

The millenium that was coming; sickness prevented
and death postponed; lost ground among civilians;
tuberculosis increases; malaria returns; the "cootie"
spreads typhus; drinking typhoid sewage; influenza
and war; war, baby killer; health aspects of cave-
dwellings; a postponed millennium; meeting the
situation; American tuberculosis work in France;
health agencies, America's best gift to the Balkans.

XI. CIVILIZATION'S INDICTMENT OF WAR 298

What civilization is; war its negation; ten million
homeless; forty-million enemy subjects; sent into
slavery; nine million soldier dead; fifty million man-
less homes; ten million empty cradles; war diseases;

CONTENTS

CHAP. PAGE

a submerged continent; a mortgaged future; conti-
nental reconstruction and nobody to do it; what
America can do.

APPENDIX 323

Outline of survey of conditions and needs of civilian
populations in belligerent countries.

ILLUSTRATIONS

THE NIGHT BEFORE CHRISTMAS Frontispiece

DR. BOCHKO KONIEVITCH AND THE AUTHOR IN A

MILITARY HOSPITAL IN BELGRADE .... Facing p. 18

MANY HANDS " 20

NOT MUCH LEFT " 20

A BAD SPOT ON SERBIA'S "Gooo ROAD" ..." 38

WALKING HOME " 38

HARD LUCK " 40

THE OVERFLOW " 40

PLOWING IN SERBIA " 54

THE RED CROSS HELPS ......... " 54

A SHEPHERD GIRL ON THE HILLS NEAR BRALO . " 88

APPLICANTS FOR RELIEF " 88

SAFELY BACK " 104

DANGER IN DEBRIS • " 104

HOME FOR A FAMILY OF Six " 130

TEMPORARY SHELTER AT MERCATEL [ " 130

THE BREAD-LINE . . ; " 176

THE CHILDREN MAY RIDE " 176

A SHEPHERD BOY *' 220

A DOUGHBOY ON THE ACROPOLIS ...... " 220

EVERYBODY CARRIES SOMETHING " 232

ON THE WAY HOME " 232

THEIR HOME-COMING " 264

THEIR HOME "264

ILLUSTRATIONS

PICTURESQUE, BUT THINK OF LIVING IN IT . . Facing P. 266

THE BATTLE-FIELD AT HOOGE " 266

A DISINSECTING PLANT " 290

REFUGEE CHILDREN AT SKOPLIE " 290

HOME-MAKING UNDER DIFFICULTIES " 300

IN THE HEART OF THE SOMME BATTLE-FIELD . " 300

PREFACE

WHY doesn't Europe function?

This, in substance, is the question which puzzled
America has been asking all through the last half of
1919. Why must 1919 go down in history, as M.
Brieux says, as "a lost year"? With huge excess
stores of food and products, why does trade delay?
Why does foreign exchange jump up and down like
the temperature of a "flu" patient? When Mr.
Hoover returned last July he was quoted as saying
that, unless Europe began promptly to produce, there
would be starvation in unheard-of proportions this
winter. Now we hear that it is at hand. Did they
deliberately choose starvation, or did they drift into
it, or is there still another and perhaps a more
valid reason? Production implies producers. Who
and where and in what condition are the producers
of Europe? We hear that Belgium and England
are making real progress toward production. Has
this any relation to the fact that their military losses,
especially those of Belgium, were much less in pro-
portion than those of some other countries?

For five and a half years we have scarcely opened
a morning paper without reading a head-line telling
of the sufferings of some new group of victims of the
war. This morning — January 10, 1920 — it happens
to be Poland, and the Red Cross reports that, of its

PREFACE

twenty millions, four millions are refugees at this mo-
ment. Nevertheless, seeing many things of this kind
at first hand from July, 1917, to the end of the war,
in the extensive relief work of the American Red
Cross in France, the thing which impressed me most
painfully as I read the American papers was the
infinitesimal fraction of reality which found its way
into print. I saw the utter impossibility for the
average American reader, from such fragmentary
accounts, written by so many different persons, from
so many different angles, with so many different
purposes, to form any true picture of what the war
was meaning to the health and happiness of Europe.
It is even more necessary now, if we are to think
and act with the slightest realization of our respon-
sibilities in the world that actually exists, to be able
to see in a fair degree of perspective and sequence
the disasters inflicted by the Great War on the
peoples of Europe. These may prove to be the most
far-reaching of the war's results.

Just as the war was ending a request came to me
to make the best estimate then possible of the needs
of southern and southeastern Europe. The trips
through Italy, Serbia, Greece, France, and Belgium
for this purpose ended in April last, but the collec-
tion of data and the effort to set the facts in their
true proportions have continued to the date of
publication.

Chapter I tells the origin of the survey which re-
sulted in this volume and gives an account of the
itinerary of our trips. Chapters II to VII, inclusive,
deal respectively with Serbia, Belgium, France,
Italy, and Greece. Chapters VIII to X endeavor
to sum up the war's results in all these countries, in

PREFACE

the three vital aspects of childhood, home, and
health. Chapter XI tries to fit the whole into a
picture of War vs. Welfare.

No effort has been made to present a constructive
program — this is simply a contribution toward a
diagnosis which might make it possible to outline
a well-considered course of treatment.

THE HUMAN COSTS
OF THE WAR

INTRODUCTORY

Comfort, content, delight,

The ages' slow-bought gain,
They shriveled in a night.

— KIPLING.

A unique survey: Europe's woes at the war's end; experience in France;
assistants; itinerary; transportation difficulties; with refugees in
an ^Egean storm; Saloniki, crossroads of the world; through
Serbia as freight; Serbians, near- Americans; Belgrade, not dead,
but convalescent; in a Serbian hospital; the home-coming of war's
exiles in Belgium and France; limitations of present estimates;
disasters dimly seen, but terrifying; not an account of American
Red Cross work.

A UNIQUE SURVEY.— On the evening of No-
-*^ vember 11, 1918, while laughing, singing, shout-
ing, kissing crowds were jostling one another on the
boulevards, I left Paris for Italy and the Balkans
on a unique mission. It was to find out at the end
of a great war how much suffering there was, and
of what kinds. During the war I had been in charge
of the American Red Cross relief work in France.

As the war drew to a close, the calls for relief from

THE HUMAN COSTS OF THE WAR

eastern and southern Europe became more and more
urgent. The American Red Cross felt that it must
have a fresh appraisal of the needs, of their relative
urgency, and of how they could be met.

Even at first impressions the job did not seem an
easy one, and the more one considered it the less easy
it seemed. Everybody knew vaguely that the able-
bodied men of these countries had been at war for
several years; that their usual work of getting food,
clothing, and shelter for their families must have been
done in a makeshift way or left undone; that widow-
hood and fatherlessness had been spread broadcast;
that millions of men had been made cripples; that
millions of people had been driven from their homes,
and that these homes had been destroyed; that
other millions had lived under the rule of the armies
of their enemies; that many thousands had been
forcibly deported to labor as slaves; that fatigue,
underfeeding, indecent overcrowding, and exposure
to cold, rain, and snow had been general; that prices
had been fantastically high, many supplies unob-
tainable, and transportation broken down. All these
things were known to be not simply uncomfortable,
but dangerous to health and life. They were bad
enough, but they were the earlier stages of war
disaster. What were the later ones? What would
be the full fruits of such conditions lasting through
four years? We heard rumors of whole peoples
clothed in rags and starving; of outbreaks of typhus
and other epidemics; of hordes of famished refugees
returning to the bare ruins of non-existent villages.
How much was there of all this suffering? Where
was it? How could it be helped most quickly and
most efficiently?

INTRODUCTORY

The job was essentially that of estimating, in such
parts of Europe as could be reached, the net results
of the war upon human welfare. It required study
as well as observation. Wretchedness and misery
do not thrust themselves forward. Ruined homes
and buildings are obvious, but ruined lives, starva-
tion, and illness are unobtrusive and have to be
looked for. The weaker people get the less noise
they are able to make. The worst possible condi-
tions of human suffering are entirely compatible
with complete external calm and with complete con-
fidence on the part of the authorities that all is going
quite well, or at least as well as can be expected.
This is true in peace as well as in war, and in this
fact lies one of the most serious difficulties of relief
work. People who need help do not come forward
to ask for it. They do not know that it can be had,
or they are too proud to ask. Even in the most
humane and socially minded countries there is only
the slightest general realization of the amount of
extreme poverty and of preventable disease. An
epidemic is alarming because, being something new,
it is "news," and gets the head-lines. The steady,
all-the-year-round lists of deaths from ever-present
epidemics, such as tuberculosis and children's
diseases, get only the small type of the obituary
columns and nobody is disturbed. In those coun-
tries in which poverty is greatest the least is said,
known, and done about it. Short of impending
revolt, it is not vocal. This makes a survey of sick-
ness and distress difficult, even in peace-times when
all the usual means of getting information are at
hand. It is vastly more difficult when the ordinary
community life is disrupted by war.

THE HUMAN COSTS OF THE WAR

To have definite objectives, I prepared an outline
of various ways in which war is likely to cause dis-
tress in an invaded country (see Appendix). In
framing this I had the great advantage of my ex-
perience as organizer and director of the relief work
of the American Red Cross in France, since its be-
ginnings in July, 1917. I had seen this work de-
velop from giving first aid to a few straggling refugees
returning to the area devastated in the famous Hinden-
burg retreat of March, 1917, to perhaps the largest
relief work ever undertaken. It included a vast
relief agency in all parts of France for a million and
a half of refugees, later to become two million;
for the repatriates arriving a thousand a day through
Switzerland from back of the German lines, and for
an army of half a million war cripples. It included
also planning and getting under way two compre-
hensive efforts which it was hoped would be con-
tinued long after the war had ended and which
should help to make up some of the terrible losses
inflicted by the war upon the people of France —
campaigns against tuberculosis and child mortality.
Assistants. — I was given a free hand in the selection
of my survey aides. The question of food was para-
mount, and the United States Food Administrator
in Europe detailed one of his staff, Capt. Edwin G.
Merrill, to assist in this phase of the inquiry. Cap-
tain Merrill had been president of the Union Trust
Company in New York City, and was a man of wide
experience in business. The American Red Cross
Tuberculosis Commission to Italy placed at our dis-
posal Capt. Louis I. Dublin, who was in charge of its
research work. Captain Dublin is statistician of the
Metropolitan Life Insurance Company, lecturer on

INTRODUCTORY

vital statistics at Yale University, and one of the
recognized authorities on the bookkeeping of human
assets in the United States. As adviser on epidemics
and contagious diseases generally, I was fortunate in
securing Capt. Edward S. Godfrey, M.D., epidemi-
ologist of the New York State Department of Health,
formerly of the Illinois State Board of Health, and
at an earlier date Health Officer of Phoenix, Arizona.
Captain Godfrey had had a wide experience in
tracing epidemics to their origin and in public health
activities. Capt. Lawrence Pumpelly, assistant pro-
fessor of French in Cornell University, and skilled
in the art of language, acted as interpreter and trans-
portation manager, as well as unwinder-in-chief of
the interminable red tape which hampers travel in
foreign countries during war. Capt. Lucien W.
Booth, of Wichita, Kansas, was our secretary and
ever-present stenographer, and kept a full record
of all important interviews and observations. Capt.
Lewis W. Hine, who first made the photography of
social betterment a career, kept a record of human
conditions and needs with his camera which is quite
as complete and enlightening as the record of con-
versations and interviews. By his remarkable pho-
tos of various types of persons seen on our travels
he helps us to understand that these people are of
the same kind as ourselves, and to realize, not only
that we are our brothers' keepers, but that the
brothers are well worth keeping. Capt. James A.
Mills, who had been a member of the original Red
Cross Commission to Rumania, accompanied us as
far as Saloniki, where he took charge of an important
emergency relief expedition to northeast Serbia. If
I were starting on a similar trip again, I could not

THE HUMAN COSTS OF THE WAR

improve my selection of personnel. They helped
both in securing data and in judging of its sig-
nificance. While I alone am responsible for state-
ments of fact and of opinion, I am quite certain
that I have expressed the judgments of the group
as a whole.

Itinerary. — When the survey was proposed, the
war was obviously in its later phases, and it happened
that the date of our departure fixed some time previ-
ously, the evening of November llth, proved to be
armistice evening. It had been a wild day in Paris.
The restrained emotions of weary months and years
were let loose, and the celebration of victory and peace
excluded all else. The breakdown of organization,
even in the American Red Cross, was such that some
members of our party were unable to secure trans-
portation to the railway station and had to follow
us a day later. It was a sobering thought that on
the evening of the day of victory for which we had
been waiting so long we were setting out to make
an estimate of the sufferings, distress, and losses
which no armistice could discontinue, and some of
which actually increased in volume and in intensity
for months to come.

We went first to Italy and were told the essence of
what the indefatigable American Red Cross workers
in Italy had learned during a year of strenuous
activity in every part of the kingdom. Besides the
heavy military losses, it was a story of half a
million refugees, and of an entire population on the
edge of unendurable want. We were made ac-
quainted with the government officials charged with
the relief of refugees, food administration, and ques-
tions of public health, and interviewed leading

INTRODUCTORY

citizens. We visited Italy's devastated area stretch-
ing from the Piave River west and north to what had
been Austria, and including some of its most fertile
and most prosperous regions. The trip had to be
made by auto, as there were only temporary bridges
over the Piave, and no railways beyond it. At the
pontoon bridge we were held up a few moments to
allow a procession of foot-passengers coming this
way to cross. Who were this weird-looking lot,
ragged, bearded, gaunt, tired, hungry? They were
Italian soldiers, prisoners of war returning from
Austria. They had walked part of the way through
Austria and now had walked all the way through
Italy's devastated area. We met them after that all
along the road, in twos and threes, in scores and
in hundreds. We had our first look at occupied
territory and saw bread-lines standing before Amer-
ican Red Cross relief stations in a region which had
been impoverished to the last degree during the past
year, and from which the retreating Austrians had
carried away only two weeks before the little food,
clothing, and bedding that had remained. Here and
there family groups of refugees were returning, the
children, in spite of all their hardships, looking as
irresistible as only Italian children can look. They
were cold, hungry, and homeless, but they were
incomparable.

We traversed the peninsula to Taranto on the
south. The Odessa, originally a Russian boat on the
Black Sea, carried us to Corfu, where we caught
glimpses of the Isle of Death, so named since the
remnants of Serbia's army found refuge there, and
many of those who had survived the Albanian Moun-
tains perished of the later effects of exposure. We

2 7

THE HUMAN COSTS OF THE WAR

noticed with especial interest the summer home of
the Kaiser on a hillside in the distance, now serving
as an Allied Military Hospital. We sailed along the
Adriatic coast, into the Gulf of Corinth, and landed
at a tiny port on the north shore, Itea, very near
Delhi, and were driven over an excellent road, re-
cently constructed for military purposes, to Bralo,
a station on the Athens-Saloniki Railway.

Transportation Difficulties. — Our transportation ex-
periences from here on may well be narrated in some
detail, for they reflect better than anything else the
complete breakdown of the movement, both of per-
sons and of goods, a breakdown which in large
measure still exists and is one of the most serious
obstacles in preventing wholesale starvation in Eu-
rope in this winter of 1919-20. We represented gen-
erous America, coming to see what was needed, and
the best was placed at our service. For the ordinary
traveler, even for the local official of high station,
the facilities were still more scanty and uncertain.
The express train from Saloniki to Athens which runs
three times a week was due to pass Bralo at 7.20
A.M. We noted that it was being planned that we
should arrive at 9.30. We called attention to the
time-table. "Oh, we shall be in plenty of time; the
train is always later than nine-thirty." When we ar-
rived the train had not gone by. We waited and from
time to time various numbers of hours were stated
as the time yet to elapse before the train would
arrive. There had been a rain the day before, and
the road-bed was not in good condition. Finally
at 7.30 P.M. a train appeared. No one could tell us
whether it was the regular express or a special made
up a few stations above. After two hours' further

INTRODUCTORY

wait it pulled out without light or heat. It was some
ninety miles to Athens, but it occupied us until six
the next morning.

At Athens, as at Rome, the American Red Cross
workers gave us the results of their experience, in
this case covering a few weeks only. We also saw
numerous government officials and private citizens
interested in health and relief work. We heard of
scores of thousands of destitute Greek refugees on
Mytilene and other Greek islands off the Asia Minor
coast. We heard of destroyed villages and cities
in Macedonian Greece, and of thousands of Greeks
who had been deported from this region into Bulgaria
and who were returning famished and half clad.
We learned that we were in a country in which the
entire population at one time had been in sight of
starvation. We heard of health conditions which
had been very bad before the war, and now were very
much worse.

We were looking forward, however, with impa-
tience, to Serbia, the country whose heroic defense
in the early days of the war had won the surprised
admiration of the world, the country which had had
to yield later to overwhelming numbers, which had
disappeared behind the lines of the Bulgarians,
Austrians, and Germans, until, again to the surprise
of the world, the reorganized Serbian army and other
Allied troops drove victoriously through the Coun-
try in a few weeks, in September and October, 1918,
writing in large characters the first chapter of the
end of the war. We were all so anxious to know what
had happened to stout-hearted Serbia during the
three years of enemy occupation, and no one as yet
knew much about it.

THE HUMAN COSTS OF THE WAR

At the Serbian Legation in Athens good fortune
threw us in with a Serbian army officer, Capt. Rado-
mir Chaponitch, attached to the diplomatic service,
who had made the retreat through Albania with the
Serbian army in the winter of 1915-16, and had
since been in exile in Rome and Athens. He wished
to return to Belgrade and offered his services as
guide and interpreter through Serbia. He proved
to be not only a most efficient aid in these ways,
but also a well-educated and most agreeable com-
panion. He was of great assistance to us, and when
we parted we all felt that we were leaving a life-
time friend.

With Refugees in an Mgean Storm. — Saloniki was
the point of departure for Serbia as well as for Grecian
Macedonia. On the railway from Athens to Saloniki
a "rapide" express makes the three-hundred-mile
trip every other day at the terrifying speed of thir-
teen miles an hour, when it arrives on time (which
it never does) ; ordinary trains are much slower.
On the best advice, in view of the uncertainties of
the railway, we set out from Athens to Saloniki by
water, taking the best of the coastwise Greek boats,
which was to make the trip in thirty-six hours in
special comfort. This was faster, however, than a
telegraph message, which usually took two days.
At Volo we took on board many refugees returning
to Grecian Macedonia; their huge bundles, their
crates 01 live fowls, and their packages of foodstuffs
for the next forty days were piled high in all the
passageways of the boat. Like other travelers in
the JSgean, we met heavy winds and seas. The
unhappy refugees were drenched and terrified; their

flour became paste, and their chickens became water-

INTRODUCTORY

fowl. Our good ship Peloponnesus was forced to
turn back and to lay in the shelter of the island of
Sciathos a couple of days. The influenza was ex-
tremely bad on the island and we were not allowed
to land. Finally we reached our destination, six
days, instead of thirty-six hours, after leaving the
port of Athens.

Saloniki, Crossroads of the World. — Saloniki had
been headquarters of the Allied armies of the Near
East and also of the American Red Cross Commission
to Serbia since 1916. Although belonging to Greece
since the Treaty of Bucharest in 1913, it is also,
by arrangement with Greece, the ^Egean port for
Serbia. It had now become the crossroads of the
world. Some of our impressions of Saloniki as
jotted down on the spot may help to recall the most
picturesque of the war headquarters of Europe.

Saloniki, which has had a continuous history of two thousand
years, mostly of fighting and war, is an island of dirt, surrounded
by an ocean of army hospitals. It is unlike anything that
ever was before or ever can be again. The native population is
composed entirely of foreigners, chiefly Spanish Jews, Turks,
and Greeks. No two civilians are dressed alike, and each cos-
tume is different from anything any one has ever seen before.
They vary from a few primeval rags to such a brilliant collection
of fiery colors as is only to be found in an old-fashioned flower
garden.

The military element of the population is made up of soldiers
from Great Britain, France, Italy, Serbia, Greece, Russia,
Senegal, Madagascar, Tunis, Morocco, and India. Huge army
hospitals, interminable rows of barracks, wonderfully trim and
orderly-looking, stretch away as far as the eye can see, on the
Macedonian plains. Tent colonies house Bulgarian prisoners.

The anopheles mosquito, fed up for centuries on Turks,
Greeks, and Jews, applied himself diligently to the Allied
armies. It was chiefly the mosquito that built these large

THE HUMAN COSTS OF THE WAR

hospitals. It was the mosquito that filled them with thousands
and thousands of Allied soldiers. It was the mosquito that
sent thousands upon thousands home to France and to
Britain.

Saloniki is dirty, without any sort of qualification; it smells
to heaven. A flood would not clean it, and if it did it would
dirty itself again within twenty-four hours.

Its narrow sidewalks, paved with rounded stones and conceal-
ing deep holes at irregular intervals, make walking a hazardous
occupation. If you step from the sidewalk into the street,
you are in danger of being run down by the innumerable army
automobiles, camions, and trucks rushing in every direction,
and splashing everything and everybody with dust or mud.
Saloniki is always either dusty or muddy.

Some of the buildings date back to the fourth century, and
all of them have that look. A famous Roman structure, quite
intact and looking like the Pantheon, was being overhauled
and its floors excavated by French soldiers. A wonderfully
illuminating plan of the building, showing the date of con-
struction of its various parts, was the work of the Armee Fran-
caise d'Orient, Service Archeologique (French Army of the
Orient, Archeological Service). When before did an army have
an archeological service?

In Saloniki, old men, barefooted, dressed in pieces of burlap
packing — it is mid-December — are beasts of burden. One sees
them stooping over until they could almost walk on all-fours,
carry ing inconceivably heavy loads, over rough sidewalks and
streets. The cargoes of numberless boats that sail the ^Egean
are unloaded by them.

Through Serbia as Freight. — When we reached
Saloniki on December 6th with the plan of going
through Serbia overland to Belgrade on the Danube
the opinion there was unanimous that the trip was
practically impossible. No Americans had made the
trip from Saloniki to Belgrade overland since the
armistice. The local representative of the American
Red Cross who had returned from a trip some dis-
tance into the interior was certain that it could not

INTRODUCTORY

be done and that the only way to reach Belgrade
was either to find some boat going direct to Ragusa
or Fiume or to retrace our steps to Corfu, hoping
to find there such a boat, and thence go in by rail.
We learned later that the boat which had set out
three days before from Saloniki for Fiume was
sixteen days en route. The Serbians themselves had
no transportation and were dependent upon the
Allied armies. The Italian army had just removed
all its transportation facilities. The English were
rapidly moving on farther east. Overland trans-
portation in Serbia was under the control of the
French military authorities. We sought out their
commanding officer. He was most agreeable, but
definitely discouraging. He would not say it was
actually impossible, but it was practically so; their
personnel and the Serbian officials who had returned
to Saloniki, expecting to go up to Belgrade, were being
sent back the other way; no new parties were being
started. The railway terminals were heaped high
with freight. Efforts were being made to move it
into the interior of Serbia, but little could be accom-
plished. The railroad line in the interior of Serbia
was out of commission, and the roads were as bad as
they could possibly be.

But we said we did not wish simply to arrive at
Belgrade. Our object in coming was to see the
interior of Serbia at first hand. Belgrade would be
even more effectively cut off from the interior than
Saloniki. A very laudable object, yes, but just
short of impossible; if we were to atart, we would
have no assurance of when we would arrive, if at all.
The only vehicles making efforts to get through were
heavy trucks for carrying freight; if we insisted on

THE HUMAN COSTS OF THE WAR

trying it, he would certainly place one at our service
as soon as he could; but he had not the least idea
as to how far or how fast it could go. It was neces-
sary to carry gasolene for the trip both ways. The
roads were getting worse every day as winter came
on. He was sorry he had no better transport to
offer the Americans, but the only possibility was to
put our hand-baggage on the floor of one of these
trucks and make ourselves as comfortable as pos-
sible sitting on the baggage.

We decided to try it.

The railway ended at Skoplie (better known by
its Turkish name, Uskub), the metropolis of the
portion of Serbia annexed by the treaty of 1913,
some 190 miles northeast of Saloniki, 140 miles of
which are in Serbian territory. The trip of 360
miles from there to Belgrade was divided into
short sections, over each of which the French or
English military authorities attempted to start ten
or twelve heavy trucks daily. If weather conditions
had been favorable for some time all the trucks in
the convoy might reach their destination by night-
fall. More likely some of them would be left behind,
stalled in the mud or out of repair. Not infre-
quently the whole convoy would spend the night
in the middle of the road, between villages. Numer-
ous trucks, injured beyond repair, lay by the
roadside.

Our mission of eight members, including our
Serbian friend, made the trip in this way in twelve
and a half days. Twice the night was spent in
villages which were not regular stops, and with
difficulty we found shelter on the dirt floor in tiny
rooms in peasants' cottages. Once we were stalled

INTRODUCTORY

after dark, miles from any village, and slept in the
camion, which was just large enough to accom-
modate us all packed as closely together as possible
on the floor. One day the distance covered was less
than six miles. Three and a half days before reach-
ing the Danube we passed at Chupria, where we
crossed the wide Morava on a temporary wooden
bridge, a half-mile procession of mules, heavily
loaded with French military supplies. Within a
half -hour after the arrival of our truck at its destina-
tion the mules arrived. Mules and auto had made
the same average speed for three and a half days.
It should be borne in mind that we were proceeding
along the main line of travel and that in all other
parts of the country conditions were still more
difficult or, so to speak, still more impossible, than
those which we met.

It was following a trail of destruction for three
hundred miles. Windowless buildings and frag-
ments of walls lined the roadsides; skeletons of
horses and oxen were everywhere. But what we
shall remember longest are the groups of refugees
in rags returning southward — Serbians, Albanians,
and Greeks, old men, women of all ages, and children,
all carrying bundles on their backs as they trudged
along the muddy highway or the disrupted railway,
and little groups of convalescent Serbian soldiers
just out of the hospitals, patiently plodding toward
their homes in the north.

Serbians, Near- Americans. — Throughout the trip
the members of the Survey Mission were practi-
cally the guests of the Serbian authorities. At every
stopping-place for the night (except the unexpected
ones) we were received by the prefect or mayor, or

THE HUMAN COSTS OF THE WAR

both, and assigned to selected families for shelter.
We thus saw the interiors of some of the best homes
in Serbia, as well as of some of the poorest, and
enjoyed the hospitality of some of its humblest
peasants and some of its leading citizens.

The thing which impressed me most strongly about
the Serbians was their likeness to Americans. They
look like Americans, talk like Americans, and seem
to think like Americans. An amusing incident
emphasized this American-like atmosphere in a
little village at which we arrived one evening after
dark. A peasant family shared with us their one
room and fire for the evening, and we slept on the
ground in another house, destitute of floor, furniture,
or heat. It was rainy and cold and altogether cheer-
less. The English officer in charge of our transporta-
tion, who was sharing our frugal meal, bethought
himself of a bottle of whisky brought along for a
rainy day, and decided that no day was likely to
be rainier. Those who wished shared the liquid
good cheer; American songs were sung; and in turn
the Serbian family sang their national songs. It was
suggested that our host, an elderly, weather-beaten,
and, to say the least, non-professional-looking person,
might also like a taste of whisky. Our interpreter
was asked to make the offer. After some conversa-
tion he explained that our host was extremely sorry
not to accept the invitation of his guests, especially
so since they were Americans, but that he could not
share the whisky because he was the president of
the Total Abstinence Society of the village.

The peasants and villagers were most simply and
frankly curious about the American visitors. They
studied every detail of our behavioi4, our clothes, and

INTRODUCTORY

our belongings. They sat in our rooms and watched
us make our toilets with undisguised interest in
every article of our equipment. Even though com-
munications were limited to the sign language, it
was impossible to misunderstand their kindly,
though embarrassing, interest and their desire to
learn.

Belgrade, Not Dead, but Convalescent. — As we
neared Semendria, below Belgrade on the Danube,
we met two French officers who inquired our destina-
tion. When we said Semendria, they remarked,
"A dead city," and when we explained that we were
going on to Belgrade, they said, "Still more dead."
We did not find either city dead; rather, just be-
ginning to convalesce after a terrible illness. The
following are some of our notes on Belgrade:

Belgrade, the beautiful capital of Serbia, has a superb location
at the junction of the Save and Danube Rivers. The central
portion of the city lies along a ridge, sloping gradually on
one side toward the Save and on the other toward the Danube.
As you approach the city it is still beautiful in its general as-
pects. As you get into it, go about it, and live in it you begin
to appreciate the extent to which the capital city of Serbia
has been hit by the war.

Before the war there were large factories in the lower dis-
tricts at the foot of the hill on either side. Some of these are
now crumbling heaps of bricks; of others the walls are standing,
but the interiors are partially or completely demolished. Not
one of them is operating. All over the town you find damage
done by shell-fire. Sometimes it is obvious; more often
it is hardly to be seen from the outside. It. is only when you
enter the building or look closely through the windows to dis-
cover why the building is unoccupied that you realize that the
interior is a mangled mass of partitions, doors, windows, floors,
in hopeless confusion. Of the two best hotels in the city, one
is a complete wreck, and the other so badly damaged that no

THE HUMAN COSTS OF THE WAR

effort had been made to repair it. The buildings of the Uni-
versity of Belgrade stand abandoned, and a considerable part
of them is in ruins.

Before the war Belgrade approached 100,000 in population.
When the Austrians took it there were 20,000 inhabitants.
Soon 30,000 came back. At the present time its population
may be 65,000. Some shops are open, but nobody seems to
be buying anything except food. At the moment the food
supply seems to be sufficient, but the prices are so high that
25 per cent, of the population is on the list of applicants for
free distribution. The only autos going about the streets are
those of the military and of a few of the high government
officials. These are used very sparingly, for gasolene is almost
unobtainable.

Also there is a marked crisis in fuel.

Belgrade was a modern city with interior plumbing. The
water-supply comes from wells and is distributed by a pumping-
station. On account of the scarcity of fuel the pump is operated
only a few hours each day, and in some parts of town does not
operate at all for periods of several days. For the same reason
tramcars have been discontinued entirely for several weeks.
Everybody walks. The electric current is turned on late in the
afternoon, and is turned off at ten o'clock.

After arriving at Belgrade we spent a week
checking up the information which we had secured
on the way through Serbia, by interviews with
officials, representatives of the Serbian Red Cross,
physicians, and others, and by looking about the
city. It was not surprising that we found that in
several respects we were better informed as to con-
ditions and needs in the interior of Serbia than
were the officials at Belgrade, many of whom had
only recently returned from exile.

In a Serbian Hospital. — We had hoped to see
Rumania and then Palestine, but our trip had already
occupied more than twice the time allotted. Several
members of the party were ill at Belgrade, which

DR. BOCHKO KONIEVITCH AND THE AUTHOR IN A MILITARY HOSPITAL

IN BELGRADE

ALEXINATZ, 20 December, 1919.
MY DEAR MB. FOLKS:

It was with greatest pleasure I received last week your cordial letter, and
some days later the books from the Health Office — just the thing I needed so
much. Then the S. C. A. A. News are welcome to me, the new and so inexperi-
enced President of the County Society for the care of Needy Children.

Sorry, I was for long time not in Belgrade to meet Mr. Doherty and learn
something from him; but here is much plenty to do, then our railway is still
so bad (the locomotive stops somewhere in open road to take breath and needs
sometimes 30 to 40 hours to make 200 km. to Belgrade) ; and lastly, I am only
three months at home and in good health. For there in Belgrade I contracted
the amoebic dysentery and was very ill, lying in the same bed and room as you.
And the medication was worse than the illness, but not in vain, for now I am
feeling quite well and working with such delightfulness that my patients grow
cured if only seeing my cheerful countenance. No wonder, for I was at last
relieved from the military service, came to my regular occupation, found my
family well, and am at last post tot discrimina rerum after hazards of things
enjoying delights and comfort of my sweet home — well deserved after vicissi-
tudes of the seven years' warfare, 1912-1919.

Perhaps it looks sometimes we Serbians are too much given to this "well-
deserved rest," but if you remember that in these seven years we suffered
much, and still have, plenty of depressant moments; then — pity I can not suf-
ficiently express my thoughts in writing, and we are not together to pursue our
discussions — but to visit America remains only my desire and plream.

Please accept my most cordial regards and thanks for the books you sent
me. Sincerely yours,

DR. BOCHKO KONIEVITCH.

INTRODUCTORY

detained us there ten days after our work was
finished. A week as a patient in the chief military
hospital in Belgrade gave many interesting side-
lights on things Serbian. It gave one a great respect
for the diagnostic ability of the best surviving
Serbian physicians. We sometimes say of a person
with a keen eye that he looks through one. I can
only say of the Serbian physicians that their sensi-
tive finger-tips seem to feel through one. Having
been in contact with many refugees suffering from
strange diseases on the way up, it was disquieting
to have them inquire so persistently and seriously
as to the date of the last successful vaccination, and
it was a relief when, after various guesses, they said,
"A mild case of the 'flu."

With my physician, Dr. Bochko Konievitch, of
Alexsinatz, who had gained a modest knowledge
of English during the war, I soon found many sub-
jects of common interest. Before the war, in his
home town, he was head of the public hospital,
active in public health matters, and had given
courses of lectures on hygiene to the pupils of the
local normal school. His parting request was for
publications in English on public health.1

Trained nursing would have been lacking had
Heaven not sent an English nurse of the Scottish
Women's Hospitals for temporary service in the
hospital at that particular time. The hospital
itself had been stripped of every bit of furniture
and equipment by retreating Austrians only two
months before, but a fair collection had been found

1 These publications were sent after the author's return to America
and he was rewarded by receiving, some weeks later, a very interest-
ing letter from Doctor Konievitch. See illustration facing this page.

THE HUMAN COSTS OF THE WAR

for the private room which I occupied. The poor
Serbian privates in the wards were much less
fortunate.

The only route to Bucharest, the capital of
Rumania, was by rail through Hungary. Under the
most favorable conditions the trip, which should
be made in a day, would now occup»y five days,
traveling in cars without windows and without heat,
in midwinter. It was thought that the train
service would probably last until we reached Bu-
charest, but by that time it would undoubtedly be
suspended for lack of coal. We regretfully gave up
Rumania and Palestine, and accompanied an Eng-
lish admiral and a French general on a special train
to Fiume. Here one of our party, who had been
taken with pneumonia en route, was left in the care
of an American military hospital unit. An English
cruiser carried us to Venice, and we returned to
Rome to write our report on Serbia and to see what
changes had occurred in Italy since early November.

The Home-coming of War's Exiles in Belgium and
France. — Some weeks later we made a trip to
Brussels and various other Belgian cities, and
through the Belgian and French war-zone, to which
large numbers of refugees were already returning.
Our special purpose was to see the conditions of
housing, food, and employment at this very early
stage of reconstruction. Already nearly six months
had passed since the signing of the armistice. About
one-fifth of the refugees had returned and more were
coming every day. If ever courage and a strong
heart were necessary, it was here. These people,
who, three or four years before, or perhaps only a

year before, had been driven from their homes by

MANY HANDS

But even so, it is not light work when you are building shelters in the
ruins of Lens, France.

NOT MUCH LEFT

But even in these ruins this mother and four children, who have been
refugees two years and a half, find a shelter.

INTRODUCTORY

the temporary success of the German army, who had
lived in communities which did not need them,
had no homes for them, and were not very hospitable
toward them, who had lived under the worst con-
ditions of overcrowding and bad sanitation, returned
now to what had been their homes. But if there
were to be homes here, they would have to make
them. The .heaps of sticks, stones, bricks, and
mortar, which showed where buildings had been,
were but symbolic of the utter ruin of the economic,
social, and political life of the devastated area. Not
only buildings, but all the organized activities which
make up civilized life, even the family groups, had
been disrupted. The final chapters of the story of
reconstruction will be written decades hence. We
can here record only its very beginnings.

Limitations of Present Estimates. — The trips out-
lined above furnished the original data for our
reports, but our study has continued up to the
moment of publication. The American Red Cross
sent many workers to various parts of Serbia sub-
sequently to our visit. We have seen their reports
and interviewed some of them upon their return.
We have also seen the later reports of the relief
workers in various parts of Greece. Through the
courtesy of M. Andre Tardieu, High Franco-Ameri-
can Commissioner, two of his staff prepared as full
a memorandum on all the points covered in our
questionnaire as the available data would permit.
There were necessarily many gaps, for France has
been too busy to give much attention to vital
statistics, and when figures are so disturbing as
those of France's population during the war who
can be blamed if there should be some hesitation

THE HUMAN COSTS OF THE WAR

both in compiling them and in letting them be
known? Similar reports were received from the Bel-
gian officials and the Belgian branch of the Amer-
ican Red Cross. No effort has been spared to revise,
verify, and complete our data by all possible means.
We are well aware, however, that it is both incom-
plete and imperfect. It is incomplete in that some
important matters are not touched upon at all;
imperfect in that all present data must be subject
to revision by the more exact statistics which may
become available when the tasks of government
everywhere are less overwhelming and immediate.

No complete measurement of the human disasters
and distress caused by the war is now or ever will
be possible. No country has made a census. No
country has made a complete survey of its devastated
area. Vital statistics are non-existent or far in
arrears. Starting out, however, with a careful re-
view of the pre-war facts in each country as to preva-
lent diseases, death-rates, and birth-rates, we were
able to form a tolerably good opinion of what would
be likely to happen under conditions of food shortage,
invasion, and hardship generally. We sought infor-
mation from every source, always preferring to see
things with our own eyes. At every stopping-place
the various members of the party took up their
special lines of inquiry, on food, health, refugees,
clothing, transportation, etc. We compared notes,
checked up reports from one source with those re-
ceived from another, made special search for facts
which pre-war conditions indicated as important,
and took special pains to get information from those
actually concerned, not simply from the high-up
officials. We knew only too well what a wide gap

INTRODUCTORY

often separates the plan from the execution. If we
began a study of food conditions at the office of the
food administrator by examining his regulations and
statistics, we always ended by finding out what food
was for sale at local stores, and what the poorer peo-
ple were actually living on, and what it had cost
them.

We are satisfied that we gained not only what
might be called a "going" knowledge of the situa-
tion— one sufficient for planning and executing relief
measures, but also one sufficient to show that the
magnitude of the disasters brought upon the peoples
of the Allied countries by the forces let loose at the
end of July, 1914, far exceeds any estimates or de-
scriptions hitherto made; that, though the relief
work of societies and of governments has been on an
unparalleled scale, nevertheless, it has been able to
deal with only a fraction of the need; and that,
besides the remediable distresses of the war, there
are far deeper, more far-reaching, and fundamental
human losses, from which recovery can take place
only after decades, if, in fact, they can ever be made
good.

Disasters Dimly Seen, but Terrifying. — The human
costs of the war are indeed beyond understanding
and measurement. There is no nook or corner of
Europe in which the every-day life of the average
person has not been tremendously changed. No such
breaking up of the complicated fabric of organized
society has ever before occurred, no such wholesale
breaking away from former habits of doing and of
thinking. We have not undertaken to deal with the
biological results of war on the racial stocks of the

various countries, though these may prove to be the
3 23

THE HUMAN COSTS OF THE WAR

most important and permanent results of all. We
have not tried to take into account the effects of the
unprecedented employment of women (except so far
as it may be reflected in disease and death-rates),
nor the great impetus to the extension of the fran-
chise to women, nor the partial or complete suppres-
sion of the sale of liquor, nor, of course, most diffi-
cult of all to estimate, the war's effects on the people
of Russia. For countless errors of omission we
ask indulgence in advance. We have not considered
the political changes produced or hastened, perhaps
unduly hastened, by the war, for who can tell at
this time what they will prove to be? Nor have we
tried to deal with the changed public opinion in all
countries, irrespective of formal political changes.
Every country seems certain to be either more or
less democratic than before, but as yet it is not clear
which it will be. We do not yet know whether com-
pulsory military service is to be restricted or ex-
tended. We know that the world is made ripe for
changes, for big changes, for doing big things, but
we do not yet know in what direction they will lie.
We do not yet know whether justice and right, as
such, speak more, or less, loudly than before. Our
effort, in substance, is to find out what sorts and con-
ditions of men and women are left to take up the
new tasks; whether they are stronger or weaker, more
numerous or fewer, more fit or less so. There is but
one answer — the harm done to the white races by the
war is unprecedented, many-sided, deep-seated, in-
capable of exact measurement, but truly terrifying.
Not an Account of American Red Cross Work. —
The American Red Cross was already at work in all
the countries we visited. We were not charged, ,

INTRODUCTORY

however, with making an examination of what was
being done, but rather with consciously laying aside
any presuppositions, and taking a new measurement
on a uniform basis of the total effects of the war upon
the civilian populations of these countries, of how
far their needs could be remedied by relief, and of
what kinds of relief were most urgently needed.
There will be no effort, therefore, in this volume to
give any adequate statement of the varied and effec-
tive work of the American Red Cross; that story
will be told in detail by those to whom the task has
been assigned. It should be said, however, that
there was no country in which the efforts of America
through the American Red Cross had not softened
the blows inflicted by the war, no country in which
we did not find Americans hard at work with char-
acteristic American resourcefulness. The two Amer-
ican girls at Skoplie, who had gone to do stenography,
and who, not being urgently needed for that, were
busy undressing, washing, and "delousing" refugee
babies, were typical Americans. The volume and
variety of help given by America to these suffering
countries was unprecedented in the world's history.
It secured funds and accomplished results, which
even the most optimistic considered impossible of
attainment. Every American should feel a jus-
tified pride in the accomplishment of his repre-
sentatives.

Perhaps it should be said that it is equally im-
portant that every American should also recognize
that the damage done by the war was so extensive
and so varied that not even the huge sums given to
the American Red Cross could make more than a
faint impression upon it. We could be, as it were,

THE HUMAN COSTS OF THE WAR

a first aid to the injured when war conditions per-
mitted us to be there; we could prevent a few of the
worst things from happening, but, in spite of all
anybody and everybody could do, the great brutal
forces of the war smashed hither and thither, dislo-
cating and disrupting human society, ruining human
lives, and piling up a burden for future generations.
It is necessary to see these facts in perspective in
order to form a just understanding, both of what our
part in this phase of the war has been and of our
further opportunity and duty in the relief of suffering
and the repair of damages which the results of the
war still produced and will produce for years to come.

One of Mr. Hoover's most-quoted remarks was
that the Allies had a common cause, and therefore
must have a common table. He was the great
socialized food controller of the world. There are
still the same reasons and the same need for com-
munity of action in repairing the damages done
by the war and in securing the benefits made pos-
sible by it as there were in winning it.

This volume is an effort to state wholly dispas-
sionately the facts as to the actual effects of this
particular war upon the men, women, and children
of Europe. It is not prompted by any desire to
influence any pending matter or support any policy
or theory. It is in no sense a propaganda for or
against anything. Any one who has been in Europe
during the past two years, and has seen how what
passes for public opinion is cynically manufactured
and systematically inflamed, has learned to hate the
very word propaganda. The obvious facts are,
however, that the war has gone much deeper into
the fabric of human life than one who has lived

INTRODUCTORY

during the war on this side of the Atlantic can easily
understand; that some of its worst effects are only
now beginning to be felt; that they will project
themselves very far into the future; that it is the
most serious strain which western civilization has
ever undergone, and it inevitably raises the question
whether that civilization could stand another such
strain.

If this study presents a terrible picture of the state
of the European peoples at the end of the war, this
picture should surprise no one. It is of the essence
of war to produce such results. That was the inten-
tion of the war-makers. Each side was trying to do
just these things to the other, and both measurably
succeeded. In peace, men are engaged in many and
diverse occupations, but they may all be summed
up as the doing of those things which they believe
will make life healthful, comfortable, and attractive.
In war, men's whole effort is just the opposite; it
is to destroy life and to make life so uncomfortable,
unhealthful, and unendurable that the enemy will
cry out, "Enough." This study, in a sense, shows
only that both sides waged an effective war. That
of the Allies was so effective that the Central Powers
eould not go on. But the Central Powers also
inflicted widespread and terrific suffering and loss.
How widespread and how terrible it is the purpose
of this volume to indicate.

SERBIA: THE COST OF ASPIRATION

God of Justice! Thou who saved us

When in deepest bondage cast,
Hear Thy Serbian children's voices,

Be our help as in the past.
With Thy mighty hand sustain us,

Still our rugged pathway trace;
God, our Hope! protect and cherish

Serbian crown and Serbian race!

(The first verse of the Serbian National Anthem, as translated
by Elizabeth Christich. The music is as inspiring as the words.)

Paralyzed Serbia; the people and the country; a glorious war history;
non-existent transportation; everybody going somewhere; Serbia's
boys die on Albanian mountains; displaced peoples; a whole
country three years under enemy armies; sent into slavery in
enemy territory; from bad to worse after the armistice; short
rations of food, fuel, and clothing; "a new kind of poor."

PARALYZED SERBIA.— The net impressions
of a first-hand survey of Serbia in December,
1918, and January, 1919, can best be summed up in
the expression that it is a paralyzed country. A
description of its activities is essentially a succession
of negatives. Passing through the country, one saw
numbers of people, but nothing seemed to be happen-
ing. This is not to be wondered at, since the enemy
had had full charge of the country for three years and

SERBIA: THE COST OF ASPIRATION

had recently departed, taking with him not only
supplies and materials, but funds and official records.

In Serbia no banks were doing business.

In Serbia no schools were open for the children.

In Serbia the state university was closed and its
buildings partly destroyed.

In Serbia there were practically no doctors, no
Serbian hospitals, and disease was everywhere.

In Serbia the stores had practically nothing to sell
except local food-supplies.

In Serbia some regions would have been starving
except for the American Red Cross aid.

In Serbia nobody had sufficient clothing.

In Serbia practically no fuel was to be had, and
nearly everywhere no means for lighting.

In Serbia no factories were in operation.

In Serbia no mines were operating.

In Serbia there were no means of transportation,
no through railway, no horses, no mules, no automo-
biles, no gasolene, no trucks, and but few oxen.

In Serbia only a very small fraction of the normal
volume of public business was being transacted.

In Serbia there were almost no men between
eighteen and fifty.

In Serbia there were almost no children under the
age of three.

Serbia had to begin afresh and rebuild step by
step the entire organized life of the country. If the
Serbians had shown fewer qualities of courage, re-
sourcefulness, and determination, one might have
felt that they were headed straight for complete dis-
integration and anarchy. That thought never oc-
curred to one who met them at first hand. One
never doubted that little by little the threads would

THE HUMAN COSTS OF THE WAR

be picked up, the wheels begin to move, and Serbia
again be an organized community. Meanwhile she
needs all the help her friends can give her. The
amount of this help will largely determine the
length of her sufferings and the completeness of her
recovery.

The People and the Country. — To visualize the
effects of the war upon Serbia, it is necessary to glance
for a moment at her history and at the general
aspects of her life at the outbreak of the first Balkan
War in 1912.

Most Americans think of Serbia simply as one of
the "turbulent" Balkan States, presumably with an
undeveloped, backward people, with no glory in its
past and little promise in the future. We forget that
for five hundred years, up to 1913, the Turkish rule
was the best possible justification for turbulence. If,
after centuries of freedom, the Mexicans had con-
quered and held in bondage our Southwestern States,
or the Eskimos the New England States, we would
have expected some turbulence, and would have re-
garded it as evidence of progress, not of backward-
ness. The facts are that long before America was
discovered Serbia was an important kingdom with,
for those times, a high degree of civilization. The
culminating point of earlier Serbian history was the
promulgation in 1354 of a code of laws, ordinances,
and customs of the Serbian Empire. Then the Turk
clapped the lid on Serbia and under Turkish rule it
remained an oppressed and depressed people until
the early part of the nineteenth century. The last
stages of the Napoleonic War Serbia considered a
favorable time to make a drive for independence.
This she substantially achieved in 1815. She had had

SERBIA: THE COST OF ASPIRATION

a national independent existence of almost one hun-
dred years at the outbreak of the Balkan War.

By the Balkan wars of 1912 and 1913 Serbia was
largely extended toward the south to include regions
of Macedonia, with the important cities of Monastir
and Skoplie, which had remained under Turkish
rule and had a very mixed population.

The Serbia which had existed as a nation for one
hundred years had a population of a little under
3,000,000 in 1910. The territory which was added
to Serbia in 1913 was without reliable vital statistics.
A census, made soon after by the Serbs, showed a
population of 1,700,000, making a total Serbian
population by 1914 of about 5,000,000.

Belgrade, the metropolis, had a population of
92,000 in 1910; the next largest city, in territory
added in 1877, was Nish, with 30,000. There were
only a few cities with a population of between
10,000 and 20,000. The great bulk of the popula-
tion lived in small villages. In the territory added
in 1913, Monastir, toward the far southwest, had
60,000 inhabitants, Skoplie, 50,000, and Pryzrend,
20,000. About 90 per cent, of the Serbians are
peasants, owning their own small farms. This land
ownership has had a very important influence on the
development of the Serbian character, as well as on
the diffusion of a degree of well-being among the
people.

The soil of Serbia is very fertile and before the
war its peasant farmers easily lived comfortably.
They raised large quantities of corn, wheat, barley,
oats, and rye. In the western part fruit was grown
and plums were exported in large quantities as

prunes or preserves. The farms were rich in live-
si

THE HUMAN COSTS OF THE WAR

stock, especially cattle and hogs, and, in the south,
sheep. Little use had been made either of large
areas of rich forests or of valuable deposits of copper,
silver, and other metals or of widely distributed
coal deposits. It was a peaceful, prosperous, well-
distributed, rural population.

Austria succeeded Turkey in the exploitation of the
Balkans and deliberately hindered the economic
development and kept closed the natural transporta-
tion outlets of Serbia.

From its capital city on the Danube the main
line of the Berlin-Bagdad Railway ran toward the
southeast. At Nish, 210 miles distant, it turned
more directly east to Pirot and on through Bulgaria.
A branch line, which was in fact the main line of
the Serbian Railway, ran from Nish southwest 150
miles to Skoplie, whence, bending again toward
the southeast, it ran 190 miles to Saloniki, the last
50 being in Greece. Saloniki, by arrangement with
the Greek government, was the Serbian outlet to the
^Egean Sea. Serbia thus had a continuous line of
550 miles of through railway from Belgrade to
Saloniki. There were several short branches and a
few short separate lines.

There was also a main highway, paralleling the
railway from Skoplie, through Nish, to Belgrade. It
had been a fair road with a stone base throughout,
but little effort had been made to avoid steep grades.
It had always seemed easier to go over a hill than
to make a cutting through it.

In the Serbia which had existed for a hundred
years there was a fairly complete system of vital
statistics, the bookkeeping of human resources.
It was, in fact, better than that of the United States,

SERBIA: THE COST OP ASPIRATION

in that it covered the entire country, while 20 per
cent, of the territory of the United States is in this
respect still in the Turkish age. The Serbians are a
religious people, adhering to the Greek Orthodox
Church, and births and deaths were conscientiously
reported to the priests and through them to the
public authorities, though the description of the
causes of death doubtless contained many inac-
curacies. The statistics show that the birth-rate
and the death-rate were each about 50 per cent,
higher than in the so-called "registration area" of the
United States — that is, those parts of our country
in which reasonably complete records of births and
deaths are kept. The birth-rate was 38 per 1,000
of population in Serbia in 1912 and the death-rate
21. This left a margin of 17 per 1,000 as an annual
addition to the population. The actual number of
births in 1912 in excess of deaths was just under
51,000. The conditions in the newly acquired ter-
ritory were probably not very different in these
respects from those in old Serbia, and the normal
annual increase in the population was about 85,000.
Such was the country which in alliance with
Greece and Bulgaria entered upon the first Balkan
War early in October, 1912. This war was short and
astonishingly successful. Turkey was brought to
her knees before the middle of November. The
European Powers intervened and refused to Serbia
the necessary outlet to the Adriatic Sea. Serbia
in turn asked Bulgaria to readjust th^ir earlier under-
standing as to the new territory. Bulgaria declined,
and thus arose the second Balkan War — Serbia and
Greece, soon aided by Rumania, against Bulgaria.
This also was a short war, lasting only from June 29th

THE HUMAN COSTS OF THE WAR

to July 31st. Serbia extended her boundaries south-
ward, taking in territory which would have gone to
Bulgaria under the earlier understanding. This
territory was very far from being homogeneous. It
had been Serbian long ago and still included many
Serbs, but also many Albanians, Bulgarians, Turks,
and Greeks. The Serbian army remained mobilized
for six months, until early 1914, when conditions
seemed stable and the soldiers were returned to their
homes.

Serbia had long aspired for union with those on
the west and the north related to her by ties of
language, of race, and, in most cases, of religion.
The people of Bosnia and Herzegovina, forcibly
annexed by Austria, also aspired to rejoin their
Serbian kinsmen. Although this sentiment found
expression in various mild forms of what might be
termed "propaganda," it was almost as great a sur-
prise to the Serbs as it was to the world at large
when Austria, on July 23d, handed its fateful
ultimatum to Serbia, and the Great War began.

A Glorious War History. — The general outline of
Serbia's fortunes in the war may be stated in very
few words. On August 12th an invasion occurred
on the northwestern frontier from Bosnia, but twelve
days later the invading army had been driven back
across the frontier. Early in November a very much
more serious invasion was begun. The Serbians re-
tired step by step. Belgrade was evacuated. On
December 3d the Serbians, having received ammuni-
tion, began a heavy counter-attack. The Austrians
were again driven back; by the 12th of December
they were at Belgrade. On the morning of the 15th
the Serbian artillery destroyed the pontoon bridge,

SERBIA: THE COST OF ASPIRATION

the 40,000 Austrians remaining in Belgrade sur-
rendered, and Serbia was once more free. The losses
had been heavy and the army which had been
350,000 was now 160,000. From the middle of
December, 1914, until October, 1915, Serbia was not
molested by the Austrians, but suffered heavily from
typhus.

In October, 1915, German gift for organization
put a backbone into the Austrian army and the
great invasion of Serbia was begun. The Serbian
army was now about 200,000. Belgrade was taken
in October; simultaneously the Bulgarians attacked
in the south, cutting the railway between Nish and
Skoplie. The Allies tried to advance from Saloniki,
but were not in sufficient numbers to relieve the
Serbian army. It was driven toward the south and
toward the west. There were only two alternatives:
surrender or retreat over the Albanian mountains to
the Adriatic. Surrender was not considered. With-
out hesitation the Serbian army destroyed its trans-
portation facilities and all stores which it could not
carry and started for the narrow passes over the
mountains, accompanied by the officials of the gov-
ernment and their families. Even when they
reached Scutari near the coast in north Albania they
were unable to secure food and were obliged again
to cross mountains southward to Durazzo and
Valona on the Albanian coast, whence about 105,000
were taken by the Allied war-ships farther south to
Corfu in Greece.

The country was overrun by Austrians and Ger-
mans in the north and west and by the Bulgarians
in the east and south. Finally the day of reckoning
came. In September, 1918, the Serbian army, re-

THE HUMAN COSTS OF THE WAR

organized and transported to Saloniki, and its allies,
began their advance. The Serbs attacked and capt-
ured positions which were considered by their allies
to be impregnable. The enemy was driven from all
of southern Serbia and on September 30th Bulgaria
asked for an armistice. The Serbs entered Nish
after severe fighting on October 2d, drove the
Austrians and Germans rapidly to the north, and,
before the armistice with Germany on November
11, 1918, had again cleared their territory of the
enemy and had advanced into the portions of
Austria-Hungary occupied by their kinsmen.

A month after the signing of the armistice, and
three months after the beginning of the Allied offen-
sive on the Saloniki front, the American Red Cross
Survey Mission left Saloniki to see for itself the
condition in which Serbia and its people had been
left after the ravages of two Balkan wars, the typhus
epidemic in 1914, two unsuccessful invasions by the
Austrians in the last half of 1914, a complete occu-
pation in December, 1915, three and a half years of
enemy domination, and the final expulsion of the
enemy in September and October, 1918.

Non-existent Transportation. — The first question
which any one wishing to help Serbia in any way
is obliged to consider is transportation. No matter
how much food, clothing, medicine, or equipment, nor
how many doctors, nurses, or relief agents there
might be in Saloniki or in Belgrade, they could be
of no help to the people of Serbia unless they could
be distributed. Some of our experiences in getting
from Saloniki to Belgrade were narrated in the in-
troduction, but further particulars are needed to
afford an understanding of the harassing difficulties

SERBIA: THE COST OF ASPIRATION

which the absence of transportation placed, and still
places, in the way of Serbia's every attempt to get
onto her feet.

Trains were running as far as Skoplie. Our train
was, in fact, one of the first to make the trip through
from Saloniki. A temporary bridge over the Vardar
River at Strumitza had been completed only the
day before. We left Saloniki in a hospital train
without heat or light at eleven o'clock at night and
did not reach Skoplie until eight o'clock the follow-
ing evening, the trip of 190 miles having occupied
twenty-one hours, an average of nine miles an hour.
It did not altogether surprise us when, asking some
families of refugees in a box-car on a siding at
Strumitza how far away their starting-point was,
we were told, "Two days by horse and cart, or three
days by train."

During the first part of our journey in a freight-
truck from Skoplie to Nish our chief difficulty was the
steep grades. Farther north, when we neared the
Danube, there were few grades, but the mud was
deeper and more sticky than before, although we
had had continuously good weather for a fortnight.
When the road was not a river of mud, or a steep
grade, or both, it consisted of a succession of holes
which had been worn deeper and deeper by the iron-
tired German trucks used in the later stages of the
war. At numerous points groups of Bulgarian
prisoners were supposed to be improving the road,
but none of those whom we saw were doing anything
which, by any stretch of the imagination, could be
called hard work. In fact, having seen thousands of
prisoners, Bulgarians, Austrians, and Germans, sup-
posedly at work, in Greece, Serbia, Italy, France, and

THE HUMAN COSTS OF THE WAR

Belgium, I have yet to see a group of prisoners who
were really working. I have never been able to
understand this phase of leniency, in view of the
great demand for labor everywhere. These groups
of prisoners helped to push the truck through the
mud or up the grades. Sometimes the efforts of the
heavy engine of the truck, of three ox-teams, and of
as many men as could find places to push were fruit-
less. During the whole trip we met very few con-
veyances of any kind.

For nearly the entire distance the main railway
ran alongside of the road. As the enemy retreated
he put the railway out of commission by blowing
up all the bridges, large and small, which were
numbered by the hundreds. There were only a few
tunnels, but these also were destroyed. The road-
bed itself remained intact, though we were told that
near Belgrade it was blown up every thousand meters.
In the south the bridges were being temporarily re-
paired, but it was slow work, owing to lack of men
and of materials. A fortnight after we passed, trains
were running to the first station beyond Skoplie,
Kumanovo. By February it had been put in order
as far as Vranja, and in April it had been opened to
Nish. There still remained a long stretch north-
west from Nish toward Belgrade, which could not
be operated for at least several months. The main
line of the Berlin-Bagdad Railway from Nish east-
ward to Pirot and on to the Bulgarian border was
similarly disrupted.

Not only was the railway destroyed and the main
highway in an almost impassable condition, but the
former means of transportation over the highway
had almost disappeared. We saw practically no

A BAD SPOT ON SERBIA'S "Gooo ROAD"

The main highway of Serbia from north to south, and its only means

transport.

WALKING HOME

In Serbia, in December, 1918, groups of ragged, convalescent soldiers were
to be seen along the main highway trudging bravely along.

SERBIA: THE COST OF ASPIRATION

horses or mules in Serbia except mules in the French
military service. Skeletons of horses and oxen were
scattered by the roadside all the 500 miles through
Serbia. As we approached the north they were more
abundant, and on some of them the vultures had not
yet finished their work. Many of the oxen that
were carrying transport for the Serbian army on its
last triumphant march through the country had
succumbed to fatigue and lack of food. There are
still some oxen in Serbia. A little below Grdjlitza
we saw a procession of ox-carts stretching along the
road for nearly half a mile, carrying sick and wounded
soldiers. The number of oxen, however, is only a
fraction of what is needed for the agriculture and
transport of the country.

Automobiles and trucks were non-existent except
for military purposes or for very high civilian of-
ficials. Even in Belgrade high officials of the gov-
ernment had but few cars and used them very spar-
ingly because of the great scarcity of gasolene.

There is nothing inherently difficult in the trans-
portation problem in Serbia. There is no reason
why express trains should not run from Saloniki to
Belgrade in ten hours. The topography of the
country presents no difficulties in the way of a system
of good roads. It would be easier to build a first-
class highway from Skoplie to Belgrade than from
New York City to Rochester. The fertility of the
farms, the pine forests, and the rich deposits of
metals all suggest that, under conditions of peace
and with such a populatidn as it would have had at-
tained by this time except for the war, Serbia might
readily be one of the richest and most attractive
countries of its size in the world. Now, it is barely

4 39

THE HUMAN COSTS OF THE WAR

possible to distribute food sufficient to prevent
starvation in some regions; its women walk barefoot
over miles of country roads to market in winter; such
stocks of clothing and shoes as can be sent to its
larger cities cannot be distributed to its rural dis-
tricts and the few doctors and nurses can reach
only a small fraction of those needing their care.
The whole country is, as it were, bound hand and
foot in a rigid and helpless position by the paralysis
of transportation.

Everybody Going Somewhere. — Passing through
Serbia at the close of the war, one was puzzled by the
extraordinary number of the groups of men, women,
and children going from one place to another.
Everybody everywhere seemed to be going some-
where. They all were going home, yet the currents
were running crisscross and in every direction.
Among them were many Greeks and Albanians.
They were coming back from the north, where they
had been sent by the enemy. Serbians from the
south, who had been sent north, were also slowly
finding their way back. Serbians from the north,
who had shared the fortunes of the army and had
been exiled as far away as Italy, Corsica, continental
France, or the northern shores of Africa, had found
their way back to Saloniki, hoping to proceed from
there to Belgrade, and had been stranded at various
stations along the line as transportation had given
out. To untangle the story of the origins of these
confusing currents and to reconstruct the story of
Serbia's civil population as it was thrust hither and
thither by the changing fortunes of war seemed an
almost impossible task. Little by little, however,
the general features became discernible.

HARD LUCK

This family of refugees were driven from their home in El Basan in Albania.
They were the most distressed of all refugees seen in Serbia.

THE OVERFLOW

Several hundred refugees at Grdjlitza, Serbia, unable to find shelter, camped

in the open.

SERBIA: THE COST OF ASPIRATION

We must distinguish clearly between the civilians
and the soldiers. The age of compulsory military
service at the outbreak of the war was twenty to
forty-five inclusive. Later it included the age of
fifty. The mobilization at the opening of the Great
War was very inclusive. Only government officials
in posts of urgent necessity were exempt. Those
found obviously unfit by a hasty medical examina-
tion were assigned to military service in the rear.
None were released for agricultural work. The
civil population, therefore, included males under
twenty and over fifty, the obviously medically unfit
between those ages, and girls and women of all ages.

Serbian Boys Die on Albanian Mountains. — The
first large group of civilians whose fate we must
follow is the young men of fourteen to eighteen and
many younger boys. The Serbians, desiring them as
soldiers as they became eligible, and not wishing
them to be used by the enemy, hastily collected them
into groups which retreated with the Serbian army.
With it they attempted the passage over the Al-
banian mountains, along the Adriatic coast, and to
Corfu. They became separated from the army and
from one another. Arrangements for feeding them
were almost non-existent. They were two weeks
on the way, with only such food as they carried when
they left. They suffered indescribably from hunger
and cold. It is estimated that 35,000 started over
the mountains, that only 14,000 actually crossed the
Albanian frontier, that 10,000 reached the seacoast,
that 1,000 died on the ships en route to Corfu,
and 100 died per day for a time after their arrival,
and that only 5,000 to 6,000 of the original 35,000
survived the hardships of the entire trip, to find their

THE HUMAN COSTS OF THE WAR

way later to Corsica or to France as refugees. This
almost complete loss of its younger male population
is perhaps the saddest in the many sad pages in the
war history of Serbia.

Displaced Peoples. — Besides the young men, a
number of other civilians, chiefly officials' families,
accompanied the Serbian army in its retreat. They
fared considerably better as to food and care than
either the Serbian army or the young men. There
were three routes : the first lay through southwestern
Macedonia into Greece or to the extreme southwest
coast of Albania through El Basan. A number of
civilians escaped by this route. The second was by
almost impassable roads, country paths, and trails
northwest from Pryzrend over mountains 5,500 to
6,000 feet high to Ipek and to Podgoritza in Mon-
tenegro and thence to Scutari in Albania. The
group which took this route included the King of
Serbia and the Ministers of the Allied Powers. The
third route went more directly westward from
Pryzrend to Scutari, shorter than the preceding one,
but even more difficult and dangerous. Many
Serbian officials took this route. The total num-
ber of civilians who accompanied the Serbian army
in its exile was much smaller than has been
often supposed. It was probably much less than
100,000.

Some 20,000 Serbian refugees, sick soldiers, and
returned., prisoners met a hearty welcome in France.
The refugees received the same allowance as the
French refugees ; the best shelter available was given
to the sick and wounded soldiers; the schools and
universities were opened to the young men. France,
with its own overwhelming refugee problem, could

Aft

SERBIA: THE COST OF ASPIRATION

provide only the barest necessities. The American
Red Cross found no more appealing groups in France
than these Serbian refugees. Tuberculosis was as-
tonishingly prevalent, and nearly all showed plainly
the evidence of extreme hardships.

When the enemy entered Belgrade late in 1915
there was a tremendous temporary exodus from the
city and its population was reduced from 100,000 to
20,000, but in a very short time, the enemy not only
remaining in this region, but having taken possession
of the entire country, many returned, and the census
increased to 50,000. The 30,000 of Nish dwindled
to 18,000 when the enemy took possession. Numer-
ous other temporary migrations occurred, but, in the
main, people did not go far from their homes. This
was not the case, however, along the southern border
where the battle-line was formed at the close of
1915. From the immediate rear the civilians were
evacuated to north Serbia or to Bulgaria. As in
France, this line swung back and forth. A serious
effort on the part of the Allies to advance in the late
summer of 1916 resulted in the recapture of Monastir,
but the enemy was not driven far and the city re-
mained within range of his guns. It was bombarded
from time to time, sometimes with gas-shells, until
the final Allied advance, and its population fell from
60,000 to 15,000.

After taking into account all of the exiles, driven
from their homes into Greece, Italy, or Corsica, to the
northern shores of Africa, or to far-away France, or
deported into Bulgaria, the great bulk of the civil
population remained in Serbia during more than
three and one-half years of its occupation. The
vital question of the total effect of the war on Serbia,

THE HUMAN COSTS OF THE WAR

therefore, turns largely on what happened to these
four and a half million people.

A Whole Country Three Years Under Enemy
Armies. — From December, 1915, until September
and October, 1918, except for a small corner, Serbia
was practically annexed to Austria and Bulgaria.
What were the conditions of life among the Serbians
during this period? It must be borne in mind that
the blockade of the Central Powers was becoming
more and more effective, and that it finally broke
the backbone of the German civil population and
helped to end the war. Serbia, being behind enemy
lines, suffered from all of the effects of the blockade.
It was even more serious than this, for when the
Austrians and the Bulgarians began to feel the pinch
of hunger, finding food in Serbia and other crops
being produced, they took •possession of much of
the food and sent quantities home regularly to their
families. The officers naturally took the lion's share,
but even the private soldier was allowed to send a
package home every week. Effective means were
taken to seize the Serbian food. The peasants living
near the larger cities, who had been accustomed to
bring live-stock, grain, and vegetables to the city
markets daily, were forbidden to do so, except on one
or two -specified days each week. The quantity they
were allowed to take for sale was rigidly restricted.
Supplies of raw materials for clothing and of im-
ported food were soon entirely exhausted. As in the
Central Empires, cotton became unobtainable. A
small spool of thread cost the equivalent of five
dollars in Serbia, but it was more usually sold by the
yard. Coffee, rice, and all other "dry groceries"
(or, as they are ordinarily called in Serbia, "colo-

SERBIA: THE COST OF ASPIRATION

nials") were not to be had at any price. Sheets
and bedding, like clothing, were seized by the enemy
to replenish his vanishing stocks. Coal, kerosene,
and candles were practically unobtainable. The
lack of food was very serious and undoubtedly
caused the prevalence of disease referred to later.
In the cities a ration was established. In Nish it
was stated that 120 grams of flour per capita per
day were allowed, about one-third of an adequate
ration. The flour was made chiefly, it was said, of
chestnuts with but little wheat. In Belgrade the
ration was from 150 to 200 grams. Meat of poor
quality could be bought twice a week, 180 grams for
adults and 90 for children. All this, together with
the inevitable mental depression, made life in Serbia
very bare and hard.

We were accompanied on our arrival in Belgrade
and in some of our visits about the city by our
Serbian friend, Captain Chaponitch, who had come
with us from Athens. This was his first visit to
Belgrade since he was driven out with the army
in the fall of 1915. Repeatedly, after he had
stopped to greet affectionately and embrace former
friends who had been in the city during the occupa-
tion, he remarked as he joined us: "How old they
look! They seem to have aged at least ten years
during the past three."

But hardships other than deprivations were to be
the lot of the Serbs, especially in the region occupied
by the Bulgarians. As noted in an earlier chapter,
the portion of Macedonia which was awarded to
Serbia at the end of the second Balkan War was by
no means wholly Serbian, but included many Turks,
Bulgarians, and Greeks. In fact, by the original

THE HUMAN COSTS OF THE WAR

agreement between Bulgaria and Serbia, a large part
of this territory was to have been recognized as
Bulgarian if Serbia had -secured its outlet to the
Adriatic. Now Bulgaria temporarily came into
possession of what she regarded as rightfully hers.
She wished to prove that this was really Bulgarian
territory, and to extinguish once and for all the
Serbian nationalistic aspirations which had been
rapidly developing in this region under Serbian rule.
To accomplish this purpose she did some very cruel
and some very ridiculous things. The cruelties in-
volved the use of a super-German frightfulness to
crush out the Serbian spirit and the deportation of
large numbers of Serbs into Bulgaria.

We found it difficult in all except the northern
part of Serbia to secure the information we were
seeking as to present conditions because of the fact
that every Serbian was bursting with indignation
at the atrocities of the Bulgarians, new facts about
which were coming to light every day, and insisted
upon telling us all the details. Not to listen would
have seemed hardness of heart.

At Leskovatz, having interviewed various groups
of refugees all the forenoon, we went into the out-
skirts of the town in the afternoon with a leading
citizen whose hospitality we were enjoying and who
had been the owner before the war of one of the
few large factories in Serbia. It had made woolen
and linen cloths. The factory was as thoroughly
out of commission as the railway. The complicated
machines imported before the war from Germany had
apparently been put up at auction and sold to
Bulgarian citizens. Many of them had been re-
moved, and many of those remaining were marked

SERBIA: THE COST OF ASPIRATION

with the names of the successful bidders at the
auction sale. There had not been opportunity for
their removal, but the Bulgarians had taken pains
to see that they were rendered useless by carrying
away or destroying the more delicate mechanisms.
All leather belts had been taken away and leather-
covered rollers had been stripped of their covering.
It would take three years to restore the factory to
operating condition if funds were available, and the
owner estimated his losses at $13,000,000. As we
were walking back to town, reflecting upon the
scenes of privation, sickness, and hardship of the
morning, and on the afternoon view of the ruins of
what had been the chief industry of the town, we
noticed on a hillside, at some distance, an attractive
building and inquired what it was. Our host told
us that it was the finest church in the vicinity and
added, parenthetically, as if it were a matter of no
special significance, that there was a well under the
church and that they had found in it a few days
before the bodies of some twenty important people,
who had been thrown into the well with hands and
legs bound. In Nish, the Nisus of the Romans,
there is a famous fortress surrounded by a moat,
said to have been built by the Romans and having
that appearance. In this fortress, a huge stone
affair inclosing several acres, are several dungeons,
dark, gloomy, and unventilated, such as the Romans
of that day were wont to build. We were told that
a large number of the citizens of Nish and the sur-
rounding towns were thrown into these dungeons.
The gallows on which fifty citizens of Nish and
several thousand from the region were hung was

still standing in the inclosure. We were taken tp

THE HUMAN COSTS OF THE WAR

the corner of the wall in the moat where each evening
for a fortnight in March, 1917, thirty unfortunate
Serbians taken from the dungeons faced a firing-
squad, and the wall certainly showed evidences of
many volleys. The victims, we were told, were
buried in a shallow trench directly underneath. So
anxious, in fact, were our guides to convince us
that they called on several soldiers to excavate the
trench. Protests that we were already convinced
were of no avail; not until several pieces of clothing
had been turned up and we turned away were they
willing to discontinue their quest. Our concern was
with the living, not the dead. An international
Allied commission was investigating the subject.
Late in July a report signed by British, French, and
Serbian representatives was published, not only con-
firming these charges, but containing many more
of an unprintable character. They will be a part
of the record of a great war in which atrocities became
commonplace.

We remarked a moment ago that Bulgaria did
some very cruel and some very ridiculous things in
her efforts to exterminate the national spirit in
Macedonian Serbia. We have noted some of the
cruelties. There were ridiculous things, too. In a
printed notice posted in Uskub by the Bulgarian
prefect on December 9, 1915, occurred the following:

(1) Serbians who remain in Skoplie are forbidden to walk in groups.
They must not leave their houses except in special instances.

(2) The Serbian citizens who speak to Bulgarians must speak
in the Bulgarian language, and it must be good Bulgarian;
otherwise the matters might not be attended to. It is for-
bidden to speak the Serbian language in the streets, and it
is also forbidden to listen to it.

SERBIA: THE COST OP ASPIRATION

The tombstones at Nish and elsewhere of Serbian
officers who were killed in the second Balkan War
frequently recorded the fact that the officers had
fallen in battle with the Bulgarian enemy. The
Bulgarians actually took time to chisel away all parts
of the inscriptions which referred in any way to the
Bulgarians as enemies. Also, it is the custom in
Serbia to place a small likeness of the deceased in a
niche of the tombstone hollowed out so as to protect
the picture from the weather. The pictures of these
officers naturally showed them in the uniforms of
Serbian army officers. These affronts to the na-
tional sentiments of Bulgaria were also carefully
removed.

Sent into Slavery in Enemy Territory. — The process
of de-Serbianizing included also sending the popula-
tion of entire villages, old men, women, boys, and
children, far from their homes into Bulgaria where
their conditions of life were extremely severe unless
they had sufficient money to buy special favors.
Many of them lived in the open or with rudimentary
shelter. Labor was severe; food scarce; clothing,
what they had taken with them; medical care, non-
existent; and, according to the universal testimony
of those who returned, the utmost severity and
cruelty was constantly practised by those in charge.
Bulgarians naturally made a special point of de-
porting those who would be leaders in perpetuating
Serbian nationalist sentiment, such as school-
teachers, judges, and priests. The Serbian Church
is a branch of the Orthodox Greek Church, but it is
practically independent and autonomous so far as
other ecclesiastical authorities are concerned. It is,
however, neither independent nor autonomous so

THE HUMAN COSTS OF THE WAR

far as the Serbian state is concerned. In fact, one
is almost tempted to say that in all these countries
the church has the aspect of being a camouflaged
branch of the government, charged especially with
the task of stimulating national spirit.

No one in Serbia seemed able to give anything like
a definite and credible statement as to the number
of Serbs who had been deported into Bulgaria.
From the city of Nish and its immediate vicinity
the authorities state that 5,000 were deported into
Bulgaria, about half of whom had returned at the
end of December. One official estimate of the
number of war prisoners and civilians interned in
Bulgaria is 80,000, mostly civilians. Another es-
timate of the number of civilians deported was
50,000. Nor was there any definite knowledge of
the number who had returned. At Kumanovo
37 returning prisoners passed through in the fore-
noon of December 19th, the day of our visit, and
250 the day before. They had been coming through
for two months in very irregular numbers, some-
times as many as 300 per day. They poured through
the passes from Bulgaria into Serbia and down its
main highway, walking on foot on the road-bed of
the ruined railway or along the muddy highway.
An American Red Cross relief worker states that
40,000 passed through Pirot and that 10,000 others
who came from other parts of Serbia settled near
Pirot, being unable to go farther or learning that
their former homes had been destroyed. We saw
many of them clad in rags infested with vermin,
anrd the women especially hungry and emaciated.
It must be said, however, that most of the children
were in a less serious condition than would have been

SERBIA: THE COST OF ASPIRATION

expected. We were told that many had not sur-
vived, and this seemed plausible. Children, how-
ever, are among the toughest of young animals, and
will survive ar>d quickly recover from conditions
apparently impossibly bad. It seems likely that in
all some 70,000 Serbians may have been deported
and that 80 per cent, of them returned.

It also developed that many of those who were
thought at first to have been deported into Bulgaria
would never return and, in fact, had never reached
Bulgaria. Fresh evidence was coming to light from
day to day, at the time of our visit, of groups of
leading citizens who had been started toward Bul-
garia and, upon reaching the mountains along the
frontier, had been massacred and buried in large
numbers in shallow trenches.

A good many Serbians were deported also into
Austria. The Austrians had occupied a relatively
small part of Serbia, roughly speaking, that part of
northern Serbia which is west of the Morava River.
The Austrians apparently deported chiefly those
whom they suspected of active aid to the Serbian
cause during the war. The former schoolmaster was
among those deported from Semendria into Austria.
He said that between 200 and 300 had been deported,
of whom 50 to 60 died. Again it was impossible to
secure anything like a convincing estimate of num-
bers. The total number of Serbian prisoners of war
and civilians interned in Austria and Germany was
officially estimated at 160,000, a very great majority
of whom were soldiers. One authority, on whose
judgments we were disposed to rely, thought that
perhaps not more than 10,000 civilians were deported
to Austria. Their condition was quite serious as to

THE HUMAN COSTS OF THE WAR

lack of food and shelter, but fewer complaints were
heard of brutality and cruelty.

From Bad to Worse After the Armistice: Short
Rations of Food, Fuel, and Clothing. — Our Survey
Mission were practically guests of the Serbian gov-
ernment. We were escorted through Serbia by a
thoroughly competent and helpful Serbian official.
On arrival at a town we were taken first to the
office of the prefect, who is the chief executive officer
and highest representative of the central government
in the department.

We were likely to be taken to a forlorn-looking
building, some portions being unusable and nearly
every room showing evidences of shells or bombs.
Most of the rooms were apt to be quite bare. The
furniture of the prefect's office might include some
sort of a table or occasionally a dilapidated desk, a
few chairs (no two alike), and a bench or two. The
prefect might have one or two aids and a few con-
valescent soldiers to do errands. The prefects had
returned within the preceding two months from
their years of exile in Greece or France. They came
back to empty buildings, destitute of furniture and
records. Even tax records had disappeared. The
cities had no budgets, no resources, no credits.
The prefect, empty-handed and barehanded, had
to set up a new administration. He represented the
state. He had hardly collected a few odd pieces of
furniture and called upon a relative to act as as-
sistant before lines of people began to form before
the building to ask for aid and reparation. If he
were able to get in touch with the capital at Bel-
grade by telegraph, or at intervals by courier, he
was not much better off. The central authorities

SERBIA: THE COST OF ASPIRATION

likewise were rebuilding a government. One thing
they had done — they had formed, with other Serbs,
the new Kingdom of the Serbs, Croats, and Slovenes.
New departments had been created — on paper at
least. The problems that seemed most pressing to
these high officials were those to be taken up shortly
at the Peace Congress. They were thinking in
terms of boundaries and reparation. They were far
too busy to give much thought to the prefects in the
different parts of Serbia. These could get along in
some way for a time. They must get along as best
they could.

One thing, however, stood out clearly everywhere.
However hard conditions had been during the oc-
cupation, they became much worse immediately
thereafter, because the retreating enemy took with
him all he could carry away and destroyed what he
could not take. Bulgarians, Austrians, and Ger-
mans alike pillaged the country. Train-load after
train-load of household furniture, hospital supplies,
bedding, clothing, linens, tools, metals, food-sup-
plies, were sent into Bulgaria, Austria, and Germany,
leaving behind a country as nearly stripped as can
be imagined. Great stocks of enemy military sup-
plies, which could not be removed, were burned.
Those who had been leading citizens before the war,
people of means or of professional position, who had
been too old for military service, were left with only
the clothes they were wearing and with only such
household goods as were too old or too worn to seem
worth removing. The enemy also drove away large
quantities of live stock, especially cattle and hogs.
Grain was also sent away, though they allowed the
peasants to retain a small per capita allowance.

THE HUMAN COSTS OF THE WAR

However, the Serbian peasants had learned some-
thing in the seven long years since the beginning of
the Balkan wars, and it had become a custom to
conceal food-supplies by burying them. We were
told everywhere that they Lad succeeded in secreting,
usually in the ground, considerable amounts of grain.
Our personal experiences threw little light on the
subject of food, for we were guests of the government
and undoubtedly had the best there was. We took
a good supply of food with us, but, except when we
stopped in some small village, we did not need to
draw on it, and hospitality prevented our doing so.
We did not have any of the imported kinds of food.
We had plenty of meat and bread, though in one
town there was only corn bread. Before the war
Serbia produced not only all its chief articles of
food, but also a good deal for export. In this re-
spect it was better able to meet war than countries
that were largely industrial. On the other hand,
during the war it could not be reached by friendly
allies with such life-saving help as that of the Com-
mission for the Relief of Belgium. It was an oc-
cupation ex-Hoover. Considerable grain was pro-
duced in Serbia even during the occupation. Serbia,
as a whole, was not starving for lack of food-sup-
plies in January, 1919, but there were regions which
would have been starving had it not been for the
American Red Cross and the Serbian government.
All along the southern boundary where the fighting-
line ran and where many troops were quartered not
much food is produced even in peace, and the armies
had consumed what little there was. In Monastir,
and especially in the regions west of there, to which
food could be sent only by ox-carts, the population

PLOWING IN SERBIA

Agriculture in Serbia, if not modern, is not primitive. The scrawny cows

evidently resented the double job of giving milk and plowing ground.

THE RED CROSS HELPS

Capt. G. H. Edwards and his chief assistant, a citizen of Serbian birth,
directing the unloading of supplies in Belgrade.

SERBIA: THE COST OF ASPIRATION

was on the very edge of starvation a few weeks after
the armistice. Among the reports which came to
us at that time from competent Red Cross workers
who had come to Saloniki to report and to secure
further supplies were such as the following:

In Monectir, now a city of 25,000 instead of its former 60,000,
everybody needs clothing. The Serbian authorities are giving
a quarter of a pound of bread per day to 20,000 of the 25,000
inhabitants. The American Red Cross is also giving out a little
bread, as well as rice and lard, to 5,500 people. In a few days
it will begin also to distribute beans. There are two doctors
for this population of twenty-five thousand.

From Monastir to Lake Ochrida, a distance of fifty miles,
there are 50,000 people and no physician. The "flu" is still
very bad. The authorities are not distributing food in that
region because there is no way of getting it there. No crop was
raised this year because the people had no seed, and the farming
implements had been taken away by the Bulgarians, who also
drove away the sheep and cattle. Ten thousand people here
are in immediate need of food and clothing. In another dis-
trict not far away, including forty -seven scattered villages with
23,000 inhabitants, 6,000 are in immediate need of food. There
are neither physicians nor medicines.

Circumstantial accounts were also received of
alarming shortages of food- supplies in the extreme
northeast. The only possibility of relief was to send
supplies partly by truck and partly by rail by a
roundabout route through eastern Macedonia and
Bulgaria by way of Dedeagatch and Sofia. A train-
load of supplies sent by this route was distributed
in Pirot and vicinity, having traveled some 900
miles to reach a point 280 miles distant. At this
time and place bread was 60 cents per loaf; sugar,
$5 a pound; kerosene, $6 a quart. Women's shoes
were $60 a pair and men's, $70. Underwear was

5 55

THE HUMAN COSTS OF THE WAR

a suit. Milk, coffee, and soap could not be
had. A few days after the arrival of relief supplies
prices fell 50 per cent.

In most parts of Serbia there was in December,
1919, enough food to meet immediate requirements.
The distribution of the food-supply, however, pre-
sented very grave and entirely unsolved difficulties.
The Serbian government was too recently returned
from exile and too busy with foreign questions to
deal effectively with the question. The price of
bread all the way up through Serbia ranged from
2 to 3 francs per 800 grams, that is to say, from
20 to 30 cents per pound, or about five times the
price of bread in France or in Italy. This was not
a matter of great seriousness to those who produced
their own food, but to the others, the professional,
clerical, office-holding, and laboring classes in the
cities, it was very serious. In the city of Nish, for
instance, food was for sale in bakeries and stores.
However, when we visited the part of the city
occupied by the working-people they said that
though wages had risen somewhat during the war
it was now hard to find work, as nobody had any'
money or was carrying on any business, and that
the price of bread had risen very much faster than
wages. They said they were selling whatever they
possessed in order to get money to buy bread. They
took us into their homes and showed us that they
were selling furniture, bedding, and even clothing.
Within a very few weeks they would have nothing
more to sell. We heard of a similar state of affairs
in the cities generally, but did not learn of any
official distribution of food, even to the needy, except
in the cities of Belgrade, Monastir, and Skoplie.

SERBIA: THE COST OF ASPIRATION

All European countries took special pains to pro-
vide food-supplies for the capital city during and
after the war. It was important to make a favorable
impression on foreign visitors. Also it would be
embarrassing if the civilians, pressed by hunger, were
to create disturbances in the centers of government.
It was probably, however, owing rather to the
personality of the mayor that the city of Belgrade
had taken energetic measures to organize food dis-
tribution. The mayor of Belgrade had been re-
cently transferred from the position of prefect at
Monastir, where he had organized relief. Although
at Belgrade but a short time, he had already ap-
pointed a local committee of citizens for each of the
fifteen wards of the city. Posters had been dis-
played requesting those who were unable to secure
food and clothing to register at the local offices.
The families already registered represented 16,000
people in a total population of about 60,000, or
27 per cent. Before the war there were about 3,000
needy persons in Belgrade in a population of 100,000.
The local committees were making a house-to-house
canvass of all the families registered as needing aid,
and suggesting what aid should be given. The
mayor was consolidating these lists and was about
to call together the relief agencies to invite them to
co-operate with one another and with the city.
Meanwhile, he had secured stocks of various kinds
of food in Hungary and had distributed in December
to those who were registered as needy a ration of
three hundred grams of flour per day per capita
and a pound of sugar to each family and a small
amount of cabbage. He had also secured a small
stock of potatoes and onions and sufficient wood to

THE HUMAN COSTS OF THE WAR

give a small quantity to each household. He was
preparing for a serious situation during the entire
winter. Except in these three cities, even though
the total amount of food might be sufficient, many
people would not be able to buy bread unless the
price could be reduced. Some effort had been made
to control the price of grain, but we were told that
as soon as this had been done no grain came on the
market and conditions were worse than before.

It seemed certain that food-supplies would be
exhausted in one locality after another in the course
of the winter and spring, to say nothing of the need
of seed for the next crop. No one knew, and there
seemed no way of finding out, how much grain was
actually in the possession of the peasants of Serbia.
The crop had been less than normal, the enemy had
consumed or sent away a good deal, and the Serbian
army had "lived on the country" as it passed
through in September and October. The per-
sistence of the high price of bread confirmed these
indications of a real shortage. We learned in Bel-
grade from the government officials that there were
surpluses of grain in some portions of the new
Kingdom of the Serbs, Croats, and Slovenes and
that probably, if this could be distributed, it would
be sufficient for the needs arising in Serbia itself
before the next harvest. The very serious question
of transportation still remained. If one after an-
other of the isolated regions reached the end of its
supply, would it be possible, after getting the
food into Serbia, to distribute it soon enough over
these rivers of mud, called highways, and up the
narrow paths and trails? Reports from Serbia state
that these difficulties were overcome, that the very

SERBIA: THE COST OP ASPIRATION

narrow margin did not actually become a deficit.
The end is not yet, however, for the 1919 crop is
far below normal and the present sowing is also
below normal. We must be prepared to hear of
further shortages before the harvest of 1920.

The loss of live stock in Serbia is a more serious
menace to its prosperity than to its immediate food-
supply, except as it affects distribution. There are
literally almost no horses left in Serbia. They were
taken by the army, and their skeletons are scattered
along the roadside from Saloniki to Belgrade. In
Nish, in the absence of automobiles, two very
antiquated-looking teams were found and two car-
riages discovered which served to conduct the
American visitors about the town and to the military
hospital in the outskirts. I do not recall having
seen any other horses. The number of cattle is very
greatly reduced, but some oxen were seen everywhere
and meat was seen in the city markets. Prices were
high, but not more so than in other countries. The
increase from pre-war prices, however, is great, for
before the war meat was exceptionally cheap. The
principal local purchaser was the government, which
bought for army use and kept the price low (eight
cents per pound) to discourage the slaughtering of
the herds. The surplus of meat was exported to
Austria, and the Austrians managed by a variety
of devices, mostly grossly unfair, to keep the prices
very low. This, in fact, was one of the reasons why
the Serbs were so desirous of an outlet to the Adriatic,
giving them access to other markets. In southern
Serbia many sheep were raised on the treeless plains
and mountainsides, and we saw a considerable num-
ber of fine flocks of sheep which, we were told, had

THE HUMAN COSTS OF THE WAR

escaped the Bulgarians. Formerly many hogs were
raised in Serbia, but we saw almost none, except a
day or two before Christmas, when in the open
markets of Semendria and of Belgrade there were
many squealing young pigs which were to be the
holiday delicacy for those able to buy them. Upon
leaving Belgrade, we crossed the Save River to
Semlin and started directly west toward Fiume.
Almost immediately we saw very large numbers of
hogs, greater numbers than I have ever seen in
America.

Besides coffee, tea, and rice, the imported articles
most missed were soap and candles. Tea and cof-
fee were being quoted at fifteen dollars a pound, but
as there was none to be had the price was not sig-
nificant. Soap was unavailable and its absence
led to many unpleasant and unsanitary conditions.
Candles were selling at fifty cents each and kerosene
was not to be had at any price. Relatively normal
trade conditions would soon exist as to the sale of
clothing, shoes, soap, candles, kerosene, and sup-
plies generally, if the transportation systems were in
working operation, for the Serbians were not with-
out money. But the resumption of normal trade
activities is impossible until the railways are
restored.

Lack of transportation created also a fuel crisis
in the towns. Serbia is bordered by mountain
ranges, nowhere far distant, which, except in the
south, are well wooded. Coal-mines are quite well
distributed and before the war provided considerable
fuel for industrial and domestic uses. Coal was also
imported. At present the mines are out of com-
mission, and importation is reduced to the narrowest

SERBIA: THE COST OF ASPIRATION

minimum by lack of transport. There is neither
labor for cutting wood nor transport for getting it
into the cities. In Nish, which is not far from the
wooded mountains, wood was selling at 200 francs
($40) per cubic yard, and very little could be had.
Before the war the same quantity sold for 5 or 6
francs. Fuel was used only for cooking, and if the
weather had not been exceptionally warm there
would have been much suffering. Serbian winters,
except in the high mountains, are about like those,
say, of the Hudson Valley of New York State.

In Belgrade the lack of coal and wood was, in
January, 1919, very serious, although it is reached
by railways from Fiume on the west and from
Hungary on the north. Small amounts of coal were
brought by rail and some wood was cut on the shores
of the Danube and brought in by barge, but there
was not enough for even the most necessary pur-
poses. The municipal water-supply is operated by
a pumping-station which was operated only a few
hours daily. In some parts of the city no water
had been available for several days at a time.
It is a modern city, with indoor plumbing, and the
lack of water was very serious. The tramway system
had already been out of commission for several
weeks. The electric-light current was turned off at
10 P.M. The hospitals were without fuel for heating
the wards. Only the exceptional weather prevented
the plight of Belgrade from becoming very serious.
The railways were running at only a small percentage
of their capacity for lack of coal. The line from
Belgrade to Fiume was running one train a day,
although there was said to be sufficient rolling stock
for thirteen. The Hungarian railways were about to

THE HUMAN COSTS OF THE WAR

discontinue entirely. As to fuel, as well as food,
clothing, supplies of every description, and even
medical service, the rebuilding of Serbia had to
await the re-establishment of its transportation
system.

"A New Kind of Poor."- -The most acute lack
was that of clothing. At Palanka a well-educated
English-speaking Serbian woman said she had paid
fifty dollars for a pair of shoes which lasted less
than a month and two hundred for a simple baby
outfit. In Semendria I had two conferences with a
group of three leading citizens: the mayor (three
days out of the hospital and looking as though he
had left the hospital much too soon) ; the former head
of the school system, a man past middle life who was
very interesting and evidently very well informed;
and a widow who had successfully carried on the con-
siderable business interests of her former husband and
was now organizing a civil hospital at the mayor's
request. She was shabbily dressed, but her manner
and attitude recalled to me the best of the women
who help to direct the charitable societies of New
York and Boston. I asked her who were most in
need. Thinking a moment or two, she replied (in
French): "The war has created a new kind of poor
in Semendria. Those who were best off before the
war are now the poorest. Please do not think badly
of our mayor and our schoolmaster because of their
shabby clothing — they have no other. What little
there is to be bought is at such fantastic prices that
they cannot afford to buy. I myself have been
considered one of the most well-to-do citizens of the
town. These rough clothes are all I have. I do
not mind that, but if you could bring in some

SERBIA: THE COST OF ASPIRATION

clothing and sell it at reasonable prices you would
be helping those who need help most." The weather
was then unusually warm for January, but in early
February the snow was deep in the streets of Semen-
dria, Belgrade, and all northern Serbian cities.
Footwear of all sorts was lacking. The Serbian
peasant ordinarily wears a very closely knit, thick
stocking, and over these a sort of leather sandal
fastened by a stout cord. The people in the cities
and villages, as well as the soldiers, have learned to
wear shoes. The peasants have no disinclination to
wear shoes if they can get them, except that they
are so impressed with the beautifully finished
leather that some of them are disposed to keep them
in the home as an ornament and an evidence of
prosperity, even at the cos,t of going barefooted.

Our necessarily rapid examination of Serbian con-
ditions was strikingly confirmed by the reports
made after much more detailed inquiry by the
American Red Cross relief workers who went to
Serbia upon our return. For instance, several
American women investigators made a survey of
seventy-five towns in northern Serbia with a popu-
lation of 335,000 and registered 63,000 persons as in
dire need of the necessities of life — food, clothing,
and shelter.

Milk was almost unobtainable in many districts,
and clothing even of the most elementary kind was
far beyond the reach of any except the wealthy. A
case of second-hand clothing from Buffalo, valued
in America at seventy-two dollars, was appraised
by a merchant in Nish at fifteen hundred dollars.

In 44 towns of a total of 75 there was an immediate
need of food, in 63 of clothing, in 10 of housing, in

THE HUMAN COSTS OF THE WAR

29 of medical supplies, in 25 of medical attention,
in 38 of sanitary measures, in 9 of hospitals, in 33
of child-welfare activities, in 32 of employment
workrooms, and in 14 of other forms of relief.
Between 30 and 35 local relief organizations were
found in existence in these towns, but many were
quiescent for lack of funds or supplies.
One of these American women reported:

Almost every family has lost in the war father, husband, or
brother — frequently all the male members of the family are
gone and the women-folk are left without means of support.
The number of widows with small children is distressingly
large, and the suicide rate among young Serbian women is very
high. The children plead tearfully for help, and we found many
of them who had gone without food for several days at a time.
All the children show the effects of under-nourishment. A
majority of them are suffering either from "war dropsy" or
from a chronic malnutrition of which the most characteristic
feature is an enlarged stomach, spindly legs, pinched face, and
sunken eyes.

The most serious aspects of the occupation and
post-armistice periods, those which relate to the
subject of health, will be considered in the next
chapter.

Ill

SERBIA: THE COST OF ASPIRATION (Continued)

Health: the Serbian disease, tuberculosis; the slaughter of the innocents;
the older children; syphilis; typhus; typhoid; influenza; "Wanted,
Babies"; total human losses; pre-war health agencies; organized
medicine; the new Public Health Ministry; war orphans and
widows; soldiers' families; cripples and prisoners; devastation;
impressions of the Serbians.

TTEALTH. — For a people whose military losses
J- -*• were so overwhelming as those of Serbia the
health of its civilians is of first importance. We took
special pains to learn as much as possible about sick-
ness and mortality in Serbia during the occupation
and at the time of our visit, and also as to future needs.
Our informants, though vague and inexact, were
clearly trying to describe conditions which had been
most serious. We have noted that very fair vital
statistics were kept in Old Serbia prior to the war.
These were incomplete during the Balkan wars of
1912 and 1913. Those for 1914 are still less com-
plete, and before the end of 1915 the Serbian army
and its government had been driven wholly out of the
country and no records are available for that year.
Most of the records kept during the occupation by
the Austrians, Germans, and Bulgarians were re-
moved or destroyed. The pre-war records, however,
indicate what would be likely to happen under war

THE HUMAN COSTS OF THE WAR

conditions. We were interested in finding in Bel-
grade a ten-year report on the sanitary conditions
and vital statistics of that city. It was a volume
quite comparable to such as might be gotten out
by an enterprising American city. In fact, I doubt
whether many American cities of one hundred
thousand would publish as thoughtful and enlighten-
ing a review of their health conditions, though they
might have more material available.

Also, we were fortunate in securing in Belgrade a
copy of a printed report dealing with sanitary condi-
tions in the part of Serbia held by the Austrian
army. It was by a member of the Austrian military
staff and was entitled, The Sanitary Watch at the
Gate of the Orient. It was written from the point of
view of the danger of importing into Austria,
through Belgrade, the epidemic diseases which were
always more or less prevalent in the Balkans. Its
statistical material was quite complete and showed
careful preparation. The comments naturally must
be taken with due allowance. We found also a few
elderly physicians who had remained in Serbia dur-
ing the Austrian occupancy. We learned something
from the army physicians as to conditions found
when the Serbians reoccupied their country in the
late fall of 1918. Gathering, bit by bit, the facts
in regard to Serbia's birth and death rates before the
war, the epidemics of 1915, the hardships during the
occupation, the conditions at the time of our visit,
the traditions of the country in matters of medicine
and sanitation, and the attitude of the people toward
new ideas and methods, it became clear to us that
the greatest opportunity to aid Serbia is to help
to care for her sick, especially her children, to bring

SERBIA: THE COST OF ASPIRATION

under control the epidemic diseases which are always
prevalent, and to establish a public health organiza-
tion, state and local. Even moderate success in
applying scientific knowledge of disease and its
causes would greatly reduce sickness and mortality.
This, with the high birth-rate, should go far in a
decade or two toward restoring Serbia to that posi-
tion of numbers and influence to which she is en-
titled by the very distinguished and heroic part she
has taken in the war.

For these reasons some of the interesting facts as
to health conditions will be stated in detail.

The Serbian Disease: Tuberculosis. — One of the
questions we asked wherever we went was, "How
about tuberculosis?" Our first contacts were with
important officials, prefects of departments, mayors
of cities, and leading citizens. To the question,
"Have you much tuberculosis?" they uniformly
replied in the negative; in fact, they stated em-
phatically that there was no tuberculosis to speak of
in Serbia. They explained that with its wonderful
climate and its naturally healthful conditions it
could not be otherwise. They pointed to the
mountain ranges along the eastern and western
frontiers and to the beautiful open rolling country
bathed in sunlight as convincing evidence. They
believed what they said. It was very like what one
hears from local authorities in any American rural
district. They are always quite positive that in
their districts conditions are too healthful to permit
tuberculosis to gain any foothold. They, too, are
honest in their beliefs, and have been genuinely sur-
prised when trained nurses everywhere find hundreds
of consumptives,

THE HUMAN COSTS OF THE WAR

The vital statistics of Old Serbia showed a tuber-
culosis death-rate in 1911 of 32.4 per 1,000, more
than twice that of America or Great Britain. Tuber-
culosis, being a lingering disease with easily recog-
nized symptoms, was probably fairly accurately re-
ported as a cause of death. We were certain that
our optimistic officials and citizens were mistaken.
From experienced Serbian physicians we met an
entirely different response: "Oh yes, plenty of it."
"Yes, tuberculosis, we call it 'the Serbian disease/'3
"Quantities of it, and more than ever since the war."
The doctors were right and the well-meaning
officials and citizens were wrong. Tuberculosis was
very prevalent, but had not been "put on the map"
by an organized educational effort such as has made
the facts about it common knowledge in America
and western Europe.

The cities were worse than the country. The re-
port on Belgrade showed that in 1912 tuberculosis
deaths were 72 per 1,000, more than four times the
rate of an ordinary American city. It was to be
expected that three years of hunger during the
enemy occupation would increase tuberculosis. It
did. The Austrian report showed a population in
Belgrade in 1917 of 45,000. The deaths from
tuberculosis in 1917 amounted to 145.3 per 1,000,
an absolutely unheard-of figure. All reports agree,
even this Austrian volume, that food was very in-
sufficient in Belgrade in 1917. It even expresses a
regret that so fine a people as the Serbs should have
to suffer so much from lack of food.

Wherever pulmonary tuberculosis is unusually
prevalent one is almost certain to find also much
tuberculosis of the bones and glands among children.

SERBIA: THE COST OF ASPIRATION

Nurses and doctors from Great Britain who had come
in contact with Serbian children were aghast at the
amount of tuberculosis among them. American
relief workers and nurses who have reported since
have made the same comment. We saw on the
streets of Belgrade and other Serbian towns large
numbers of crippled children and many hunchbacks,
most of them undoubtedly crippled by tuberculosis.

We learned that the Serbian medical profession
was quite awake to the seriousness of tuberculosis in
Serbia and that just before the outbreak of the war
an anti-tuberculosis movement was being organized.
A plan had been agreed upon and lectures had been
given in several of the larger cities. This promising
plan was wiped off the slate by the war. Money,
men, and thought — all were devoted to the destruc-
tion of human life, not to its conservation.

An effort for the control of tuberculosis must be
built upon a broad educational movement, informing
all the people of a few important facts about its
prevalence, its curability, and its preventability, and
thus creating a public opinion willing to foot the
bills. Is it possible to carry on such an educational
work in Serbia? I am convinced that it is not only
possible, but relatively simple and easy, and that no
time could be more favorable than the present.
Serbia has had one somewhat similar experience.
The epidemic of typhus in 1915 was brought under
control by the aid of physicians and sanitarians from
France, Great Britain, and America. We were told
that this left a permanent impression upon the people.
They remember that typhus is carried by the body-
louse. Many peasants during the winter of 1918-19
asked aid in freeing themselves from vermin for fear

THE HUMAN COSTS OF THE WAR

of typhus. The Serbians are quick to learn, natu-
rally curious, interested in all public movements,
responsive to new methods and ideas, and realize
that everything possible must be done to rebuild
Serbia's population. As to underlying conditions,
Serbia is ripe for an active and comprehensive anti-
tuberculosis movement, but it must be begun from
the bottom up and Serbia must have a great deal of
help in it. How anti-tuberculosis, infant welfare,
and other health movements can be made to undo
some of the most serious effects of war in the Balkans
will be considered in Chapter X, on "War, Best
Friend of Disease."

The Slaughter of the Innocents. — The infant mor-
tality rate of Serbia before the war was high, but not
extraordinarily so. In 1911 the number of deaths
of babies under one year of age was 146 per 1,000
of births. This is about 50 per cent, greater than
the present rate in the state of New York.

There are no exact figures showing the effects of
the war on infant mortality in Serbia, but every one
agreed that sickness and mortality among children
had very greatly increased. The priest of a large
church in Belgrade, who had long taken a special
interest in his people, said that before the war there
were several times as many births as deaths among
the children, but that during the war the figures had
been reversed. His statement need not be taken too
literally, but it is in line with what we heard on every
side. Epidemics of children's diseases were common.

Only a very few years ago 100 deaths under one
year of age for each 1,000 births was considered a
distant goal toward which we might work. That
has already been largely surpassed in numerous

SERBIA: THE COST OF ASPIRATION

localities, including New York City, where the 1919
rate reached the unprecedentedly low figure of 82.
The report of the Local Government Board of
England for 1917, after reviewing the progress made
in the reduction in infant mortality during the war,
announces its conversion to the belief that a death-
rate of 50 per 1,000 births is an entirely practicable
goal, to be attained in England in the very near future.
In fact a few English cities have already secured a
rate below 50. At least one Australian city has even
secured a rate below 40. The Serbian infant death-
rate had ranged during the previous decade between
135 and 181. There is no reason why it should not
be reduced as low in Serbia as in any other country.
The practice of breast-feeding is almost universal
and the population is largely rural. The significance
to the future of Serbia of a reduction of the infant
death-rate to one-half or even to one-third its
present volume, which should not be in the least
impossible and hardly difficult, can easily be ap-
preciated. The disappearing birth-rate in Serbia
during the war, which makes baby-saving work
especially imperative at present, will be referred to
later.

The Older Children. — Another striking fact is the
high mortality among children from one to five years
of age. The infectious diseases of children are
widely distributed and some are of unusually serious
types. Scarlet fever of a virulent type, one which is
rarely found in the United States at present, known
as the anginous form, is widespread. Whooping-
cough before the war showed a death-rate about ten
times that in the United States. All agreed that
these diseases, like tuberculosis, were vastly more

6 71

THE HUMAN COSTS OF THE WAR

prevalent during the war, especially at the time of
the typhus epidemic. There are laws for the report-
ing and isolation of these diseases, but enforcement
was impossible during war because of the lack of
physicians, the difficulties of communication and of
travel, and the closing of the civil hospitals.

Syphilis. — This is a most serious disease in Serbia
as elsewhere. The northeastern departments are
reported to have had an extraordinary prevalence
of syphilis for several decades. This is attributed to
the occupation of these provinces for some years by
a foreign army some forty years ago. The facts
that Serbia has been at war almost continuously for
seven years, that the armies of Bulgaria, Austria,
and Germany as well as the Allied armies have
marched through her territory, and that the entire
country was occupied for three years by an enemy
army, have been important causes undoubtedly of
the present reported prevalence of syphilis. The
crowded conditions under which the people live,
several people sleeping in the same bed and eating
from the same dishes, may also be a factor.

There was a very fair system of general hospitals
in Serbia before the war maintained by the public
authorities and open to all needing their care. We
were told by experienced physicians who had been
at the head of some of these hospitals that 25 per
cent, of the patients received in them were admitted
because of venereal diseases. The Austrian report
spoken of above also comments on the prevalence of
syphilis, and says that in certain departments of the
country, in 1898, 4 per cent, of the population were
registered as syphilitic and that this covered pre-
sumably only a portion of the cases actually existing.

SERBIA: THE COST OF ASPIRATION

Typhus. — Typhus fever has been present in the
Balkans for many years, breaking out in epidemics
from time to time, especially during war. It
was a serious problem during the Balkan War, but
it became a national menace in the Great War.

The great epidemic appeared in the late autumn
of 1914, after the second Austrian offensive. The
successful Serbian counter-offensive began early in
December. As a captain in the Serbian army re-
marked: "Our army fought the Austrians and the
typhus at the same time. It won the battle with
the Austrians but lost that with the typhus."

The crowding together of the civil population
during the retreat from the invaded territory, the
absence of sanitary precautions, the lack of physi-
cians, nearly all of whom were with the army, the
presence of a considerable number of enemy prisoners,
and the general shifting back and forth of masses of
people — all were favorable to the spread of vermin
and hence of typhus. Not only typhus, but also
other infections, such as typhoid, dysentery, small-
pox, and scarlet fever, spread rapidly, and the
Serbian government applied to the Allied countries
for medical aid. Medical supplies and physicians
arrived under the auspices of the British, French,
and Americans, and with this help, and with the
coming of summer, which diminished the amount of
crowding in sleeping-quarters, and with the establish-
ment for a time of more stable conditions after the
Austrians were driven out of the country, the epi-
demic was brought under control and practically
disappeared in the summer of 1915. Various es-
timates are made of the number of deaths from
typhus, but the consensus of opinion places the

THE HUMAN COSTS OF THE WAR

number at about 150,000 civilians and soldiers. Ac-
cording to one Serbian authority over 45,000 deaths
from typhus occurred in the valley of Valjavo (near
the invaded frontier) alone, including civilians, sol-
diers, and Austrian prisoners. It is stated that in
that province there was not a house in which one or
more deaths from typhus did not occur. One hun-
dred and twenty-five Serbian physicians died of
typhus of a medical profession stated at from 310
to 400.

When we were in Serbia many conditions were
favorable for a renewal of the typhus epidemic,
although large numbers of the population must have
become immune. In fact, if such a thing be possible,
the survivors in Serbia should be almost plague-
proof. Large numbers of prisoners and civilians
were returning from Austria and Bulgaria vermin-
infested. All Serbia presented a confused picture
of shifting groups of population, all of them grievously
lacking in every essential of cleanliness and sanita-
tion. Added to this, the housing destroyed or made
unusable by war, the shortage of fuel, and the lack
of bedding, all caused overcrowding of vermin-
infested people. The representatives of the Amer-
ican Red Cross were not in Serbia at this time in
sufficient numbers to make any large contribution
toward warding off typhus. At Skoplie and one or
two other points stations were being established for
assisting refugees to clean up. Fortunately, how-
ever, no extensive epidemic developed in the early
winter of 1918-19. In the spring typhus appeared
in eight regions. Skoplie, Monastir, Leskovatz,
Palanka, and others — they were all familiar names
to us and recalled hordes of famished, half-clad,

SERBIA: THE COST OF ASPIRATION

compulsorily filthy refugees. The American Red
Cross now had thirty physicians, fifty nurses, and
several health workers in Serbia. It aided in setting
up many "disinsecting" stations which helped to
control the outbreaks.

A report of the early spring of 1919 shows how
six women of the American Red Cross, one of whom
fell ill of the disease, fought typhus in the Serbian
town of Palanka, some sixty-five miles inland from
Belgrade.

The stronghold of the typhus was in an army barracks where
267 Serbs and Bulgarians lay on filthy straw on the floor, without
bedding or medicines, with vermin crawling over them. The
barracks, called a hospital, had no modern surgical instruments,
no baths, no toilets with running water, no pails, no utensils,
no nurses, no medicine. The stench was overpowering. Each
day several typhus victims were taken out on two planks nailed
together and buried in a trench. The American women installed
delousing baths, used hundreds of gallons of lysol on the men,
clipped and shaved the patients, bathed them in hot water, put
them into freshly set-up beds with white-linen sheets, gave them
food fit for convalescents, distributed American pajamas,
scrubbed, whitewashed, and disinfected the barracks from cellar
to garret, drained near-by cesspools, screened doors and win-
dows— and soon were out with gangs of Serbian soldiers cleaning
up the town.

Typhoid Fever. — Typhoid fever has been always
present for many years. In 1909, 1910, and 1911
the typhoid death-rates were respectively 122, 121,
and 87 per 100,000, five to seven times the present
rate in the United States, and sixteen times that of
the state of New York. There are, doubtless, many
errors as to causes of death, but at least these num-
bers of people died of something which looked like
and was called typhoid. Under war conditions the

THE HUMAN COSTS OF THE WAR

contamination of drinking-water was bound to be-
come much more common, and typhoid steadily in-
creased. Sixty-seven cases were reported in the
city of Belgrade during the week beginning August
20, 1916, and sixty-one cases during the week be-
ginning November 1, 1917. Belgrade is the most
favorably situated of Serbian towns. It is the only
one having a system of sewage disposal, and few
have a municipal water-supply. Farther south, ap-
proaching Turkish rule, the sanitary arrangements
become more and more primitive, or are altogether
lacking. City streets are generally regarded as the
proper places for the deposit of human waste.

One of the striking triumphs of modern sanitation
is the reduction of typhoid fever to a mere fraction of
its former prevalence. The essentials in its preven-
tion are very simple and present no special difficul-
ties in Serbia.

Influenza. — The epidemic of influenza had just
passed its maximum when we were in Serbia. We
heard everywhere of the "flu" as having been very
serious — comparable to typhus in 1915. We heard
of whole families being wiped out, of villages in which
no household failed to lose one or more of its mem-
bers. The prefect at Kumanovo, whom we saw on
December 19th, was just in receipt of a report from
the subdivisions of his department, showing during
the preceding two weeks a total of 972 deaths among
a population of 125,000, mostly from influenza. This
was a high death-rate, especially as it was the second
wave of the disease. A Serbian physician of Mon-
astir said that for a time the influenza deaths there
were 50 per day. From what we know of the num-
ber of deaths from influenza elsewhere, and from the

SERBIA: THE COST OF ASPIRATION

pictures presented to us of its ravages in all parts of
Serbia, we estimate the losses as about 40 per cent,
of those of the typhus epidemic. This would be
about one-half the rate in Italy and 50 per cent,
greater than that of the United States.

"Wanted, Babies"— A wholly different effect of
the war has diminished the population of Serbia
probably more than all other causes combined, more
certainly than typhus, more than deaths of soldiers
from wounds and disease. It is the fall in the birth-
rate, apparently more marked than in any other
country.

Even while its army was still in Serbia, transporta-
tion conditions were primitive and overburdened,
and it was not easy for the men to visit their families
during the year and a half before the great retreat.
Before the end of 1915 the Serbian army and its
young men became exiles and remained so until 1918.
Even then they marched through the country and
on into what had been Austria-Hungary, and were
still far from their homes and families.

We have noted that the birth-rate is normally
high, 38 per 1,000 in 1912 against 24 in the United
States. Young people marry at an early age and
babies come along promptly and regularly. Their
numbers were greatly reduced by disease, but there
remained an annual increment to the population
amounting to nearly 2 per cent. Mobilization was
followed in due course by a great reduction in the
birth-rate, as in every other belligerent country.
When, however, the entire army was driven out of
the country and remained away for more than three
years, this reduction became very much more
marked. Statistics on any large scale are not to be

THE HUMAN COSTS OF THE WAR

had, but it is apparent that the birth-rate took on
the aspect of a disappearing phenomenon, and that
the midwives of Serbia, had there been any system
of unemployment insurance, could have qualified
as applicants for its benefits. The mayor of one of
the cities on the Danube said that he had found
records of births and deaths kept by the Austrians
during the occupation, that the deaths were many,
and the births a negligible number. He said that
while there had been more or less of irregular rela-
tions between the Austrian soldiers and the Serbian
women, such relations were not likely to result in
births, and that the practice of abortion had spread
most alarmingly. A physician long past middle life
with a long practice in Belgrade stated as his opinion
that the number of births was less than 20 per cent, of
the normal. In Semendria the physician had heard
of four or five during the last six weeks, less than one-
fifth the normal. A group of twelve hundred poor
children in Belgrade were brought together for a
Christmas dinner with their mothers. There were
only about twenty under three years of age. The
absence of small children was apparent to even a
casual observer.

The actual number of births in Old Serbia in 1912
was 114,257, indicating a total for the entire country
of about 190,000 per year, or during a period of four
years a total of 760,000. If the rate of births has
averaged one-fifth of the former rate, and this
seemed a fair estimate, the number of births during
the four years was 152,000 instead of 760,000, a defi-
cit of 608,000. This is certainly the largest item,
though it is but one in a melancholy series, in the
diminution of the Serbian population by the war,

SERBIA: THE COST OF ASPIRATION

Total Human Losses. — Can we now form any es-
timate of the total effects upon the population of
Serbia of four years of war? We have seen that the
population of Serbia at the outbreak of the war was
about 5,000,000, with an annual increase of about
85,000, or 340,000 for a period of four years, which
would have given a population in Serbia in 1918 of
about 5,340,000. The war factors, which we have
discussed, indicate certain losses. These estimates,
it must be remembered, are based on the best in-
formation now obtainable, but not in any case on an
actual census. All the varied information which we
have received from Serbia since our visit tends to
confirm the substantial soundness of our conclusions,
though only a census would give actual figures. Such
a census might increase some factors and diminish
others, but I am satisfied that it would not materially
change the net result. The estimated losses are:

Deaths from Spanish influenza 60,000

Deaths from typhus 150,000

Deaths of soldiers from wounds and diseases 240,000

Deaths of prisoners and civilians interned in Bulgaria,

Austria, and Germany 100,000

Deaths among boys and young men from the Al-
banian retreat 30,000

Decrease in the number of births 608,000

Total losses 1,188,000

On this estimate the population of Serbia in 1918
would be not 5,340,000, but 4,452,000. We have not
taken into account as yet the deaths among the civil
population during the period of occupation from
the increased prevalence of tuberculosis, infant

THE HUMAN COSTS OF THE WAR

mortality, typhoid fever, and such diseases, other
than typhus and influenza. Taking these into
consideration, it is probable that the prevalent
Serbian estimate that the present population is
not over 4,000,000, and that the loss from what
the population would otherwise have been is
1,340,000, is a conservative estimate as to net
results. The Serbians and others making such
estimates seem to me to overestimate the losses from
death and to underestimate the factor of birth
deficit.

This estimate finds confirmation in the census
taken by the Austrians in the part of Serbia which
they occupied. This census, taken in the midsum-
mer of 1916, seems to have been carefully made by
the military authorities as a basis for rationing food.
In the departments under their control they found a
total population of 1,218,027. According to the
Serbian census of 1910 this same area then contained
a population of 1,568,048. This represents, there-
fore, a net decrease of 22 per cent, during the first
two years of war, in addition to the sacrifice of the
normal increase. If these figures are approximately
correct, and they seem to be as correct as census
figures taken under such circumstances can be ex-
pected to be, and if a similar loss occurred in the area
occupied by the Bulgarians, the total net loss at the
middle of 1916 from the census figures of 1910 would
be about 1,050,000 in addition to the loss of the
normal increase.

The problems of physical reconstruction in Serbia,
of rebuilding cities and villages, of the reconstitution
of its herds of live stock, and of the rebuilding of its
railways and highways are indeed great, but they are

SERBIA: THE COST OF ASPIRATION

unimportant except as they contribute to Serbia's
underlying, fundamental problem — that of the re-
plenishment of her human resources.

Pre-War Health Agencies. — We have passed in re-
view some of the important factors in Serbia's
health problem, but have not yet asked what re-
sources she had before the war for dealing with
disease, and what have been the effects of war upon
these resources.

There had been, unfortunately, only a slight de-
velopment of agencies for the cure of the sick and
the prevention of disease. There is no medical school
in Serbia. In the northern portion, especially in the
capital, there were physicians who had received their
training in some of the best medical schools of the
world, those in Vienna, Berlin, or Paris. Having
been under their care for ten days in a hospital in
Belgrade, I cheerfully testify to what seemed to me
quite remarkable thoroughness and skill in diag-
nosis and treatment. Even these practitioners had
thought little of the modern science of preventive
medicine. In the south, recently Turkish, physicians
were extremely rare and the sick received little treat-
ment. It was a saying among the physicians that
the Serbians are in the habit of sending for a priest
when they should send for a doctor, and of sending
for a doctor when they should send for an under-
taker. This, however, is by no means limited to
Serbia. Before the Balkan wars the medical pro-
fession of Serbia numbered, according to various
estimates, from 310 to 400. If the number were
400 and if the physicians had been evenly distributed
throughout the country this would mean one phy-
sician to each 12,500 inhabitants. As a comparison

THE HUMAN COSTS OF THE WAR

we may recall that in the United States the number
is one to 500. Even this small number of physicians
was most unevenly distributed. The city of Bel-
grade, with one-fiftieth of the population of the
country, had more than one-fourth of its medical
profession.

Trained nursing, that happy by-product of the
Crimean War, which has changed the entire aspect
of illness in England and in America, and which not
only contributes enormously to the comfort of the
patient and of his family, but also greatly increases
his chances of recovery, did not exist in Serbia. A
slight beginning was made in 1908 toward the train-
ing of nurses, but it was short-lived.

There were a number of general hospitals in
Serbia before the war, which seem to have been as
efficiently organized as the very limited medical
service and the total absence of trained nursing
would permit.

Health administration as a function of government
was almost non-existent. Deaths and births were
reported through the Church. It does not appear
that any one studied the deaths from various causes
for the purpose of deriving from them a program of
health activities.

Such was the meager equipment for dealing with
sickness and epidemics before the war. Even this
little quickly became almost non-existent. One hun-
dred and twenty-five of the physicians of Serbia
died of typhus, a considerable number of others were
lost in military service, and almost all the survivors
were attached to the army. Except for a very few
aged practitioners and for such slight and altogether
incidental attention as the military physicians could

SERBIA: THE COST OF ASPIRATION

give, the civil population of Serbia went practically
without medical attention during the war. The de-
partmental hospitals left without staff or resources
were discontinued. Some were taken by the enemy
for military hospitals. When the enemy retired he
took with him all movable hospital equipment. We
found what had been civilian hospitals occupied as
temporary shelters for refugees, or unused. There
were a very few hospitals operated by physicians
from England or America, but the system of civilian
hospitals had ceased to exist. In Semendria an
efficient and benevolent woman was establishing a
civilian hospital of twenty beds. I heard of it some
months after as having attained a capacity of sixty-
five and as being crowded with one hundred and
thirty patients who were sleeping on the floors and
in every other available bit of space.

Organized Medicine. — While Serbia had few phy-
sicians before the war, several aspects of its medical
and hospital organization are of unusual interest and
are quite in line with the present trend of medical
practice and organization in the most progressive
countries. Such medical practice as it had was
largely organized as a public function. Each of the
eighteen departments into which Serbia was divided
had a departmental physician, chosen after a careful
examination, who received what was for Serbia a
very fair salary regularly increased at five-year
intervals and supplemented by a system of pensions
after thirty years of service. These state physicians
were a majority of the profession and included many
of its best representatives. They were allowed to
engage in private practice and their state salaries
usually constituted from one-fourth to one-half of

THE HUMAN COSTS OF THE WAR

their income. They were required to examine and
treat all who came to them and also to call upon
those who were too ill to come to their offices. Since
the territory of each physician was large, and
transportation difficult, it was usually necessary for
the patient to go to the physician's office. This was
often a great hardship to patients who were perhaps
very ill and spent many hours in slow travel in cold
weather before reaching the physician. Patients
whose income was such that they paid taxes were
required to pay a small sum to the state for the
services of the physician. Others received treatment
free. Each arrondisement (ward) of a department
also had its public physician and each village or city
of more than three thousand was permitted to have a
municipal physician. All these were selected and
remunerated similarly to the state physicians, and
the obligations to the people of their districts were
similar. There was, however, very little supervision
of their work from the central government. Depart-
mental, arrondisement, and municipal physicians were
slowly being reappointed in January last as physi-
cians became available. On our visit to Semendria a
physician, until recently a resident of Croatia, had
just been appointed to all such positions of the de-
partment, arrondisement, and municipality, there be-
ing no other physician available for the service. In
Prishtina as late as June, 1919, medical practice
was in the hands of one Czech and one Greek doctor.
Also, each department had a departmental general
hospital, managed on the same principles as the
medical service. They were public institutions to
which all persons needing their care were eligible for
admission, those being required to pay whose cir-

SERBIA: THE COST OF ASPIRATION

cumstances were such that they paid taxes. The
hospitals differed greatly in their adequacy to meet
the needs of their communities, in their equipment,
and in the efficiency of their medical service. The
system of public hospitals was also being slowly re-
established in the early part of 1919.

These traditions of public medical service to which
the Serbian government is committed and to which
the people are accustomed afford a valuable founda-
tion upon which to build modern health service,
which must of necessity be public, and they afford
an excellent opportunity for the close co-ordination,
or actual merging, of the hospital and medical service
with the health service.

The New Public Health Ministry. — The unusual
opportunity for medical and health assistance in
Serbia is emphasized by the establishment in the
new Kingdom of the Serbs, Croats, and Slovenes
of a Ministry of Public Health, a recognition of the
importance of the subject which has not yet been
given in many other countries. The British Parlia-
ment has just passed a bill for the establishment of
a Ministry of Public Health, with a seat in the
Cabinet. A similar proposal, but much less definitely
outlined and much less advanced, is under considera-
tion in the United States. The Ministry of Public
Health of the Kingdom of the Serbs, Croats, and
Slovenes is as yet little more than a beginning, but
its establishment is an interesting recognition by the
framers of the new government of the timeliness
and importance of the subject. The Minister of
Public Health had already called about him a council
of medical advisers from various parts of the new
kingdom. We had the valued privilege of dining

THE HUMAN COSTS OF THE WAR

and having an extended conference with the Minister
and his medical advisers, who did not underestimate
the seriousness of the problems before them. We
were favorably impressed by the evident professional
competence of this group and by their attitude
toward their responsibilities. At the outset the
Minister stated that he was well aware that he had a
tremendously difficult problem before him, and that
not much could be done in less than ten years. He
hoped that the end of the war and the reduction of
military expenditures might leave larger sums avail-
able for public health. He said that if the American
Red Cross could find it possible to help him, its aid
would be most gratefully received. He said that he
needed help most in dealing with infant welfare,
tuberculosis, and venereal disease. It is clear that
whatever help the American people, or any other
Allied nation, may give Serbia in medical care, nurs-
ing, or public health should co-operate closely with
this newly established Ministry. How this help
should be given is considered in Chapter X, on
"War, Best Friend of Disease."

War Orphans and Widows. — The war brought an-
other blight upon Serbia's childhood on a scale here-
tofore unknown — that of fatherlessness. Orphanage
occurs in all countries at all times, and everywhere
it touches deeply the human heart. Serbia is per-
haps the first country in which the loss of the father
may almost be said to be the rule instead of the
exception. The official statement of the losses of the
Serbian army in killed and dead from disease, from
August, 1914, to the end of the war, is 238,835.
This does not include those who died as prisoners in
enemy countries, very likely at least 60,000 to 80,000,

SERBIA: THE COST OF ASPIRATION

nor does it cover deaths from wounds or disease
during the two Balkan wars. Including these, the
military losses of Serbia were somewhere between
300,000 and 350,000. In fact, a responsible Serbian
official, independently of the preceding estimate,
stated that since the beginning of the Balkan wars
Serbia had lost 350,000 soldiers. This official es-
timates that as early marriages and frequent births
in early married life are the rule each deceased soldier
left an average of two fatherless children. This
would make a total of 700,000 half orphans. This
estimate is much higher than that given by a dif-
ferent department of the Serbian government, which,
without any definite method of reckoning, roughly
estimated the number at 250,000. I am inclined to
believe that the larger estimate is more nearly cor-
rect; but whether the number be 250,000 or nearer
700,000, it is far beyond the ability of our imagination
to form any adequate picture of its realities and its
significance.

Fortunately, the mothers of a majority of these
children are living. In France the records indicate
that only 2 per cent, of the fatherless children are
also motherless. The proportion is probably not
far different in Serbia. Of this 2 per cent, it is cer-
tain that the great majority have brothers or sisters
or other close relatives. "War orphans," so called,
need help, but happily it has not been proposed thus
far that we should deprive them also of their mothers
by setting them apart in orphan-asylums. Soldiers'
orphans' homes would be a most doubtful benefit to
offer the fatherless children of Serbia, and, when this
generation had grown up, the orphans' homes would
still exist with their coteries of employees and their

7 87

THE HUMAN COSTS OF THE WAR

imposing buildings calling almost vocally for in-
mates. Impersonality, cheerlessness, and the dead-
ening atmosphere of all except the very best insti-
tutions, would be a poor preparation for those who
were made fatherless by the war to take up the great
problems and to live up to the great opportunities
which the near future will bring to Serbia.

It is a happy by-product of Serbia's misfortunes
that some of her leading officials in their exile went to
France and came closely into touch with the agencies
and the policies of that country. Knowing at first
hand the experiences through which Serbia was pass-
ing, France extended to them an unqualified welcome.
Among these exiles was the man who, at the time of
our visit, held a very responsible position in Bel-
grade as Minister of Public Instruction. This de-
partment was then charged with the care of those
made fatherless by the war. We had become
thoroughly acquainted with the remarkably well-
drafted statute enacted in France in July, 1917 (more
fully described in the chapter on France, see p. 144),
by which all the children made fatherless by the war
became wards of the nation, which accepted final
responsibility for their education, guardianship, and
support. A similar law drafted by him was enacted
by Serbia.

The American friends of the fatherless children of
Serbia should adapt their measures of relief to
strengthening and supplementing this far-sighted
provision of the Serbian nation and, under no cir-
cumstances, should set up institutions except as es-
sential parts of the national system. Since the date
of our visit the care of the orphan children has been
separated from that of public instruction and now

88 '

A SHEPHERD GIRL ON THE HILLS NEAR BRALO
(Not far from Delphi, Greece.)

APPLICANTS FOR RELIEF
At the American Red Cross Relief Station in Skoplie, Serbia.

SERBIArTHE COST OP ASPIRATION

constitutes a ministry of child welfare, remaining,
however, under the direction of the same official
who is vice-president of the Cabinet of Serbia.

When all has been done which can be done for the
benefit of the fatherless in Serbia it is only too certain
that nothing can replace the Serbian fathers.
American relief workers report in May and June,
1919, that everywhere Serbian women are seen doing
men's work, repairing or rebuilding houses, repairing
railways and highways, and especially working the
land, instead of looking after the children and the
homes.

The needs of the orphan children in Serbia are
many, among them training in improved methods of
agriculture and of homekeeping. These needs are
in no respect different from those of all the other
children of the community. It would be a mis-
fortune if training in agriculture, in industries or in
homekeeping were provided only for war orphans,
and it would be nothing short of a calamity if institu-
tions, under whatever seductive name they might be
called, were established and these children set apart
from others in order to receive a much needed train-
ing in such lines. Instruction and support are sepa-
rate questions and should be dealt with separately.
The mother should be helped to meet the question
of support, and the public school should be helped to
meet the question of training, for all the children of
Serbia.

Soldiers9 Families. — The husband and father is
normally the support of the family. When the hus-
band and father and big brother were mobilized,
how was the family supported? It obviously was
not by any system of allotments and allowances from

THE HUMAN COSTS OF THE WAR

soldiers' wages, for the soldier was expected to
serve his country as a matter of obligation, not as
a matter of employment. In common with other
continental countries Serbia paid her soldiers
very little. The soldiers in the fighting force
received the equivalent of six and two-thirds cents a
day and those in the auxiliary forces of five cents a
day. On this pay the soldiers could hardly buy
minor necessities for themselves, to say nothing of
sending anything home to their families. Nor did
the Serbian government, out of the deficit of its
almost non-existent treasury, make any allowances
for the support of soldiers' families; in fact, it is
difficult to see how it could have done so during
the greater part of the war, since those families were
back of the fighting-lines. Most of the families
were soldiers' families, and they subsisted as best
they could on products raised upon the farms by the
women, the old men, and the older children, or by
their earnings if they lived in cities. The sufferings
of soldiers' families were part of that great volume of
semi-starvation, cold, and bareness of life which
filled Serbia during the years of the occupation.

Cripples and Prisoners. — We can glance for only a
moment at two other groups of war victims. There
are those permanently crippled by the war — who
will spend the remainder of their days in blindness;
who will painfully find their way about on crutches or
sitting in a wheeled chair; who have lost one or both
arms, or who suffer from some other injury which
may spell a maimed and unfruitful life. Such are to
be seen in all parts of Serbia, but their numbers, in
proportion to population, seem less than in France.
The reasons are grim. The Serbian army was short

SERBIA: THE COST OF ASPIRATION

of medical service and of hospitals, even at the
outset. It was not possible to give to those seri-
ously wounded that immediate surgical attention
and skilled nursing which often means the difference
between life and death. Also, typhus leaves few
cripples; neither does hunger nor cold. Neverthe-
less, the total number of permanent cripples, officially
estimated, is twenty thousand, a serious loss of man-
power in a country so desperately short of men. One
catches glimpses of what it means to each of that
group of twenty thousand, in spite of the courage,
determination, resignation, and perhaps fatalism of
the Slav, to be set apart from the ordinary activities
of life, to be unable again to till the soil of Serbia,
or to care for its herds and its flocks, or to be a con-
structive factor instead of a dead weight in the up-
building of a nation.

Then, there are the prisoners of war — those to
whom war loses all its glory and to whom it resolves
itself into a weary effort to continue to live under
the most depressing circumstances imaginable; who
chafe under the consciousness of being able no longer
to help their former comrades in arms; to whom the
thought of working for the benefit of the enemy is
abhorrent; and to whom each day and each night
bring fresh pangs of hunger and fresh suffering from
cold and exposure. Some 50,000 Serbian soldiers
are stated to have been carried away as prisoners
into Bulgaria and not far from 150,000 to Austria.
At the end of December, 1919, about half this num-
ber had returned. No one needed to ask them if they
had been half starved. No X-ray was needed to
diagnose many of them as tuberculous. In one hos-
pital in Belgrade 790 returning prisoners had been

THE HUMAN COSTS OF THE WAR

received, of whom 235 were dead by December. Some
of them returned in very fair condition. Obviously
those who had returned, including the sick, repre-
sented the more vigorous and resistent of the total
number who had been captured. These were they
who had been able to survive hardships through
several years and to make the trip back on foot to
their own country.

Devastation. — We have purposely left to the last
that aspect of war's effects which is the first to catch
the eye of the visitor — physical destruction. It is
seen everywhere, but to make any general statement
about it is difficult. As a whole, it is less than might
have been expected in view of the fact that hostile
armies conquered every inch of the country and were
subsequently driven out.

There is a fringe of destruction across the north
border in the* cities on the Danube and on the Save.
There is a fringe of it along the southern border
where the battle-lines were stationary for several
years. There are streaks and splashes of it along the
central highway, yet there are no cities that I know
of which are wholly destroyed, and some villages
even along the main highway look quite uninjured.

Belgrade suffered at the time of its original capture
in November, 1914, and in the expulsion of the
enemy thirteen days later. It was again baptized
by fire when the army of Mackensen entered it in
November, 1915, and considerable additional injury
occurred in connection with the final departure of the
Austrians and Germans in November, 1918. The
industrial parts of the city along the river-front
suffered most. A great tobacco-factory which had
employed hundreds of people is now only crumbling

SERBIA: THE COST OF ASPIRATION

heaps of brick. On the opposite side of the street
stands a mill for grinding grain which seems to be
quite intact. All through the best parts of the city,
which, on superficial examination, seem to be unin-
jured, one finds a vast amount of physical destruction.
Of the two largest hotels, one is completely destroyed,
the other so much so as to require the entire recon-
struction of the interior. The buildings of the
University of Belgrade were seriously damaged. The
royal palace cannot be occupied. One end of the
Russian Legation was converted into fragments. In
fact, over the entire city one comes across buildings
which, appearing to be intact, are a mass of ruins
in the interior. After spending a few days in such a
region, when one is shown new lodgings he looks
about to see in which corner of the room a shell
came through the wall or where the hole in the floor
or ceiling happens to be. The city of Semendria,
some thirty miles east of Belgrade, on the Danube,
was damaged rather more than Belgrade. As you
look casually at the cathedral you see that one
corner of the tower has been injured by a shell, but
when you enter it you see that there are great gaps
in the roof and that the distinction between indoors
and outdoors has largely disappeared. The city of
Chabatz, some sixty-five miles west from Belgrade,
on the Save, is reported to have suffered still more seri-
ously. Along the southern border the cities and vil-
lages which were close to the fighting-line are in ruins.
A third of Monastir, the second city of Serbia, was
destroyed, and another third seriously damaged.

As the enemy fell back he found time not only to
destroy railway and highway bridges, but also to
leave a permanent record of the line of retreat. He

THE HUMAN COSTS OF THE WAR

apparently was too busy to do much except along
this line. The sight of windowless buildings during
the greater part of our trip of five hundred miles
through Serbia will remain one of the most vivid
impressions of the trip. Glass is now unobtainable
in Serbia. Many of the owners of buildings facing
the main street have filled the window space with a
solid brick wall to within some six inches of the top,
or entirely. In the northern part of Serbia we saw
hundreds of such buildings in which the interior re-
ceived only such light as might come through the
door when it was left open or from narrow slits six
or eight inches wide at the top of the space where the
window had been.

It is much too soon to begin to talk of reconstruct-
ing the injured buildings of Serbia. Not until its
transportation system is fully repaired will building
materials become available. The problem of man-
power will for a long time be almost hopeless.
The financial problem is likely to be very serious in
spite of whatever reparation it may be possible to
secure from the scattered fragments of Austria-
Hungary. So far as houses are concerned, the
problem is not always one of immediate urgency.
The population has been so greatly reduced by
seven years of war and war epidemics that, although
a good many of the houses have been destroyed, the
remaining population still finds shelter, though with
great difficulty in Belgrade. The task of physical
reconstruction can wait; the task of human recon-
struction is immediate and urgent.

Impressions of the Serbians. — This chapter may
properly be closed by recording a few personal im-
pressions of the Serbians.

SERBIA: THE COST OF ASPIRATION

Everywhere they were extraordinarily hospitable
to the American party. There was no evidence any-
where that this was the calculating hospitality of
officialdom nor that it was with a view to future
favors. It seemed to be a spontaneous expression
of a real appreciation on their part of what America
had done toward ending the war in the right way,
and of the principles of nationality, democracy, and
freedom, so brilliantly stated by President Wilson,
whose ideas we were given to understand were better
understood by everybody in Serbia than those of
even the most popular Serbian personage. The
Serbians seemed to us a very self-respecting people,
wishing to conceal, rather than to display, the suf-
ferings they had undergone. They often turned aside
our comment on the seriousness of their losses with
some optimistic remark that everything would soon
be right, or that nothing else mattered since they
had gained freedom from the danger which had
threatened them from the north, and were reunited
with their brother Serbs. When they learned the
purpose of our visit they seemed to wish to help us
to secure accurate information. We saw nowhere a
disposition to color the facts or to exaggerate them.
They appeared to be a very individualistic people,
doing their own thinking, owning their own land,
and, before the war, having almost no poverty. We
asked to be taken, for instance, to the poorest quar-
ter in the city of Nish. It seemed to us quite like
other parts of the city, quite superior to living con-
ditions which might be seen in the slums of most
European and American cities.

The Serbians seemed to us a very simple people,
affectionate, and even sentimental. We happened to

THE HUMAN COSTS OF THE WAR

see a number of reunions of friends who had been
separated by the war and the display of a warmth
of affection was something quite foreign to our
habits, especially as between men.

The impression made upon us by the heads of the
various ministries at Belgrade, by the mayors of the
various cities, and the prefects of departments, was
that, with exceptions, they were curiously like
Americans. They were of many different types as
to personal appearance — some blond, some brunette,
some large, some small, and, in fact, presented as
many different types as one would meet in an Amer-
ican city. Our impression as to the intelligence and
serious interest of these officials in their work was
almost uniformly favorable. How competent they
would be in executive duties we could not judge.
Subsequently we heard some less favorable com-
ments on the official classes, but high praise for the
peasants from every one.

We heard from numerous sources that the return-
ing Serbian soldiers, after seven years of war, were
not especially anxious to work. In this they are not
altogether different from soldiers of other countries.
The officers, trained more or less in Austrian and
German methods, were reported, in a few instances,
to have absorbed some of the undesirable features of
the military caste, as shown in their attitude toward
privates and civilians. We did not see this, but we
heard it referred to several times.

The Serbian peasant, as a rule, has had little
education. A fair proportion of those in the north-
ern part read. The public-school system was being
developed rapidly before the war. The peasants,
however, seem to be generally alert, active-minded,

SERBIA: THE COST OF ASPIRATION

interested in things, and responsive to new ideas and
methods, with a whole range of new interests and
curiosities awakened by their contact with other
peoples during the war.

The Serbians seem like the Japanese in their de-
sire to learn the best quickly from other peoples;
like the French in scrupulous politeness and defer-
ence; like the Italians in the warmth of their wel-
come and the frank expression of their sentiments;
like the English in their dogged resistance; and like
the Yankees in their rugged individualism, born of
a long period of individual proprietorship in land.

BELGIUM: THE COST OF DECISION

Belgium's material losses; military losses relatively small; four waves
of devastation; results of rationing; tuberculosis doubled; birth-
rate halved; infant mortality; unemployment; exiles in Holland,
France, and England; reconstruction beginnings.

MATERIAL LOSSES.— The story
of Belgium's suffering is better understood in
America than is that of any other Allied country. No
war victims have made a more insistent appeal to
American hearts than those who were in no sense a
party to the issues of the war, but, happening to be
across the easy way from Germany into France, did
not hesitate an instant to choose the path of honor
and of resistance, which was also that of sufferings
and disaster at the time unparalleled. Now that the
long period of oppression is over, now that all Belgium
is again free and we can look about and attempt to
measure the results of the war, it should be a very
real satisfaction to America to find that, heavy as
were the sorrows of Belgium, urgently as she needed
every ounce of help that could be given her, and little
as all this help could do to diminish her losses, it is,
nevertheless, the final fact that in permanent injury,
in depletion of her people, in irremediable losses, Bel-
gium suffered less proportionately than most of the

BELGIUM: THE COST OF DECISION

Allied countries. A larger proportion of Belgians are
now at home and living fairly comfortable lives, with
families intact and firesides in order, than of most
of the other invaded Allies. This is due to the fact
that the invasion was so unexpected and so rapid
that she had no time to mobilize a large army in
proportion to her population. Her army being
relatively small, her military losses were relatively
low. The greater part of her men remained to carry
on local administration and activities in such
fragmentary ways as a brutal enemy occupation
would permit. This made possible the handling of a
large part of the detailed work of the Commission
for Relief in Belgium by the Belgians themselves
through local organizations amounting almost to a
system of local government. When the German
army swept over the country the vast majority of the
population remained in their homes. Of those who
fled into Holland, many soon returned. The Belgian
Relief Commission was able to send both food and
clothing for the entire population during the whole
period of the occupation. There certainly was never
what could be called an ample supply, but there was
always enough to go around after a fashion. The
Belgians early recognized the importance of saving
the lives of the babies, with the result that, in some
localities at least, as in England, infant mortality
was actually lower during the war than it had been
formerly, a sharp contrast to conditions in other
invaded countries.

If the permanent war losses of Belgium may be
said to be comparatively low, they are, nevertheless,
so serious that standing by themselves they would
cause the whole world to hold up its hands in horror.

THE HUMAN COSTS OF THE WAR

Among the major losses are the following: the
complete destruction of the industries which occupied
a majority of her population, so that, as late as April,
1919, no less than nine hundred thousand men, repre-
senting more than one third of the population, were
drawing an unemployment allowance; the under-
mining of habits of industry of very large numbers
of people; the devastation of cities, villages, and
agricultural areas to an appalling total; the driving
from their homes of perhaps a million refugees; a
very marked increase in tuberculosis and a 50-per-
cent, reduction in the birth-rate.

Military Losses Relatively Small. — Belgium is a
country of 7,500,000 people. The rapidity of the
German invasion was such that the number of men
whom it was possible to mobilize in the Belgian army
of 1914 is estimated at 180,000. This is a much
smaller number in proportion to the population than
the mobilized army of France, or Italy, or Serbia.
Subsequently, a goodly number of those who had
been left behind found ways, hazardous though they
were, of getting out of the country and of reaching
France, where they joined the Belgian army. At the
end of the war the army was considerably larger than
at the beginning, and is stated to have been 250,000.
The deaths of soldiers from wounds and disease are
placed at 41,000. The number of missing is 20,000,
of whom at least one-half must be reckoned as killed,
making a total of soldiers' deaths of about 51,000.
Under ordinary circumstances the loss of 51,000 men
would be an appalling disaster. It is not less so now,
but it seems less when dealing with deaths by the
millions. Compared with this rate of loss of men,

that of France is about seven times as great; that

100

BELGIUM: THE COST OF DECISION

of the United States, about one-seventh as great.
The number of widows and orphans is correspond-
ingly less than in France or Serbia. The number of
war orphans is put at 5,800. It is startling to learn
that to these 5,800 orphans of soldiers there must be
added a larger number, 6,200, orphans of civilians
who were shot during the demonstration of the
*' value" of frightfulness, or killed by shells or bombs,
or died in exile, making a total of 12,000 children
made fatherless by the war. Forty thousand Bel-
gian soldiers were taken prisoners or interned in
Holland, and 10,000 civilians were deported as
prisoners. Many thousand civilians, one German
estimate says 56,000, were deported as laborers.
There are about 15,000 permanent cripples. All
these direct military losses of the Belgian people
should lose none of their significance because of the
fact that other countries, having had more time in
which to complete their mobilization, suffered
accordingly.

Four Waves of Devastation. — Belgium is spotted
from the German border to the sea with areas of
devastation. It happened at four different periods.

First, when the German tide became strong enough
to sweep over the frontier forts and spread through
the country. The amount of devastation by fighting
at this time was very much less than might have been
expected. There are areas of destruction in eastern
Belgium, but they are chiefly due not to fighting,
but to deliberate arson. The German troops claimed
that civilians fired on them and as a punishment and
deterrent they burned cities and towns. The names
of Vise, Termonde, Dinant, and Louvain are identi-
fied for all time with this phase of the spread of

101

THE HUMAN COSTS OP THE WAR

Kultur. Nearly five years afterward the burned
areas of Louvain stand almost as they were left in
August, 1914. The walls of the great university
library stand, but there are nothing but walls. The
major part of the cathedral, that in which the
Germans built fires in one chapel after another,
stands as they left it. A very few small permanent
buildings have been put up. Scattered through the
burned area are a variety of one-story buildings,
mostly of wood. Not all of Louvain was burned, of
course — perhaps not more than one-eighth or one-
tenth. Except for this wanton destruction, rela-
tively little harm was done; even Antwerp, in spite
of the serious fighting and heavy bombardment, was
relatively little injured. Here and there, however,
all through Belgium, are found marks of the original
invasion.

The second belt of destruction is that along the
trench line, as it stood after the race between the
Allies and the Germans to the sea had stabilized the
positions for the time being. The trench line ex-
tended for about twenty-three miles in Belgium
from the sea to the French frontier. Close to this
line everything was destroyed. A little farther away
the destruction varied from 5 to 100 per cent. For
example, Furnes, a city of six thousand people, four
and a half miles this side of the trenches, which was
bombarded so heavily that at one time the entire
population except four people fled, finds itself at the
end of the war with one-fourth of the houses entirely
destroyed, one-fourth badly damaged, one-fourth
slightly damaged, and one-fourth intact. These
twenty-three miles of front saw much of the heaviest

fighting of the war, for it was here that the English

102

BELGIUM: THE COST OF DECISION

and the Germans tried to see which could endure the
most. Nieuport, Dixmude, the Forest of Huthulst,
Meerkein, Bixschoote, the Passchendaele Ridge,
Ypres, Hooge, Dickibush, Messines Ridge, Kemmel,
and Neuve-figlise are a few of the names which recall
to the world the titanic struggles which took place
along these short twenty-three miles that separated
"free" Belgium from that vastly greater Belgian
area which never lost confidence that it would some
day again be free. Nowhere in Europe, perhaps, are
to be seen more obviously the results of high tide of
battle in the Great War than on the western half of
the ten-mile road from Menin to Ypres, and on
Messines Ridge, a slight and gradual ascent, from
which one looks in every direction and sees only
utter, complete, unqualified destruction. Very pos-
sibly such areas as these cannot be made again
suitable for agriculture until another forest growth
has created another soil. Nevertheless, the owners
are back and are beginning to pick over the soil of
the former fields by hand, bit by bit. The flooded
area extending some miles inland from the sea has
the look of an unreclaimable marsh. The ruins of
Ypres, to which the British, with Germans on three
sides of them, held on throughout the entire war,
have been made familiar to the entire world.

A third period of serious destruction occurred
when the Germans pushed the southern end of this
twenty-three-mile line toward the west and short-
ened it to a line of about fifteen miles. The regions of
Messines, Wulverghem, Locre, Kemmel, Dranoutre,
names which the world read with a sinking heart in
the spring of 1918, represent regions of complete
destruction.
8 103

THE HUMAN COSTS OF THE WAR

Then, finally, the fourth and last period of destruc-
tion took place in September and October, 1918, when
the German line farther to the south was shattered,
the coast line was abandoned, the Belgian, French,
and British armies moved forward and a new trench
line was established along the Lys, as formerly it had
been along the Yser. Along the area of this retreat
there are spots of destruction, but it is chiefly along
the line of the Lys that the fourth zone of devasta-
tion is to be found. Here the Germans remained
until the armistice.

An official estimate of the total number of build-
ings wholly or practically destroyed in Belgium is
86,348, of which 48,498 were in West Flanders. In
the province of Antwerp the number is 6,000; in
that of Namur, 5,000; in Brabant, including Lou vain,
5,800. The total is about one-fifth of the official
French estimate of the number of buildings destroyed
or materially damaged in France. In proportion to
its total population, the amount of physical destruc-
tion in Belgium is, perhaps, slightly greater than that
of any other country on the western or southern
fronts.

There is to be added to these successive waves of
destruction connected with fighting the dismantling
of factories in all parts of Belgium, many miles from
any fighting-line. Partly, no doubt, in order to use
the materials for munition manufacture, and partly
probably also for the deliberate purpose of breaking
down competition in the future, the great factory-
buildings of industrial Belgium were taken down,
piece by piece, the materials shipped to Germany,
and the machines either destroyed or shipped with
the materials. This is probably Belgium's most

104

SAFELY BACK

This little girl and her parents live in a temporary hut of corrugated iron
and boards, near Ypres, Belgium.

DANGER IN DEBRIS

Ruins of the buildings in the city of Armentieres. The boy had been injured

while playing with powder from unexploded munitions.

BELGIUM: THE COST OF DECISION

serious loss, for she raised only one-third of her food
and depended on her manufactured products for the
means with which to pay for the imported two-thirds.
Results of Rationing. — Turning from the tremen-
dous amount of physical destruction in Belgium to
the effects of the war upon its civil population as a
whole, we begin to appreciate how very different the
reckoning is from what it would have been had it
not been for the prompt organization of the Com-
mission for Relief in Belgium. Belgium had formerly
produced considerable amounts of food. She raised
enough potatoes as well as hogs to met her needs.
The production of eggs met nearly the need, and
oats and rye fell short by one-seventh. Wheat, on
the other hand, was largely imported, local pro-
duction meeting less than one-fourth of the need.
Three-fourths of its importation of four million tons
of food per year came from France. The war, of
course, immediately stopped this importation, and,
as the industrial population faced starvation, Hoover
appeared upon the scene. With the aid of a very
complete organization of the Belgians themselves
the Commission for Relief in Belgium waged a suc-
cessful fight against starvation for five long years.
It provided not only a modest ration of food for the
population at all times, but also distributed great
quantities of clothing. Except for this greatest relief
work of history the human assets of Belgium would
have been devastated far more effectively than her
homes and other buildings actually were; yet it is
both incorrect and inadequate to refer to the work
of Mr. Hoover and his aids in Belgium as relief. It
was a mobilization of the food-supplies of Allies and
neutrals for the benefit of a whole people. It was

105

THE HUMAN COSTS OF THE WAR

superseding the breakdown of supply and demand, by
a conscious and effective control of a vast commercial
operation for a tremendous social purpose. It was
business elevated into social statesmanship. The
vast majority of the Belgians paid for their food as
they should do, but nobody went without because
he was unable to pay. It was as different in kind as
it was in volume from anything which had ever
been done before, for it had to meet a situation such
as had never existed before.

We have said that the ration of food which it was
possible to provide was modest. It became more
so as the war progressed and especially after America
entered the war. In May, 1918, a report from the
sanitary officer of Bruges says:

At the present time the individual per diem ration of our
population is composed of 300 grams of bread [two-thirds of a
pound], 11 grams of meat [four- tenths of an ounce], 15 grams of
lard, 30 grams of rice, 18 grams of corn flour, 18 grams of beans,
and 8 grams of sugar. [This makes a total daily ration of
nine-tenths of a pound.]

He adds that the very small meat ration is not
always given, that milk can be had only in trifling
quantities for the sick, that butter, home-made lard,
and cheese have practically disappeared, and that
there has been no distribution of potatoes since
April 15, 1917.

For all of Belgium, the Inspector of the Health
Service states that the average adult ration varied
from 1,800 to 2,000 calories. An expert of the Com-
mission for Relief in Belgium l says that the minimum

1 Robinson Smith. Food Values and the Rationing of a Country.

10G

BELGIUM: THE COST OF DECISION

amount of utilized calories sufficient for light mus-
cular work is 3,000. "We may reduce this at least
1,000 if we merely wish (because we can only afford)
to keep body and soul together." His minimum
balanced ration gives a total amount of food of 870
grams per day (one and four-fifths pounds), including
340 of bread and 300 of potatoes, and giving a total
of 2,000 utilizable calories — i.e., units of energy-
producing force. He adds that this minimum was
not maintained for Lille (France) and people began
to die, the normal mortality of 16 per 1,000 running
up to 26 in October, 1915, and 39 in March, 1916.

For months after the war the food prices remained
very high. In reply to questions, a representative
of the National Committee on Food said (April,
1919):

Food is no longer rationed. No foodstuffs, strictly speaking,
could be said to be absolutely lacking, but food is so dear that
it seems to be abundant.

He gave the following prices:

Prices

Articles Quantity Before War April, 1919

Bread. per Ib $.027 $.08

Meat per Ib 27 .90 to 1.09

Lard per Ib. . . . 18 .45

Ham per Ib 44 1.80

Eggs each 02 .045

Milk per pint 023 .09

Potatoes per Ib 01 .027

Butter per Ib 32 1.60

Tuberculosis Doubled. — It is beyond question that
we owe to Hoover the fact that we have no serious

107

THE HUMAN COSTS OF THE WAR

epidemics to record in the history of occupied Bel-
gium. But even a rationed food-supply was not
sufficient to prevent an alarming increase in that
disease which seems to be so very closely related to
nutrition — tuberculosis. In the summer of 1916
Dr. William P. Lucas, later chief of the Children's
Bureau of the American Red Cross in France, made
an inquiry on behalf of the Belgian Relief Commis-
sion as to the health of the people in occupied Bel-
gium, covering three months. He found the well-to-
do and the agricultural classes, together amounting
to 35 per cent, of the population, in their usual state
of health. The industrial and minor commercial
classes, however, already showed a great change as
to the amount of tuberculosis. Dispensaries and
hospitals reported that many people who had been
cured of tuberculosis were reappearing with the
disease in a serious form. The attendance at some
tuberculosis dispensaries increased 100 per cent.
Every tuberculosis sanatorium and hospital was
crowded and there were long waiting-lists. The
number of children having tuberculosis of the glands
or joints increased tremendously. In Antwerp the
number of deaths due to tuberculosis increased 94 per
cent, from 1913 to 1917, and in Liege 102 per cent.
In Brussels the increase from 1914 to 1916 was from
17.7 to 22.3. In one of the schools in Brussels
63 per cent, of the boys between four and sixteen
years old had infected glands of the neck, and in
another 70 per cent.

These conditions became worse and worse to and
through 1918. At the end of the war the tubercu-
losis death-rate of Brussels looked like this:

108

BELGIUM: THE COST OF DECISION

Year Tuberculosis Deaths per
10,000 Inhabitants

1914 17.7

1915 17.9

1916 22.3

1917 35.0

1918 39.0

There is a well-organized society for the preven-
tion of tuberculosis in Belgium, and it is its opinion
that these figures reflect the actual facts throughout
Belgium. It is commonly reported that the tuber-
culosis death-rate increased threefold during the war.
Whether it be slightly over twofold, as the Brussels
figures indicate, or threefold, it is an increase of
ominous significance for Belgium's future. She will
have rebuilt her factories and her war zone long be-
fore she has succeeded in reconstructing her diseased
multitudes.

Birth-rate Halved. — In view of the fact that the
mobilization in Belgium was very incomplete and
that a large proportion of the men remained through-
out the occupation, a reduction of 50 per cent, in the
number of births is astonishing. It is also disturbing
as indicating that some of the factors which pro-
duced it may continue long after the end of tfce war.
Doctor Lucas noted, in the summer of 1916, that in
the larger cities the birth-rate had already fallen 40
per cent. He commented on the fact that the num-
ber of men absent from the country was unimportant
as compared with the proportion of the men absent
from other Allied countries, and suggested the low-
ered vitality of women, due to poor nutrition and
their anxiety and fear of being unable to care for
their children, as probably large factors in the situa-

109

THE HUMAN COSTS OF THE WAR

tion. This reduction became still more serious as the
war continued. The actual figures for certain cities
during the entire war period are as follows:

1914

1915

1916

1917

1918

Brussels and vicinity

,093

,317

6,846

,051

,709

Province of Liege . . .

,669

,069

8,637

,902

Not known

Province of Namur .

,316

,633

3,027

,704

Not

known

Province of Hainaut.

16,763

,233

9,131

,499

Not

known

City of Ghent

3.058 2

,145

1,654

,370

,407

City of Eecloo

284

225

183

151

113

City of Alost . .

808

620

478

381

361

City of Lookeren . . .

648

501

401

311

318

City of Courtrai ....

863

679

548

414

359

City of Hamme ....

440

346

283

232

187

City of Grammont. .

298

211

164

113

133

These are widely separated regions, most of them
far removed from the fighting-area, yet almost
uniformly they show a reduction in births of about
50 per cent. The total reduction for the war period is
sufficiently serious. The fact that it occurred not-
withstanding that a great majority of the men were
still in Belgium, and the further fact that hard con-
ditions of living, a restricted food-supply, over-
crowding on account of lack of buildings, uncertainty
of income until factories and machines can be re-
built and industries re-established, are continuing
and will continue long after the war, suggest that
some reduction in births is likely to continue. Before
the war, in 1912, Belgium had a high birth-rate,
twenty-two, and a low death-rate, fifteen. A reduc-
tion of even 35 per cent, in births with no increase
in deaths, would mean a stationary population for
Belgium. A larger reduction than that means a di-
minishing population. Belgium has started on the

BELGIUM: THE COST OF DECISION

road along which France had traveled a considerable
distance toward depopulation.

Infant Mortality. — Observing the great fall in the
birth-rate and fearing a high mortality among chil-
dren, the National Committee on Food made a
special effort to reduce infant mortality by the
establishment of infant welfare stations. These met
with marked success among the limited number of
children and of mothers able to avail themselves of
their advantages, and great efforts were made to
extend this baby-saving work as widely as possible.
Numerous instances are given of striking reduction
in the death-rate among babies as a result. It is
impossible as yet to secure figures as to the death-
rate among babies in the whole of Belgium, and it is
uncertain as to what extent the number of infant
welfare stations which it was possible to establish
were able to overcome the great combination of
adverse circumstances under which the children of
Belgium were trying to live. The most inclusive
figure available is that for regions including about
one-fourth of the population. In this region there
were 44,000 deaths of children under two years of
age in 1914. In 1915 it had been reduced to 38,000,
and in 1916 it was 40,000. On the other hand, in
1917 it reached 49,000. Having in mind the great re-
duction of births during this period the figures as a
whole are not encouraging. As against these, how-
ever, there are isolated instances which show that an
efficient method was worked out which under the
more tranquil circumstances of the present it should
be possible to apply on a wide scale throughout
Belgium. The National Committee reports such en-
couraging instances as the following: that in one re-

THE HUMAN COSTS OF THE WAR

gion in which the deaths of children under three years
of age, from 1890 to 1894, was 22 per cent., in 1915
it had been reduced to 15.3 per cent., and in the
month of July, 1916, to 7.5 per cent.; in another
region a rate of 12 per cent, in 1914 was reduced to
3.2 per cent, in 1916. In the city of Brussels, where
the deaths of children under three had averaged
436 per year from 1911 to 1914, in 1915 it was 284,
a diminution of nearly one-third, although the num-
ber of births had fallen off about one-fifth. The
number of deaths per thousand births in Brussels,
1911-14, inclusive, was 154; in 1915 it was 121. In
various cities in Flanders, in all of which infant wel-
fare stations had been established, the average death-
rate under two years of age varied from cities having
as low as 1J4 per cent., 3.8 per cent., 4.8 per cent.,
to others in which it was as high as 10.8 per cent., 12
per cent., 14 per cent., or even 15.9 per cent.

From the point of view of total results the picture
is somewhat confusing, but it suggests that, although
in certain localities by special effort the infant death-
rate was actually reduced, as it always can be by a
special effort, yet that for Belgium as a whole the
actual rate of death among the new-born was high,
probably higher than before the war.

Unemployment. — Belgium is a predominantly in-
dustrial country. It is estimated that its industrial
and minor commercial populations include nearly
65 per cent, of its entire population. The complete-
ness of the industrial breakdown can hardly be
overstated. There were not only the financial dif-
ficulties and the difficulty of securing raw materials,
but the buildings were very largely destroyed and the

machinery either destroyed or removed to Germany.

112

BELGIUM: THE COST OF DECISION

One of the vivid recollections of my trip is that of a
visit to what had been a very important iron- and
steel-factory employing several thousand workmen
some fifty miles south of Brussels. Some of the
buildings were still standing and some were in ruins.
High furnaces had been taken down and taken
apart and the iron and fire-brick shipped to Germany.
Most of the machinery had also been shipped. The
little that remained had deliberately been made
unusable. On a siding of the railway track there
were still standing railway cars loaded with ma-
chinery which apparently there had not been time to
send away. Their destination had been plainly
marked upon them. It was Essen!

If money were plenty and credit ample, it was
estimated that it would take about three years to
replace the machinery to enable the factory to re-
sume its work. The other side of this picture was
presented to us in the government offices at Brussels.
Here we were told that of about 1,200,000 laborers in
Belgium, 900,000 were unemployed and receiving
unemployment benefits — three-fourths of all the
workmen in the country; that each of these men
represented an average of several dependents, and
that this meant that something like 3,000,000
people in a total of 7,500,000 were being supported
by the government — a government which had been
in exile for over four years and whose only resources
were loans. It is evident that even with the most
rapid recovery possible large numbers of Belgians
must be carried for a long time before they can
again be supported by the highly developed industry
which made Belgium so prosperous a country up to
1914.

113

THE HUMAN COSTS OF THE WAR

Exiles in Holland, France, and England. — When
the German army overran Belgium in 1914 about one-
sixth of the population fled. A great majority of the
refugees went into Holland, probably at least a
million. Many of these soon returned. Travel
between Belgium and Holland was not very diffi-
cult until 1915. Others, perhaps 200,000, went to
France. A good many went to England. Some-
thing like 600,000 Belgians remained exiles during
practically the whole war — in England, France, Hol-
land, or Switzerland. There were some 70,000 in
Paris alone, perhaps as many in London, and about
30,000 in Havre. The French government treated
the 200,000 Belgian refugees exactly as it did French
refugees. It made an allowance to them of the same
amount and in every way it made no distinction
between refugees in its territory. The English also
tried to make the Belgian refugees, some 20,000 in
number, as comfortable as circumstances permitted.

But when Dutch, French, and English hospitality
had done the best it could, that best left much to be
desired. The Belgian refugees in France, as well
as the million and a half French refugees, were
obliged to live at standards far below those to which
they had been accustomed, and considerably below
those of the native populations of the localities to
which they went. The natives owned their own
homes and many of them small farms, so that they
were not completely at the mercy of the high cost
of living either as to rent or as to the important
parts of the food-supply. The refugees, on the
other hand, were absolutely at the mercy of the
landlords and of the ever-rising cost of living, and in

late 1917 and to a greater degree in 1918 the prob-

114

BELGIUM: THE COST OF DECISION

lem of subsistence became very acute. Invariably
the refugees were obliged to take the poorest living-
quarters available. The dark, gloomy, damp, un-
sanitary quarters fell to their lot and often from
four to eight persons occupied a single room. The
opportunities for cleanliness and sanitary living (and
the standards of many of them were fairly high in
these regards) were almost nil. It must always be
remembered that refugees were not the unsuccessful
class, but included all classes of people driven from
their homes. It was inevitable that a great deteriora-
tion in their health, as well as in their moral stand-
ards, should occur, and especially that the develop-
ment of the children should be greatly delayed and
their vitality undermined.

In the remnant of "free" Belgium, a strip of land
nowhere more than ten miles wide and about twenty-
three miles long, some seventy-five thousand persons
remained at all times within the range of the enemy's
guns, though, as a matter of fact, a great deal of the
territory was not actually subjected to fire. They
were also at all times within easy reach of bombard-
ment by airplanes at night. This bit of Belgium
was even more densely inhabited until the spring of
1918 than before the war because employment in the
manifold forms needed by the armies was plentiful.
Nearly half of this whole number were obliged to
flee into France during the advance in the spring of
1918, when the Germans captured a large number of
additional villages near the French frontier. Col-
onies of Belgian child refugees were established in
Switzerland and in France. The refugee problem of
Belgium throughout the war in proportion to its
population was a very serious one, and but for the

115

THE HUMAN COSTS OF THE WAR

friendly aid of France, England, Holland, and
Switzerland the lot of these groups, which together
formed about one-eleventh of the total population
of Belgium, would have been still more painful and
harmful to their future well-being than it was.

Behind the lines there was also great shifting of
population from time to time. In 1917 the city of
Roulers, with thirty thousand population, ten miles
from the line, was wholly evacuated toward the in-
terior, as were many other localities similarly placed.
Also, Belgium was the temporary stopping-place of
many thousands of French evacuated by the Ger-
mans from St.-Quentin, Lens, Lille, and elsewhere.
Refugee migrations were, in fact, a more or less con-
tinuous factor in Belgian life from August, 1914, to
midsummer, 1919.

The great amount of unemployment was seized
upon as an excuse for deporting thousands of Bel-
gians into Germany for compulsory labor. The
editor of the Tageblatt is quoted as saying that fifty-
six thousand were so deported, that they were treated
as slaves, and that fifteen hundred perished in the
first two months. Definite information from Bel-
gian sources as to these deportations is not at hand.

Reconstruction Beginnings. — The condition of the
returning Belgian refugee is quite like that of his
French brother. The Belgian war zone presents
every variety of partial and complete destruction.
Probably a greater proportion of the Belgian war
zone is completely destroyed than of that of any
other country. The government endeavored to de-
lay the return of the refugees until it could provide
temporary housing for them in barracks and could
extend assistance for agricultural rehabilitation and

116

BELGIUM:: THE COST OF DECISION

for the beginnings of industries. It was not surpris-
ing, in view of the superhuman difficulties under
which the government of Belgium labored after the
armistice, that these forms of organized relief de-
veloped far more slowly than did the determination
of the refugees to return, a determination before
which the resistance of the authorities inevitably
soon began to break down. All through the Belgian
war zone are found people housed in every conceiv-
able kind of improvised shelter. Many of them are
in temporarily repaired buildings in which windows
have been replaced by solid brick walls; others are
living in many varieties of temporary shelters or
huts made of boards, corrugated iron, building-
paper, and every other sort of material salvaged
from the battle-field. Many others are living in
basements and even cellars over which they have
been able to arrange some sort of a roof. These sur-
roundings are undoubtedly far more unhealthful and
far less attractive than the gloomy quarters in which
most of them had lived as refugees during the pre-
ceding four years, but it is all that remains to them
of home. It is the locality to which they had been
accustomed. It is the land they own. There may
be nothing left but a few stumps of trees, but owner-
ship and attachment to locality exercise an irresist-
ible attraction for the refugee. Until the harmful
results of living for weeks, months, and years in these
primitive huts and shelters are known, the harmful
effects of the war to Belgium cannot be fully reck-
oned. These are the kinds of surroundings which
have always been associated with lowered vitality
and increased death-rates. They are incomparably
worse than the types of tenements which have been

117

THE HUMAN COSTS OF THE WAR

forbidden by law in progressive cities for many years;
vastly more healthful quarters than these have been
torn down by municipal authorities because of their
unsanitary nature and injurious effects. It is as
certain as that the sun will rise upon the Flanders
plains that the effect upon this large element of the
Belgian population of living in these areas of de-
struction under these circumstances of hardship,
privation, overcrowding, and insanitation will be
seriously and permanently harmful, that it will
further undermine their strength and their moral
standards, that it will impair their ability to under-
take the reconstruction problems which are formi-
dable for their country, and that it will project into
Belgium's history for a long time to come a vast
amount of lowered vitality, of sickness, of depend-
ence, and of premature death.

Economically, the reconstruction of her factories
is first in order of importance. A higher order of
statesmanship would put first of all the rebuilding
of the houses in the devastated areas. The health
and efficiency of the returning population depend
largely on their housing, and the prosperity of the
future must be built upon a healthy and efficient
people.

FRANCE: HER SUPREME SACRIFICE

The French; the exoduses of 1914 and 1918; repatriation; under the
enemy army; how devastation came about; how much is there of
it?; her soldier dead; cripples; widows' veils; fatherless wards
of the nation; soldiers' families; general conditions; huge excess
of deaths over births; intensive survey of a typical French com-
munity after four years of war by Mr. and Mrs. Basil de Selincourt;
population; prices; wages; labor — some family groups; refugees;
health; government.

FRENCH.— France helped us to be free and
-*• is our friend by a long tradition. It is a land of
clear thinking, a home of ideas and of idealism, of uni-
versal thrift, and of luxury as a fine art. The names
of her scientists and philosophers are household
words among us. It was France toward which two
million American homes turned when their boys
crossed the water. We think more frequently of
France probably than of any other ally^ and when
we think of her we see a picture of ruined cities, dis-
mantled factories, and destroyed dwellings. That
is a terrible picture, but it does not show France's
supreme sacrifice. It is not the destroyed houses in
the war zone, but the lonely homes all over France
which are her chief claim to our sympathies. She
can rebuild her cities, with help, but can she rebuild
her people?

A glance at the perspective of her recent history
9 119

THE HUMAN COSTS OF THE WAR

will help us to understand the greatest injury which
she suffered from the war. France is often cited
as a proof of the speed with which a country re-
covers from war; she recovered unexpectedly quickly
from the Napoleonic wars and from that of 1870.
Did she? Financially, yes; but from another and
more fundamental point of view, no. In 1801
France had more than one-quarter of the population
of the five great countries of Europe. In 1910 she
had less than one-eighth. May not the necessity of
paying an enormous indemnity have contributed to
that thrift which reduced her numbers in order to
recover her prosperity? Certain it is that the excess
of births over deaths in France fell off very rapidly
during the early period of the last century and that
during the five years 1871-75 it almost disappeared.
From then on the birth-rate and the death-rate ran
a neck-to-neck race. In 1871 France had 37,000,000
inhabitants, Austria 36,000,000, and Germany 35,-
000,000; in 1914 France had 39,500,000, Austria 50,-
000,000, and Germany 65,000,000. Even before the
war no problem of France called for higher statesman-
ship than that of her population. The hardest blow of
the war struck France at her most vulnerable point.
No previous losses which she has ever suffered can
compare for a moment with the loss of her men in
the Great War and the tremendous decline in her
birth-rate. Each of these causes has diminished her
population by about 1,500,000, and some of the
factors which have produced this extraordinary de-
cline in the birth-rate seem likely to continue for
several years to come. The evidences of France's
supreme sacrifice are the millions of fatherless or

childless homes.

120

FRANCE: HER SUPREME SACRIFICE

The Exoduses of 1914 and 1918.— One phase of the
story of the French refugee is familiar to Americans.
We know that as the gray German flood rolled over
northern France a million and a half of people fled
before it as before a tidal wave. When we think
of them we think chiefly of their dramatic leave-
taking, of the hurried good-bys to all the things to
which they were accustomed and which they held
dear ; of the hardships to people of all ages of walking
long distances, of being crowded into trains, and of
making long journeys to strange places; of families
being separated; of hunger and cold; of anxiety and
distress — but the real tragedy of the refugee came
later. These things were serious enough, but they
could be endured. All traveling is more or less un-
pleasant and, for a few days, most people can endure
even what the refugees passed through without any
serious permanent harm. The really serious task
of the refugee family was how to establish itself,
how to care for the children, not for a few days, but
for a few years. Hunger, cold, exposure, over-
crowding, discouragement — all these can be put up
with for a short time, but their effects are cumula-
tive. Surroundings and deprivations which may
have no bad result for a few days or even a few weeks
become serious in a few months and very serious in a
few years. We must follow this homeless popula-
tion of a million and a half, later to be two millions,
scattered throughout every part of France so that
every community had its refugee group. In fact,
the cities and towns were all told by the government
that they must receive up to 5 per cent, of their
normal population. The average quota exceeded

this. The refugees brought nothing with them ex-

121

THE HUMAN COSTS OF THE WAR

cept what they could carry. They were of all the
types and classes that make up the industrial cities
and the rural districts of northern France, but, as
would be the case everywhere, the great majority
of them were people living close to the margin of
subsistence and with little money or articles of value
which they could take with them. They found
themselves in communities already thrown into the
utmost confusion, from which the men had been
mobilized, whose normal activities had thus been
suddenly interrupted, in which little work was to be
had. There were no homes for them to go to, no
schools to accommodate all these additional children,
no doctors to look after the sick, no extra supplies of
food to meet these unusual demands. The kinds of
work to which they were accustomed were not car-
ried on in these regions. The native people were
different, talked a different kind of French, had dif-
ferent habits of life, and did not like the new-
comers. After the first period of extreme distress
there came a time in many districts when munition-
factories and other war industries had been de-
veloped, when wages had risen, and food was fairly
plentiful, when the governmental allowance to refu-
gees was in operation, when such of the refu-
gees as could be useful in the new lines of work were
reasonably able to make both ends meet, though the
housing conditions of the great majority of them were
at all times extremely bad, very much worse than
they had been accustomed to, and very much worse
than those of the natives.

Then in the spring of 1918 came the last great
German effort and another half-million people were

driven from their homes. This time the departure

1*8

FRANCE: HER SUPREME SACRIFICE

and the trip to the interior were a shade less dis-
tressing. There were more people to help. The
American Red Cross and its various allied organiza-
tions carried away a good many of the sick, the
crippled, and the aged in their ambulances and trucks.
It met the refugees when they arrived in Paris,
helped to care for them overnight, gave clothing
to those in need, helped the mothers to look after
their babies, and provided care for the sick. When
this new half-million refugees reached their destina-
tions the American Red Cross was there, too, and
did what it could to help to make the best of a bad
situation. Everybody else had to crowd up still
closer; buildings that had been abandoned as being
too bad for human use were again put into service.
The American Red Cross was now represented in
every department in France. Its coming toward the
end of 1917 and in the early part of 1918 had put
new life into the wearied officials and impoverished
French relief committees. Many things which they
had recognized should be done for the refugees, but
which they had decided they could not undertake,
they thought might be possible with the aid of the
Americans. A little coal could be gotten for each
family, a few rudimentary articles for housekeep-
ing, some bedding. With such things as the Red
Cross could import from America, buy in France,
or Spain, or England, or Scotland, or have made
in France, it was possible to put the families into
as good quarters as were unoccupied. Otherwise,
having no furniture and no credit, they would have
been obliged to go into the worst of the avail-
able so-called "furnished rooms." So far as first
adjustment was concerned, the last group of refu-

123

THE HUMAN COSTS OF THE WAR

gees, with American help, did better than the
earlier ones.

The entire group of two millions, however, now
began to face new difficulties, in common with the
entire working population of France. Prices soared
skyward and there began to be actual shortages of
available food here and there. The allowance which
the government had made the refugees and the
wages of those who could work, which at first looked
large, now proved to be hardly sufficient to provide
the barest living. The winter of 1918-19 looked
indeed dark to these two million people until peace
came almost unexpectedly, and even then there was
no immediate improvement. The relief and rejoic-
ings were so great, however, as almost to make up for
a time for the lack of other things.

Repatriation. — Meantime, something new in the
history of war had been happening. Three millions
of French people had remained back of the German
lines. Those who lived nearest the line, in a region
which began to be under the Allied artillery fire or
subject to air bombardments, were sent back by the
Germans into the extreme north of France or into
Belgium. A good many of them were a dead load
to be carried — the aged, the sick, and the young
children. As food began to be more and more scarce
in Germany, the Germans in December, 1916, hit
on the plan of sending these people back into
France. Each day they selected a thousand or
twelve hundred of those least able to work and sent
them by special train all the way along the frontier
into Switzerland. They passed through Switzerland
and entered France on the south shore of Lake
Geneva, near the city of Evian. Here there occurred

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FRANCE: HER SUPREME SACRIFICE

from December, 1916, with few intermissions, until
September, 1918, such a sight as only war can pro-
duce. Daily there were welcomed back into France
a thousand people who had been under enemy rule
for some three years, who had been carefully kept
in ignorance as to the progress of the war, most of
whom had had no information in regard to relatives
who were on this side of the line, who did not know
whether their brothers or fathers in the French army
were still living. It was a royal welcome they re-
ceived, with plenty of music, a speech, and a good
dinner at the casino. Then they passed into a large
hall in which a remarkable system of records had
been arranged with wonderful card indexes and filing
arrangements. Each family received whatever let-
ters or communications their relatives on this side
of the line had sent to them in the hope that they
might be among the repatriated. Wives who had
supposed that their husbands had long since been
killed in battle found that they were still living, and
their joy made almost as great demands upon their
powers of self-control as did the bad news which
many other wives and mothers received. Children
were restored to their parents, sisters to their
brothers, wives to their husbands. French people
were restored to France. They all passed before a
doctor and those who were obviously sick were
placed in hospitals. After the early fall of 1917 the
children were examined by the physicians of the
American Red Cross and those having contagious
diseases were cared for by it in a hospital opened for
that purpose. A group of American Red Cross
ambulances carried the aged and sick and facilitated
the physicians' work. Clothing was given to those

125

THE HUMAN COSTS OF THE WAR

who needed it, a certain amount of the local money
which they had been using back of the lines, if
they had any, was exchanged for French cur-
rency, and the following day, those who had
friends or relatives who could provide for them
went on their way. The others, from six hundred
to eight hundred, were placed on a special train
and sent to the prefect of some department who
had to provide for their shelter and care, as he
had done for the refugees. The American Red
Cross helped him after it had secured its staff by
the end of 1917.

Sometimes there was an intermission for a few
day or a fortnight, but several hundred thousand
people were welcomed back to their country in this
unique way and added that much more to the im-
possible load which their country was already
carrying.

Under the Enemy Army. — The condition of those
remaining in the occupied territory can best be
realized, perhaps, from a description by Professor
Calmette, a physician and sanitarian of international
reputation, who remained at Lille throughout the
occupation. Lille, the fifth city in size in France,
had a population at the beginning of the war of
220,000. About 60,000 people were mobilized in
the French army or left in advance of the arrival of
the German troops. About 25,000 were sent back
into Belgium to be out of danger, or to France by
way of Switzerland. Another 25,000, Doctor Cal-
mette says, were sent away to enforced work in the
workshops or military establishments of the Ger-
mans. When Lille was liberated there remained
only 110,000 of its former 220,000.

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FRANCE: HER SUPREME SACRIFICE

The death-rate before the war had been from 19
to 21 per 1,000. It steadly increased as follows:

1915 27.73 per 1,000

1916 29.26 per 1,000

1917 30.41 per 1,000

1918 41.55 per 1,000

This was due particularly, in Doctor Calmette's
opinion, to diseases due directly or indirectly to lack
of food, such as tuberculosis, dysentery, scurvy, and
others. During the last three years of the occupa-
tion the food rations distributed to the population
were much below the normal needs of young people.
Bread was scarce and of bad quality. There was
little rice, beans, or corn, and very small amounts
of sugar, lard, and canned beef. For more than a
year before the end of the war there were no potatoes
and no fresh meats. Butter and eggs were to be had
only by the very rich. One of the most serious
effects, in Doctor Calmette's opinion, was the arrest
of growth of the juvenile population. Children of
fourteen appeared to be not more than ten. A
large majority of girls of eighteen were no further
developed than girls of thirteen should be. They
attained their development as women tardily, if at all.

How Devastation Came. — When France's losses are
mentioned most of us have come to think of ruined
cities, bridges, railways, and highways. While
these things are not France's greatest loss, they are
a gigantic problem which complicates and greatly
increases all her other problems. Buildings, like the
Sabbath, were made for man, and their destruction
means homelessness, exposure, and suffering, and

127

THE HUMAN COSTS OF THE WAR

stoppage of income for men, women, and children.
In trying to gain an impression of what the war
means to France we must form some notion of the
extent of the destruction of the shelters which men
had built for their habitations, and the factories,
railways, and bridges which they had built to serve
human needs. It will help, perhaps, to see how it
came about. It is possible for armies to do a great
deal of marching back and forth and considerable
fighting without causing any considerable destruc-
tion. In fact this is the rule; destruction is the
exception.

It is related that when the war of 1870 was un-
loosed the high German command was awakened
from his sleep and that he sleepily said something
like, "Third drawer on the right, folder number
sixteen seventy-five." Here were found complete
detailed instructions concerning every step of the
march to Paris. We may be sure that in 1914 the
plans had been worked out even more carefully, and
that no detail for which human research and foresight
could provide was left unattended to for facilitating
the one grand push which should again make Ger-
many master of France and thereby make her master
of Europe and of the world. The Belgians made
them stop to take breath and modify the schedule
a bit. Then they rushed on and did not stop until
they reached the Marne and had spread over north-
eastern France. At this high tide of invasion they
had taken possession of fifteen thousand square miles
of French territory, or one-twentieth of France.
But as this is its foremost industrial, as well as the
best agricultural region, it had, not one-twentieth,
but over one-tenth of the population of France,

128

FRANCE: HER SUPREME SACRIFICE

about four million people. Thus far little destruc-
tion of buildings had occurred, but now the German
army ran against something. The French stopped
at the Marne, and the Germans stopped there, too.
The Crown Prince, who, we are told, had selected his
restaurant and arranged for his dinner at Paris that
night, changed his plans again. Fighting and de-
struction raged all along the line. When the Ger-
mans fell back no other permanent memorial of the
battle of the Marne was needed. On the customary
route from Paris to the front, when one arrives at
Senlis, about fifteen miles out, one discovers con-
siderable areas of the city in ruins. From here a belt
eastward across France marks high tide at the
Marne. This belt of devastation is one hundred and
fifty miles long and from five to ten miles wide. A
few temporary repairs have been made here and
there, but in the main the ruins stand as they were
left in September, 1914.

The Germans fell back a long way. In fact, they
gave up almost one-half of the territory they had
taken, say, about seven thousand square miles.
Then both sides dug in, and trench life began, and
with it a second belt of destruction, all the way from
the North Sea to Switzerland. It varies in width,
it varies in completeness. It is nowhere very wide.
Although modern artillery carries long distances,
there is not enough of it and it does not last long
enough to destroy anything like all the territory
within its range, but the main trench line of 1914
to 1916 will always be an easy line to trace along its
hundreds of miles.

Then came the terrific fighting of 1916 in the
British offensive along the valley of the Somme and

129

THE HUMAN COSTS OF THE WAR

in its vicinity. It was of Unprecedented intensity, and
in the many square miles over which the Germans
were pushed back nothing was left standing. The
Germans boasted that the British offensive had been
stopped in a sea of blood and mud, but they were
sufficiently impressed by it to make a grand strategic
retreat in March, 1917 — the famous Hindenburg
retreat. This time they voluntarily gave up fifteen
hundred square miles of territory and, in doing so,
gave their first example on a large scale of voluntary,
deliberate, wanton devastation. This zone, stretch-
ing through the departments of the Aisne, the Oise,
and the Somme, was marked by substantially com-
plete devastation except in a few cities, such as
Noyon, to which the unfortunate inhabitants were
gathered while their villages and country homes were
destroyed. Back of this line the Germans held from
March, 1917, to March, 1918, roughly speaking,
5,750 square miles. Then the Russians pulled out.
The German lines on the west were reinforced and
they made their great efforts of March and May,
1918. These were so formidable as to carry them
over 2,300 square miles of territory, recapturing the
devastated area and much more. Considerable de-
struction occurred all the way wherever anything was
standing, for the going was bad, but still some cities
survived in part even this trial by fire. At high
tide, in the German advance of May and June, 1918,
they held 8,000 square miles of territory. Then, the
Americans helping, they were pushed back step by
step, fighting every inch of the way, and the greatest
amount of devastation in all the war occurred in
driving them out of their holes.

How Much Is There of It? — There have been

130

HOME FOR A FAMILY OF Six

A shelter to house a miner, his wife, and four children at St. Nicholas, a
suburb of Arras, France.

TEMPORARY SHELTER AT MERCATEL

A destroyed village on the road between Arras and Bapaume. The German
advance of March and April, 1918, was stopped at this point.

FRANCE: HER SUPREME SACRIFICE

various official accounts of the number of buildings
destroyed, and they are interesting. In May, 1916,
before the battle of the Somme, there was a survey
which indicated 46,000 buildings partially or com-
pletely destroyed. In July, 1917, after the Somme
battle and the Hindenburg retreat, another census
showed 102,000 buildings damaged, of which almost
exactly one-half were completely destroyed. When
the smoke of the fighting preceding the armistice
cleared away and it was possible to take account it
appeared that in the fighting of 1918 the amount of
physical destruction had been multiplied by four, so
much more destructive had become the agencies of
warfare during the progress of the war. This account,
which is embodied in va report to the Chamber of
Deputies on December 18, 1918, and which was
revised a month later, indicated that the number of
damaged buildings is 410,000, of which 240,000 are
totally destroyed and 170,000 partially so. Totally
destroyed, in this sense, undoubtedly means so far
destroyed that it will be cheaper to tear down and
build anew rather than to attempt to repair. The
net result of all these orgies of destruction is that
about 6,000 square miles of France, the equivalent,
roughly, of a strip two miles wide stretching from
New York to San Francisco, has become for all
practical purposes a wilderness. This area had
housed about 2,000,000 people, or 5 per cent, of
France's population.

The value of these buildings is placed, in the report
referred to above, at 19,000,000,000 francs, or nearly
$4,000,000,000, an average of $2,000 per inhabitant.
This might seem a high average, but it must be
remembered that it not only includes houses, barns,

131

THE HUMAN COSTS OF THE WAR

and outbuildings, but also public buildings of all
sorts and descriptions — school-houses, churches,
hospitals, city halls, hotels, etc. Also, that in
France buildings were of a permanent character and
represented a large outlay of capital; also, that the
cost of materials and of labor has been greatly in-
creased by the war. Taking these facts into con-
sideration, the estimate of an average of $2,000
per inhabitant for the destruction of buildings is
perhaps not greatly excessive. The value of the
furniture, supplies, etc., in these buildings is es-
timated at $2,000,000,000, one-half the value of the
buildings. This again seems high and it may be
found excessive. The total amount of damage in-
flicted by the war on the invaded regions is estimated
in the same report, including the damages to agri-
culture, to mines, to factories of all sorts, machinery,
railways, bridges, etc., at 122,301,000,000 francs, or
a total of $24,000,000,000.

When one comes to dealing with figures of this
size they have long since lost any definite meaning.
It might as well be $5,000,000,000 or $100,000,000,-
000 as $40,000,000,000. No one can form any
rational estimate of what it means in human terms.
The one sure thing is that these physical properties
have gone; that all these products of human labor
put up by human hands through several centuries,
all built to serve some useful human purpose — to
keep out the rain and the cold in winter, to shelter
children while they were being educated, or the
sick while they were being cared for — have been
wiped out, and this vast amount of human effort
has been undone.

It is not simply a question of so many millions

132

FRANCE: HER SUPREME SACRIFICE

or billions of francs or dollars. Human hands must
relay these bricks and stone. The cement, the
lumber, and the glass must be brought from else-
where. Somebody must get them ready. Long
before the process of destruction was completed and
its full magnitude known it was estimated that if all
the men engaged in building operations before the
war did nothing but build in the devastated area
continuously they would be so occupied for fifteen
years. If that were a correct estimate when made,
the period of time must now be multiplied by three
or four, since the fighting in 1918. Never before
has the world faced at one time such a tremendous
job of building, and never before was it in so bad a
shape to begin it, so short of materials, so few means
of getting them where they are needed, so short of
men to do the work. But we must not think too
much of the value of these buildings nor of the labor
which must go into their reconstruction. We must
bear in mind that until the job is finished, years from
now, the purposes for which they were built will
not be fulfilled. The people who were living in
these houses will be living in cellars, shanties, cor-
rugated-iron houses, dugouts, wooden barracks, that
until just lately would not have been thought good
enough stables for cows; that makeshifts will have
to be used for schools, hospitals, churches, and for
all community uses in so far as these are met.
Because of the lack of suitable buildings life will
remain for hundreds of thousands of people for
indefinite periods, in many cases for years, a bare,
hard existence without most of the aids which civiliza-
tion has gradually evolved to make life cheerful,
interesting, and worth while. In some such way as

133

THE HUMAN COSTS OF THE WAR

this the real devastation of France must be recorded.
It is a devastation not simply of buildings, but of
life, of thought, of feeling, of affections, of religion,
of brotherhood, of hope, of courage. If we could see
this devastated area of life, as we can that of the
devastated city and country, we would have a
clearer conception of what devastation means to
France.

Her Soldier Dead. — The deaths among the soldiers
of France caused by wounds are estimated by the
American army authorities at 1,385,000. Besides
these, there remain some 250,000 accounted "miss-
ing," but most of whom must be added to the list of
the dead. Then there are the deaths from sickness
in the army and among the war prisoners. For the
550,000 war prisoners the deaths notified by German
authorities amounted to 25,000. The deaths from
sickness we may estimate at 80,000, or a total of
1,740,000, reckoning deaths from disease in the army
and among prisoners very conservatively. Com-
pared with any of the other great countries engaged
in the war France's loss of about one-fifth of her
effective adult male population was far the highest.
This unhesitating sacrifice of her sons entitles France
to the gratitude and sympathetic friendship of every
ally for all time to come.

It is quite impossible for us to arrive at the slightest
conception of what the loss of 1,750,000 men means
to a country the size of France. Consider it first
simply from the human point of view, of grief, of
mourning for lost sons, husbands, fathers, brothers.
One or two slight comparisons may help. The
United States' loss from influenza amounted to
about 600,000. It created everywhere in this

134

FRANCE: HER SUPREME SACRIFICE

country a sense of imminent danger. Undertakers
could not bury the dead. Every one lost one or
more from his immediate circle of relatives, friends,
or acquaintances. Gloom, apprehension, grief, and
distress were broadcast in the land. It was truly
an appalling disaster and every bit of apprehension
and distress was fully justifiable. If, however, we
wish to picture France, all of France, her cities and
villages and her countrysides, in their true condition,
we must think of them as having lost, not only prob-
ably as heavily as we from the grippe, but also as
having lost by deaths in the army eight times as
many in proportion to population as we lost from
influenza. If we had lost as many soldiers in pro-
portion to our population as France did, we should
have lost some 4,780,000 men, or eight times our
estimated loss from influenza and ninety-three times
our deaths from battle.

Shortly after my return from Europe I happened to
meet a neighbor who was living a few doors away.
We chatted a moment. I remarked, casually and
thoughtlessly, "I suppose your boys are back from
France." "Yes," he said, and his face quivered as
he turned away, "that is, all who are coming back.
We lost one." I reproached myself for not having
remembered that this might be the case. I knew
another neighbor whose son was killed in the war.
There was a third friend in the same town, a city of
100,000, whose son I knew was killed in France. My
first impression was that this was a large number,
since only 51,000 Americans gave up their lives in
France. May God forgive the "only"! When one
is dealing with totals of millions, 51,000 seems but
few. I happened to pick up the Annual of the

10 135

THE HUMAN COSTS OF THE WAR

graduating class of the high-school and found that
of the class of 1919 no less than 17 were among those
who had died in the service. I began to sense the
extent to which the shadow of war sorrow had come
to our own city. In the evening paper, in the pro-
ceedings of a memorial meeting was given a list of
the boys from Yonkers who had died in France. It
filled nearly a column. I was astounded at its
length. I made a calculation then for the first time
as to what would be, so to speak, Yonkers' quota of
51,000 deaths and realized that it would be 50.
It was appalling to think that in these few square
miles of territory and in every other group of popu-
lation of the same size, on an average, from Florida
to Washington and from southern California to
Maine, there were fifty households which, however
they might rejoice at the successful outcome of the
war, would feel that the price to them had been ter-
ribly, terribly high. The loss of 51,000 men had
brought a shade of gloom to every community in the
entire land.

Then I tried to think for a moment what it would
be like if we had lost our men in the same proportion
as France. If we were mourning, not 51,000, bat
4,780,000, this city would have lost, not a quota of
50, but a quota of 4,640. The average loss in every
city, community, and town would be 93 times as
great. The shade of gloom, so to speak, would be
93 times as heavy, the cloud 93 times as black. The
question is whether it was worth while 93 times as
frequent, the missing places in the ranks of industry,
education, agriculture, and the professions and all
along the line 93 times as numerous. France lost
about one-fifth of all her men between eighteen and

136

FRANCE: HER SUPREME SACRIFICE

fifty. If there were no additional work to do, four
men would have to do what was previously done
by five, and from these four-fifths there are still to
be deducted an army of cripples, and a much larger
army than France had before, keeping the watch
on the Rhine, on the Danube, and in Asia. And
France not only has the work which she had before,
but has a problem of reconstruction so big that
nothing like an adequate survey has been made.

One should stop a moment in passing, too, to
think of the sufferings of these poor men who died.
Otherwise our picture would be hopelessly incom-
plete. Some of them were hardly conscious that
they were wounded, death came so instantaneously.
For huge numbers of others, who knows how many
hundreds of thousands, there were hours or days
or weeks of mental anguish and of physical torture.
In all the earlier period, and all through the war,
for that matter, only a small proportion in any of the
armies could receive that immediate attention upon
the battle-field which would have relieved their
sufferings and increased their chances of recovery.
They had to lie in the open field, perhaps under the
hot sun, without drink or food, or walk or crawl or
wriggle over fields or through woods or swamps,
often for long distances, to find help, and then
possibly could find none, for in such battles the in-
dividual counts for naught. Everything is dis-
organized, everything is insufficient, and he is lucky
indeed who receives prompt and adequate atten-
tion. We must think, too, of their mental sufferings
as they thought of the dear ones at home — of their
wives, their children, their fathers, and mothers.
They were dying gloriously for France, but they

137

THE HUMAN COSTS OF THE WAR

were human. They loved their homes, their chil-
dren, and all the places to which they were accus-
tomed. They loved life, believed in its promises,
looked to its future. Not unwillingly they risked
all and lost, but that did not diminish the bitterness
of their grief when they realized that they were
among those who were to pay the full price.

One must think, too, of the five hundred and fifty
thousand French soldiers taken prisoners by the
German armies and living in prison camps. As we
saw German prisoners in France evidently not suf-
fering from any serious lack of food nor from over-
work and having a considerable degree of liberty, one
gained the impression that they did not greatly mind
being prisoners. The lot of the French prisoner
was different. He was in a blockaded and a losing
country whose resources and strength were hour by
hour less adequate for the strain. The French
prisoners, we may be sure, would not be the last to
feel the pinch. There were not enough doctors to
go around. The influenza was severe in the prison
camps. Tuberculosis made great headway. Thou-
sands of French families denied themselves needed
food to send a package regularly to the father in the
German prison camp, hoping it would reach him
undiminished. Perhaps it did, perhaps not. The
full story of the French prisoners is for the future.

Cripples. — It might naturally be expected that
having so large an army, and having been in the
thickest of the fighting from the outset to the last
day of the war (France held 55 per cent, of the line
and had 40 per cent, of all the soldiers on the western
front on Armistice Day), and having a very skilful
medical service, France would have a large number

138

FRANCE: HER SUPREME SACRIFICE

of cripples at the end of the war, probably larger both
in numbers and in proportion than in any other
Allied country. Such is, in fact, the case. The
total number of cripples who had been awarded
pensions or similar grants up to April 1, 1919, was
just short of three hundred thousand. There were
still three large categories to be added — those who
had not yet established their rights, those still in
hospitals, and those suffering lesser injuries who
were still mobilized. All those having lost 10 per
cent, of their effectiveness are entitled to pensions
and the Pension Service estimates that the number
will amount to two million. Even should this be an
overestimate, the total will be formidable. Of
those already pensioned 41 per cent, are farmers,
16 per cent, industrial workers, 12 per cent, in the
building trades, and 9 per cent, in commerce.

The pensions to be paid these victims of the war
will amount to a huge sum, but it is not so much of
this that we should think, as of the crippling of the
lives of these men, of losses for which no pension
can make up. Their injuries range from minor ones
which hardly interfere with normal enjoyment and
usefulness, to those manglings which stopped just
short of causing death, which make the victim help-
less to enjoy life and useless in its tasks, perhaps an
object of involuntary aversion on the part of his
fellows who can hardly bear the sight of a man so
distorted and deformed. For years they will endure
an existence which has largely lost its meaning,
however they may be cherished by their families
and supported by a grateful people. They constitute
not only a great financial burden, one of the elements
in the reparation which Germany must pay if she

139

THE HUMAN COSTS OF THE WAR

can, but both subtract from the man-power available
for reconstruction and add to the load, for they must
be fed, clothed, sheltered, and tended.

The great bulk of those able to work will naturally
return to their former occupations unless their in-
juries make this wholly impossible. Special courses
of training go a surprisingly long way toward en-
abling a crippled man to earn a livelihood in some
line of work. Schools for the "re-education" of
cripples sprang up in various parts of France, some
under private initiative and some under municipal-
ities. Subsequently there was established a National
Service for Cripples to co-ordinate and supplement
these schools. The number of schools was consider-
able and their training very ingenious and very use-
ful to the pupils, but the number of cripples seeking
re-education remained quite small. This was due
largely to a lack of understanding of what re-
education could accomplish, partly to a fear of im-
pairing their prospects of securing an adequate
pension, and partly to an inclination to feel that they
had done their duty once and for all and that some
minor governmental post without excessive duties
was the least reward which the government should
offer. The number of pupils completing their re-
education per year was as follows:

1915 1,288

1916 8,161

1917 17,935

19181 18,339

This rapid increase is encouraging, but the total
is pitifully small compared with the number whose

1 To September 1st.
140

FRANCE: HER SUPREME SACRIFICE

usefulness would be greatly increased by such
training.

Widows9 Veils. — We have spoken of the loss of
a million and three-quarters of men to the future of
France, but let us return for a moment to the present
generation. We do not know how many of these
men were married. The Pension Office had formal
knowledge on the day of the armistice of 585,000
widows. The number must have been much larger
than this. The black veil was to be seen on every
street of every city of France. To the American it
was, perhaps, the most frequent reminder of the war.
But what the bystander felt for a few passing mo-
ments was the widows' lot all day, and every day —
theirs and their children's.

We all have observed the effect of the changes
wrought by the slowly passing months in homes from
which the father has gone. We know how the acute
grief, or even bitterness, is slowly and kindly dulled
as time passes, but also how the added responsibilities
sprinkle the mother's hair with gray and write lines
in her face. Governments and peoples intend to be
grateful and the generous would always recognize
instantly the widow's paramount claim to aid. The
trouble is that generosity is apt to be soon weary
or to be fickle in its attachment, while the widow's
need remains constant three hundred and sixty-five
days in the year. It is hard, too, to devise any plan
which is sufficiently elastic to fit the varying family
circumstances and economic situations. Thus it
has happened that the lot of the widow has usually
been a much harder one than the complacent com-
munity has supposed. She has tried to carry a
double load — support, as well as care for, her family.

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THE HUMAN COSTS OF THE WAR

She has fallen short, inevitably, in three directions —
insufficient support, insufficient care, and over-
drafts on her own strength. Being unable to leave
her home for domestic service, she falls into the
hardest and least well paid of unskilled employments
for women, with long hours, low pay, and excessive
strain. That this will happen to a proportion of the
widows of the Great War is inevitable. They will pay
more than their share of its cost.

Fatherless Wards of the Nation. — The alarming
state of the human resources of France is further in-
dicated by the small number of fatherless children
left by this million and three-quarters of dead
soldiers. The official estimate as of the armistice
date is 887,500 who have lost fathers only, and
12,000 who have lost both fathers and mothers.
These figures probably approach quite closely the
final totals. Shall we be glad or sorry that the
number of fatherless children is so few; that of a
million and three-quarters of the men of France
only 585,000 were married, and that the average
number of children left by these was but one and a
half? Yet the real significance of 899,500 fatherless
children is altogether beyond our comprehension.
We may enter in some slight degree into the mis-
fortunes of one fatherless child. It is to a slight
degree only, for no one of us really knows the child's
soul. But it is absolutely beyond the range of our
powers of imagination and sympathy to form any
notion whatever of what fatherlessness means to
899,500 children. Long before we had compre-
hended more than a minute fraction we should cry
out in distress and beg for any other fate rather than
that of wholly understanding what such figures mean,

FRANCE: HER SUPREME SACRIFICE

The fatherless children of France rightfully ap-
pealed to the sympathies of America. The American
Red Cross, through the Children's Bureau, minis-
tered especially to medical needs and to saving the
lives of the babies. The organization known as the
Fatherless Children of France distributed monthly
grants to many thousands of these half-orphans.
Other American agencies established institutions for
them or for children driven from their homes near
the front. The war orphans, as they were popularly
called, were also a first charge upon French benevo-
lence. But all these agencies combined could
diminish their hardships by only pitiful fractions
and could in no appreciable degree dimmish their
sorrow.

The children must prematurely assume responsi-
bilities and must be without the guidance, compan-
ionship, inspiration, and education which can come
only from daily contact with both parents. Such
losses are not all of to-day or to-morrow. They
project themselves through many years of the future.
Not until well after the twenty-first century has
begun to write its record will there be none in France
to look back and say, "How different my life might
have been had I not lost my father in the Great
War!"

The government of France was conscious of its
peculiar obligations to these children and after suit-
able deliberation it expressed its sense of that obliga-
tion by the enactment of a law making the nation
their guardian. This statute, remarkably well drafted,
as well as based on the soundest of principles, became
a law on July £7, 1917. Its opening sentences read
as follows:

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THE HUMAN COSTS OF THE WAR

France adopts those orphans whose father, mother, or family
support perished, in the course of the war of 1914, a military or
civil victim of the enemy.

There are entitled to the same privileges as orphans those
children, born or conceived before the end of the war, whose
father, mother, or family support are incapable of gaining a
livelihood by their labor by reason of wounds received or ill-
nesses contracted or aggravated by the war.

Children thus adopted have a right to the protection and to
the material and moral support of the state for their education,
within the conditions and limits set forth in this law, until
they have attained their majorities.

This does not mean that the nation deprived the
mother or close relatives of the actual care of the
children nor of the duty of providing for their sup-
port in as far as she could. The war had robbed
these children of their fathers, but the state did not
make the mistake of taking away their mothers also.
It meant in substance that the nation, recognizing
that the father's life had been given for it, acknowl-
edged its obligation, and underwrote the making good
of his loss in so far as such a loss can be made good.
The plan is to give the mother any assistance she
may need to maintain and educate the children. If,
unfortunately, the mother also is dead or if she is
unable to actually care for the children herself from
sickness or serious disqualification the children are
to be supported by the state and placed with near
relatives or with other carefully chosen families,
keeping so far as possible their former status and
identity in the community, and not being set aside
as a separate class of children. Only those needing
some special treatment or needing protection by
reason of mental defect are to be placed in institu-
tions. Such institutions are to be especially de-

144

FRANCE: HER SUPREME SACRIFICE

signed to provide for the particular needs of their
inmates, whether physically or mentally.

The machinery created to administer the law is
imposing, but such as to justify confidence in its
impartiality. The whole administration is in a
sense auxiliary to the Ministry of Education, but it
is in a very large degree autonomous. There is
created as the highest authority and ultimate re-
sponsibility for proper administration a National
Board with ninety-nine members. These are se-
lected in an interesting way. They include among
others: three Senators elected by the Senate; four
Deputies elected by the Chamber of Deputies; the
presidents of the Municipal Council of Paris and of
the Council-General of the Department of the Seine;
the mayors of the five largest cities of France; the
presidents of the Councils-General of the five most
populous departments ; various government officials ;
the president of the Chamber of Commerce of Paris;
six delegates from the agricultural syndicates, elected
by the Superior Council of Agriculture; six from the
syndicates of employers and workers, selected by the
Superior Council of Labor; two delegates from work-
men's co-operative societies; four delegates from
friendly societies; twelve delegates, of either sex,
from philanthropic or professional associations hav-
ing to do with war orphans; five persons chosen by
the President of the Republic for special qualifica-
tions or achievements; a delegate from the Institute;
one from the Academy of Medicine, etc.

There is also to be in each department a board
made up in a somewhat similar manner, and finally
there is in each canton a board with at least one mem-
ber for each commune.

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THE HUMAN COSTS OF THE WAR

An effort has obviously been made to create an
organization broadly representative of French opin-
ion and separated from the network of bureaucracy.
The national body is the law- and policy-making
organ; the departmental body is the executive
agent; and the local sections are to exercise a friendly
oversight, to give the mother advice and moral
assistance, and to see to it that she is given such
material aid as she may need.

The principles and general plan of this statute are
admirable. Its operations must inevitably depend
upon the wisdom and the efficiency of those chosen
to administer it.

Soldiers9 Families. — The ordinary soldier of France
served his country as a matter of duty, not of em-
ployment. During the first fourteen months of the
war he received 1 cent per day; from October 1,
1915, to October 1, 1918, 5 cents per day; since
October 1, 1918, 15 cents per day. His living was,
of course, provided by the army. Obviously his
family could not receive any aid from his pay. To
meet their needs an allowance was made to soldiers'
wives of 30 cents per day, and of 30 cents per day
for each child over sixteen unable to work and 25
cents per day for children under sixteen. In view of
increased cost of living the allowances for children
were raised to 35 and 30 cents per day on November
1, 1918. The allowance to refugee families was the
same for the mother, but was 20 cents per day per
child. The soldier's family also profited by the fact
that if living in the same place since the opening of
the war it could not be evicted or prosecuted for
non-payment of rent. Since mobilization was very
complete, the great majority of families were

146

FRANCE: HER SUPREME SACRIFICE

included in the term "soldiers' families" and were
supported by a government allowance. In case of
families having large gardens or owning farms which
could be worked by the women, the aged, and the
children a fair degree of well-being was not difficult.
For refugees, and for those depending wholly upon
wages, and in which there was no able-bodied worker,
the full force of rising prices was felt, and living
became a serious problem. This applied to all
classes of families alike, whether widows with or-
phans, soldiers' families, refugees, or the relatively
few families not included in any of these categories.

General Conditions. — We have considered the refu-
gees, the widows and orphans, and the various groups
which suffered directly from the war. How about the
French population as a whole? What were the
general conditions produced by the war? We have
heard many conflicting opinions on this subject,
from that which saw France on the verge of revolu-
tion from privation, to that which saw her becoming
swollen with riches spent by the Allied armies;
from that which saw her on the edge of starvation,
to that which saw her eating plenty of the best
of everything while her allies went on short ra-
tions. The facts were complicated and far from
any of these extremes. France is a great food-
producer. Before the war, an average of 1909-13,
she consumed annually 19,000,000 tons of food, of
which she herself produced 17,000,000 tons. Her
imports were chiefly wheat, dried peas and beans,
olive-oil, and cocoa. The French lived well; cook-
ing was a fine art; they knew good food, and knew
how to enjoy it.

During the war, in spite of the mobilization of the

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THE HUMAN COSTS OF THE WAR

men and of the use of transport so largely for war
purposes and of countless obstacles to agriculture,
production held up remarkably well. There was,
of course, some falling off. The estimated produc-
tion of grain for the year beginning September 1,
1918, was 13 per cent, below that of pre-war days,
that of meats 33 per cent., that of sugar 83 per cent.

Meanwhile, it had become necessary to impose
various restrictions upon the consumption of food
by the civilians. The evil day was postponed as
long as possible, but it came. The composition of
the bread was fixed some time before it was rationed.
Later, a previous average consumption of 600 grams
per person per day was cut to a ration of 300 grams
per day and a system of bread-cards instituted. For
those engaged in hard manual labor an increase to
500 grams was allowed. Sugar was rationed at
first at 750 grams per capita per month, and this
was subsequently cut to 500. The selling of con-
fectionery, cakes, etc., at first limited to certain days,
was discontinued altogether. The use of milk was
sharply controlled, children and the sick having
first claim. Its service in hotels and restaurants
was discontinued. Meatless days were established,
but as other food became even more scarce, they
were subsequently discontinued. The total con-
sumption of food contemplated for the year be-
ginning September 1, 1918, was 10,000,000 tons,
not including the occupied area, as against a total
pre-war consumption, noted above, of 16,000,000;
3,000,000 tons of dairy products are not taken into
account in either estimate.

Food prices rose in the course of the war, but not
remarkably until toward the end of 1917. During

148

FRANCE: HER SUPREME SACRIFICE

1918 the rise was very sharp and all families which
were obliged to buy their entire food-supply and
were living on an allowance or a fixed income
found themselves obliged to curtail sharply their
purchases.

Fuel was also very scarce during the last two win-
ters of the war and, in fact, also in that of 1918-19.
Some of the mines were in German hands, the supply
of labor was sharply limited, and transport was very
difficult. Everybody suffered from the cold. Heat
could not be turned on in steam-heated premises
until November 1st and was cut off on April 1st.
People sat in the library of the university in their
overcoats. Even the well-to-do were lucky to have
one warm room in the house. Hot water was
available in hotels only on Saturdays and Sundays.
The use of electric current was reduced by substitut-
ing bulbs of lower voltage and cutting out many
lights altogether. Street lighting was cut to a
minimum. Cities and villages were in a semi-
darkness during evenings and in many rural districts
there were no lights at all. There were a few cities
in which the enforcement of all these measures for
saving food and fuel was notably inadequate, but
these were minor exceptions. France as a whole, from
1916 on, went cold, gloomy, and, if not hungry, at
least in sight of hunger.

All these conditions, together with interesting side-
lights on some of the economic changes which took
place in France, will appear more clearly in an inter-
esting study of actual conditions in a typical French
community in 1918, a summary of which is the
closing portion of this chapter.

Huge Excess of Deaths Over Births. — What were

149

THE HUMAN COSTS OF THE WAR

the effects li'pon the population of France of whole-
sale mobilization and of lowered standards of living?
It is too soon to give a final answer to questions ex-
cept as to one extremely important phase — the
declining birth-rate.

Here the effect of the war was very prompt and
very striking. In the seventy-seven uninvaded de-
partments (of a total of eighty-six) the number of
births for the six years beginning 1913 was as follows:

1913 604,811

1914 594,222

1915 387,806

1916 315,087

1917 343,310

1918 399,041

This is cutting it perilously nearly in half. In
reality, the facts for France as a whole are consider-
ably more serious even than these figures indicate.
In the nine invaded departments, where the births in
1913 numbered 141,203, there were very few after
1914. Two million refugees from this zone were in
the interior, and their births are already included in
the figures above. The three million people back
of the lines included so few men that we may be sure
that the birth-rate was very low. In Lille, for in-
stance, the population was reduced to one-half, but
the number of births was reduced to one-eighth.

The same situation may be expressed a little dif-
ferently, as follows: Beginning with 1914 the num-
ber of deaths (not including the deaths of soldiers)
exceeded the number of births in the seventy-seven
uninvaded departments of France. The excess of
deaths was as follows:

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FRANCE: HER SUPREME SACRIFICE

1914 53,327

1915 267,340

1916 292,655

1917 269,838

1918 389,575

Total 1,272,735

This makes a total of 1,272,735 excess of deaths
over births during these five years. The birth
deficit will undoubtedly continue through the greater
part of 1919. If it continued at the same rate in
1919 as in 1918 this would mean a further 205,771
excess of deaths, or a total for the six years 1914
to 1919, inclusive, of 1,478,506 more deaths than
births. The American army's estimate of the num-
ber of French soldiers who died on the battle-field
or from the effects of wounds is 1,385,000. To this
must be added the proportion of deaths among those
reckoned as missing. It is evident that, so far as re-
ducing France's population is concerned, Germany 's
terrific war-machine was not more successful upon
the field of battle than was the indirect effect of the
war in the homes of France.

This great fall in the birth-rate would ordinarily
be accompanied by a fall in the infant death-rate.
On the contrary, the death-rate rose. In 1914 one
in every nine of the babies of France died, in 1915 one
in seven, in 1916 and 1917 one in eight, in 1918 one
in seven.

The death-rate of the population as a whole also
rose considerably. Not counting soldiers' deaths,
the death-rate per 1,000 on the estimated population
in the seventy-seven uninvaded departments was as
follows:

11 151

THE HUMAN COSTS OF THE WAR

1913 17.7

1914 19.6

1915 19.1

1916 18.1

1917 18.6

1918 23.8

Except as to infants under one year, we have no
classification of deaths by causes after the beginning
of the war. We cannot, therefore, trace the war's
effects upon tuberculosis, for example, with any
degree of certainty. Numerous partial statistics
from various localities show conflicting results. Two
broad general facts, however, stand out clearly-
first, that France lost about 1,750,000 soldiers, and,
second, that the excess of deaths over births during
the war period (including 1919) will be about
1,480,000, a total loss of population of 3,230,000.
France started the war with 39,500,000 people. She
ends it with about 36,280,000, with every prospect
of a death-rate exceeding its birth-rate for some
years to come. She could not stand many such wars,
even if always victorious.

Intensive Survey of a Typical French Community
After Four Years of War. — In the summer of 1918,
primarily for the purpose of getting a fresh estimate
of the actual serious needs of the French population
at that time, the American Red Cross in France
detailed two of its experienced workers, Mr. and
Mrs. Basil de Selincourt (the latter, Anne Douglas
Sedgwick), to take up their residence in a typical
French community for the purpose of making as
complete a picture as possible of the actual condi-
tions of human life in that locality. Both these
workers spoke French with facility, one of them

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FRANCE: HER SUPREME SACRIFICE

was half French, both of them had lived a great
deal in France and were extremely devoted to her
interests. They were told to forget all previous
plans, estimates, and activities, and ask, simply,
"Who are suffering here and what help do they most
need?" They had taken part in several important
pieces of American relief work in France and were
exceptionally qualified to describe accurately what
they saw. A summary of a few of their actual ob-
servations in this community will give a better pict-
ure of the effects of the war upon the people of
France than could be secured in any other way.
The locality was selected as being typical, so far as
that is possible, of French communities. It was suf-
ficiently far from the war zone not to be affected
except as most other parts of France had been. It
had no munition-factories. It was a village with a
population of 2,600, in which there was one large
factory established a hundred years ago. Before
the war it employed 1,540 people, of whom 125
were men, 630 were girls living at the factory, 410
were women living at home, and 375 both lived and
worked at home. Not all these employees, how-
ever, were residents of the town; in fact, about two-
thirds were from elsewhere. The girls who lived at
the factory and were over thirteen years of age
worked from six to six and lived under the immedi-
ate supervision of a religious sisterhood. There was
another small factory which closed immediately after
mobilization. The other large element in the com-
munity was the peasant farmer, 450 in number,
typical, presumably, of that vast number of farmers
who we are accustomed to say constitute the back-
bone of France. At any rate they are the largest

153

THE HUMAN COSTS OF THE WAR

factor in France as a whole, for the official figures
state that agriculture occupied 8,500,000 French men
and women in 1911; industry, 7,500,000; commercial
pursuits, 2,000,000; domestic service, 700,000; army
and marine, 600,000, and liberal professions, 550,000.
The cultivateur is the most numerous, and probably
the most characteristic, element of the French popu-
lation. A quarter of the land of this village is
tilled, a quarter is forest, a sixth each is vineyards,
pasture, and waste land or lawns and gardens, the
proportion of forest and waste land being unusually
large.

Population. — This little town, like many others in
France, was already losing ground before the war.
In the three years ending 1913 its deaths numbered
110, while its births numbered only 80. This serious
menace was greatly intensified by the war, for in the
three years 1915, 1916, and 1917 the deaths, not
including soldiers, increased to 144 and the births
fell to 42. It had, therefore, lost 100 people in
those three years, a rate which, if continued, must
result in the disappearance of the community in the
early future. The soldiers' deaths numbered 42,
making a total of deaths of 186 during the years
1915, 1916, and 1917, as against 42 births. In 1918,
up to October 1st, there were 8 births and 36 deaths
of civilians, as well as 14 of soldiers, the worst
record of all. Sixteen of its men were taken as
prisoners of war and 14 were discharged from the
army as unfit for service from injuries or illness.
There were 666 households in the town; among these
were 124 childless couples, 202 with one child, 132
with two children, and only 98 with three or more.
But, alas, of these latter a goodly proportion were

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PRANCE: HER SUPREME SACRIFICE

not French people, but had come from a far more
fertile country to the southeast for the employment
offered in the factory.

Prices. — The cost of living in this town, in the
opinion of our inquirers, had increased 200 per cent,
during the war. The actual figures of some of the
items were:

Article Quantity 1914 Price 1918 Price

Potatoes per 100 Ibs $.64 $5.45

Rice per Ib 07 .32

Milk per pint .017 .06

Butter per Ib 22 1.00

Veal or pork per Ib .20 .545

Eggs each .009 .045

Dried beans per Ib .036 .20

Dried peas per Ib .045 .27

Bread doubled in price and still sold at a loss.

The article most frequently substituted for bread
— potatoes — had increased eight and a half times in
price. Clothing and other necessities had increased
in price even more than food. Some details as to
clothing materials are given later.

Wages. — Before the war the women earned from
60 to 80 cents per day in the mill. Wages had in-
creased during the war by slow stages to a total of
35 per cent., or rather the wage had remained sta-
tionary, but there had been added a temporary allow-
ance amounting to 35 per cent., in recognition of
the high cost of living, making the average earnings
from 80 cents to $1. Thirty-five per cent, had been
added to the wages, 200 per cent, had been added
to the cost of living.

Labor. — The war brought many changes to the

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THE HUMAN COSTS OF THE WAR

economic life of this village. The men mobilized
numbered 247 at the outset and over a hundred more
were called out later. The smaller factory closed
at once. The larger factory lost many of its men,
and many of its women left to work in the fields in
place of their mobilized husbands. After much dif-
ficulty some of the women in the factory were in-
duced to take up the essential jobs which had here-
tofore been reserved for the men. The hesitation
was overcome in some cases only by taking the
women to a large city some distance away and show-
ing them how the women were successfully doing
men's work. About one hundred workers from
Italy left for home when Italy entered the war.
The number of "hands" in the mill was reduced from
1,540 in 1914 to 967 in 1916. In 1918, even with
126 refugees, its employees numbered 1,010.

The farms had to be operated, for they were the
source of living for 338 of the 666 households. Omit-
ting forests, building sites, and waste. land the aver-
age size of the farms was 2 1/2 hectares, or about 7
acres. Each farmer needs four sorts of land— forest,
pasture, tilled field, and vineyard — and each man
has a number of different strips of each kind of land,
often from 25 to 50, to make up the small total of
7 acres. The work before the war was done largely
by oxen. There were only 52 horses in the commune
in 1912 and more than half of these were requisitioned
for the army. Most of the others were owned by
tradesmen. There were very few sheep, almost no
hogs, and very few goats. The farmer was reason-
ably independent of the price of food, but was very
dependent upon the surplus farm produce for the
income with which to buy other necessities. Practi-

156

FRANCE: HER SUPREME SACRIFICE

cally all the men went to the war. The women,
old men, and boys carried on the farms as best they
could with a diminished number of cattle and hardly
any horses. * They could not secure proper fertilizer
for the land and they planted crops for immediate
results without regard to future fertility. Also, they
could work only part of the land. The rest grew up
to weeds. They managed to raise food sufficient
for their actual necessities and also to make their
outside purchases, but it was done at the cost of a
serious impairment of the value and future fertility
of their land.

The smaller mill, above referred to as closing upon
mobilization, was subsequently reopened under gov-
ernment control. Its roster of 78 employees in-
cluded 17 Portuguese, 10 Russians, 5 Italians, 27
French mobilized men, 3 refugees, and only 16 local
residents.

The village is much more isolated than formerly.
Formerly there were seven trains each way on its
railway, but now there were only two.

Some Family Groups. — Here is an account, con-
densed from the de Selincourt report, of one
family of war orphans in this little village. The
widow has four children. She is a farmer's wife,
but there is something in her perfect candor, in
her manner, in the courteous reception, in the
sober and care-worn beauty of her features, which
produces a singularly sympathetic effect upon the
visitors and gives them a sense of the virtues and
values of the solid foundation of the farmer's life,
the underlying strength of France. Her husband
was lost from tuberculosis. He came back from the
army with it, and died after a disabling illness of

157

THE HUMAN COSTS OF THE WAR

three months. One girl was without the use of one
arm and hand which had remained weak and unde-
veloped. She was ill, and they feared tuberculosis.
There were two little boys aged ten and thirteen and
another boy, a stalwart youth with red cheeks and
frank eyes, who was just old enough to join the
military class of 1920 the next month. The mother
remarked, thoughtfully, but without bitterness, that
this was one of "the little annoyances of the war."
What are they to do when the boy goes? The
mother is already working for her children as hard
as possible. They own the small farm and have
two cows. They have already been obliged to let a
good part of their land go to weeds. "Work in the
fields is hard for a woman," the widow remarks,
"but when she has an invalid child upon her hands
and two others it is impossible for her to look after
them and also do the farm-work, which alone takes
an able-bodied man, for the hours of work are long
for the French farmer."

In this little town 247 men were called to arms at
the opening of the war. This number has since been
increased to about 360. Of these men, 56 have
been killed, 16 are prisoners in Germany, and 14
are out of the service on account of injuries. Most
of the cripples are still able to go on with their
former occupations. One, who had lost his left
arm, had learned bookkeeping. Among the cripples,
however, was one very pitiful case. He undoubtedly
represents what in the total is a large number in
Prance. He has lost both arms, one at the shoulder.
He had been married just before he left for the war,
and they were now, as he said, enjoying their first
housekeeping. They were shortly expecting their

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FRANCE: HER SUPREME SACRIFICE

first baby. He had learned the trade of rope-making
in a hospital for the re-education of cripples, but
much of that work requires the help of the wife. She
has not only to do her housekeeping, to wash, dress,
and feed a husband who is helpless to care for himself,
but also to do the greater part of the rope-making
and to carry their wares to the market at some dis-
tance. The best the two are able to earn is 30 cents
per day. They have an allowance from the govern-
ment which amounts to 60 cents, so that they have a
total income of 90 cents per day. They reckon that
it will be impossible for them to keep the baby at
home and go on with their work and are planning to
put the baby out to nurse, as is common in France.
This will greatly diminish the baby's chances of sur-
viving infancy, a fact which they did not at all under-
stand. They were charming and courageous, and
the responsibility for the future seemed to rest more
heavily upon the woman than upon the helpless
cripple, who had the sunniest expression and even a
gay smile.

Refugees. — Some refugees came to this little town
as early as the spring of 1916, others came in 1917,
but up to January, 1918, the total number was only 60.
Then came the deluge, and by July there were 283
refugees from the front, or repatriates who arrived by
way of Switzerland. This equaled 11 per cent, of the
original population. Most of those who could, worked
in the factory; some of them received a small allow-
ance from the government; none of them, of course,
had farms. It was plainly to be seen that life for
these people was more bare and difficult than for
the natives. The refugees and repatriates had been
pf a rather better economic status than the natives

THE HUMAN COSTS OF THE WAR

of the town, and it was difficult for them to lire in
the worst of the dilapidated houses, or even in the
barracks and outbuildings, and to match scanty
earnings and a slender allowance against a cost of
living which rapidly increased to three times its
normal figure.

Here, for instance, is a family consisting of a
Madame X., her married daughter, Madame W., an
unmarried daughter, and a little granddaughter aged
four. They live in a tiny, dilapidated, unsanitary
house, crowded in behind the other houses on the
street. The married daughter, aged twenty-six, is
soon to have another baby. She works in the fac-
tory when she can, and earns about 75 cents a day.
The unmarried daughter seems to be mentally lack-
ing and usually works only about two days a week.
The mother is a curious, tidy woman who seems be-
wildered and extremely disheartened by the ex-
traordinary changes which the war had brought to
them. The son-in-law, having been mobilized and
assigned to work in the vicinity, receives no wages,
but, on the other hand, is an additional expense when
he comes to spend week-ends with them. The
purchase of clothes or shoes is out of the question,
and the little girl's feet are almost without covering.
Equally impossible is it to buy any of the necessary
utensils for the household. There are no toilet con-
veniences, either inside the house or outside. Old
Madame X. spoke with tears in her eyes of the com-
fortable house they had near Lille and seemed to miss
most of all the tidy privy. Her husband had been
accidentally killed some years before. At home they
had four well-furnished rooms with plenty of good
beds and immaculate sheets. They had a neat

160

' FRANCE: HER SUPREME SACRIFICE

garden and kept chickens and rabbits and a goat.
She and her daughter, whose mental abilities were
sufficient for working in the field, earned 50 cents
a day each in the field. The married daughter
and her husband each earned $1 a day in the
factory, so that altogether they earned $3 a day, and
living only cost one-half of what it does now. There
also was a son at the front to whom packages of food
had to be sent from time to time. The picture,
altogether, was that of a former life of comparative
prosperity, of assured comfort, while now the only
certainties were a most uncomfortable home, an
income barely sufficient to buy food and wholly
insufficient to provide clothing and fuel.

Here is another refugee household consisting of
Madame C. and Madame D., sisters-in-law, living
in two bare, miserable rooms. Madame C., with a
baby of six months, cannot go out to work. Her
husband is at the front, and her son of sixteen was
killed by a bomb before they left their home. A
boy of thirteen works in the factory, but, as he does
some sort of apprenticeship work, he receives no
wages. Before the war her husband and she had
been market-gardeners with a comfortable house,
stable, horse, chickens, and had lived very com-
fortably. Madame D. is not well enough to work
in the factory, but goes out to housework for three
or four hours a day and earns from 20 to 30 cents.
She has a little girl of eight who, obviously, needs
shoes and many things besides, Madame D.'s hus-
band before the war was a factory worker, earning
$1.10 a day. Madame C., with the baby in her
arms, still maintained an air of patient philosophy,
but Madame D., sunken together on a chair, with

161

THE HUMAN COSTS OF THE WAR

dull eyes, wan cheeks, pinched red nose, and an
expression of utter fatigue, helplessness, and hunger,
could only bewail with dull regret the lack of their
comfortable house with its pleasant and well-
furnished rooms.

A man who was thoroughly familiar with the life
of the town before and during the war, who held an
important position in the factory and assisted in
much of the buying of groceries for the village,
worked out a very interesting budget of family ex-
penses as they were before the war and now, with
characteristic French detail. He had in mind a
family of a workman, wife, and three children under
ten years of age. Such a man, he assumed, would
earn $1.20 a day for six days, a total of $7.20 a week,
before the war. To this there will now be added
about one-third increase in wages, or a total of $9.60.
His weekly expenses were worked out in great detail,
but we may summarize them as follows:

Article Pre-war Present

Food $3.98 $16.29

Laundry .25 1.76

Light 19 .30

Heat .33 .80

Clothing 1.17 4.66

Shoes 39 .78

Medical care and medicine. . .07 .07

Rent 61 .61

Miscellaneous . . .19 .37

Totals $7.17 $25.63

If we omit from the $25.63 the estimated cost of
the wine, $4, which the French certainly consider
necessary, there still remains a living cost of $21.63

162

FRANCE: HER SUPREME SACRIFICE

to be met from an income of $9.60. Under these cir-
cumstances the only thing to be done is to tighten the
belt, buy no clothing, and shiver in cold weather for
lack of fuel.

In support of his estimate on clothing he gives the
following prices of materials:

Article 1914 1918

Material for woolen dress (per yard) . . $.90 $8.24

Material for cotton dress (per yard). . . .25 .90

Woolen stockings 40 to .60 2.00

Straw hats 40 1.40

Men's shirts 70 3.00

Men's boots 4.00 11.00

Children's shoes 1.60 to 2.00 5.00 to 8.00

Material for linen shirts 38 2.40

Health. — We can readily imagine that in such a
town as this under these conditions there will be
many sick people. There were two physicians, but
one of them was so old as to be unable to practise.
The other, besides being responsible for all the
medical practice within a radius of twenty miles,
occupied also the most important public position in
the community, one which might naturally have oc-
cupied all his time. It goes without saying, there-
fore, that only the most necessary medical attention
could be given to those who were obviously most
seriously in need of it. Nursing as we know it is an
unknown factor. Before the war there were two
small hospitals, but at present two military hospitals
with sixty beds each are the only hospital facilities.
The epidemic of influenza was just beginning and
one heard of whole families prostrated with it. No
one felt any responsibility for the medical care of the
refugees and repatriates.

163

THE HUMAN COSTS OP THE WAR

Government. — The point of contact with all the
great world at Paris is the secretary to the mayor.
Before the war he was a whole-time employee and
received a salary of $345 a year, plus rent and heat
for the family of himself, wife, and two children.
The high cost of living has been recognized for him
by the municipal authorities granting him a total
increase in salary of 30 cents per day. His wife also
has been recognized as an assistant and given a
salary of 40 cents a day. The two children have
grown up and earn small wages in the factory. With
this total income of a little over $600 the family
barely manages to live. The amount of work piled
upon this municipal official has increased fully in
proportion to the cost of living, if his income has not.
He it is who must look out for all the bewildering
variety of governmental allowances given under
widely varying conditions to the families of soldiers;
to widows and orphans; to the families of those who
have been dismissed from the army for sickness or
disease, if they are fortunate enough to receive any;
to the heads of large families. He also must dis-
tribute a complexity of allowances to refugees and
repatriates, with wide variations under special cir-
cumstances. This population of refugees and repa-
triates differs from day to day. Arrivals and de-
partures are almost daily matters, and the lists must
be changed constantly. Any one leaving town must
have a safe-conduct from the mayor. He must give
out all the food-cards for each man, woman, and
child. He must make the delicate decisions as to
who are entitled to 500 grams of bread, who to 400,
who to 300, and who only to 200. All military
requisitions must pass through the City Hall. Here

164

FRANCE: HER SUPREME SACRIFICE

come all the farmers to make known the size of their
crops of wheat, of corn, and of wine, and to tell how
many horses, cattle, sheep, and pigs they have and
in what condition. He must reply to the in-
numerable requests from the government of every
conceivable sort. His office hours are from daylight
until dark, and he has to deal with an endless pro-
cession of people, all of whom have very justifiable
grievances. He knows that they can get only a
fraction of what they want and actually need, and
his principal job comes to be that of finding excuses
and of presenting reasons as to why things cannot
be done. He must throw all possible obstacles in
the way of those who want relief because there is not
enough to go around. The infinite perplexities which
red tape will yield must be availed of to the utmost.

Aside from the funds coming from the govern-
ment, there is little to be expected from private re-
sources. The mind of the French people does not
run in that channel. Every man is to have his fair
chance in life — that is what democracy means; but
if he does not succeed in providing for himself and
family, whose fault is it but his own? The margin
is so slight that who can expect those who succeed to
divide with those who have failed? The people are
sharply divided, too, into those who adhere strongly
to the Church and those who do not. If you receive
any private relief, it is most scanty.

As a check against the conditions of this particular
town, similar inquiries were made by other inves-
tigators in another town only two and a half hours
from Paris. This was a city of 5,000 people which
had run a fairly normal course during the war until
after the misfortunes of early 1918, when it was over-

165

THE HUMAN COSTS OF THE WAR

run both by refugees and by military establishments
which had been driven back from nearer the front.
It tells almost exactly the same story of increase m
the cost of necessities in 1918 as compared with 1914.
It adds some interesting comparisons of wages in dif-
ferent establishments. In one which made toilet
articles, the largest factory in town before the war,
for a work-day of eleven and a half hours men made
from 80 to 90 cents. Now they received from $1.10
to $1.40. It also now employed women, which it did
not do before, and they received from 8 to 9 cents
per hour. Both men and women also received an
allowance on account of the high cost of living which
amounted to 20 cents per day additional. This in-
dicates a total increase in wages of from 60 to 80
per cent. In another establishment, dealing with
wines, wages have increased from 80 cents to $1.20
for a day's work of eleven hours. In another, men's
wages for a work-day of eleven hours have increased
from a dollar to $1.30 and $1.50 and women's wages
from 50 cents to from 65 to 75 cents. Also, the men
received 20 cents additional and the women 15 cents
additional as an allowance on account of the high
cost of living. Carpenters' wages have risen from
10 cents an hour to 16 cents an hour; laundresses
who formerly received 50 cents a day now receive
75 cents a day. Women doing general housework
have increased from a range of $6 to $8.50 a month
to that from $10 to $12 a month. The increased
cost of food, light, heat, and clothes follows very
closely that for other cities — namely, an increase of
about 200 per cent, as compared with an increase of
wages of 50 per cent.
This concrete account of the details of life in two

166

FRANCE: HER SUPREME SACRIFICE

typical communities, just before the close of the war,
shows that to everybody life had become a serious
and, to many, almost an insoluble, problem. Long
hours of hard work, instead of yielding a comfortable
living as formerly, with sufficient food, clothing, and
fuel and with reasonably comfortable surroundings,
brought now only the barest of necessities, scanty
food, no new clothes, and not enough wood or coal to
keep comfortable in winter. The doctors were
mostly away with the army, and those remaining
could give only the slightest of attention to a few
of the very sick, to those most able to command
medical services. Scattered through this population
were refugees and repatriates, notably worse off
than the natives. It is a picture of bareness which
could not but diminish still further the already very
low birth-rate and the effects of which upon the
health, vigor, and spirit of the people must continue
to be felt for many years to come. It is not sur-
prising that the people who before the war accepted
the existing situation as very satisfactory are now,
almost to a man, bitterly discontented and anxious
for some sort of change.

ITALY: WAR WIPES OUT TWO MARGINS

Pre-war Italy; exiles after Caporetto; the occupied Veneto; devastated
Italy; a hungry nation; from deprivation to disease — slipping back
into the plagues; tuberculosis; the return of malaria; child mor-
tality; typhoid; "flu"; military losses; total human losses; war
orphans; cripples; the return of the prisoners; soldiers' families.

PRE-WAR ITALY.— Before the war Italy pre-
sented the contradictory picture of an infertile
country lacking the necessities of life and a fertile
and rapidly increasing population. She imported
coal to keep her people warm and run her transporta-
tion and factories, raw materials for making clothes,
and great quantities of food, but she exported men by
the hundreds of thousands annually. She had a nar-
row margin of economic well-being and a wide margin
of population growth. War wiped out both.

Her population by actual count in 1911 was
34,671,377. Her birth-rate was over 30 per 1,000 as
compared with 18 for France and 24 for the United
States. Her death-rate also was high — 20 per 1,000,
as against 14 in the United States and 17.7 in France.

She entered the war in May, 1915. Already she
had been feeling the effects of the war in the increas-
ing difficulty of securing her supplies of food and
fuel. Mobilization immediately stopped her export

168

ITALY: WAR WIPES OUT TWO MARGINS

of men and diminished her production of food. The
submarine increased the difficulties of getting sup-
plies from overseas, and high prices quickly placed a
sufficiency of these articles beyond the reach of a
large part of the population. At best, they had led
so precarious a living, on so narrow a margin, that
huge numbers annually turned their faces toward
America.

Austria, against whom her effort was directed, was
already busy fighting Russia, and only the difficul-
ties of a mountainous frontier prevented Italy from
carrying the war far into the enemy's country. As
it was, she made slight progress geographically, but
succeeded for over two years in keeping the war
just over the border into Austrian territory. The
earlier effects of the war on Italy were those common
to her entire population — absence of men at the
front, scarcity of food, high prices. Two years later,
however, in October, 1917, she was to know fully,
as Belgium, France, and Serbia had done, what it
meant to have war waged on her own soil.

Exiles after Caporetto. — When the war had gone on
for nearly two and a half years, and Italy, though
fully mobilized and making extraordinary efforts,
had made but little headway in carrying the war
into Austria, and as food became more and more
scarce, and prices higher and higher, the voice of the
pacifist began to be heard in the land. Teuton
propaganda saw the opening and soon converted
this break in the line of the national will into a break
through the line at the front. She accomplished
by the aid of propaganda what she had not been able
to accomplish with the bayonet and artillery alone,
and, in October, 1917, the Germans and Austrians

169

THE HUMAN COSTS OF THE WAR

came through the Italian line at Caporetto in the
far northeast. The whole front had to be with-
drawn, enormous quantities of stores had to be
destroyed or left behind, great military hospitals
had to be abandoned at the moment of their greatest
need. With some aid from their British and French
allies, but chiefly by the reorganization of their own
forces, they stopped the enemy along the Piave
River, which empties into the Adriatic some twenty
miles east of Venice. The new line ran from this
point some forty-five miles northwest along the
Piave, then turned west another forty-five miles to
the Austrian frontier. From this point on, the re-
maining ninety miles of the line were still in Austrian
territory.

As the Italian army retreated in confusion and the
Austrian and German armies came on rapidly the
people of the invaded region, known as the Veneto,
one of the richest agricultural districts of Italy, with
only a few cities, had to make the choice which so
many of their allies in France and Serbia had faced —
to flee or to hide. They were equally unprepared.
The war had been on for over two years, but every
one had expected the Italian line to move forward,
not backward. There were about a million and a
half people in the portion of Italy east of the Piave
River and about one-third chose to flee, the same
proportion as in invaded France. When the line
was re-established at the Piave the villages and
countrysides near the line had to be evacuated.
Venice and some other near-by cities were also
evacuated by reason of danger of capture and the
imminence of air bombardments. About a half-
million people hastily gathered a few articles in their

170

ITALY: WAR WIPES OUT TWO MARGINS

hands, streamed along the roadside, walking day
and night, and later were crowded into freight-trains
and sent somewhere, anywhere, into the interior of
Italy. Their physical sufferings en route, while
serious and sufficiently dramatic to attract the at-
tention of the world, were far less serious than the
utter confusion, helplessness, and mental distress
into which they were plunged by this sudden and
complete break with their hopes of a lifetime, the
surroundings to which they were almost as com-
pletely and intimately adjusted as are the trees to
the soil, the means by which they had been able to
live in comfort and happiness. It was one of the
most progressive, efficient sections of Italy, free from
the grinding poverty of the infertile south, free also
from the narrow margin which a rapidly growing
and unsympathetic industry had imposed upon the
industrial populations of the cities of the north.

Where could they go? Naturally everybody's
first thought was of the vacant summer homes and
tourist hotels with which Italy was well provided.
Long train-loads after train-loads found their way
to the Adriatic coast, to the Riviera district, and to
Sicily. Other scores of thousands went to the in-
dustrial cities of the north — Milan, Genoa, and
Florence. Not many were sent to Rome — it is not
a good thing to have too much evidence of the
distress of war and too many dissatisfied voices
heard at the seat of government. Not many went
to the southern end of the peninsula or to Messina.
People here were already living in temporary bar-
racks which were on the verge of being uninhabit-
able. They had been extemporized at the time of
the earthquake in 1908 as temporary refuges and

171

THE HUMAN COSTS OF THE WAR

had developed an unexpected and obstinate inclina-
tion to become permanent. Almost nothing had
been done by the people of this region in the ten
years since the earthquake to build new houses —
hardly enough even to keep the temporary barracks
in repair.

But the empty hotels could take in only a small
fraction of the great streams of refugees. School-
buildings, factories, churches, were pressed into
service, and even public parks and gardens, where
refugees lived in the open. Winter was coming on.
Fuel was so scarce that they could hardly expect
to be kept warm, but it was impossible for the women
and children and the aged to live in the open, un-
protected from wind and rain. Any kind of an out-
building was pressed into service. The live stock
of Italy had been seriously depleted in order to feed
the army fresh meat, a luxury to which the soldiers
had not been accustomed in peace, but which helped
to keep them in fighting mood. The refugee families
crowded into these barns, sheds, and outbuildings,
which had sheltered domestic animals. Even these
were not enough, and the native families, already
packed pretty closely into a minimum of house space,
crowded up still closer and two families lived where
one lived before.

Getting there and finding some kind of shelter
was only the first, and was, perhaps, the simplest of
the refugee's problems. He still had to live; food
had to be bought. He looked about to earn some-
thing. The old men, beyond military age, were ac-
customed to work in the fields of the Veneto; the
women also knew well the art of husbandry, and the
older children were almost as useful as men in much

172

ITALY: WAR WIPES OUT TWO MARGINS

of the work. They looked about for a chance to do
the work they knew how to do. Alas ! they were to
all intents and purposes in a strange land. These
were Italians all about them, but of an almost dif-
ferent race, with very different ways of living. They
raised crops which were unknown in the north and
did not raise the crops to which the people of the
Veneto were accustomed. Even if they tried to raise
the same crops, the conditions were very different
and the methods had to be very different. The ex-
perienced farmer of the north was almost as much at
a loss in the farming of the south as though he had
always worked in a factory. A few of the refugees
had lived in cities, but the few industries in the
south were of a different character from those in the
north. Some were given work in making uniforms
for government contractors, but a large part of the
refugee population of one-half million remained un-
adjusted. The kinds of work to which it had been
accustomed were lacking, and it was too old to be
taught new tricks. The time was too short and the
people too pressed to bother with awkward hands.
The government created a division for aiding the
refugees which considered the possibility of redis-
tributing the refugee population so as to place them
where they could work in ways to which they were
accustomed, thus providing a certain amount of
much-needed labor where it was most needed and
enabling more of the refugees to earn a living. The
redistribution of a half-million people was a trans-
portation problem of some magnitude. The trans-
portation service was already hard pressed, and be-
came more so with every month of the war. Then
came the influenza, and instead of encouraging

173

THE HUMAN COSTS OF THE WAR

travel the government forbade it except in special
necessity. The refugees stayed where they were
and made the best of it. The government made an
allowance toward the support of those unable to
work or to obtain work. Only about 10 per cent, of
the refugees were physically fit to work. In the
resort towns the refugees had shelter and scenic
beauty, but little else. Tourists had been the suf-
ficient if not the only industry, and in their absence
there was no work. In a number of these localities
the American Red Cross established workshops in
which the refugees manufactured articles, subse-
quently sold to them or to other war victims.

In general, from this time on, the lot of the
refugees did not differ very greatly from that of the
bulk of the population of Italy, not because they
were well provided for, but because nearly everybody
else was also in serious trouble. Most of the men
were at the front. The soldiers* families also re-
ceived a governmental allowance. Food and fuel
were equally scarce for all, and prices becoming more
and more impossible.

The Occupied Veneto. — Meantime, about twice as
many people had remained beyond the Piave as fled
across it. We visited this region within a week after
the German armistice and within two weeks after
that with Austria. It was the same story as that of
Serbia, of Grecian Macedonia, of northern France,
and of Belgium; more like France and Belgium than
Serbia and Greece. It was a much shorter occupa-
tion. The Austrians came in October, 1917, and
went in November, 1918. A million people had suf-
fered enemy rule for a year, as against three years
in Serbia and four years in France and Belgium, but

174

ITALY: WAR WIPES OUT TWO MARGINS

it was the last year of the war and it was a territory
adjoining Austria which felt the pinch sooner and
more severely than did Germany. All the railway
and highway bridges had been blown up and it was
very difficult to get food to the region after the
Austrians left.

As in Serbia, conditions near the fighting-line were
considerably worse than those farther back. The
conditions which we saw in a few of these towns will
give a fair idea of what had happened. Conegliano
is about three miles beyond the Piave. Before the
war it was a city of 13,000. Two weeks after the
armistice it was a city of about 3,000. The people
had not received a ration of bread or flour during
the occupation. They had lived on such vegetables
as they were able to raise, on plants gathered in the
pastures and untilled areas, and on a little corn or
wheat, if they were able to hide any or to keep a
small part of what they raised. Just before the
Austrians left they requisitioned and shipped all
blankets, bedding, clothing, shoes, and even under-
wear, not always excepting even some of the clothing
which the people were actually wearing. They also
took out car-loads of windows and shipped them to
Austria. Many of the buildings were completely
destroyed by shell-fire, but some were standing in
various degrees of destruction. Even the best were
without windows. We saw a long line of people
getting food from the American Red Cross relief-
station. About one in five of them was emaciated
and obviously had suffered extremely from lack of
food. Yet those who were able to come for food were
the healthiest members of the families; those at
home were less well off. We noticed particularly

175

THE HUMAN COSTS OF THE WAR

one womair who was extremely emaciated. She said
she had three small children at home who had been
living for a long time on roots and greens which she
collected from the fields. They had not been al-
lowed to have any garden. A fourth child had died.

There had been practically no medical attention
for the civilian population during the occupation.
There had been a good deal of illness in the town,
including especially pneumonia, "bronchitis," and
influenza. The American Red Cross since the
Austrian retreat had been distributing beans, peas,
rice, bacon, condensed milk, salted beef, and a little
sugar, and the Italian authorities were now issuing
bread rations.

Vittorio was ten miles beyond the Piave. It had
been a place of twenty-one thousand people. In a
considerable part of the town the buildings were
uninjured. Here the Austrians had issued a very
small ration, thirty grams of foodstuffs per person
per day, about one-tenth of the bread ration in
France. It had been as completely stripped as
Conegliano. It was evacuated on October 30th and
a camion-load of food was brought to the town by the
American Red Cross the next day. At the end of
the first week the mayor of the town said, "Thanks
to God and to the American Red Cross, we have been
able to live through this week." A little later the
authorities began to distribute food. In Vittorio
we saw a most curious form of relief. A newspaper
of Rome had collected funds for the people of the
invaded district and was making a distribution of
clothing by throwing the articles from the second-
story window of the City Hall. A large crowd below
scrambled for the articles as they were thrown out.

176

THE BREAD-LINE

There were many such lines as this before the American Red Cross relief-
stations in devastated Italy in the few weeks after the armistice.

THE CHILDREN MAY RIDE

This woman is returning with her mother and three children through
devastated Italy. For some days their only food had been yellow corn.

ITALY: WAR WIPES OUT TWO MARGINS

One person would get hold of one leg of a pair of
trousers and another person of the other, and the
legs parted company. It was a curiously futile and
inconsiderate method. On the other hand, at a town
farther on we saw an admirable example of neighbor-
liness. The people of the city of Como had collected
and sent two large camion-loads of clothing, bedding,
household utensils, etc., to the people of the town of
Oderzo, and six more camion-loads were on the way.
The clothing was of excellent quality, suitable for
winter, and was most urgently needed, for the
weather was getting bitterly cold. There were also
blankets, towels, hardware, etc. The articles were
carefully sorted and the representatives of Como
were selecting a list of beneficiaries after a con-
ference with the mayor of the city and others who
had remained during the occupation. We heard that
a number of other towns adopted in similar fashion
particular cities or villages in the occupied area.

As we went farther east, although the entire re-
gion had been occupied by the Austrians and Ger-
mans, conditions were not quite so bad. There had
usually been a food ration for the civilian population,
and it was a little larger, of better quality, and given
more regularly.

Everywhere, however, we heard of a vast amount
of sickness, and that conditions had been much
worse during the occupation. There were no figures,
for all governmental functions had been in the hands
of the Austrians and they had taken away with
them such few records as they had. Most people
thought that about 20 per cent, of the population
had died. This would be more than ten times the
normal mortality for the district.

177

THE HUMAN COSTS OF THE WAR

In the town of Oderzo, seven miles beyond the
Piave, with a pre-war population of 9,000, there
were now about 3,000 persons, of whom 600 were
reported to be ill. There was a good deal of typhoid
fever in the smaller places near Oderzo. Altogether,
it was a picture of hunger, of cold, of every phase of
misery, such as we had not seen before, such a life
as only the toughest could survive for long. Its
relief would at best be slow, incomplete, and very
difficult. The Italian army was busy in occupied
Austria. The armistice had come so suddenly that
no one thought about this relief job, and all the rest
of Italy was also suffering from lack of food and fuel.

Devastated Italy. — Italy, like every country ad-
jacent to the Central Empires, has a devastated area,
but the amount of destruction is somewhat less than
one might expect. A great part of the fighting be-
tween the Austrian and Italian armies was just over
the line on Austrian territory. This territory was
peopled by those of Italian ancestry and is now to be
a part of Italy, so that its reconstruction will be an
Italian problem. Within the boundary of what was
Italy, however, the destruction is largely limited to
a belt on the two sides of the Piave. From the
Austrian boundary to the Piave, the Italian army
retreated too rapidly and in too great confusion to
make very great resistance, and consequently there
was little destruction. The same was true when the
Austrian army retreated over the same region in
October. After it was once driven away from the
Piave it made only a few efforts to withstand the
attacks of the Italians, and hence there were few
areas of destruction by actual fighting.

Although modern artillery carries for long dis-

178

ITALY: WAR WIPES OUT TWO MARGINS

tances, the area in which anything approaching the
total destruction of buildings occurs is usually limited
to a very few miles. There may be a concentration
of big guns upon some particular point farther in the
rear, but, as a rule, the cities, villages, and country-
sides escape physical destruction up to a few miles
of No Man's Land. Many buildings are intact or
but slightly injured up to within, say, three miles of
the Piave. Within this distance a great majority
of the buildings are destroyed or seriously damaged.
Farther away, destruction is the exception, not the
rule. Here, as elsewhere, serious injury to build-
ings occurred from quartering large numbers of
enemy troops in them, tearing out wood for fuel,
or using the buildings as stables, tearing out stair-
ways and partitions. In a few places, such as
Sacile, which is eighteen miles from the Piave, the
Austrians made some effort to stand, and here nearly
every house was injured and a great many wholly
destroyed. It had been enemy headquarters during
the occupation, and there had been many air raids
by the Allies.

We made an effort to estimate the number of
people whose homes had been destroyed along the
Piave. No census of this kind had been made.
Taking into account the average density of the
population of this part of the Veneto, it seemed to
us that the homes of about two hundred thousand
persons had been entirely destroyed or so injured as
to be uninhabitable. There were vastly larger num-
bers whose homes were looted by the removal of
furnishings, equipment, etc., but whose buildings
remained intact or but slightly injured.

It was a relief to see that the greater part of this

179

THE HUMAN COSTS OF THE WAR

fertile and prosperous region had been only slightly
injured by shell-fire and trench operations. Even
along the Piave, where we crossed it, a great ma-
jority of the shade trees on the roadside were unin-
jured. There is very little territory in Italy like
the valley of the Somme, where not only have all
vestiges of construction disappeared, but the soil
itself has been so plowed by shells as to be useless
for agriculture for a long time to come.

In comparing this phase of Italy's problem with
other emergencies it is interesting to recall that in the
earthquake of 1908 the cities of Messina and Reggio,
which were destroyed, had a population of 170,000.
Numerous villages were also destroyed. It is likely,
therefore, that the reconstruction problem which Italy
faces in 1919 (not including that in the annexed terri-
tory) is not far different from that which she encoun-
tered in 1908. The housing then destroyed has not
yet been made good, though ten years have elapsed,
six of them a period of relative peace and prosper-
ity, notwithstanding the Tripolitan War; the present
destruction has to be faced by a country stripped of
resources, with disrupted transportation, and stagger-
ing under a tremendous load of debt.

We were struck by the fact, when we visited
Italy in November and again in January, that no
plans seemed to have been made for the return of
refugees and the reconstruction of the invaded re-
gion. In France the plan, on paper, was excellent
for providing temporary housing for all the returning
refugees. In Italy, on the other hand, the entire
problem of either temporary or permanent recon-
struction seemed to be pushed ahead into the
indefinite future. After its experience with the

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ITALY: WAR WIPES OUT TWO MARGINS

temporary housing of earthquake victims of 1908,
seeing that temporary housing, no matter how un-
satisfactory it may be, almost inevitably becomes
more and more permanent, the Italian authorities
were strongly disposed to avoid any form of tem-
porary housing by barracks, if possible. On the
other hand, as to what form of housing would be
provided, and how it would be provided, and who
would pay for it — these problems were all too dif-
ficult to be dealt with in a country in which so many
more pressing subjects demanded instant attention.

A Hungry Nation. — The serious war problems of
Italy are to be found among the 35,000,000 in the
uninvaded region, rather than among the 1,500,000
in the invaded Veneto. In normal times Italy had a
rather meager menu, and of this a large amount was
imported. A great deal of corn was eaten in the
north and of macaroni in the south. The consump-
tion of meat was not large. Much olive-oil was used.
About 2,200,000 tons of wheat and corn were im-
ported annually.

One of the first changes produced by the war was
the establishment of a meat ration for soldiers. A
large proportion of the live stock of Italy was
slaughtered before a sufficient amount of meat could
be imported to keep up this ration. The food situa-
tion very soon became acute, and Italy established a
food administration and rationed and bought and
distributed through government channels a number
of staple articles, including bread, macaroni, rice,
fats, and oil. The ordinary bread ration for civilians
was 200 grams (7 ounces). Working-people were
allowed 9 ounces and people doing especially heavy
work 14 ounces a day. Different cities established

181

THE HUMAN COSTS OF THE WAR

different rations according to the supplies on hand.
Florence and Genoa, for instance, had a ration of
20 grams (7-10ths of an ounce) of rice, while Milan
had 66, and in Rome rice was not to be had at all.
The bread ration for workmen was 250 grams daily
in Reggio; 300 in Florence, Milan, and Genoa; 400
in Turin, Rome, and Naples; and 500 in Bologna.
All kinds of fats, including oil, butter, lard, and fat
pork, were rationed at the extremely low rate of
YL ounce per day per capita for the entire group.
Olive-oil, which had been a common article of diet
before the war and large amounts of which came
from Greece, was almost unobtainable. The sugar
ration varied from 10 to 14 ounces per person per
month. The official ration of meat was an ounce
per day, four days per week. The other three days
were meatless. The total food ration was con-
siderably short of a pound a day and, in many
localities, for long periods it did not exceed 12
ounces per day. The slaughter of the herds greatly
reduced the milk supply. Even favored Rome se-
cured only two-thirds its former amount. Eggs
were hardly to be had. The making and sale of con-
fectionery were forbidden.

Another serious factor was the impossibility of
making the best distribution of what they had be-
cause of the lack of transportation. Military needs
took 60 per cent, of the available train service of
peace-time. During the influenza epidemic, which
lasted for a considerable length of time in Italy, on
account of illness of railway employees the 40 per
cent, available to civilians was reduced to 15 per cent.
Shortages of food in particular localities from time
to time, some of which were serious, were not always

182

ITALY: WAR WIPES OUT TWO MARGINS

due to a lack of supplies in Italy as a whole, but to a
failure of distribution. It was generally admitted,
unofficially by officials and frankly by citizens of
important position, that there had been much hoard-
ing of food-supplies and speculative profiteering.
The government had made some' efforts to prevent
this. The public authorities had opened municipal
stores in Rome, but the number of stores and the
amount of supplies available were not sufficient to
affect prices to a great extent. There was an official
list of established prices, but these did not hold out-
side of the government stores. Some of the official
prices in Rome in English equivalents just after the
close of the war, as compared with the price of the
corresponding article in peace-time, follow:

Official Prices

Article Quantity Peace-time War-time

Bread.. ....... pound ......... $.03^ $.05^ to $.07

Rice .......... pound ......... 05^ .09

Oil ............ pint ........... 22 .57

Macaroni ...... pound .......... 03 to .04 .05^ to .07

Sugar ......... pound ......... 16 to .20 .42 to .60

Milk .......... pint ........... 04^

Beef .......... pound ......... 32 .73

Potatoes ....... pound ......... 01^

Eggs .......... each ...............

The cities fared better than the country districts,
chiefly, probably, because of the greater ease of dis-
tribution, partly, also, because of political considera-
tions in view of the greater danger of organized dis-
order in the cities, in which there was much socialistic
sentiment and a marked tendency toward pacifism.

Two things stand out clearly: first, there was a
real and serious shortage of food-supplies in Italy;

13 183

THE HUMAN COSTS OF THE WAR

second, the prices were so high that persons of limited
means found great difficulty in buying even the small
quantities allowed. What was the effect of all this
on the health and mortality of the people? The
official position is that while Italy was always close
to the edge and at times facing a crisis, nevertheless
there was always a sufficient ration to prevent serious
impairment of health and working capacity. It
would be too much, perhaps, to expect the officials,
who were in charge of food distribution, to take any
other attitude. This position, however, is far too
optimistic, as we shall see from our consideration of
the distressing subject of sickness and mortality in
Italy during the war. If any confirmation were
needed of the fact that Italy was going hungry, or
had been going hungry, one glance at the children
standing by the railway line at any station in south-
ern Italy would remove any doubt. Their faces
were pinched and thin. They looked old, gloomy,
and grandfatherly, instead of like those radiant
children of Italy whom her painters have immortal-
ized for all the world.

The food shortage was not relieved by the armis-
tice. In fact, about five million additional people,
many of whom had suffered even more than the
people of uninvaded Italy, were left upon Italian
hands. There were the million people in the occu-
pied regions, the four or five hundred thousand
famished returning Italian prisoners of war, the
Austrian prisoners taken just before the armistice
and numbering perhaps a million, the occupied re-
gions of Austria, to say nothing of Albania. In fact,
eight months after the armistice leading head-lines
in the daily press told of food riots in Italy extending

184

ITALY: WAR WIPES OUT TWO MARGINS

in at least one city to the setting up of a new munici-
pal authority.

From Deprivation to Disease: Slipping Back into
the Plagues. — A glance at the condition of Italy
before the war, at the outset of this chapter, showed
a death-rate 40 per cent, higher than that of the
United States. It was made still higher by the war.
Italy had been making some headway toward health.
In fact, in 1914 the death-rate was lower than it had
ever been before, 17.9 per 1,000 of population. In

1915, the first year of the war (omitting deaths
caused by earthquakes), it had risen to 19.6, an
increase of over 9 per cent. In 1916 it had risen to
20. Complete figures for 1917 and 1918 are not
available. A change of one figure in the death-rate
per thousand may not look very large to the casual
reader, but apply this to Italy's population of
36,000,000. The increase in 1915 meant that
there were 68,000 more deaths than in 1914. The
further increase to 20, in 1916, meant 79,000 more
deaths than in 1914. The effect of proximity to
military operations on the death-rate is strikingly
shown in the province of Veneto before it was in-
vaded. Not including deaths of soldiers, the civilian
death-rate in the Veneto rose from 16.4 to 20.2 in

1916. The full significance of the lost ground in
Italy in dealing with disease on account of the war
will be better appreciated by considering certain
diseases which are known to be preventable and in
the control of which encouraging progress was being
made when the war broke out.

Tuberculosis. — Italy's pre-war tuberculosis death-
rate was not excessively high. It had been decreas-
ing for twenty-five years up to 1914 and had fallen

185

THE HUMAN COSTS OF THE WAR

40 per cent. In 1914, the lowest in Italy's history,
it was 145 per 100,000. The disturbances caused
by the war and especially the shortage of food were
immediately and startlingly reflected in the tuber-
culosis rate. From a steady decrease during a
quarter of a century, it changed to an abrupt in-
crease. From 145 in 1914, it rose to 159 in 1915
and to 169 in 1916, an increase in the country as a
whole of 17 per cent, in only two years. Even these
figures do not include tuberculosis deaths among the
soldiers. But worse things were to come. We have
no complete figures for 1917 and 1918, but we have
the facts for the cities. In the 130 cities the pul-
monary tuberculosis death-rate rose from 143 in

1916 to 160 in 1917, an increase of 12 per cent, in
that one year alone and a total increase of 22 per
cent, over the 1914 figure. As the increase from 1914
to 1916 had been greater in the country than in the
cities, it seems likely that the complete figures for

1917 will be more serious even than the alarming
increase in the cities alone.

For 1915 we have also the figures of deaths from
pulmonary tuberculosis in certain of the cities. In
nearly every case these show an increase from 1917,
and in some an increase that is extraordinary. In
several cities 1918 tuberculosis deaths are double
those of 1914. This is due in part, no doubt, to
influenza, but the steady increase from year to year
in a group of these cities is very striking. We give
a few of them in the following table:

Tuberculosis Deaths
Cities 1914 1915 1916 1917 1918

Genoa 221 227 216 325 275

Milan 131 129 145 188 268

186

ITALY: WAR WIPES OUT TWO MARGINS

Tuberculosis Deaths

Cities 1914 1915 1916 1917 1918

Bergamo 198 254 267 262 408

Bologna 114 128 127 148 172

Florence 238 244 254 306 403

Pesaro 106 125 125 166 271

Perugia 87 114 97 124 190

Rome 170 179 195 217 310

Naples 83 105 116 111 122

We must take into account, too, the large number
of cases of tuberculosis developed among the soldiers.
Careful examinations by experts of returned Italian
soldiers have shown positively diagnosed cases of
tuberculosis to a number over eight thousand. The
distressing thing about this increase in tuberculosis
is the great number of new cases all through the
country who are likely to be centers of infection.
Tuberculosis yields to control only very gradually
at best. With this great increase in the number of
persons in a condition to convey the disease to those
with whom they come into close contact, the task
of recovering the ground gained in the twenty-five
years preceding the war will be long and difficult.

For these statistics as to tuberculosis, as, in fact,
for the greater part of our information on sickness
in Italy during the war, we are indebted to the
American Red Cross Tuberculosis Commission, which
not only gave us its statistician, Doctor Dublin, as a
member of our mission, but also turned over to us
the information it had collected and made special
inquiries on lines on which we expressed a wish for
additional data.

The Return of Malaria. — Malaria affords an even
more striking illustration of the disruption of an

187

THE HUMAN COSTS OF THE WAR

effort approaching complete success for the preven-
tion of sickness and the saving of life. The progress
made over a term of years is lost in one or two. It
is generally known that some parts of Italy have long
been infested with malaria. We have all read of
malaria in the Roman Campagna and of the danger
of visiting some of the Italian cities on the southern
Adriatic coast containing some of the most interest-
ing monuments of the fourth and fifth centuries.
Perhaps it is malaria — who knows? — which accounts
for the fact that these localities are now known
chiefly for the monuments which they contain. It
is not generally known that Italy some years ago
recognized malaria as a national menace and began an
organized governmental effort for its control. It
drained swamps, screened houses, and popularized
the use of quinine. It bought quinine in enormous
quantities, carried on a widespread educational cam-
paign for its use, and made it available to every
one by selling it through the postal authorities.
The movement was successful. The malarial mor-
tality was reduced by 1914 to one-tenth of that
twenty years before.

Then came the war. The expense of drainage
operations and such enterprises was considered im-
possible, in view of the tremendous expenditures for
the war and the general poverty of the country.
Quinine became scarcer and scarcer and then prac-
tically impossible to secure. The result was astound-
ing. The death-rate from malaria rose from 5.7
in 1914 to 10.5 in 1915 and to 14 in 1916, increasing
from 1914 to 1916 246 per cent. But malaria is not
evenly distributed over the country. Its increase
in one of the most infected provinces was from 22

188

ITALY: WAR WIPES OUT TWO MARGINS

in 1914 to 128 in 1916, an increase of nearly 600
per cent. It also began to spread to regions ad-
joining those previously infected. In Rome no
malaria deaths were reported in 1916, but there were
56 in 1917.

Numbers of deaths give only a slight indication of
the damage which malaria does to the people of any
locality. It is directly fatal in only a very small
proportion of cases. It produces an enormous
amount of sickness, and consequent poverty, which
may not lead to death or may be only a contributing
cause through weakening resistance. The number
of cases reported, each one of which means a very
definite and serious impairment of vigor and effi-
ciency, is more suggestive. The number of cases
reported during the four years before 1914 and the
four years then beginning were as follows:

Malaria

1910 Cases reported, 201,000

1911 186,000

1912 167,000

1913 157,000

1914 129,482

1915 214,000

1916 224,000

1917 " 304,216

It thus appears that during 1917 no less than
174,734 more persons were reported infected by
malaria than would have been the case if there had
been no further reduction from 1914; but the num-
ber of cases had been diminishing at an average of
17,750 per year for some years. If this reduction had
continued at the same rate, as it seems possible would
have been the case had there been no war, the re-

189

THE HUMAN COSTS OF THE WAR

ported cases would have been 76,232, whereas they
actually were 304,216, a war excess of 227,984 cases
in 1917 alone. In the island of Sardinia, with a
population of 880,000, the number of cases reported
in 1917 was 100,000, or more than one-ninth of the
entire population of the island. Italy will suffer in
every aspect of her national welfare as the result
of these hundreds of thousands of increased infec-
tions from malaria. Her children will be less fit
for education, her laborers less productive, her peas-
ants less successful in the cultivation of their land.

Child Mortality. — The largest single factor in
Italy's mortality is "diarrhea and enteritis," which
is a disease of infants. In 1914, when its rate was
201 per 100,000, it caused almost twice as many
deaths as tuberculosis. It responded at once to the
evil conditions of war. In 1915 its rate was 244 and
in 1916 it was 248. We have noted the steady in-
crease in mortality from tuberculosis in some of the
cities of Italy. The mortality of children under
one year of age per 1,000 births shows a similar
increase. Here are the figures:

Infant Death-rates

Cities

1914

1915

1916

1917

1918

Genoa

.... 120

150

128

149

134

Milan

.... 107

132

123

138

167

Bergamo

.... 186

223

259

243

246

Bologna

121

136

134

195

Florence

120

131

186

188

232

Pistoia

.... 127

138

230

208

334

Pesaro

.... 161

199

317

638

Perugia

.... 115

142

155

217

....

Rome

124

122

131

122

144

Naples

154

155

169

186

230

Fano

183

172

258

424

675

190

ITALY: WAR WIPES OUT TWO MARGINS

This increase in mortality among infants is the
more striking by reason of the fact that the number
of children born during the war was very greatly
reduced. Ordinarily, when the birth-rate goes down
the death-rate among babies goes down also. The
food-supply for a small number of children is more
ample than for a larger one. Mothers can give more
individual attention to a few children than to many.
Overcrowding is less, and the chances of spreading
communicable diseases are correspondingly less. The
war upset this, however, as it upset many other things.
While the infant death-rate went up, the birth-rate
went down even faster. The Italian birth-rate be-
fore the war was 31.1 for the five years ending 1914
against 24 in the United States and 18 in France.
In 1915 it was very little affected, as Italy did not
enter the war until May. In 1916 there was an
abrupt drop from 30.5 in 1915 to 24.4. In 1917
(figures from a few provinces being incomplete)
there was a further drop to 19.5 or a loss of more
than one-third from the figures of 1915. These
figures translated from rates into actual figures af-
ford a better picture of their significance to the
future of Italy. They mean that during 1916, 1917,
and 1918 there was a deficit of births in Italy of
considerably more than one million. Furthermore,
the loss will continue during a large part of 1919.
The total deficit in births in Italy, therefore, due to
the war will be in the neighborhood of a million and
a half, a sum far in excess of her losses from any
other single cause and about equal to the losses from
all other causes due to the war.

Typhoid. — In previous wars typhoid fever has
caused enormous mortality among soldiers. Even

191

THE HUMAN COSTS OF THE WAR

in our own Spanish-American War the losses from
typhoid were far in excess of those from all other
causes put together. In this war anti-typhoid vac-
cination was very generally enforced among the
armies, and typhoid fever caused only a small num-
ber of deaths of soldiers. This was not true of the
civil population in Italy. Italy's typhoid-fever
death-rate had fallen from 27.5 in 1911 to 22.1 in
1912, 22.5 in 1913, and 19.4 in 1914. During the
first year of the war it rose to 26 and in the second
year, 1916, to 27.9, considerably above the figure
which had prevailed as long ago as 1911. Here,
again, entirely apart from deaths of soldiers, the
increase was greatest in the area adjacent to the
fighting. In the Veneto the typhoid rate of 21 per
100,000 in 1914 increased to 64 in 1916, and in the
city of Udine, in the Veneto, typhoid became an
epidemic, with a rate of 410 per 100,000, a rate equal
to one-fifth of the entire death-rate in Italy as a
whole during that year, and thirteen times the
death-rate from typhoid in the country as a whole.
"Flu." — Italy suffered extraordinarily from the
influenza. Definite returns as to its mortality in a
number of large cities have been received. In
Genoa, Milan, and Bergamo the mortality was 7
per 1,000; in Modena, Florence, and Rome it was
10 per 1,000, or 1 per cent, of the entire population.
In Padua and Naples it was 12 to 13 per 1,000, and
in Foggia it was 20, or 2 per cent., and in Fano
it was nearly 2^ per cent. In the rural districts
medical help was almost entirely lacking, the one
available physician in many cases dying at the
beginning of the epidemic. It seems likely that the
mortality was even higher in the country than in

192

ITALY: WAR WIPES OUT TWO MARGINS

the cities. A study of the distribution of the in-
fluenza deaths in Rome by wards shows that it
ranges from 4 per 1,000 in a well-to-do section to
four times that amount in the poorer districts. The
total number of deaths from influenza in Italy is
probably not far from 1% per cent., which would
be 540,000.

Military Losses. — In considering the effects of war
upon the population of Italy we must add to the
deaths due to war diseases the number of soldiers
killed in battle or dying of wounds or of disease in
excess of the normal death-rate of men of that age.
The Statistical Division of the United States army
estimates the Italian losses of men killed in battle or
dying of wounds as 462,000. No official statement
has been made of the losses from disease. We know,
however, that the losses among the prisoners of war
was large. There were, perhaps, 500,000 Italian
prisoners of war. The condition of those who re-
turned, to say nothing of their account of the suf-
fering they had endured, was such as to leave no
doubt that very large numbers of them died. We
shall, perhaps, not be far from the truth if we
estimate the number of deaths among the prisoners
of war at 50,000.

Total Human Losses. — We are now in a position
to form some estimate of the extent to which the
population of Italy was diminished during the war in
comparison with what it would have been had pre-
war conditions continued. It can be only an ap-
proximation, but it is intended to be conservative
and it is confidently believed that in its general
outlines it indicates the true situation. The main
items are:

193

THE HUMAN COSTS OF THE WAR

Civilian deaths, 1915 to 1918, inclusive, in excess of
1914 (excluding influenza and the occupied

region) 310,000

Deaths from influenza, 1918 540,000

Deaths of soldiers in action and from wounds 462,000

Deaths in excess of normal rate among prisoners of

war 50,000

Deaths in excess of normal rate among civilians in

occupied area 80,000

Total deficit in births 1,435,000

Total 2,877,000

It seems to us a very conservative estimate to
place the population of Italy at the end of the war,
or, rather, at the end of 1918, at least 2,877,000
less than it would have been with no war. The
normal excess of births over deaths in the few years
preceding the war was about 450,000 per year, or
1,800,000 for a four-year period. If our estimate is
correct, the population of Italy at the end of 1919
is something more than 1,000,000 less than it was at
the beginning of the war.

This estimate does not take into account migration,
in regard to which the facts are not now obtainable.

War Orphans. — We have noted the official estimate
of men killed in action or dying from wounds as
462,000. Adding deaths among prisoners of war
in excess of the normal death-rate among men of
that age, which we estimate as at least 50,000, the
total loss of soldiers was some 512,000. We were
unable to secure any estimate of the number of these
men who were married or of the number of children
left by them. We know that in France the number
or war orphans is placed at a little more than half
the number of deceased soldiers, but Italy is dif-

194

ITALY: WAR WIPES OUT TWO MARGINS

ferent. The marriage age is earlier and the number
of children born in the early years of marriage much
greater. The birth-rate in Italy is 50 per cent,
greater than in France. While some of the fallen
Italian soldiers were unmarried and some of the mar-
ried soldiers were childless, it is probable that these
men left behind them an average of one child each,
or an army of fatherless children of 512,000. The
great majority of them are living with their mothers
and will continue to do so. The problem is that of
widows' pensions. Widows are given a pension of
approximately $8 per month, with an additional
allowance of $2 per month for one or two children,
and if there are more than two an additional allow-
ance of 80 cents per month for each child up to the
age of eighteen years. This was tolerable when the
law was enacted, but with the high cost of living at
the end of the war, and, in fact, to the present, it is
barely sufficient to provide food, and leaves nothing
for clothing or other necessities. The widows and
children, of course, will not be allowed to starve.
A law was enacted in June, 1918, creating a com-
mittee in each province under the direction of the pre-
fect to take general charge of war orphans, to arrange
for them to be suitably cared for in their own homes
if possible, or, if this is impossible, to place them in
suitable institutions. While war orphans of Italy
will not be allowed, visibly and obviously, to starve,
nevertheless the conditions of life, bare and hard
for the people of Italy generally, will fall with
especial severity upon these unfortunate children,
and we must expect that deaths related to mal-
nutrition and lack of adequate care because of the
absence of the mother at work will be distinctly

195

THE HUMAN COSTS OF THE WAR

more numerous among them than among other chil-
dren. Also, it is obvious that no committee what-
ever and only one mother in a hundred can fully
take the place of a missing father, and that the
chances of moral disaster among these children, or
at least of failure to acquire that education, training,
and development which would fit them for self-
support and leadership, are very greatly increased.
The absence of this half-million men will be felt in
many ways in Italy, but perhaps in none will it be
more serious than in the lack of leadership and
guidance which they would have given to their
families.

Cripples. — We were told that 450,000 soldiers had
been made unfit for further service by injuries re-
ceived in the war. Probably 80 per cent, of these
were farmers. The government was too deeply en-
grossed with the bare task of keeping the nation intact
to be able to give very serious attention to the
question of their re-education or special training for
farming by methods not inconsistent with their
crippled condition.

The Return oj tine Prisoners. — At the time of the
disaster at Caporetto in October, 1917, it was re-
ported that over three hundred thousand Italian
soldiers had been taken prisoners. In the severe
fighting of the earlier portion of the war large numbers
of prisoners had been taken on both sides. The
total number of Italian prisoners approached a half-
million. Most of these were kept in Austria, but
a few were taken into Serbia as laborers. Upon the
conclusion of the armistice with Austria these men
were released from prison-camps. Some of them
were brought by train to points near the Austrian

196

ITALY: WAR WIPES OUT TWO MARGINS

frontier and there released to walk into Italy; others
walked all the way. They arrived at the frontier
in a distressing condition, clothed in rags, without
sufficient food for months, many of them seriously
ill, and all without adequate medical attention since
their imprisonment. When they reached the fron-
tier they had two choices before them. To go south
to Trieste, now occupied by the Italians, or to push
westward through devastated Italy and across the
Piave. If they chose the latter, they had to find
their way through a region seventy-five miles wide
which had been stripped by the enemy, where rail-
roads were not operating, in which even the barest
necessities of food were lacking. We met thousands
of these. One man said he had been walking fifteen
days, another eleven, and another eight. All said
they had been without food for three days. Many
thousands went to Trieste, where they were taken
under control. They were placed in a large, open
area, exposed to the bitter cold of winter in that
region. It was, perhaps, too much to expect the
Italian government to be able to provide immediately
for this unexpected addition to its responsibilities.
At any rate, these men, after all the bitterness of
their prison life, went without food for some days
except such as the American Red Cross with very
depleted transportation resources was able to get
through the devastated regions to them. Perhaps
the fact that among these prisoners were those who
had opened the way to the enemy at Caporetto,
though they were only a fraction of the whole, was
not without its influence upon the nature of their
welcome. After some days the government set up
disinfecting-stations, an important step in prevent-

197

THE HUMAN COSTS OF THE WAR

ing the possible introduction of typhus. It also dis-
tributed food rations; but to any one who has seen
the condition of those very large numbers of pris-
oners as they returned on foot and in rags to the part
of their beloved Italy which had been laid waste
by the enemy, the sight will remain one of the tragic
aspects of the war.

Soldiers9 Families. — If there were times when the
war was not enthusiastically supported either by the
Italian people or by a considerable portion of its
army, the explanation is not difficult. The Italian
soldier received practically no pay (ten cents per day
in the war zone and two cents per day in the rear),
and the allowance to soldiers' families was even less
than to the refugee. The soldier who constantly
hears from home of hunger, cold, and increasing dis-
tress is not in a mood for fighting. The very ef-
ficient branch of the American Red Cross in Italy
very wisely devoted its first efforts to the relief of
the families of Italy's soldiers from the immediate
dangers of utter destitution. When one realizes how
serious the economic plight of Italy actually became
or, in other words, how near the whole country was
to starvation and how far it did actually suffer from
hunger, cold, and every sort of privation, one has
complete sympathy with the feeling that Italy has
made great sacrifices for the war and that they should
not be in vain. One also hopes that she may not be
led astray by any will-o'-the-wisp, that her internal
problems may now receive the same degree of at-
tention she gave to winning the war, that she may
think in terms of welfare rather than of glory.

VII

GREECE: THE COST OF INDECISION

Pre-war Greece; the futility of a glorious past; Greece's war history;
fleeing from the Turk and the Bulgar; refugees from earlier wars and
fires; under Bulgar rule; sentenced to slavery; destroyed villages;
the fire in Saloniki; nation-wide hunger; a virgin field for sanitation;
tuberculosis; typhoid; Greece's malaria menaces Allied success;
infant mortality.

PRE-WAR GREECE.— Like Serbia, Greece had
a population before the Balkan wars of about
3,000,000 (2,643,109 by actual census in 1907), to
which was added in 1913 a population of about
2,000,000, making a total of about 5,000,000.
Athens, the metropolis, had a population of 200,000,
and its seaport, Piraeus, only six miles distant, the
second city in Greece before the Balkan wars, had
another 100,000. In the new area, Saloniki had
170,000 in 1914. Greece lived chiefly by agriculture,
though only one-fifth of its soil is tillable. It also
had considerable commercial and maritime interests,
with about 1,000,000 tons of shipping.

The Futility of a Glorious Past. — If classical Greece
taught the world for all time the beauty of the
human body, modern Greece is as conspicuously
lacking in any appreciation of the value of its human
resources. It has no general statistics of births and
deaths, except for a few of its larger cities. Opinions
H 199

THE HUMAN COSTS OF THE WAR

as to the trend of human welfare in Greece, both
before and during the war, cannot be based on num-
bers and causes of deaths, but must be drawn from
various indications. These are not lacking, and
indicate as unpleasant a picture of human conditions
as we have seen. It is doubtful whether any country
in Europe has been so neglectful of its people as
modern Greece. The birth-rate appears to have been
high. It must have been; otherwise, in view of the
prevalence of disease, the country would have been
depopulated. The death-rate in the twelve cities up
to 1909 was about 23 per 1,000; in Athens in 1907
it was 26.5, about double that of New York City.
Volo, a city of 25,000, had a death-rate in 1907 of
34, two and a half times that of New York. Ma-
laria, typhoid, tuberculosis, and infant mortality all
were very prevalent.

Greece 's War History. — Unlike Serbia and Belgium,
Greece did not readily find herself in relation to the
war. The sympathies of the Greek people were un-
doubtedly with the Allies. Those of the king and
of the well-to-do and royalist element were undoubt-
edly with the Central Powers. But Greece was not
moved in this matter by sympathy. She had much
at stake, both her gains of 1913 and others hoped for,
and naturally she wished to be on the winning side,
or at least to be neutral in order to hold her earlier
gains and profit as much as possible commercially.
But she was too intimately bound up with the
Balkan situation to be able to remain neutral. When
Bulgaria entered the war in October of 1915 Greece's
interest was obviously with the Allies, and, presum-
ably on invitation of Venizelos, when the Allies left

Gallipoli, they landed at Salonika on October 1,

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GREECE: THE COST OF INDECISION

1915. They were too late to help Serbia, and the
Germans, Austrians, and Bulgarians overran all
Serbia and stopped only at the Greek border. All
through 1916 there was uncertainty and anxiety
on the part of the Allies as to whether they might
not be attacked by the Greeks in the rear as well as
by the Bulgarians and Austrians at the front.
Eastern Macedonia, which Greece had received at
the end of the second Balkan War in 1913, was
treacherously surrendered by King Constantine to
the Bulgarians in May without a fight. Two divi-
sions of Greek troops marched into Bulgaria and sur-
rendered and were sent as "guests" to Germany.
Bulgaria, which had expected to receive this region
in 1913 and which claimed that it was really Bul-
garian and not Greek, took substantially peaceful
occupation of the region, including the cities of
Kavala, Seres, and Drama. A new Allied front was
established along the Struma River and the Bay of
Takinos, the line leaving the ^Egean Sea near Orfani,
about half-way between Saloniki and the eastern
boundary of Greece, as fixed in 1913, and running
northwest nearly to the Bulgarian boundary, where
it turned west and followed closely the boundary
between Greece and Serbia. In October Venizelos
set up an independent government at Saloniki.
From an Allied point of view the uncertainty had to
be ended, and a blockade of Greece was established
in December, 1916. King Constantine endeavored
in vain to withstand its effects. In February, 1917,
he established a Food Ministry, but no Ministry
could make an adequate ration from a food deficit.
By common consent the government was turned
over to Venizelos in June, 1917, and Greece, after

201

THE HUMAN COSTS OF THE WAR

nearly three years of vacillation, became one of the
Allies. With the lifting of the blockade food condi-
tions began to improve, but the food situation in
Europe was by this time too difficult to permit much
relief to Greece. She took part in the fighting in
the autumn of 1918.

The outstanding facts of Greece's relation to the
war were: the effects on the Greek population of the
shortage of food from the blockade of December,
1916, until some months after the armistice; the
flight of refugees from the Turks in Asia Minor and
from the Bulgarians in Macedonia; the devastation
of Macedonia and the deportation of Greeks into
Bulgaria after Greece had placed herself on the
Allied side; and the disruption of some feeble be-
ginnings to deal with the terrible incidence of disease
throughout Greece.

Fleeing from the Turk and the Bulgar. — All the
world knows how the Turks set out to exterminate
the Armenians on the pretext of deporting them into
the interior. Few are aware, however, that a similar
fate was planned in 1914 for some hundreds of
thousands of Greeks who lived along the western
coast of Asia Minor. Fortunately some of the
Greeks had another alternative: they fled from
Asia Minor to the islands along the coast, to Mity-
lene, Samos, Chios, and others, all of which had been
awarded to Greece in 1913. About 180,000 suc-
ceeded in reaching the Greek islands; 100,000 went
to Mitylene, 40,000 to Samos, 20,000 to Chios, and
perhaps 20,000 to smaller islands. From here the
able-bodied men found their way across the ^Egean
to ancient Greece or to Saloniki.

They were housed partly in old fortresses, burlap

202

GREECE: THE COST OF INDECISION

packing hung over wires or poles, giving a slight
degree of privacy to each family, or in houses which
the Turks had left after the islands were awarded
to Greece in 1913. In the city of Mitylene each
family was limited to one room, often so small that
there was scarcely room for all to lie down at night.
In Chios some of them were housed in wooden bar-
racks, one hundred and fifty feet long by twenty
wide, and subdivided by only one partition length-
wise. The refugees hung old carpets of coarse bur-
lap on strings to set apart a few square feet of space
for each family. Under these conditions they lived
for four years, an allowance of six cents per day from
the government barely purchasing food necessities,
and the scanty clothing and bedding they brought
with them soon being in rags. No wonder that
typhus appeared among them. The French sent a
physician to assist in its control. Influenza also
made heavy inroads. When the American Red Cross
came upon the scene in December, 1918, the number
of refugees had been reduced by about one-half,
partly by the departure of the able-bodied men, but
also by typhus, influenza, and other diseases. Even
at this time the needs of those returning to Greece's
devastated area in eastern Macedonia were so much
more pressing that little could be done for these
refugees except some distribution of clothing.

The population of eastern Macedonia beyond the
Struma River, occupied by the Bulgarians, was some-
thing like 400,000. Most of these remained, but
some 25,000 to 30,000, including most of the well-to-
do, did not fancy Bulgarian control and fled to the
island of Thasos, along the coast, then found their
way to Saloniki, or to Volo, or as far south as

203

THE HUMAN COSTS OP THE WAR

Athens. These did not fare especially badly. The
Greek men had not been fully mobilized when
Macedonia was overrun, and the refugees included
many able-bodied men who found employment with-
out great difficulty. In fact, wages increased rap-
idly. In Volo, as high as $3.20 per day was paid
for the manipulation of tobacco. The Greek gov-
ernment also made a small allowance to refugees,
distributing to them $2,500,000 in 1917 and $3,000,-
000 in 1918. It also spent $500,000 for soup-
kitchens for refugees and others whose lot was made
especially difficult by the war.

Refugees from Earlier Wars and Fires. — It was
interesting to find in various parts of Greece groups
of refugees from earlier wars still occupying "tem-
porary" shelter and expecting to "go home," some
in very poor condition and some fairly prosperous.
It seemed as though Greece never caught up with
any housing job before another came along. Every-
where in northern Greece one found groups in make-
shift housing who had been war or fire refugees, some
of them for forty years. For example, in Volo we
found some 3,000 refugees who came from Thrace
and Macedonia in 1912 and 1913, and 5,000 from
eastern Macedonia in 1916. Three hundred families
lived in congregate buildings, an ancient Turkish
barracks, a former harbor master's office, and an
unused mill. These buildings were without windows,
chimneys, or partitions. Coarse cloth was tacked
up over the windows and burlap, hung over wire, sub-
divided the space into small sections for each family.
The families averaged five members each. Under
these conditions they had been living six or seven
years.

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GREECE: THE COST OF INDECISION

Some twelve miles from Volo, at Nea Ahnilos,
was a refugee stratum from a still earlier period.
Here were three hundred families occupying houses
which the Greek government had built for them.
The first story of each house was a stable for animals;
the family lived in the two or three rooms above.
These people came from eastern Roumelia in 1908
when that region became a part of Bulgaria. The
Bulgarians wished the Greeks to give up their schools,
religion, and language and become Bulgarians.
Their ancestors had lived in the region since before
the Christian era, but they promptly left rather than
become Bulgarian. They are self-supporting, look
well nourished, and are fairly well clothed. They all
had had malaria, of which they showed marked signs,
and regarded it as a matter of course. Fifty persons
had died of influenza during a period of seven weeks
in three hundred families, a population of about
fifteen hundred, a rate of over 3 per cent. Although
they had been here eleven years and had no special
complaint to make, they fully expected to return;
in fact they did not regard it as an open question.
Some swing of the political pendulum would make it
possible for them to remain Greeks in their ancient
home region, and of course they would return thither.
This attitude after eleven years of good adjustment
to their new economic situation seemed to us to
throw much light on a question which many had been
asking in Belgium, France, Italy, Greece, and Serbia
—will the refugees go back? It had never seemed to
us open to doubt. Whether it be one or four or a
dozen years, they will go back, with some exceptions
of course. Attachment to locality, love of the home
site, is like the law of gravitation — universal and

£05

THE HUMAN COSTS OF THE WAR

unchanging. It is the great, original, conservative
force.

The colony had, in fact, nine hundred houses,
though only three hundred were occupied. It
seemed that after the Greek government had been
informed as to the number expected, and had built
accordingly, many found work elsewhere or found
transportation too difficult. This is one of seventeen
similar colonies in Greece for refugees from the
Balkan wars and from other earlier migrations. All
were built on what was then unoccupied and waste
land. This colony seems to be successful in tobacco
culture on such land. While six hundred houses
here were unoccupied, many hundreds of war and
fire refugee families were living under conditions of
a very much worse type at Volo, only twelve miles
away, as well as at Saloniki.

Under Bulgar Rule. — The saddest chapters of the
war in Greece are those of the three hundred and
sixty thousand who remained in eastern Macedonia
when the Bulgarian army took charge in 1916. It
must be remembered that Bulgaria considered this
territory as properly belonging to her, and that the
population was very mixed. In fact, if Austria
had not intervened in 1913 and if Serbia and Greece
had received the territory which they had expected
toward the west, this territory would undoubtedly
have gone to Bulgaria and there would have been
no second Balkan War. Bulgaria undertook, after
Greece had definitely declared herself on the side of
the Allies, to make this into a Bulgarian region, just
as she had done in parts of Serbia. Something like a
third of the entire three hundred and sixty thousand
were forcibly deported into Bulgaria, many of them

206

GREECE: THE COST OF INDECISION

into the northern part, and those who remained were
in the position of a persecuted minority.

Noting in advance that any Greek description,
written under the circumstances, would not be likely
to fall short in making the picture lurid, it is, never-
theless, interesting to read a report of the sous-
prefect of Pravi to the prefect of Drama, on October
26th, about a month after the evacuation of the
region by the Bulgarians. In the opening portion of
his report he says:

Authoritative testimony as well as the concurring testimony
of the unfortunate victims cannot but convince even the most
skeptical and prove conclusively that the line of conduct followed
by the Bulgarians, as soon as their invasion of Oriental Mace-
donia was begun, was intended to exterminate scientifically
and with premeditation, brutally and pitilessly, all that which
was Greek, all that which could be said to bear a Greek character.

Acts of oppression, outrages, mockeries, and insults against
national honor, thefts, pillages, and profanations of churches
and homes, rape and abduction of young girls, the lowest out-
rages against women, deportation of young girls and children,
torture and death following ill treatment, imprisonment and
beatings without the least pretext, murders, assassinations, acts
of brigandage, of pillage and of arson, robberies and violence,
complete demolition of houses, appropriation of fortunes, total
destruction of entire villages (Tsiousti, Fteri, Nidia, Orfano,
Elef there, Karayanni), the carrying off of furniture and all
that belonged to Greeks, the deportation of about twelve
thousand hostages and their condemnation to forced work
and to certain death by starvation and privations, such is
the result, in short, of the actions of the 10th Division of the
Bulgarian army, called " Bella-Morska (Mer Egee)," and of
the Turkish army (58th Division), which carried out worthily
this work of destruction.

But as if all that was not enough, the entire population was
destined to die of starvation, for not only were no measures

307

THE HUMAN COSTS OF THE WAR

taken to insure its food -supply, but all that was at hand was
requisitioned for the needs of the army.

Thus wheat reached the price of $3.27 per pound, salt $2.18
per pound, sugar $5.81 per pound, so that the population was
forced to feed itself during entire months upon wild plants and
turtles. . . . For a time flour was distributed at the ration
of l^g pounds for fifteen days.

The Bulgarians have, besides, outrageously taken advantage
of this frightful condition, for from April and May, 1917, they
advised the population by poster to emigrate to Bulgaria.

This vivid characterization seems to be borne out
by detailed accounts of what happened in each lo-
cality, from which we quote a few.

Pram:

The population before the war had grown to 3,500.

With the entrance of the Bulgars in the valley of Simvolo,
about 4,500 Greeks took refuge at Pravi. Of this number,
8,000, natives and refugees, 2,200 died of starvation.

Three hundred and fifteen inhabitants were taken away as
hostages and 150 families emigrated. Thirty-five of the hostages
died in exile and 121 have so far returned to their homes.

One hundred houses were completely demolished, even the
materials being taken away.

A large number of the houses are partly destroyed — doors,
windows, and window-panes and other materials having been
taken away.

A large number of stores and homes were pillaged. Cattle,
crops, and various other products were taken away.

Podogariani:

A village of 100 houses before the invasion, of which 77 have
been destroyed.

One hundred and fifty inhabitants were deported as hostages.

Two hundred and forty died of starvation.

There were taken away:

Mules and donkeys 300

Oxen and cows 600

Other cattle 8,000

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GREECE: THE COST OF INDECISION

Wheat (pounds • 110,000

Barley " 110,000

Corn 178,750

Numerous houses and stores were pillaged.

Thirty-seven people were put to death (names given).

Twenty-seven women were violated (names given).

Marianni:

This was a wholly Greek village.

After the Bulgarian invasion the inhabitants received notice
on August 30th to leave the village, as it was on the sea and
therefore likely to harbor spies. After the inhabitants were
scattered, having abandoned the village, the houses were
pillaged and destroyed by the Bulgarians and Turks, pretending
to discover hidden corn. It should be stated that this village
was particularly flourishing because of the cultivation of corn,
cotton, etc. Its 120 houses were entirely demolished. At
present its site is a desert.

Dresna:

One hundred houses before the invasion.

Thirty-two inhabitants deported as hostages, of which only
13 have as yet returned.

Twenty-seven died of starvation.

Thirty-four were put to death (names given).

Nineteen women and young girls died after having undergone
the worst outrages and tortures (names given).

Ten young girls were violated (names given).

Of 500 inhabitants there remain but 212.

There were numerous acts of plunder, violence, and thefts
of cattle. Houses were destroyed. A library estimated at
about 800 books was destroyed. Churches were robbed.

There were carried away: 120 mules and donkeys, 500 oxen
and cows, 6,000 other cattle, quantities of tobacco and cereals.

The reference to Orfani is brief but complete:

Orfani:

A village of 45 houses pillaged and wholly destroyed. Now
absolutely a desert.

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THE HUMAN COSTS OF THE WAR

Also that to Fteri.

Fieri:

Thirty-five houses before the invasion. Ninety-four in-
habitants, of whom 25 were deported as hostages, 3 dying in
prison; died of hunger, 50 (names given); houses in ruins, 34;
carried away, 860 domestic animals and 1,100 hives of bees.
The village is now a ruins without inhabitants.

The fate of a refugee village is thus set forth:

Nea Midia (New Midia}:

Comprising formerly 300 houses built by the government
for the refugees from Midia (Turkey). This village was de-
stroyed utterly, after the property of the refugees had been
given over to pillage. The refugees have been sent to various
places in Bulgaria.

An American official report of a visit to Seres
within twenty-four hours after its evacuation says:

Seres, before the Bulgar occupation, was a flourishing town
of 24,000 inhabitants. It now consists of 6,000, a large number
of whom are parentless children, mostly of ten and twelve years
of age and less. Of the original population, according to the
Mussulman mayor and the city records, 5,000 have died of
starvation during the Bulgarian occupation; 2,000 men between
the ages of 18 and 60 were deported into Bulgaria or some
enemy country to work. That accounts for 13,000. The re-
maining 11,000, consisting of women, children, old men, and
invalids, have dispersed, driven away by hunger. Their condi-
tion is pitiable; the rest are at various railway stations, utterly
abandoned.

The Bulgarians have cleaned out the town, taking away
cattle, horses, sheep, goats, poultry, furniture, bedding, silver-
ware and dishes, food, everything, in fact, portable. They have
taken the glass panes out of nearly all the houses in the town
and carted them away.

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GREECE: THE COST OF INDECISION

A Y. M. C. A. worker, reporting on the same city,
says:

It is beyond my power to describe the pitiful condition in
which I found that city. Most of the houses are utterly de-
stroyed, and not one, I am sure, was left undamaged. Prac-
tically all furnishings of every kind have been carried away.
I was in the homes (if such a name can be given to the miserable
places where most of the inhabitants were compelled to live)
and I talked with the inhabitants and am convinced that at
least one- third of the 24,000 original inhabitants perished
inside of two years from privation and hunger, while another
third has been carried or driven away; many of the last third
escaped and are to-day returning to their ruined homes. Cer-
tainly a beautiful city has been laid desolate.

There are also evidences of women and even girls of tender
age having been ravaged, and the stories of brutality are too
horrible to relate.

Kavala, on the JSgean, was the largest and most
prosperous city of this region. An American report
of a study of conditions there just a month after the
armistice says:

This flourishing city, just prior to its occupation by the
Bulgars, had a population, according to official figures, of
50,000 to 55,000. To-day it bears the appearance of a deserted
town, the vast majority on the streets being Greek, British, and
French soldiers of the liberating armies. Only 8,000 to 10,000
people are left, women, children, and men over fifty-five years
of age, all bearing marks of hunger and privation. Twelve to
fifteen thousand are dead from hunger and attendant disease,
according to the municipal records kept by three Greek doctors,
among them Mr. Trifiliandides, municipal physician. The bal-
ance of the population has been deported, or has dispersed over
the country to seek food. When we were in Kavala the food
situation was still critical and the bakeries were besieged by
weeping crowds, fighting for the scanty stocks. We were obliged
to depend on the military authorities for food while there.

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THE HUMAN COSTS OF THE WAR

Two ship-loads of grain and flour had arrived from Piraeus, but
such was the lack of labor that the cargoes could not be dis-
charged until soldiers were detailed for the work.

No system of rationing seems to have been put into effect
by the Bulgars. Every one had to shift for himself. Those with
money had to pay ruinous prices, those without money ate grass,
weeds, and leaves and died in the streets.

About 40 per cent, of the buildings in Kavala have been
wholly or partially destroyed. On the only occasion when the
city was bombarded by the Allied fleet no damage was done
except by half a dozen stray shots, as the target was the customs-
house on the water-front. Many of these buildings were razed
to the foundations, the rest having been stripped of all wood-
work, floors, roofs, beams, partitions, window and door frames.
Ninety per cent, of the buildings in Kavala, including public
institutions, outside of the Turkish quarter, have been sys-
tematically pillaged.

The absence of men in civil life was startling. The Bulgar
initiated a system of deportation of Greek civilians in Mace-
donia as early as June, 1917. The original orders seem to have
been to deport all Greeks, regardless of age or sex, but later were
applied only to males between the ages of fifteen and fifty -five,
including all priests. From Kavala these deportations seem
to have been commenced in September, 1917.

Drama, the third city of some size in eastern
Macedonia, evidently suffered somewhat less:

Drama appeared in better condition than either Kavala or
Seres. It is a town of normally from 30,000 to 35,000 inhabi-
tants, of which about 4,000 are Turks, a mere handful of Jews,
and the rest Greeks. The Turkish population did not suffer
much during the first three months of the occupation, as there
were two Turkish divisions camped near by, and these aided
their compatriots. Later, however, they suffered with the
rest.

For tne first two months of the occupation the Bulgars rationed
the population. Later, they gave the people the mockery of a
ration amounting to 2 kilograms (4^ pounds) of grain per head
per month. Those who were able were obliged to pay for grain

GREECE: THE COST OF INDECISION

at the rate of 1 kilogram of copper or cotton for 2 kilograms
of grain, or in default of either material, at the rate of 5 cents
per pound. On account of the starvation ration issued, a
contraband trade at once sprang up in grain, so that the real
price was $1.66 per pound.

A few houses were torn down partially by their owners to
sell the wood to buy food. This was especially the case in the
Turkish quarter. As to deaths during the occupation from
hunger and attendant disease, all municipal records have been
destroyed or carried off by the invaders. The municipal doctor
and various inhabitants testified to a probable total mortality
from these causes of 7,000 to 8,000. This is corroborated by
the municipal gravedigger, who stated that he buried an average
of 15 to 20 a day during the last year and a half of the occupation.

We visited one large warehouse, full of stolen furniture and
household utensils collected from other places, which the spoilers
had no time to remove. These goods comprised articles from
china and glassware to expensive furniture, some of which
was, doubtless, from public buildings. Much of it was ready
packed with addresses written on it in Bulgarian, ready for
transportation.

The same system of deportations practised in other parts of
Macedonia was applied in Drama, about 3,000 being taken
from the town. This began in July, 1917. The Greek priests
were either killed or expelled. The five in Drama were replaced
by two Bulgar priests, who performed all ceremonies.

It is obvious that starvation conditions existed in
this entire region during the latter part of the three-
year occupation, and that both property and per-
sonal rights received scanty consideration at the
hands of the enemy army. It is not surprising that
a commission with British, Belgian, French, and
Serbian, as well as Greek members, found that some
thirty-two thousand deaths occurred among the
three hundred and sixty thousand persons who re-
mained under the Bulgar occupation. We have
noted that through deportation, starvation, and emi-

213

THE HUMAN COSTS OF THE WAR

gration to avoid these hardships the population of
the leading cities was reduced as below:

Seres, formerly 20,000, now 6,000
Drama, formerly 30,000, now 20,000
Kavala, formerly 50,000, now 10,000

Sentenced to Slavery. — Although King Constantine
allowed the Bulgarians to enter Greek Macedonia
without resistance, the Greek inhabitants of that
region paid a terrible price for his weakness. Soon
after Greece actually entered the war in June, 1917,
the Bulgarians began the systematic deportation of
Greeks from this region into Bulgaria, often to the
northern regions bordering on Rumania. There is
a Bulgarian military order, dated July 10, 1917, giv-
ing directions as to how this is to be done. Until
further notice two hundred persons are to be sent
daily from Drama, one hundred from Pravi, and one
hundred from another region. Those deported are
to be allowed to take with them only two suits of
underwear, a pair of boots, a winter overcoat, and
food for three or four days. If they have additional
food or cattle or beasts of burden they are to
deliver them to the Bulgar Commission of Requisi-
tioning. The deportations are to begin in the dis-
tricts at the frontier and to be extended to the dis-
tricts in the rear of the armies. That it was prompted
by political, not military, reasons is shown by the
fact that it began in the region farthest from the
military zone. Including at first only men, it later
included also women and children.

It is not easy to exaggerate the sufferings of those
deported. One can only account for what happened

214

GREECE: THE COST OF INDECISION

on the theory that the Bulgarians were quite uncon-
cerned as to how many of these people lived to return
to Greece. Families were broken up. Women and
children as well as men were obliged to work at very
heavy labor, such as breaking stones and mending
roads, often without shelter at night, with very little
clothing and with an extremely low food ration.
Many circumstantial accounts are given of extreme
hardships, such as being made to work when very
ill, being driven to work under these conditions by
beating and by the withholding of the meager food
allowance. There are also many circumstantial ac-
counts of still more revolting things, as to which it is
difficult to separate established fact from statements
made in good faith, but unconsciously exaggerated.
There is unanimity, however, that a large number of
these unfortunate Greeks died from lack of food,
exposure, and disease. No one knows how many. It
may be as high as thirty thousand of the one hundred
and twenty thousand deported, and some estimates
are even higher. When the war closed, the survivors,
or most of them, were released wherever they hap-
pened to be. Many of them were left to walk back;
others were sent part way by train. Whatever funds
they might have were taken from them to pay for
their transportation. There was a line of railway
running west from Constantinople through Turkey
and through Bulgaria along the north shore of the
^Egean. In one way or another many of the Greeks
found their way south to this line. They collected
about the railway stations in great numbers and
streamed on to every passing train, whether it were
passenger, freight, or military, squeezing into every
inch of space, and packing as closely as possible on
15 215

THE HUMAN COSTS OF THE WAR

top of the cars. They had very little clothing, and
the temperature was approaching the freezing-point.
Three very trustworthy Americans who arrived
in Saloniki Friday evening, December 7th, having
come over this route from Constantinople by rail in
six days, gave this account of their observations of
Greek refugees along the road:

From the Turkish frontier through all Bulgaria and as far
as Seres in Grecian Macedonia there were large numbers of these
refugees at every station, and many encampments were seen
along the railway. Most of the refugees had no personal or
household effects, only their clothes and small bundles. They
were poorly clad. The British authorities in charge of the rail-
way system had made it known that these refugees would be
provided with transportation in so far as the British could
furnish it .

These refugees had no money, of course, with which to buy
food. At Xanthi, Drama, and Seres we found American Red
Cross feeding-stations where bread was being given out. An at-
tempt was being made to supply the people with one meal a day.

Every train carried from three to twenty freight-cars which
were filled with these refugees. They were riding ©n the trucks,
on the bumpers, on the roofs, and, in fact, wherever they could
get foothold. The military trains carrying war material were
also packed with these people. They were under the guns,
under the field kitchens and artillery wagons. At practically
every station some passengers were taken off dead. We saw
several instances of this. At Xanthi we were told that six
people had died on the cars the night before. At the Drama
station eight to ten were taken out of the train dead, although
the train stood there only a few hours. They died on the train
en route or on the train at night. The weather was very severe.
They had no food, and were made ill by being packed in so tight.

At Drama there is a dispensary, and efforts were being made
by the Red Cross there to supply food. I counted forty-five
fresh graves at Kavala. The deaths were due to the bad condi-
tion in which the people arrived at the station, lack of food, and
being worn out.

216

GREECE: THE COST OF INDECISION

At Drama I saw a child, barefoot, standing in icy water up to
the ankles, waiting for food to be brought from the Red Cross
camp, with ice all around the edges of the pools, and no other
place to stand.

Just outside of Drama, perhaps for a quarter of a mile, the
railway track was lined on either side with thousands of bundles
of clothing, trunks, and all kinds of cooking-utensils, etc., which
the more fortunate had been able to bring. The people were in
tents or grass huts alongside the railroad. The railroad puts
them off at the village nearest their former homes where they
can be taken care of.

As we came on from Drama we saw twenty car-loads of these
refugees. At every station little groups would get off and go
across the plains or over the mountains to their home villages.
One very sad thing I saw at Drama — two women sitting beside
grass huts, each holding a dead child in her arms. These grass
huts are just a few sticks put up and thatched on the roof and
sides with grass or straw.

It was very much the same in Bulgarian territory. We saw
many at the stations. At every station on arrival the trains
would be besieged for transport; many traveled on the roofs
of the cars. We suffered from cold inside the cars, and the suf-
fering of those on top must have been terrible.

The physical condition of most of them is very bad. Some
of the men were husky, but all were in rags, and it looked as
though it would not take much to break them down. At
Xanthi two young fellows were coming back with their families;
one said four children had died of starvation. A mother and two
children of twelve years had been working on the roads under
the Bulgarians nearly two years. They spoke of the very
severe treatment they had received; no effort was made by the
Bulgarians to furnish shelter. They were paid for their work
on the roads, but only sufficient to buy a little food, and unless
they worked they got no food.

As to numbers, the facts were hard to get. The
number deported was estimated at the time of our
visit by various officials, Red Cross workers and
others, at from 50,000 to 150,000, and the number
who had returned at from 5,000 to 40,000. Subse-

217

THE HUMAN COSTS OF THE WAR

quently, in July, 1919, the mixed commission above
referred to reported that 42,000 were deported, and
another 12,000 went voluntarily, in search of food;
that of this 54,000 about 12,000 died in Bulgaria.

Destroyed Villages. — Notwithstanding her tardy
entry into the war, Greece paid what was for her a
heavy price in physical destruction. The line of
battle all along her northern boundary and down
through Grecian Macedonia is marked by an area
of villages destroyed by shell-fire. Fortunately this
is not a region of cities, Seres, with its 20,000, being
the largest. An official survey completed in Febru-
ary last shows 161 villages totally destroyed and 61
partly so. East of this, through to the Bulgarian
frontier, 13 villages were completely destroyed and
13 others partly so, for no military purpose what-
ever. Others were greatly injured by the use of the
timber of the houses for fuel. The total number of
people made homeless may be from 70,000 to 80,000.
There was also looting of all movables, furniture,
bedding, and supplies of every description, including
doors and windows, such as characterized the
enemy's departure from Serbia and Italy.

The Fire in Saloniki. — The destruction by military
operations, and that for no obvious reason, was almost
matched by another disaster which befell the city
of Saloniki during the war. In August, 1917, a fire
of unknown origin swept over one-third of the city,
destroyed most of the business portion, and made
seventy-three thousand persons homeless. The walls
of many of the stone buildings remain standing, and
the appearance of this part of Saloniki is strikingly
like that of the devastated cities of northern France.
Saloniki had not caught up with her housing problem

218

GREECE: THE COST OF INDECISION

created by an earlier fire in 1871, and there was still
a colony of fire refugees in the suburbs. The various
Allied armies helped to meet the emergency. The
British and French armies erected colonies for the
fire refugees. The Serbs erected a colony for their
refugees who had fled from Monastir, Istip, and
elsewhere. The refugees from the former fire moved
up closer and took in some of the new generation of
refugees. Mosques and synagogues were pressed
into service all over the city, and many hundreds of
families lived in tiny cubicles separated from one
another, if at all, by pieces of burlap hung over
wires. After all sorts of temporary devices had been
fully availed of, there still remained a large number
of families unprovided for. Digging among the
ruins where their houses had been, they often found
brick arches of cellars, basements, or sub-basements
which had withstood the falling of the timbers and
walls above. By clearing away a small entrance to
these they could find temporary shelter. Ofttimes
two or three families would crowd into a single small
cellar. Naturally these cellars were almost without
light. When it rained, the water settled in them and
stood several inches deep on the floor until bailed
out. The families expected these to be temporary
quarters, but in December, 1918, sixteen months
after the fire, more than a thousand families (one
authority estimated it as high as five thousand) were
occupying such quarters, and apparently would do so
through another winter.

A splendid plan for the rebuilding of these ruined
parts of Saloniki has been adopted by the Greek
government. New streets are to be laid out. Open
squares and parks are to be provided, and, in general,

219

THE HUMAN COSTS OF THE WAR

the plan is that of a thoroughly modern city. Un-
fortunately, though the statute had been considered
for a long time and finally enacted, it still remained
simply a project. Everybody had been too busy
with the war, and the government was too poor to
actually carry it into effect.

Nation-wide Hunger. — Turning now from Greece's
war zone to its population in general, the great war-
time problem was that of food. Before the war
Greece, like Italy, consumed more food than it pro-
duced. It had a high per-capita consumption of
bread and a low one of meat. About two hundred
and fifty thousand head of live stock were imported
annually, mostly from Turkey and Bulgaria; large
quantities of wheat were imported. For the first
two years of the war food conditions in Greece re-
mained almost normal. Then came the blockade
in December, 1916; food-supplies began to fail and
prices to rise. This happened first as to wheat,
the great staple, then as to rice and all other im-
ported articles. In February, 1917, a Food Ministry
was established and a ration system put into effect
for bread, rice, potatoes, and other supplies. No
meat could be imported from the former sources of
supply, and the slaughtering of live stock took place
on a large scale. Some districts went without bread
for periods of several weeks, and some indefinitely.
This had happened even before the war in isolated
currant-growing regions. The cities fared better
than the country, and Athens best of all, but toward
the end of the blockade the conditions which existed
everywhere can only be described as starvation.
When the blockade was ended in June, 1917, things
began to improve somewhat. The Allies supplied

220

A SHEPHERD BOY

Tending his cattle and sheep on the slopes of the foothills on Mt. Parnassus
at Bralo, Greece.

A DOUGHBOY ON THE ACROPOLIS

An American soldier of Greek birth, returning to visit his birthplace after
twenty years in America, views the sunset from the Acropolis.

GREECE: THE COST OF INDECISION

some wheat, rice, and sugar. Stocks everywhere in
Europe were getting low, and transportation was
difficult; Greece remained on scanty rations. Her
situation was laid before the Allied Powers in
December, 1917, and an import program agreed
upon. If this could have been carried out it would
have been sufficient, but, because of the shortage of
shipping, food remained scarce for a long time after
the armistice.

The price of bread was kept fairly low, but the
government cannily made sufficient profit on the
other articles to cover the loss. Government mo-
nopolies and a ration system were established for
coffee, sugar, rice, and dried vegetables, and efforts
were made to fix prices for other articles. The
bread ration was usually a little over 300 grams
(two-thirds of a pound). Manual laborers received
25 per cent. more. The bread was three-fourths
wheat and one-fourth either corn or rice. It was
sold at the equivalent of about 8 cents a pound.
White bread could be had by the fastidious at twice
the price and with a reduction of 25 per cent, in the
ration.

The allowance of sugar in the import schedule
was slightly over a pound per month per person, but
little more than one-half of this was actually brought
in by the available ships. There was practically no
meat for the civil population. Available meat was
assigned in the following order of precedence:
(1) the army; (2) the hospitals; (3) the officials;
(4) the sick (on doctor's orders); (5) the general
public. Olive-oil was plentiful and was much used
for food, as also for lubricating and lighting pur-
poses. Olive-oil could not be exported, nor mineral-

221

THE HUMAN COSTS OF THE WAR ,

oil imported, on account of the lack of ships. While
Italy's population was starving for lack of its accus-
tomed olive-oil, Greece had so much to spare that it
used it lavishly for all sorts of purposes. Butter had
never been available except for the rich. A little
butter made from sheep's milk could be bought at
four times its earlier price. After the slaughter of
many of the cattle for food it became very difficult
to secure milk. Confectionery was to be seen in
shop -windows, made chiefly from syrup extracted
from currants and mixed with glucose. Matches
became very scarce and were given out on bread-
cards, two boxes per month, if available, in the
larger cities; the smaller cities and country dis-
tricts did without. The expensive hotels and
restaurants were provided with food materials, and
their prices rose from 300 to 400 per cent.; aside
from this for some months after the armistice the
quantities of food were very limited, even among the
well-to-do, and among the poor living was reduced
to the barest necessities. A very intelligent citizen
of one city of 20,000 inhabitants gave the following
prices as of December 6, 1918, as compared with pre-
war prices:

Prices

Article
Bread

Quantity
. . . per Ib

Pre-war
$.07

Present
$.10 to $.14

Oil

. . . per Ib

.28 to .36

1.08

Cheese

per Ib.

.09

.90 to 1.01

Olives

. . . per Ib

.04

.16

Butter . . .

. . . per Ib

.58

2.18

each

(best quality)
.01

(poor quality)
.20

Milk

Not obtainable

Sugar . .

Not obtainable

GREECE: THE COST OF INDECISION

The first four articles are the principal articles of
diet.

The absence of bookkeeping of human assets in
Greece makes it impossible to give any statistical
evidence of the effect of semi-starvation upon her
people. It was the consensus of opinion, however,
that here, as elsewhere, scarcity of food registered
immediately in much higher rates of sickness and
death.

A Virgin Field for Sanitation. — Lacking every-
where in sharp outlines, the picture of health con-
ditions in Greece is seen vaguely as one of vast
volumes of sickness patiently borne because con-
sidered inevitable. The seriousness of the situation
is fully realized by a few leaders, but, on the whole,
is not felt either by the medical profession or by the
governmental authorities. Here is almost a virgin
field for the prevention of tuberculosis, malaria,
typhoid fever, and the diseases of childhood. These
alone produce a high mortality in every one of the
twelve cities for which figures were available, and
the same undoubtedly holds true for the entire
country.

Tuberculosis. — This disease seems to have been
more prevalent in Greece than in any other European
country which keeps vital statistics except Serbia.
In Athens the death-rate from pulmonary tubercu-
losis was 294 per 100,000 during the three-year
period 1906-08. Other forms of tuberculosis were
also very prevalent, making a total tuberculosis
death-rate of 365, or one death in every six. There
was a beginning of an anti-tuberculosis movement in
Athens, with a dispensary and a small sanatorium
with about twenty beds for early cases. A few

223

THE HUMAN COSTS OF THE WAR

tuberculous patients might be received in the small
general hospitals in a few of the larger cities, but as to
any general program for the control of tuberculosis,
by either private or public initiative, there was none.

Typhoid. — Typhoid fever is continually preva-
lent throughout Greece, and from time to time
becomes epidemic. In the three-year period 1906-
08 the typhoid death-rate in Athens was 59 per
100,000, about four times the present rate in the
United States. In the city of Larissa the rate was
96 per 100,000. An obvious explanation of these
high typhoid rates is the absence of sewers and of any
safe and sufficient water-supplies, even in the large
cities. In Athens the water-supply is still brought
in through an aqueduct constructed by the Emperor
Hadrian. In summer months it is insufficient to
flush the water-closets. No Greek city has any-
thing except cesspools for sewage disposal. In the
country districts and smaller towns the rudimentary
privies, where there are any, afford no protection
against surface or underground contamination of
water-supplies and no safeguards from infection by
flies. Plans were drawn to provide Athens with an
adequate water-supply and a modern system of
sewage disposal, but the execution of these plans
was put off by the war.

Greece's Malaria Menaces Allied Success. — Malaria
also is prevalent throughout Greece, probably more
so than anywhere else in Europe. In some areas,
especially in Thessaly and in the west, nearly every-
body is infected. The disease is often of a malignant
type, resulting in chronic disability and in many
deaths. The malarial death-rate in the larger cities
in 1906-08 per 100,000 was as follows:

224

GREECE: THE COST OF INDECISION

Athens 33

Patras 54

Larissa 179

Volo 248

In Volo malaria caused more deaths than pul-
monary tuberculosis. Besides this, other diseases
showed a high death-rate, indicating that malarial
infection reduces resistance to other diseases.

Malaria in Greece became a distinct menace to
Allied success in the Balkan campaign. Many
thousands of troops near Saloniki were invalided at
critical periods. Thousands were returned to France
and England unfit for further service. One of the
first requests made to the American Red Cross in
France in the summer of 1917 was to establish a large
hospital in Paris for malaria patients returned from
Saloniki. The actual money cost to the Allies for
the building of hospitals in and about Saloniki for
the maintenance of patients, for the return of in-
valided soldiers, and for their subsequent support
was enormous. Diminished efficiency of the Balkan
armies was still more serious. It would have been
money in pocket and an insurance against some pos-
sibilities of failure if the Allies had recognized years
ago that the evils arising from malaria in the Bal-
kans cannot be limited to those countries and had
joined hands to assist the poorer Balkan countries in
eliminating it.

The Greek government in 1911, on the recom-
mendation of a voluntary anti-malaria society, under-
took to control malaria by promoting the widespread
use of quinine. As a result of three years' work,
1911-14, the amount of malaria was reduced one-

225

THE HUMAN COSTS OF THE WAR

half, according to a well-informed government of-
ficial. During the war the purchase and distribu-
tion of quinine became impossible and, in his
opinion, malaria returned to its former level. It is
the policy of the government to re-establish this
method and also to undertake a national system
of drainage. The government has already surveyed
Thessaly and other regions for this purpose. In
Athens and perhaps other larger cities it is pro-
posed that the work shall be done by the national
government directly, and in the smaller com-
munities it is hoped that it will be done by local
authorities on plans laid down by the government
and aided by government subsidy. At any rate,
these plans await recovery from the exhaustion and
impoverishment caused by the war.

Infant Mortality. — The infant death-rate is high in
the Greek cities, notwithstanding the almost universal
practice of breast-feeding of babies. According to the
latest figures and on the best estimate of births it was
nearly twice as high as in American cities. It is due
largely to ignorance of what are suitable foods for
babies during and after the time of weaning. Much
of the food given small babies would test the diges-
tion of even a healthy adult. In Athens the rudi-
ments of medical inspection of school-children exist,
but there is no home visiting, and consequently no
effort to control communicable diseases discovered
in the schools except smallpox. There is no report-
ing of contagious diseases nor isolation of patients
except in case of smallpox and typhus. Influenza
was very prevalent in Greece, and the epidemic, in
the opinion of competent foreign observers, lasted
longer than elsewhere. In Janina the deaths were

226

GREECE: THE COST OF INDECISION

2.3 per cent, of the population and in another city
in Epirus even higher.

Agencies for dealing with sickness in Greece are
few, though not quite as rudimentary as in Serbia.
There is a medical school in Athens and the number
of physicians in proportion to the population is
1 to every 1,300, but a large proportion of the best
physicians are located in the city of Athens, which
has a population of only 200,000, the total for
Greece being 5,000,000. There are large areas of
the country in which no medical service is available.
The anti-malaria work was done in the Ministry of
Communications. There is a division of health in
the Ministry of the Interior, with a director and two
assistants, all being lawyers, we were told. The
work of this division has had to do with the suppres-
sion of alarming epidemics. It does not have in
hand a general health program. Athens has several
good hospitals, but available chiefly for paying-
patients. In fact, the impression which one gets in
Greece is that the comforts and the expert services of
life are to be had by the well-to-do, of whom there
are many in Greece, but that as to the condition of
the great mass of the poorer people few give much
thought, and that very little is done for their well-
being. Every one said that there was much more
poverty in the cities than before the war. Wages
had risen, but prices had risen faster. There were
no munition-factories in Greece and no unusual em-
ployment of women.

Greece has not a large problem, relatively, as to
casualties among soldiers, war orphans, and cripples.
She came late into the war and her mobilization was

227

THE HUMAN COSTS OF THE WAR

far from complete. The American army authorities
estimate her losses of men killed in action or died of
wounds at 7,000, as compared with an estimated loss
in Serbia, which has about the same population, of
125,000. It is a striking commentary on the
magnitude of the losses of the war that the killing
of 7,000 and the care of the children thus made
fatherless should seem a negligible detail to be passed
over in a line or two, if it is not to be seen out of
proportion in the total picture of human misery
drawn on the world's canvas from 1914 to 1918.

VIII

- WAR AND THE CHILDREN

"The scenes of my childhood" in war; Semendria; the obstinate
optimism of childhood; "Dad" and big brother go away; will
they return?; no more goodies — malnutrition; the refugee child;
disillusionment of home-coming; war as childhood's background;
war deficit of babies.

BISHOP PHILLIPS BROOKS once remarked
that he who helps a child helps humanity with
a directness and certainty which is possible in no
other way. If this be true, then, conversely, what-
ever harms a child injures humanity with an equal
directness and certainty. Its injury to childhood,
therefore, affords one measure of the effect of war
on human welfare.

" The Scenes of My Childhood" in War.— In what
had been the city of Lens on a cold, rainy day in
April five months after the signing of the armistice
our automobile stopped in what had been a street
and was now a sort of gigantic furrow plowed through
debris. The chauffeur blew his horn and there came
up from a cellar steps a mother and a boy of three
or four years, pale, thin, and blinking. This cellar
had been their home, not only since their return
some months ago, but also for many months during
the occupation while the Allied artillery made Lens

229

THE HUMAN COSTS OF THE WAR

a wilderness of kindling-wood, bricks, stones, and
mortar. In fact, for the greater part of the boy's
life this cellar had been his home. It was like all
other cellars, but was wholly below-ground and
lighted only by the entrance.

At our farthest point east in devastated Italy on
a bitter cold day in November we passed on the
roadway an Italian mother leading a tiny donkey
which was pulling a cart on which were three small
children and all their worldly possessions. The
children were crying from cold and hunger. An old
grandmother trudged alongside of the cart. They
had been left in the rear when the Austrians swept
forward in October, 1917, and, their home being
too near the lines, had been sent farther back. They
were now on their way back "home," to what we
knew was an almost completely destroyed village.
The only food any of them had had for many days
was yellow corn.

A bit nearer the Piave, at Pordenone, four Italian
families with quantities of children were living in a
wretched building which had been despoiled of doors
and windows and left in an unspeakably filthy con-
dition less than a fortnight before. The children
still had all the beauty which the children of that
part of Italy have had for centuries, but the faces
of the mothers left no need of any further statement
of the sufferings through which they had passed.

When we reached Skoplie, American women, who
had come as stenographers and clerks, were bathing
and cleaning up refugee children who were on their
way back from Bulgaria, whither they had been
deported from southern Serbia. The cleaning up
was being done in an old Turkish inn. The only

230

WAR AND THE CHILDREN

utensils" which could be found were empty petroleum-
tins, and there was no way of heating the water
other than by tiny fires made on the stone floor of as
gloomy, damp, and unwholesome a building as can
be imagined. The children were verminous, ragged,
and suffering from skin and eye diseases.

A little farther on we met, walking along the
unusable railway track, Albanian refugees — father,
mother, and numerous children — all stooping under
the weight of heavy bundles, getting such food as
they could from the none too hospitable country
through which they were passing, and finding shelter
as best they might. They had to go about two
hundred and thirty miles further.

At the next stop, Leskowatz, passing some low
buildings opening on the street, we noticed the most
distressed people we had seen. Their faces were thin
and pinched. The women were dressed in pieces of
coarse burlap and other rough packing-material
stitched together with strings. They were bare-
foot and sitting about on a damp dirt floor in cold
weather (December 23d). Most of them looked as
if they could not hold out much longer. El Basan,
their home in Albania, was still some two hundred
and fifty miles away. A funeral procession came
down the street and passed us. A body wrapped in
coarse cloth was being borne in an ox-cart, and four
or five men in rags were following it. Our interpreter,
a local resident, said: "Yes, that is one of them.
Every day quite a number of the refugees die."
The town seemed full of them. In the outskirts
was a building which had been the civil hospital of
the department. It had been stripped of all equip-
ment by the retreating enemy and hundreds of pass-
16 231

THE HUMAN COSTS OF THE WAR

ing refugees were camped on its stone floors. The
smoke from many tiny fires filled the building. An
open space in the rear served in place of toilet
accommodations. Near the center of the town there
was a curious ancient inn built around an open court.
The buildings had recently served chiefly as stables,
and parts of them were still occupied by cattle.
Manure and human filth and standing pools of
water made navigation in the courtyard difficult.
In places the roof had fallen in. Wherever the
space was not occupied by cattle there were refugees.
There were few babies among them, most of the
children being obviously more than three years old.
Everywhere there were the familiar family groups —
old men, mothers, grandmothers, and children of
all ages except babies. They had little or nothing
in the way of bedding and their clothing hung in
rags and tatters.

From one of the buildings opening on the street
on the outskirts of the village we heard the cries of
a child. There was something insistent, penetrat-
ing, and peculiarly mournful about the cry. Scat-
tered about the entrance to the room was all manner
of filth. Looking in, we saw a child, perhaps three
years old, lying on the dirt floor, dressed in rags,
crying bitterly. We asked a bystander what was
the matter with the child. "Its mother is dead;
she is in there." Then we saw on the dirt floor what
was apparently the body of a woman, sewn in a
rough wrapping. We were told she had been dead
two days. We asked if there were any other chil-
dren. "Yes, there are one or two more. They are
in there. They are either asleep or perhaps they
may be dead." We then saw another bundle of

232

EVERYBODY CARRIES SOMETHING
This family of Albanian refugees are walking home through Serbia.

ON THE WAY HOME

Two hundred and fifty refugees from Macedonia stopping a few days at
Leskowatz, Serbia, on their way home. Twelve died here.

WAR AND THE CHILDREN

rags, and while we were looking it began to stir
and a tiny hand crept out, reaching and feeling about
in a weak, uncertain, trembling fashion. The arm
was bare to the elbow. It was literally skin and
bones, and was covered with the most repulsive
sores. We asked who was looking out for the
children since the mother died. "No one," was the
reply. We suggested that it was not necessary to
let the children die because the mother was dead.
The bystanders shrugged their shoulders and said
something to the effect that that was the way with
these people. Just then our epidemiologist came up
and we asked him to look at the sick child. He
stepped in, pulled the rags back, looked at the bare
arm, and said, "Smallpox." We asked him to look
more carefully, and he decided that probably it
wasn't. Our inquiries had the intended effect, for,
returning a little later, we found that the two
children had been removed to an adjoining room
with another family. The child who had been
crying was eagerly devouring a piece of dry bread
with every appearance of extreme enjoyment. The
scene remains fixed in our memory as the last work
in human misery.

Semendria. — At Semendria on the Danube we
talked with the former schoolmaster. He had been
one of those deported into Austria. His shirt was
collarless and he had no other. His eye was keen
and kindly, and he was exceptionally interesting.
He was much troubled over the condition of the
boys and girls of his town who had been running wild
in the absence of schools and fathers, on streets
left unlighted at night for military reasons or simply
to save fuel. A good many half -grown girls and boys

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THE HUMAN COSTS OF THE WAR

were working in a tobacco-factory where conditions
were very bad. After four years of absence from
school they had gotten out of the idea of going.
Conditions in these respects are even worse now than
during the occupation. The high-school building is
being used by one of the Allies for a hospital, and
even if they were to vacate, there is no school fur-
niture and there are no books. The Austrians
burned them all.

These few incidents, among hundreds of like
character, prompted me to try to form some estimate
of the effects of war on the childhood of this genera-
tion. The task is impossible, many times over, but
at least a start can be made.

The Obstinate Optimism of Childhood. — Normally,
childhood is the springtime of life. Always the sun
shines, summer is coming with fruit and flowers.
Home is the center of the universe, a sure refuge if
any danger threatens from the great unknown out-
side world. Father is the superman, easily able to
vanquish any enemy, a marvel of strength, the very
incarnation of power and of wisdom. Big brother
has many of father's qualities, but is not so busy
and perhaps understands a child's plans better and
is more ready to join in the serious and venturesome
amusements of playtime. Mother is the source and
sum of tenderness and understanding, with miracu-
lous powers to heal all hurts and to summon the sun
from behind the clouds that occasionally cross the
April skies. It does not need riches, palaces, nor
college graduates to make up this environment for
childhood. Give children ever so slight an oppor-
tunity, and their sublime optimism and unconquer-
able idealism will construct an almost perfect home,

£34

WAR AND THE CHILDREN

set in their own world, of the barest, scantiest, and
commonest of materials. To them it is perfectly
real, and its daily exchange of affection, experience,
and ideas constitutes the rich soil out of which the
living soul of the child ripens into a human life.
Into this land of dream-reality there occasionally
comes a rude shock. The superman father in the
world outside meets some enemy which for the
moment is too much for him, or the wonder-working
mother through some inexplicable error in the gen-
eral scheme of things becomes ill. Perchance the
mystery of death comes close by. But this is
altogether exceptional. In the vast majority of in-
stances the dream-world of childhood gradually
changes into that of reality without any rude shock
or violent transition and without wholly losing that
atmosphere of promise, of confidence, of good will
and good intentions. Into such a world, as well
as into the tamer and disillusioned one which we
adults believe to be the real world, came an un-
precedented shock in 1914. With one rude blow
it shattered the picture of springtime joy and sub-
stituted for it the gloom and threatening sky and
the bitter cold of November.

"Dad" and Big Brother Go Away. — Its first blow
to childhood throughout Europe was to take away
the superman, whose strength had kept the world in
order and whose companionship, in the brief inter-
vals when he had time to be companionable, stood
out as a succession of almost miraculous events. I
do not know the equivalent of "dad" in French or
Italian or the tongue of Serbia or Rumania, Greece,
or Russia, but I know that every language must
have such a word. "Dad's" place in the home had

235

THE HUMAN COSTS OF THE WAR

been secure and supreme. In the word "dad" he
had felt compressed such volumes of affection, such
completeness of confidence, that for him life had
taken on new meanings and vast responsibilities.
The failure to meet them would be the greatest of all
failures; the chance to live up to them drew forth
his greatest powers and made long hours of monot-
onous toil seem a negligible part of the day.

Now, however, for no reason that appealed to the
child — because somewhere a bugle sounded, or
somebody brought to the door a bit of paper with
some typewriting upon it — "dad" had to go away.
Life thereupon became very quiet and monotonous.
All parts of the day were alike. Mother seemed very
still. There was nothing particular to do. Nobody
came home to dinner with interesting accounts of
what had happened during the day. At night the
streets were dark, and it was best to say nothing to
mother about what took place in them. There was
nothing to do but to look forward to the time which
mother said would be soon when "dad" would come
back. Life became chiefly a matter of waiting.

Big brother went away, too. The games in which
he helped, which were the best games of all, could be
played no longer. There remained only the tame
ones in which all parts were taken by children. He
had gone off on the same kind of an errand as "dad,"
and he, too, was coming back soon.

The number of children whose world was suddenly
darkened in this way is so huge as to be utterly
beyond all comprehension. Some 50,000,000 men
became soldiers; one authority says 56,000,000.
Most of them were fathers or brothers. The devas-
tation of child life was world-wide. It struck not

WAR AND THE CHILDREN

only the children of France and England, of Italy
and Russia, of Belgium and Serbia, of Germany,
Austria, Turkey, and Bulgaria, of Canada, Australia,
New Zealand, and the United States, of Rumania
and Greece and Switzerland; it included the children
of Japan and the children in hundreds of thousands
of homes in China and in the "black continent." We
thought we had accomplished something quite re-
markable when we arranged a more or less unreal
kind of "big brothers" for a few hundred children in
our juvenile courts, but in a very short time the war
called away more big brothers than we are likely
to provide in something like seventy thousand years.
Will They Return?— So long as "dad" and big
brother were going to come back, the child could call
upon his reserves of patience and endurance. He
could make the old and worn-out games do after a
fashion. But to many of them something happened
so very much worse that it was quite useless to make
any effort to understand it. It was so inherently
improbable that it could not really be true. People
began to say that "dad" and big brother would not
come back. The child's searching eye, which turned
to mother for reassurance, saw that something ter-
rible had happened. It was so impossible to under-
stand how anything could really interfere with such
a big, powerful man as "dad" that the child's mind
resisted to the last the thought of his having been
harmed in any way, and equally the thought that
anything in the world could possibly prevent him
from returning sometime to his children. But, how-
ever long and doggedly the child denied to himself
the truth of the terrible statement, there was always
the haunting fear that it might be true, and in pro-

237

THE HUMAN COSTS OF THE WAR

portion as fear got the upper hold the future was
dark. Mother was absent-minded and could not
heal this hurt as she had done so many before.

Millions of children went through this experience.
Do I say went through it? They are going through it
now and will continue in its shadow for many years
to come. How many war orphans there are in the
world God only knows! There are millions and
millions — probably nearer ten millions than five.
Nothing can really take the place of the father in
normal contact with his family. The lessons of life
are passed over from one generation to the next in a
multitude of daily events and experiences which
occur only in a home in which father and mother
both occupy their natural places.

No More Goodies — Malnutrition. — Another thing
happened to the childhood of the world. The child
is always hungry and naturally expects to be fed.
The process of relieving hunger is one of his chief
occupations. But now, in millions upon millions
and in yet other millions of homes, there was not
food enough. There were not so many kinds of
things to eat; the good things especially were lacking
— cakes and candies, meat and gravy. There re-
mained mostly bread, which was even drier and
harder than before and there was less and less of it.
To the child this meant daily disappointment, a
vague, uncomfortable sense that life was no longer
satisfying, and that everything interesting which
might be done involved so much effort that it was
not worth while to begin it. To the understanding
eye of the mother this atmosphere of insufficiency,
this feeling of never being able to provide enough,
was much more serious. It meant a gradual chang-

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WAR AND THE CHILDREN

ing of the bright flush of unconscious health to the
pale, anemic look of one who had been, or was going
to be, sick. It meant that the child became thin,
weary, downhearted, peevish, always wanting some-
thing. To the physician it meant stunted growth; a
delay in physical development which could never
wholly be regained; a dozen cases of tuberculosis of
the glands or of the joints where before there were
but one or two; an inability to withstand children's
diseases which ordinarily seem at least to come and
go, leaving little impairment for the future. Insuf-
ficient nourishment was so widespread in the world
and affected so very large a proportion of the people —
those who buy their daily food and upon whom the
full burden of higher prices immediately falls — that
it sweeps far beyond any stretch of the imagination.
About one-third of the world's population are chil-
dren under sixteen. There are so many millions upon
millions of people in the countries which were at war
in Europe and in Asia that it is almost futile to try to
think of these under-nourished children in terms of
numbers. Europe's population in 1910 is estimated
at 447,000,000. One-third of this would be 149,000,-
000. Add the children in Asia who went more
hungry than before. We understand a little bit of
what insufficient food means to the individual child.
We know that the underfed child is a poor scholar,
a weakling, a problem of the future, but who can
form any conception of the tremendous sweep of
these continental areas of backwardness, invalidism,
fertile soil for infection, resulting from a shortage in
the world's food-supply because so many men were
at war, so many ships were sunk, and so many

soldiers were eating more than they had before? It

239

THE HUMAN COSTS OF THE WAR

is a heritage which will plague the world for scores
of years, producing inefficiency, breeding discontent,
burdening the public treasury with the support of the
sick and the invalids, and reducing everywhere the
joy and richness of living.

The Refugee Child. — For a proportion of these
children the war very quickly changed from some-
thing vague and far away which claimed "dad"
and big brother, to something terrible, something of
explosions, of terrific noise, something so dreadful
that they must leave their homes and flee before it.
Home had been a fortress, an absolutely sure pro-
tection from all danger, but this was something so
terrible that a home was of absolutely no account.
In one second it would convert a home into a mass
of ruins. It spared nothing. The child's playthings,
the furniture in his room, the doors, windows, par-
titions, ceilings, and walls of his house, all crumbled
into bits at the touch of this terrible thing. The
child did as he was told. He picked up his kitten
or his dog, carried a bundle which was so heavy that
it immediately began to make his back ache, and
walked off down the road. His feet became so sore
that he could hardly take another step, he was
desperately sleepy, terribly hungry, and more un-
comfortable than he had ever been in all his life,
and there was everywhere a vague feeling of still
more terrible dangers. The child had to go with
his mother, his brothers and sisters, and his grand-
parents on some long railway ride, or perhaps they
had to walk all the way. They were hungry, cold,
and crowded. There was no place to sleep. Finally,
after what seemed like an endless lifetime of traveling
[(which was, in fact, several days), they arrived

240

WAR AND THE CHILDREN

"somewhere." Even then there was no good place
to go. Hundreds of them would be crowded in to-
gether in some big building with no separate rooms.
It had no beds, no stoves, no nice warm blankets.
It was all so bare, dreary, and uncomfortable, and
everybody was so downhearted that the children
wept bitterly. They longed for the comfortable
places from which they had come. They feared that
nobody would look after all the treasured things
which they had left behind. They felt sure that no
one would have been so cruel as to harm them if they
remained. They could not see why mother should
have come to this gloomy and hateful place of all
others. But here, or in some such place, they had
to stay. They might as well forget all the comforts
and attractions of the homes in which they had been
brought up. They were exiles, refugees, and here
they stayed for so long a time that it seemed as
though they had lived here longer than anywhere
else, and some of them had. They came to feel that
this was where they would have to remain always,
that their former home belonged to some sort of a
golden age which would never return; that, hateful,
wretched, and uncomfortable as it was, their present
quarters were all that life held out to them, and that
they had to make the best of it. Mother did not
seem able to get any new clothes, their shoes were
worn through, their stockings had great holes in
them, their underwear and outer garments alike
grew thin and patched, and patched again. Mother's
clothes were the same way. There was nothing
handy with which to do anything. They had hardly
any dishes. Many times they had no coal and no
wood, not enough to cook, and never enough to keep

241

THE HUMAN COSTS OF THE WAR

warm. Some 4,000,000 children lived in this way
from one to four years.

Disillusionment of Home-coming. — Mother had told
them from time to time that by and by they would
go home, but the waiting was so long they had come
to disbelieve it. One day they were told that they
would start.

But when they reached home what disappoint-
ment! Perhaps they had heard that home had been
destroyed, but they had easily reconstructed it in
their imagination. They had refused to see a heap of
bricks and stones; it was so much more agreeable
to think about the wonderful home as it had been,
and as they thought about it again and again it
seemed to them to be reality. But now the bitter
truth was evident. Their home had gone. The
strange place in which they had lived for so long a
time in exile seemed bare and cold and gloomy, but
this which had been home promised even worse.
This was unmistakably the place; the road and the
fields, the rivers and the hills — all proved beyond
question that this was where the golden age had been
spent, but now how different! What enemy could
thus wreck the most perfect of homes, so solid and
permanent and comfortable that the thought that
it might be broken to pieces had never occurred to
them? Now there was neither up-stairs nor ground
floor; nothing but a cellar, and that full of bricks
and sticks and stones. The stables were gone as
well, and down the street the schoolhouse had gone,
and the church and the town hall. As far as one
could see in every direction everything had gone.
Apparently this was where they were to live, for
their elders and superiors began to clean out the

242

WAR AND THE CHILDREN

cellar, to collect bits of iron and sticks and pieces of
heavy paper, to prop up some sticks to make some
kind of a hut, to look here and there for a broken
dish or anything that might be useful. It was most
strange. If, for a moment or two, it seemed interest-
ing because it was so different, they soon realized that
it was no place to live; it was more uncomfortable,
more crowded, more cold, more dreadful even than
the place where they had been. And if mothers and
brothers and grandparents said that it was to be
only for a little while, that very soon they would
have a fine new house like the old one, can we doubt
that childish minds, grown old so fast, which had
experienced in a few years more tragedy than comes
to most people in a long lifetime, saw through the
thin pretense and knew in their hearts that it could
not be done, that there were not the things to make
houses of, nor the people to make them, and that it
would be a long, long while before they would again
have the wonderful homes which they had left away
back in the golden age?

Several million children in Europe are living in
such places. Unless all that we call civilization has
been on a mistaken quest, unless sunlight, fresh air,
good food, dryness, cleanliness, and decency do not
make for health, vigor, and normal development,
these millions of children when they come to
carry on the world's work will find themselves weak
where they should be strong, lacking in vision,
adaptability, resistance, vitality, energy, courage,
affection, responsiveness, and resourcefulness.

But even in such places children must play, and
what a wonderful field for exploration! Among the
ruins were most extraordinarily interesting things.

243

THE HUMAN COSTS OF THE WAR

There were things made of iron and copper, long and
round, flat at one end and shaped like a beehive at
the other. Also, there were small, oblong, iron
things, with a curious fixture in one end. What
were they for? What was inside of them? Could one
take out the curious things in the ends? Would a
hammer break them open? Would they make a big
noise? Thousands of children experimented with
shells and hand-grenades. Many will be cripples for
life and many have found a world in which there is
no war.

War as Childhood's Background. — What are the
effects of all this upon the child's impressionable
soul? What remains to him of that rosy future
which had held out its hand so enticingly in the early
days ? Life had been false to him ; it had lied to him ;
it had promised him warmth, shelter, companionship,
love, and comfort. It had brought him noise, exile,
hunger, cold, loneliness, and homelessness. It is the
impressions of the early years which persist through
life, which give a drift to character, which shape the
instinctive attitudes and presumptions of life, which
create an atmosphere of expectation. To what can
this generation of children look forward, in what can
they believe, whom can they believe, when life has
proved so false in one thing after another; when the
whole background is that of violence, of killing, of
destruction, of hate; when the earliest recollections
include explosions, shells, and bombs? In what
temper of mind will they approach the duties of the
future, what kind of democrats will they make, how
much heart will they have for the creative under-
takings of life?

Excepting for the fresh supplies of confidence,

244

WAR AND THE CHILDREN

optimism, and good will which children are con-
tinually bringing into the sum total of life, the earth
would speedily become too blase, disillusioned, and
certain that nothing is worth while, to be a fit place
to live in. Childhood's contribution to each genera-
tion is a vital element.

War Deficit of Babies. — Those who let loose the
World War probably realized vaguely that they
might decimate Europe's manhood. Probably they
did not in the least foresee that, in addition to this,
they might reduce Europe's population to an equal
extent by causing widespread race suicide. The war
deficit of births in Europe probably exceeds the total
number of soldiers dead from wounds and disease.

In France, as we have seen, the effect of the war
on the birth-rate was very prompt and very striking.
The 77 uninvaded departments (of a total of 86)
show a deficit of births for the five years beginning
1914 of 984,589. Adding a deficit of some 200,000
in 1919, the loss amounts to some 1,184,589.

In the 9 invaded departments, where the births in
1913 numbered 141,203, there were very few after
1914. Two million refugees from this zone were in
the interior and their births are already included in
the figures above. The 3,000,000 people back of the
lines included so few men that the birth-rate was
very low. In Lille the births were reduced by seven-
eighths. The war-zone birth deficit is probably at
least 100,000 per year, a total of 500,000, including
1919, or for the whole of France a total birth deficit
of some 1,684,589.

In Italy, whose population was as fertile as its
fields were sterile — which exported men and imported
food — the war's devastation of the cradle was equally

245

THE HUMAN COSTS OF THE WAR

marked. The birth-rate for the five years ending
1914 was 31 per 1,000; in 1916 it was 24. In 1917
(with a few provinces not fully reported) it was 19,
a loss of more than one-third from the pre-war
figures. Figures from 23 cities show a still farther
drop in 1918, in some cases to less than 50 per cent,
of the 1914 rate. Obviously, this will continue
through at least the larger part of 1919. Expressed
in terms of totals, this means a deficit of births in
Italy, compared with pre-war conditions, of about
1,500,000, a number three times as great as the
number of soldiers killed in battle, which was
estimated at 462,000.

In uninvaded England the number of babies born
in 1914 was 869,096. In 1917 it was 663,340, a
falling off of about 25 per cent. In 1918 it fell still
farther to 611,991, a decrease from 1914 of 31 per
cent. For the two years 1917 and 1918 the birth
deficit was 477,861. The deficit had already begun
to operate in the latter part of 1915 and 1916 and
will continue through at least the greater part of
of 1919. In England and Wales alone, for the war
period, the birth deficit runs not far from 750,000.
If Scotland and Ireland be included the war deficit
in the United Kingdom will approach 1,000,000.

In Belgium the annual crop of babies before the
war was about 170,000. Reports from localities
widely scattered show an average falling off of about
50 per cent, or 85,000 per year, which for four and
one-third years amounts to 348,000.

In Serbia, normally a very fertile country with the
high birth-rate of 38 per 1,000, the number of births
appears to have fallen off to an even more startling
extent.

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WAR AND THE CHILDREN

The absence of children under three years of age
in Serbia was very obvious to even the casual ob-
server. The number of births in Serbia before the
war was about 190,000 per annum, or for a period of
five years some 950,000. A reduction to 20 per
cent, of its former volume would mean a deficit of
760,000, a number undoubtedly greater than the
exceptional losses which Serbia sustained during the
Great War from all other causes combined, including
the typhus and influenza epidemics, wounds and
disease in the army, internment of prisoners and
civilians in enemy countries, and the retreat through
the Albanian Mountains in midwinter.

It is well known that the birth-rate fell off tremen-
dously in the enemy countries as well, and that this
led in Germany to a comprehensive movement to
train child-welfare visitors in order to conserve the
lives of the few war babies.

Even in America the bookkeeping of human re-
sources began to tell the same story. In New York
State the birth-rate of November, 1918, was 2.6
lower than that of the average for November for the
preceding five years (19.8 against 22.4 per 1,000).
By March, 1919, it was 3.2 lower than the average
for March for the preceding five years, a reduc-
tion of 13 per cent. This would mean a falling off
of about 32,000 in the state of New York alone in
one year.

Taking France's deficit of 1,500,000, Italy's of
about the same, England's of 1,000,000, Belgium's of
350,000, Serbia's of 760,000, and recalling Russia,
Rumania, and Greece, it is evident that the deficit
in births among the Allies alone will run into some-
thing like 6,000,000 or 7,000,000, and that if we add

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THE HUMAN COSTS OF THE WAR

the figures for the Central Empires we shall arrive
somewhere in the neighborhood of 10,000,000.

One might almost think that in whatever spiritland
the souls of unborn children await their departure,
the sounds of war and strife were heard and a whole
generation just refused to come. The earth became
very unpopular as a future home. Perhaps the
population of Mars or some other planet increased
proportionately. At least these wise little souls evi-
dently refused to be born into an atmosphere of
hatred, violence, and wholesale slaughter. It was
no place for babies.

WAR EXILES AND HOME-COMINGS

By the rivers of Babylon, there we sat down, yea, we wept,
when we remembered Zion.

— Psalm cxxxvml.

Homelessness no light matter; continuing tides of refugees; refugees
everywhere; leave-taking; refugee "adjustment"; refugee "pros-
perity" and "morale"; the call of home; war zone after the war;
cave-dwellings; repairing the irreparable; other makeshifts; tem-
porary houses; more aid and less pity; immaterial ruins; sub-
standard living; Germany's devastated area; community
"adoption."

SINCE August, 1914, Europe has been full of
migrating people, homeless and heart-sick,
weeping as they felt the pinch of hunger or shivered
from cold and thought of the comfortable homes from
which they had been driven. Their numbers com-
pare with the little band of the Chosen People whose
plaintive wail has become part of the sacred literature
of the world as the ten million men who fought on the
western front compare with the little bands of sol-
diers who followed the personal fortunes of their
kings in Asia Minor twenty-five centuries ago.

Homelessness No Light Matter. — In American homes
and Red Cross workrooms millions of American
women have been making garments for these war

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THE HUMAN COSTS OF THE WAR

victims. Now that the war is over, what is happen-
ing to them? The women of America are entitled
to know, not only that on a certain day a refugee,
shivering from cold, was given clothing made in
America, but what the whole sad story of being a
refugee means. The Great War created homeless-
ness on an unparalleled scale, and homelessness is
no light matter. It is not by accident that we have
come to live in family groups and in settled habita-
tions. It is because, on the whole, after centuries
of trying many ways of living, the home plan works
best. It is not only the child for whom the barest
of walls that inclose a home are transformed. Under
the magic of romance and the great adventure of
parenthood, bare walls are covered with brightness;
each meal is fit for a king; work is child's play and
life is altogether desirable. In the home children
acquire poise, serenity, and balance, and take over
unconsciously such wisdom and grace as their
elders have acquired. Away from home we get home-
sick because at home we are surrounded by all the
things that help to make us and keep us well. The
world has seen many voluntary migrations in search
of better things, for there is a restless element in
human nature. People moved out of crowded re-
gions into newer areas to establish new homes.
War migrations, on the contrary, were compulsory
and always to worse conditions. The war exiles did
not wish to leave; they had to. They did not go
out to build themselves new and better homes, but
to put up with any temporary makeshifts.

Continuing Tides of Refugees. — There were refugees
all over Europe. For five years it had seemed that
almost everybody was either going somewhere else

250

WAR EXILES AND HOME-COMINGS

or expected to do so soon, and, meanwhile, was living
in a makeshift fashion. In Paris alone there was a
constant number of 250,000 French refugees, 70,000
Belgians, 2,000 Serbs, a goodly number of Russians,
and a sprinkling of other nationalities. Besides
these, other thousands overflowed the railway sta-
tions and temporary lodgings of Paris as they
passed through from time to time on their way
from the occupied regions to "somewhere in France."
You could not go anywhere in France without find-
ing refugees, and you could hardly remain at any
place without seeing intermittent processions pass-
ing by. The production of new groups of refugees
was an almost continuous aspect of the war. It was
just an ordinary incident of the day to hear that the
town of So-and-so with a population of 5,000 or
20,000 had become too dangerous for civilians and
would be evacuated on the following Tuesday or
Thursday. Toward a million people left Paris dur-
ing the period of greatest danger in the spring of 1918.
Throughout the war hundreds of thousands re-
mained as near home — that is to say, as near the
front — as they were allowed to. From the North Sea
to Switzerland from 1914 to 1918, when the enemy
changed the direction or range of his heavy artillery
at any point, new processions started toward the
rear. When the smoke cleared away they started
back. There was always a balancing of dangers
from bombardment, poison gas, and air bombs,
against attachment to home, getting the crops in,
and doing profitable work of various kinds for the
armies. There was always plenty of work to be had
near the armies, though life there was thoroughly
demoralizing. The Allied armies did not have the

251

THE HUMAN COSTS OF THE WAR

brutal attitude toward refugees which would have
been shown by the trained militarists of the Central
Empires under like conditions. They were sym-
pathetic and as helpful to the refugees as the military
situation permitted. The British army especially
was always ready to share its food with the refugees
coming through the lines, and to help them to get
to the rear. It liked to have them sent well to the
rear, because freedom of action was essential to it
and also there was the ever-present danger of spies
being mingled with the refugees. Sometimes the
restrictions which it placed upon persons going into
the war zone to do relief work seemed unreasonable.
But they were fully justified. Its attitude might be
summed up as, "Be good to them, but, for Heaven's
sake, keep them out of our way."

Refugees Everywhere. — When we started on our
survey mission on armistice evening the refugees
everywhere were just beginning to go back. It was
the first trickling of what was to become a returning
flood. Along the Piave River in devastated Italy
they were coming from both directions — the refugees
who had fled in advance of the Austrian army to the
interior of Italy and those who had stayed behind
and had been evacuated eastward by the Austrian
armies. In the bitter cold, through a devastated
country, with a few household utensils and a little
clothing packed into a donkey-cart, they were finding
their way back to a region as thoroughly devastated
as northern France.

A week or so later we arrived at Bralo, a tiny
station between Athens and Saloniki, the point at
which troops going by rail were transferred from the
wagon-road going overland from the Gulf of Corinth

252

WAR EXILES AND HOME-COMINGS

to the railway. On the tiny railway platform
bundles and packages of every description were piled
high. In the early evening we heard singing. It was
the Serbian refugees who had been exiles in Italy,
France, or Africa, and were on their way home.
They did not know that they were on a blind alley
and that after they reached the southern part of
Serbia they would have to stay an indefinite time or
retrace their steps many hundreds of miles to go
from the Adriatic to Belgrade. When we reached
Athens we found refugees from Asia Minor and
Macedonia. A great boat-load of clothing had just
been sent by the American Red Cross to scores of
thousands of refugees on the islands off the coast of
Asia Minor.

We started by boat for Saloniki, stopping on the
way at Volo, the most unhealthful city in unhealth-
ful Greece. As many refugees came on board as
some slight regard for the safety of the vessel would
permit. Between-decks it was full of refugees.
When we met true ^Egean weather and took in
goodly quantities of water the poor refugees between-
decks slid from one side of the boat to the other as it
pitched from one side to the other, aided in so doing
by some inches of water.

Arrived at Saloniki, the town was one seething
mass of unfortunates stopping temporarily some-
where. Turkish mosques and Jewish synagogues re-
ceived impartially hundreds of families who camped
in little groups here and there on the stone floors,
fortunate if a bit of burlap hung over a wire af-
forded a suggestion of privacy.

At Strumitza, just across the Grecian frontier in
Serbia, box-cars on the siding were loaded inside and

253

THE HUMAN COSTS OF THE WAR

on top with unhappy women and children "going
home." From then on, through southern and cen-
tral Serbia, refugees were ever present, trudging
along the muddy road, camped on the stone floor of
some empty building or in the open. The impres-
sions were of rags and tatters, dirt, eye and skin
diseases, bundles, vermin, unavoidable unspeakably
unsanitary practices, but also of determination,
patience, a spirit of "carry on," and, as to the
children, real interest in the passing show and a
confidence that somehow, somewhere, life still must
have interesting and agreeable experiences.

At Nish the refugees had passed by, but in the
cemetery two large groups of newly made graves
were pointed out to us as those of refugees who had
died on their way home. At Belgrade, too, most
of them had passed on, but there remained a few
isolated and friendly old women, many of them
with faces of extraordinary dignity and serenity.

Leave-taking. — The story of their going has caught
the world's sympathetic attention. We have all
been made to see the family groups — grandparents,
mother, children, the sick and the crippled, as they
looked longingly at their cherished possessions, their
tidy homes, the many things made with their own
hands, their animals, their crops, their fields, the
church spire in the village. They must have picked
up one thing, laid it down; took up another, and
then another. "No, it can't be taken; it is too
heavy. It must be left. We must walk, and the
road is long." Hastily they put together a few
necessary or treasured things and started down the
road. We have seen them walking footsore, burden-
bearing, falling by the wayside. We know of babies

254

WAR EXILES AND HOME-COMINGS

born on the way, and of mothers carrying new-born
babies for miles. We have seen the refugees packed
by main force into stifling freight-cars and slowly
hauled, with many long interruptions, somewhere
into the interior, hungry, filthy, weary, depressed.
This happened to 1,250,000 people in Belgium,
to 2,000,000 in France, to 500,000 in Italy, to
300,000 in Greece, to, say, 300,000 in Serbia, to
2,000,000 Armenians (except that they walked
out into the desert and most of them to death), to
400,000 in East Prussia, to huge but unknown num-
bers in Rumania, Russia, and Austria — all told, to
some 10,000,000 people.

Nobody, unfortunately, has had the imagination
to enable us to realize what happened to all these
people afterward, although that is the really im-
portant thing. Traveling is never very comfortable.
We can put up with hunger, weariness, cold, and
sleeplessness for a few days, if need be. They may
even help us to forget loneliness. The hard thing is
to endure all these things, day after day, week after
week, and month after month for several years and
with no early or certain end in sight. This, a much
more real tragedy than their more dramatic depart-
ure, is the second and greater claim of the refugees
to our continued sympathy and help.

Refugee "Adjustment'9 — When they arrived at
their destinations there seemed to have been some
mistake. Nobody was expecting them and no com-
fortable place was ready. All the houses were
occupied by people who had been living there a
long time. The only places to go to were barns,
sheds, abandoned factories, unused convents, aban-
doned hotels, etc. These became terribly crowded,

25$

THE HUMAN COSTS OF THE WAR

Instead of each family having two or three rooms,
often there were two or three families in one room.
It was awkward, indecent, noisy, and sickening.
There was nothing to cook with, nothing to sleep
on, nothing to cover up with, and it was cold.
There was not enough fuel to go around. There
never had been too much, but now, because some of
the mines had been captured and there were not
enough men to work the others, and the cars were so
busy hauling munitions, it required desperate efforts
to get barely enough coal or wood to cook with, let
alone keeping warm. Most of the refugees could not
do much work. The communities whose involun-
tary and uninvited guests they were did not like the
new-comers who talked so differently, lived differ-
ently, and crowded in everywhere. Rents went up
and food prices went up, and, as the refugee had no
home and no land, he had to buy everything, and his
scanty means would not hold out. He had to take
the cheapest, dampest, darkest, and most uncom-
fortable quarters there were — places which people
had abandoned because they were so bad. Here,
with poor food, with little heat, sometimes no light,
underclad and underfed, he did not really live; he
simply existed. Homesickness is a real handicap,
and the refugee was homesick all the time. He con-
tinually contrasted his former comfortable home,
steady employment, and relatively good food with
his present lot. All the other war distresses — the
longing for the men who were away so long at the
front, the haunting fear that they would be wounded
or killed, the knowledge that they had been — all this
cut more deeply into the heart of the refugee because
he was already homesick, cold, hungry, and dis-

256

WAR EXILES AND HOME-COMINGS

couraged. No wonder he looked forward always to
the day of home-coming.

Refugee "Prosperity" and "Morale." — When the
American Red Cross reached France in July, 1917,
and, looking about, inquired what most needed to
be done, it heard contradictory statements in regard
to the 1,500,000 French refugees who had been
scattered through France for the last three years.
The majority of the Americans resident in Paris
thought the refugees had by this time "adjusted
themselves." We were told that wages had risen
in France, and that munition-factories offered plenty
of employment. These advisers, however, added
that the morale of the refugees left much to be
desired. For some reason the refugees were dissat-
isfied. They were not enthusiastic about the war.
It did not take much first-hand inquiry to clarify
the situation. The small proportion of refugees who
were of working age and who were located in a
factory region had little difficulty in finding employ-
ment at wages which at first seemed high in France,
but which actually had not kept pace with the rise
in prices. The great majority who were too young
or too old or too sick to work, and who had to depend
on the government allowance, were in a bad way.
Those also who had been sent to the resort regions
for shelter in the tourist hotels found almost no
employment. Except in the resort regions, whether
employed or not, almost without exception, the
refugees were living in the oldest, poorest, darkest
and most unwholesome of quarters. Without suf-
ficient money to buy household utensils or even the
barest necessities of housekeeping, they were crowd-
ed into the meanest and poorest of the "furnished

257

THE HUMAN COSTS OF THE WAR

rooms." They had not been, it must always be
remembered, poverty-stricken and unsuccessful peo-
ple. They were the average population of the city
and country districts of the north who had earned
good wages, owned their homes or farms, lived in
comfortable houses, had plenty of food, kept their
children in school, and enjoyed the comforts and a
fair share of the refinements of life. Now a family
which had lived in its own comfortable home of four
or five rooms, provided a considerable part of its
food from its own fruitful garden, and surrounded
itself with attractions and comforts, found itself
crowded into one tiny room and lucky, indeed, if
another family were not camped with it. In this
tiny room it might have a few pieces of broken
furniture. More than likely they were sleeping on
the floor. There would be a tiny stove, but only
by the most watchful and constant economy could
the fuel be made to hold out for cooking. There
was no one to look after the sick. Worst of all,
these misfortunes were constantly getting worse in-
stead of better. Their dissatisfaction and lack of
enthusiasm for the war were easily understood. In
less than a year after our arrival we were helping
refugees by the hundreds of thousands, adding
$2,000,000 a month to the $12,000,000 a month
expended for them by the French government, and
wringing our hands because this touched only the
fringes of what needed to be done, as the soaring
prices of food and fuel and the ever more crowded
rooms made the problem of living more and more in-
soluble. We sent one of our volunteers, a hard-
headed man who had left behind a large business
enterprise in America, to see whether the thousands

258

WAR EXILES AND HOME-COMINGS

of refugees crowded into one of the industrial cities
in France needed any further aid. He reported that,
so far as he could see, many of them could not sur-
vive the winter without more help. Crowded into
dark and unwholesome corners, huddled around tiny
stoves in which a fire could be kept only a few
hours each day, living on the scantiest of food,
unable to buy clothing and bedding, without medical
attendance, he saw additional relief as the only hope
of their survival.

Finally victory and peace came. The war was
over. It had been won. People threw up their
hats and cheered. The fear of domination by a
brutal enemy was removed. All would be well!

The Call of Home. — It was early winter and the
government told them not to go back yet. As well
tell a ripe apple not to fall. The pull of the home
tie was stronger than everything else and streams
of refugees began to trickle slowly back. By the
middle of April, 1919, five months after the fighting
ceased, about one-fifth of the refugees had returned —
to what? Homes? Yes, if latitude and longitude
made a home. There was nothing left but locality!

Going home was very much easier than coming
away had been. It was easy to choose which things
to take, because there were not many from which
to choose, and n^ost of them they were glad to leave,
anyway. They were such poor excuses and sub-
stitutes for the uval comforts of home. They had
great confidence that now they would be taken care
of. They knew that the disaster which had befallen
them was in no sense due to any fault of theirs, but
that it was somehow connected vaguely with a suc-
cessful effort to prevent the control of the world by

259

THE HUMAN COSTS OF THE WAR

a ruthless and brutal people. The war had been
won in behalf of justice, and, of course, justice would
be done to them. Nothing could make up for the
sufferings already endured, but the future would be
different. They had heard of wrecked houses and
of devastated cities, but they felt that probably
it was not so bad as that where they came from.

We all know, and the world knows, only too well
to what they returned. Every Sunday illustrated
supplement for the past four years has brought us
its new pictures of devastated France, devastated
Belgium, and devastated this, that, and the other
country, until to us in our comfortable homes they
have ceased to be terrible or even to be interesting.
These refugees, however, were now to see ruins, not
from the outside, but from the inside. When they
returned to their former homes things were far more
out of joint than when they had arrived in the
interior. Not only was nobody expecting them;
there was nobody there. They had not even the
advantage of beginning with a clean slate. Every-
where there were tumble-down houses, broken build-
ings of every kind, trenches across the fields, rivers of
barbed wire running in every direction, and frag-
ments of wreck and ruin. Here and there just under
the surface were unexploded shells or grenades, not
found by the prisoners of war who were supposed to
have removed them. But it was h me. Here they
owned a bit of land; here they h; J been born and
reared. The hillsides, the roads, the brooks — all
spoke to them of childhood and early years. So here
they would remain; in fact, they had nowhere else
to go. It was hardly a matter of choice.

War Zone after the War. — The first and most vivid

260

WAR EXILES AND HOME-COMINGS

impression of a visit to the war zone is the tremen-
dous amount of it — the sheer volume of destruction.
In a fast auto I traveled for ten days from early
morning until dark, stopping a few minutes here
and there at most interesting spots, chatting with
mayors, relief workers, and with refugee pioneers,
and during the ten days saw nothing but regions of
ruins, and even then had covered only half the dis-
tance from the North Sea to the Swiss line. The
impression is somewhat like that of riding over
our western prairies: one becomes almost terrified
by the stretch of it. Will it never come to an end?

The second strongest impression is that of the
variety of conditions. It is impossible to make any
general statement about the war zone. At one mo-
ment you may be passing through a region in which
the fields are apparently in perfect condition and,
if not ready for the harvest, at least ready for the
plow. The next moment you enter a region where
the land is one succession of shell-holes. Rocks,
stone, and sterile clay of the under-soil to the depth
of four to six feet have been scattered over the
surface. There are many regions in which one sees
nothing but this as far as one can see in every
direction. Where the fighting occurred in the early
part of the war nature has begun to hide this ugliness
and shame by a scanty covering of weeds and grass.

The buildings, too, show every degree of damage in
the most haphazard fashion. One city will be noth-
ing but a heap of bricks, sticks, mortar, and stones;
the next may be wholly intact. In the same city
one section may be completely destroyed and the
other partly so. On the same street some of the
houses may be in complete ruins, others partially

261

THE HUMAN COSTS OF THE WAR

destroyed, and still others almost uninjured. We
can only describe it in such terms as these; in what
we might call the county of Cambrai, there are 74
villages and cities in which the destruction ranges
from 5 to 40 per cent.; 14 in which it is from 40
to 90 per cent.; and 21 in which it is from 90 to
100 per cent. A great variety of facts enter in:
Did either side make any serious attempt at re-
sistance in this particular locality? How near was it
to the line of trenches? Was it an important place
from a military point of view? Heavy artillery can
completely destroy a city twenty miles back of
the lines, but it rarely does so. The number of
big guns is limited and their lifetime short. There
are villages and towns very close to the trenches
which show little destruction.

Nearly always conditions are very much worse
than they at first appear to be. Repeatedly as we
approached a town we thought, this place seems to
have escaped. The buildings appeared to be stand-
ing, yet as we entered it and went into the buildings
we found that it was only a ghost of a city. The
walls, and perhaps even the roofs, might be standing,
but the interiors were a mass of tangled wreckage.
Any one who has ever undertaken to repair a
dilapidated house will appreciate that it always costs
a great deal more than was expected. The damage
does not need to be very extensive to make it cheaper
to tear away and build anew. Whole areas and
cities that to the casual observer at a little distance
appear almost unharmed can only be dealt with by
the radical method of completing the work of dem-
olition and building anew from the bottom up.

To this crazy patchwork these bewildering and

262

WAR EXILES AND HOME-COMINGS

planless areas of contradictions, this end-result of
an orgy of blind destruction, the weary, depressed
refugees return. If it is difficult to make any general
statement about the devastation, it is equally diffi-
cult to make any general statement about how the
returned refugees are living. They are living in
every possible way except the way of comfort,
health, and efficiency.

Surely, they thought, those great Powers confer-
ring at Versailles who were to make Germany pay
would now rebuild their homes perhaps better than
before. They believed firmly in the early resurrec-
tion of the devastated area, and therefore almost any-
thing would do for the present.

Cave-dwellings. — The first thing the returned
refugee does is to dig. Very likely he buried some-
thing under the cellar when he went away, or he
thinks something useful may have been left by the
armies, or perhaps he is simply curious. With pick
and shovel he finds what proves to be an entrance
to the cellar. The cellar may not be flooded. In
any case, when it is opened up in this way it will
be drier. Maybe the cellar would do for a time.
It ought not to be for long. A few stones for steps
will enable one to get in and out. The heaps of stones
and rubbish above have not broken through, and
probably won't. They will help to keep out the
rain and the snow. It is a bit damp, but one can't
have everything in war-time. A few pieces of fur-
niture may be picked up here and there; a stove
from somewhere; a few lengths of chimney pipe
can be gathered and pieced together; and it will
be home.

These cellar homes are the rule in the larger cities

18 263

THE HUMAN COSTS OF THE WAR

which have been completely destroyed. In the
great coal-mining center of Lens, where the destruc-
tion was 100 per cent, complete and where simply
to clear away the rubbish from the roads would
occupy a large number of men a long time, one
might ride through the city on one of the very few
roads which had been cleared up and think it still
completely deserted. Here and there a tiny wisp
of smoke would be seen in the midst of the ruins.
Looking closer, the smoke was seen to come from a
bit of stovepipe projecting a foot or so above the
rubbish. Scanning closely, as one may have done
in a country pasture for the hole into which a wood-
chuck had disappeared, one sees a path and, following
it, finds a tiny hole leading down into the blackness.
It is the vestibule of a human habitation. Sound
the horn of the automobile and here and there amid
the ruins women, children, and old men appear as
if by magic. It seems uncanny, like the emergence
of the beasts of the fields from their holes. But they
have no other place to go.

Repairing the Irreparable. — Sometimes parts of
walls of the house, or perhaps of the stable or out-
building of some kind, are still standing, for in France
they build very solidly for all time. If there are two
pieces of wall standing, forming an angle, it is
better. There is already one end and one side of a
possible shelter. By sheer good luck, once in a
hundred times, there may be parts of three walls,
making it necessary to build only the fourth. For a
roof? Well, there are plenty of pieces of corrugated
iron lying about which were used for military huts.
These can be laid on a few sticks and, if it is well
done, they will almost keep out the rain. A few

264

THEIR HOME-COMING

Near Armentieres, France. This family of returned refugees had just ar-
rived to learn the condition of their former home.

THEIR HOME

Pioneers in the famous coal-mining city of Lens, held by the Germans until
near the end of the war, and destroyed by Allied artillery-fire.

WAR EXILES AND HOME-COMINGS

heavy stones will hold them in place. Window-
glass does not exist, but the gaping holes where the
windows had been can be filled in in a variety of
ways. For a moment we thought we were in Serbia
when we saw what had been windows now solid
brick walls, though perhaps laid without mortar.
We had seen this for three hundred miles along the
central highway of Serbia, but no, this was Belgium
and France. The windows never were numerous or
large, for there had been a tax on windows. In
the next building, perhaps, the windows may be
partly boarded up and partly covered with corru-
gated iron salvaged from the battle-field, partly by
heavy building-paper, and partly by a thick, opaque
oil-cloth, with perhaps one tiny square through which
a precious bit of glass found somewhere around the
premises admits a few rays of light. Just when a
special effort is being made throughout France and
Belgium to teach the importance of light and ven-
tilation in the prevention of disease, hundreds of
thousands of people are forced to live in shelters
which effectually exclude both light and ventilation.
Other Makeshifts. — Or perhaps there may be on
the premises, or near by, one of those curious semi-
circular houses made of corrugated iron, of which
the British used so many. There is no chance for
windows except in the ends, which are of wood;
holes can be cut and some cloth will keep out most
of the rain and let in a little light. A heavier cover-
ing of some kind can be hung up when it rains. By
piling up the dirt around the sides, the wind can be
kept out. It does not look like a house, it is not a
house, but it will do for a time, and there is room
for a good many in it.

265

THE HUMAN COSTS OF THE WAR

Or the tiles of the roof may be broken to bits and
the doors and windows gone, but the walls may be
standing. Some kind of a temporary roof can be
fixed up underneath the timbers of the former roof.
A brick wall can be made without mortar, where the
windows were, since there is no glass, or they can
be boarded up. A ladder will do in place of a stair-
way. It is a little dangerous, but people must be
careful. Without any windows it is dark, but it is
not for long. The air is horribly close at night, but
it will not be so hard to keep it warm in winter.
There is nothing to make any mortar with, but bricks,
if piled up carefully, make a wall that will stand for
some little time. Pieces of boards carefully ar-
ranged and held down by heavy stones will make a
fair roof.

Or scattered here and there are what look like
heavy cement half -cellars. The big guns were under
here or the soldiers went in here when the shells were
numerous hereabouts. It was not intended to be
lived in, and it is damp, cold, and dark, but still,
until something better can be found, it will do.

A ten-day trip through the northern half of the
western front showed only too clearly that these
returned exiles were living about the barest, dark-
est, coldest, unhealthiest sort of existence possible.
Thousands and hundreds of thousands of people
began to live in every kind of dark, damp, gloomy,
unwholesome, temporary quarters which will not
really be temporary. Building something better
takes a great deal longer than one would think. It
is impossible to get nails and hammers and saws.
It is impossible to make mortar, and, besides, one
has to be thinking about raising things in the gar-

260

PICTURESQUE, BUT THINK OF LIVING IN IT

This British military hut shelters a refugee mother and her family on the

scene of some of the fiercest fighting of the war, not far from Ypres.

THE BATTLE-FIELD AT HOOGE

Site of the Belgian village of Hooge on the famous Ypres-Menin road.

liis is the condition of hundreds of square miles in France and Belgium.

WAR EXILES AND HOME-COMINGS

den and getting chickens and rabbits, otherwise onu
might starve next winter. It is a long way to go to
get bread and mail and whatever one may be able
to get. So the temporary shelter becomes more and
more permanent.

Temporary Houses. — Here and there, amid com-
plete destruction, one sees a wooden barrack. In
peace-time it would have been a poor excuse as a
stable for animals. Now it represents the acme of
comfort for human beings. It may have a window
or two, and may have even a partition dividing it
into two or three rooms. It is the official plan for
the temporary housing of the people of the war zone.
These barracks were to have been manufactured by
the tens of thousands and set up, that the people
might return and begin the tilling of their fields and
the rebuilding of their permanent homes. It is not
to be wondered at that these barracks are, neverthe-
less, few and far between. The government of
France is tired out. It accomplished marvels during
the war. It worked under the highest degree of
nerve strain, with feverish haste, to meet one appall-
ing emergency after another. It endured this strain
for weeks and months and years, knowing that it
must come to an end. When it did come to an end
it was simply impossible for them to go on at such a
pace. There had to be a period of rest and a renewal
of strength and resolution, no matter how urgent
the needs might be.

Such were the conditions, and such the people, of
whom a typical all-admiring and wholly undis-
criminating appraiser of American relief work wrote
for The Ladies9 Home Journal in May last: "There
is going to come an hour when the civilians must

267

THE HUMAN COSTS OF THE WAR

stand on their own legs or fall. By July [1919] at
the latest American benevolence, save for a few rare
exceptions, should be out of France." Never was
there a more superficial, blindly, blandly, and wil-
fully complacent view of great masses of one of the
most civilized people in the world plunged into utter
misery and helplessness in order that civilization
might be saved.

More Aid and Less Pity. — Well-informed testi-
mony is unanimous as to the slowness, not simply
of reconstruction, but of temporary housing of any
sort. On Sunday, July 6th, the President of the
French Republic visited Rheims, "The Martyr
City," to bestow upon it the Cross of the Legion of
Honor. The Evening Post special correspondent
reports that chalked on many of the fragments of
walls were the words, "Pity us less and aid us more."
The mayor said that one-third of Rheims's popula-
tion had returned and were living as best they could
among ruins and debris. The railway at Rheims
had been closed to traffic for a month. The clearing
up of the streets even had scarcely begun. The
mayor's wife broke in, " Think, there are only two
more months of good weather and there are thousands
of people living in hovels open to every wind and to
the cold." A simple and direct citizen said : "We are
proud that the government should think of decorat-
ing Rheims. What we are asking for is houses."

Writing from Lille, September 15th, Philip Gibbs
says: "... and into Lille has crowded a dense
population from that outer belt of ruin, the devas-
tated regions. There, apart from a few wooden
huts among the ruins, there is no revival of normal
life, and there the blessed word 'reconstruction'

268

WAR EXILES AND HOME-COMINGS

spoken in Paris as a magic word, a word of power,
is only a fetich and a will-o'-the-wisp. So the
people of Lille have talked to me rather bitterly and
rather sadly."

Some day there will be a new Lens, and a new
Rheims, and thousands of other new cities and
villages, but not at once nor for a long time. The
men who might have repaired these railways, pre-
pared the raw materials, cleared away the rubbish,
and put up the new buildings are resting in the soil
of France, of Belgium, of Italy, of Greece, and of
Serbia.

There are not men enough in Europe to go around,
no matter how they may be assigned, and we all know
in our hearts that one, two, three, yes, a dozen, or
twenty years will elapse before those who in this
war were refugees will all again occupy real homes.
Very weary and very sorrowful, they have returned
as pioneers to a wilderness of ruins, to dig in bit by
bit, to get some slight foothold and slowly and
painfully to bring the first elements of order out of
chaos; with their own hands to make shelters in
which to live; to endure for an indefinite time the
poorest and bleakest of existences; to live in the
dark and in the cold, in the unhealthiest and most
depressing of surroundings, and to awaken slowly to
the fact that their emergence from this humanly
created chaos is to be a painful and slow process of
an indefinite duration.

This is the refugee's third and greatest claim to our
sympathy and help. The outward journey was a
matter of a few days, the exile a matter of a few
years, but reconstruction will be a matter of a few
decades.

269

THE HUMAN COSTS OF THE WAR

Little by little, the temporary shelters will be made
a shade less unbearable. Some of the larger holes
will be stopped up, the rain will not come in quite as
much, and window-glass will replace boards and iron
in the tiny windows; but wretched, unwholesome,
insanitary accommodations must be the rule for
years to come in the zone of devastation which
stretches through Belgium, France, Italy, Monte-
negro, Albania, Serbia, Greece, Rumania, what was
Austria, East Prussia, and wanders in irregular
fashion through great areas of what was Russia.

Immaterial Ruins. — Shelter is only the beginning
of living. The thing that was destroyed in these
devastated areas was not simply buildings; it was
the whole structure of human life. All these
wrecked houses, schools, hospitals, factories, city
halls, churches, had been put up to serve human
needs. They represented the thought, the senti-
ments, and the labor of many generations who had
builded themselves into these structures.

When you go into a patched-up building with the
windows stuffed with cloth, the door turning awk-
wardly on improvised hinges, and into a bare room
with two or three bits of broken-down furniture,
and find that this is the City Hall and that this man
sitting here is the mayor, you begin to realize that it
is the whole intangible structure of human life that
has been destroyed, a thing which it will be harder
to rebuild than buildings. An organized commun-
ity, which, little by little, took shape through
centuries, had been blown to bits. This man sit-
ting here has everything to do and nothing to do
it with. He is bare-handed and empty-handed. He
has no resources and no helpers. But the entire

$70

WAR EXILES AND HOME-COMINGS

community, bereft of everything, looks to him to
make the loss good. Scores of thousands of city
fathers in Europe are trying to do this superhuman
task.

Substandard Living. — The great majority of men,
catching glimpses of better things, have crawled
slowly, bit by bit, through many hundreds of years,
out of and away from dirt and squalor, hunger, cold,
and vermin, into some degree of happiness, leisure,
and comfort. The standard of living has risen ever
so slowly, as slowly and unconsciously, it seems at
times, as islands or continents here and there are
rising out of the sea. Suddenly the standard of liv-
ing of a whole continent is again submerged, and
millions of men and women and children are thrust
back into cold and misery, into darkness and damp-
ness, bareness, ugliness, and squalor, into discourage-
ment and friendlessness, and disbelief that any one
cares for them or that there is anything desirable in
the world. This is not the misery of the unsuccess-
ful such as is always with us; it is misery spread
through the entire population of what had been
prosperous cities and towns. They had reached
various standards of living and nearly all were well
above the stage at which the fear of destitution is
ever present. They were not the unfit, if such there
are. They had built their homes in a land of
plenty. This German Vesuvius, which finally en-
gulfed them, had not always rumbled and smoked
and betrayed its volcanic character.

We have seen to what the refugees have returned
in France and Belgium, countries of high standards
of living. What their conditions must be in coun-
tries where the former standards were low, where

THE HUMAN COSTS OF THE WAR

there was always plenty of disease and, from time
to time, starvation, we can only imagine.

It is hard to climb up, but easy to slip back, and
still easier to stay down. Who can estimate the
permanent harm done to civilization by thus putting
the ways of living of millions of people back to
something which looks extraordinarily like the stand-
ards of the cavemen? We know that it cannot be
done with impunity, that there are laws not only of
economics, but of science, of health, and of morals.
Darkness and dirt, vermin and filth, bad air and cold
and hunger are not to be thought of lightly. Some-
body has to pay. The human race has climbed and
fought its way up from these things because they
are bad, because they mean suffering, disease, and
death. We cannot plunge five or ten million people
for several years into every sort of disease-breeding
condition without paying the price. Much of it
will be a deferred debt, but it will be paid with
interest, compounded at short intervals, and cal-
culated at a high rate. That we have many other
debts, and are not in a favorable position to pay,
will be no excuse. There will be no exemption law,
and no moratorium. In sickness, in poverty, in
misery, in inefficiency, in unrest, in the dislocation
of the complicated thing which we call civilization,
the price will have to be paid to the uttermost
farthing.

Germany's Devastated Area. — It is interesting to
note in passing that, although Germany planned
with diabolical skill and with a very large degree of
success, that war, when it came, should be carried
on in the enemy's territory, it was not wholly without
its own devastated area. Eastern Prussia was in-

272

WAR EXILES AND HOME-COMINGS

vaded and occupied by the Russians on two occa-
sions, from the middle of August to the middle of
September, 1914, and from November, 1914, to
February, 1915. According to a report by the Ger-
man Minister of the Interior, a copy of which came
to the knowledge of French officials, 34,000 buildings
were wholly or completely destroyed, 10,000 persons
were taken away as hostages, and 1,600 killed. The
German authorities estimated the number of refugees
from these regions at 400,000. In the different cen-
ters to which the refugees were sent public schools
were open without charge to the refugee children,
agencies organized to assist nursing mothers, and
special institutions set up for sick and convalescent
children. The great part of the population returned
in the spring of 1915. Prompt measures were taken
for the establishment of the amount of the losses, all
of which the state assumed, recognizing also the in-
creased cost of materials and of labor and the addi-
tional requirements demanded by modern hygiene.
Supplementary allowances were made to cover these
purposes. Thorough steps were taken for the disin-
fection of all the buildings in which the Russian
troops had been quartered, for the purification of the
water-supply, and for the medical treatment of the
returning refugees. Thirty million marks were set
aside by the government for the re-establishment of
agriculture in the invaded region.

One of the most interesting phases of this German
effort at reconstruction was the establishment of a
society of war relief for eastern Prussia, which
operated under a system described by the French
word parrainage, a word which has no precise English
equivalent. A par rain is a godfather and parrainage

273

THE HUMAN COSTS OF THE WAR

describes that relationship of sympathetic interest
and, on occasion, actual material aid, which, in
Europe, a godfather is supposed to extend to a god-
child. The plan was that various German cities or
organizations, or even rich and influential citizens,
would select a city or a village in the invaded region
and for a period of years would assist in some phase
of its re-establishment, financial, agricultural, educa-
tional, or sanitary. Similar plans suggested at
various times for the adoption of French cities or
towns by various American cities, failed of success
because they undertook too much. The American
cities in "adopting" French cities or villages were
expected by the promoters of the plans to provide
for their complete reconstruction, just as a parent
provides for the needs of an adopted child. The
duties of an adopting parent are very far-reaching —
— he succeeds to all the obligations and responsi-
bilities of the natural parent, including the full sup-
port and education of the child. The godfather's
duties, on the other hand, are never more than sup-
plementary and, so to speak, occasional. The
actual cost of rebuilding any village or town would
be far beyond the resources of the private philan-
thropy of any like city or town, unless the city or
town to be rebuilt were very small and the adopting
city very large. The German cities and organiza-
tions which became "godfathers" to localities in
the devastated areas, were wiser and less ambitious.
They had a great variety of plans, but none of them
contemplated more than some one need. One, for
instance, would undertake to replace the public
buildings of a given locality; another would under-
take to re-establish the various means of transporta-

• 274

WAR EXILES AND HOME-COMINGS

tion; a third would rebuild schools; a fourth would
devote itself to the restoration of the public-health
agencies, hospitals, laboratories, public baths, etc.

Community "Adoption" — A sound principle un-
derlay this suggestion that the altruistic sentiments
of a given locality should be organized to meet the
needs of some other particular locality. It was suc-
cessfully applied to some extent in the relief of the
devastated region of Italy. During the early months
of 1918 consideration was being given by some
American and French co-workers to the possibility
of working out a plan whereby the good elements
in this arrangement could be availed of for interest-
ing American towns in the ruined French cities and
villages. It was seen that the plan would involve,
first, a definition of what "adoption" in any given
case might mean — such as the restoration of the
public buildings, or the restoration of the buildings
for health or educational purposes, or both, or the
restoration of a transportation system, or a water-
supply; second, the selection and public announce-
ment of some one agency in America through which
all such requests might be forwarded to some one
agency in Paris; third, the setting up of some
machinery by such agency in Paris for securing data
by which definite suggestions could be made to any
American locality as to a particular French locality
which might be, in the above sense, "adopted,"
together with an estimate of the cost involved, the
nature of the work which might be undertaken, and
an offer to place the donor in touch with the suitable
local authorities and to co-operate with a view to the
smoothing out of all the difficulties which might be
involved. Unfortunatelv, in the very early stage of

275

THE HUMAN COSTS OF THE WAR

consideration, these plans were interrupted by the
offensive of March, 1918, and the opportunity did
not arise later to definitely formulate such a plan.
This is most unfortunate. Were such a plan in
effect, the people of many American localities would
now have a close and continuing tie with reconstruc-
tion as it is actually progressing in various parts of
the devastated area. There would now be a fuller
understanding of the slowness and tremendous ex-
pense of reconstruction, of the sufferings and loss
which the unfortunate inhabitants of these areas
must continue to undergo for an indefinite period of
time, and a larger body of common understanding
and good will upon which to build a permanent
friendship and co-operation between the two peoples.
It would have had an admirable effect if American
communities, in the full tide of their prosperity and
with all their tendencies to isolation, had in this
manner been kept interested in the cities and villages
of France, Belgium, Italy, and Serbia and other
countries as they creep slowly step by step back
toward organized living.

It is not necessarily too late to consider such a
plan, preferably, perhaps, in relation to countries
which have suffered even more than France, such as
Serbia, Poland, and Armenia.

WAR, BEST FRIEND OF DISEASE

The first wealth is health

— EMERSON.

The millennium that was coming; sickness prevented and death post-
poned; lost ground among civilians; tuberculosis increases; malaria
returns; the "cootie" spreads typhus; drinking typhoid sewage;
influenza and war; war, baby-killer; health aspects of cave-
dwellings; a postponed millennium; meeting the situation; Ameri-
can tuberculosis work in France; health agencies, America's best
gift to the Balkans.

MILLENNIUM THAT WAS COMING.
— In 1914 the millennium was on its way. It
was not at the door, but it was definitely predictable.
The war has postponed it indefinitely.

In what respects does life most fall short of being
reasonably satisfactory? Do not its great disap-
pointments arise chiefly from two things — sickness
and untimely death? There are many annoyances
and disappointments in life, but it is nearly always
sickness or the untimely death of those dear to us
which cuts across the pathway of our happiness,
ruthlessly disrupts our plans, prevents the normal
development of our powers to do and to enjoy,
wrecks our careers, and wounds our souls so deeply
that the scars are seen in our very features. These
are the things that silver our hair, round our shoul-
ders, and write lines in our faces.

277

THE HUMAN COSTS OF THE WAR

In the years just before 1914, however, a new
chapter was being written in human welfare. After
long ages of helpless resignation, of pitiful efforts to
snatch some crumbs of comfort by ascribing these
afflictions to a power outside of ourselves, we were
just beginning to see that it was in our own hands
to apply the remedies; that, to a surprising degree,
sickness and death were subject to human control.

Sickness Prevented and Death Postponed. — Life was
already being made longer, happier, and richer.
It is difficult to write truthfully of what had hap-
pened without seeming to exaggerate. Tuberculosis
was slowly but surely on its way to join smallpox as
an almost negligible factor in the bookkeeping with
death. The warfare against it was civilization- wide.
It was a slow fight and a long one, but it was winning.
Diphtheria had been reduced to a fraction of its
former proportions by a serum which is both curative
and preventive. Those of us in middle life can re-
member when serious epidemics of yellow fever oc-
curred nearly every summer, when we wondered how
far north it would get, when quarantine was by shot-
gun, and when great heroism was attributed to those
who remained in infected cities. Now yellow fever
has been reduced almost to the vanishing-point in the
United States and Cuba, and General Gorgas, for
the Rockefeller Foundation, is trailing it to its
ultimate hiding-places with the definite program of
actually causing it to disappear from the face of the
earth. All this became possible by the discovery
that the sole mode of communication is by the
stegomyia mosquito. The similar discovery that
malaria is carried, not by bad air, as its name sug-
gests, but by another type of mosquito, was already

278

WAR, BEST FRIEND OF DISEASE

beginning to rid southern Europe of a disease which
caused as many deaths in some localities as tuber-
culosis, and which injured vastly larger numbers so
that their usefulness was greatly reduced and death
came at an earlier date. Some scientists and writers
have ingeniously suggested that the downfall of the
civilizations of Greece and of Rome was due pri-
marily to the work of the anopheles mosquito. It is
unquestionably true that this little but industrious
insect has been a tremendous factor in making the
civilization of that part of Europe what we call
backward. Every one knows how an aggressive
campaign put the hook into the hookworm and
pulled him loose from the population of our Southern
states whose vitality he was draining, and that this
effort is to be carried around the world along the
hookworm belt. Typhus fever had largely disap-
peared as man had learned to rid himself of lice.
There was only enough smallpox to enable the health
authorities to keep alive an interest in vaccination.
Syphilis had been recognized as a deadly enemy and
means for its cure and for its prevention had been
discovered. Cancer remained largely a mystery, but
enough had been learned to make possible the earlier
recognition and successful surgical treatment of vast
numbers of cases which formerly would have meant
sure and painful death. These are only a few of
many discoveries and organized movements which
had already added ten years to the average lifetime
in America and Great Britain, had made life vastly
more attractive, and which in the very near future,
with increasing momentum, would have lightened
the black clouds of sickness and untimely death that
for ages had kept the world in gloom.

19 279

THE HUMAN COSTS OF THE WAR

Lost Ground Among Civilians. — It must forever re-
main one of the most serious of the many charges
against the Great War that it disrupted or delayed a
great number of these, the most promising move-
ments in modern life. In some cases progress, made
slowly and painfully through decades, was lost in
two or three years. Attention and funds were
diverted to destroying instead of saving life, and age-
old pests and enemies of man took fresh heart and a
firmer hold upon the race.

It happened among the civilians. The armies were
well cared for. A great majority of physicians,
sanitarians, laboratory workers, and nurses were
busy in keeping fit as many as possible of the soldiers.
The armies had first call on food-supplies. Whoever
else might go hungry, they were well fed. Influenza
was about the only epidemic disease which was not
substantially held in check in the armies of the
Great Powers. But the armies are small minorities.
Many times as many people remained at home as
went to war in the soldier's uniform, but in fact
everybody was drawn in and the war resolved it-
self into an endurance test between peoples. There
were few countries in which the pinch of hunger
was not felt by almost the entire population. Mill-
ions of refugees were driven from their homes to
live under the most unwholesome conditions. From
these populations under these wretched conditions,
even the rudimentary safeguards against disease were
removed. The results were immediately registered
in increased death-rates, which, in many cases, were
startling.

Tuberculosis Increases. — Every one knows the plot
of the tuberculosis tragedy. In the immediate circle

280

WAR, BEST FRIEND OF DISEASE

of our family, intimate friends, or office associates,
we have seen it develop step by step. We can never
forget the haunting fear of something wrong, the
shock of the diagnosis; the rebound to optimism;
the rude interruption of all the ordinary activities;
the uncertain income; the specter of poverty; the
alternations between hope and despair; the long
period of uselessness; the racking cough at shorter
intervals; the hectic flush; the shrinking of the body;
the inner evidences that the battle is lost; the bitter
realization of defeat; the last gurgling gasp. How
unlike a glorious death upon the field of battle. Yet
hundreds of thousands who make this slowly losing
fight in the obscurity of home or hospital are as
certainly victims of the war as those who are buried
in the war zone.

The anti-tuberculosis movement was local, state,
national, and international, voluntary and govern-
mental, medical and lay; the best organized effort to
stamp out a widespread disease yet known. Progress
was slow. In a period of twenty or thirty years the
disease might be reduced by 50 per cent. But
everywhere it was being reduced. Now comes the
war. This decrease in tuberculosis is immediately
arrested and in two or three years the hard-won gains
of twenty are lost. A review of the conditions dis-
closed in our study of the several countries shows that
increased tuberculosis stands out as one of the great
phenomena of the war.

We have seen that in Serbia there had been twice
as much tuberculosis as in the United States or
Great Britain (324 deaths per 100,000 in 1911 as
against 138 in the United States). In Belgrade
tuberculosis deaths in 1912 were 720 per 100,000.

281

THE HUMAN COSTS OF THE WAR

Serbia went hungry during the war. It suffered all
the effects of the blockade and then more. There
was no Mr. Hoover there. Very likely it was chiefly
the shortage of food which caused the tuberculosis
death-rate in Belgrade to jump from 720 in 1912 to
the absolutely unheard-of rate of 1,453 in 1917.
It is easy to understand the figures — Serbia twice as
high as America; Belgrade twice as high as Serbia
as a whole; Belgrade at war twice has high as
Belgrade at peace, or eight times as high as America.
Experienced Serbian physicians recognized before the
war that tuberculosis was the greatest medical prob-
lem of Serbia and were awake to the possibility of
doing something about it; in fact, a plan of organiza-
tion for an anti-tuberculosis society of Serbia had
been prepared. Lectures and popular education on
the subject had begun. All these, of course, were
rudely thrust aside by war. Nothing constructive
could be thought of while every ounce of energy was
mobilized for war. Now it will be very difficult.
There never were many physicians, and half of them
have died. The civilian hospitals have been dis-
rupted. The public debt is staggering. Disease has
taken a strangle-hold upon thousands who survived
the horrors of war. Under favorable conditions, with
ample resources, in the most progressive of countries,
progress against tuberculosis is slow. The task of
helping Serbia, under her conditions of unprecedented
difficulty, to overcome the menace of tuberculosis,
is almost a first mortgage upon the enlightened
generosity of the world.

Greece, too, is a country in which tuberculosis
seemed to maintain its position of primacy. We say
"seemed to," because there have never been anv

282

WA&, BEST HUEND OF DISEASE

complete figures as to deaths in Greece. In this
unenviable position, Greece is on a par with the
United States, for we have no vital statistics for our
country as a whole. It is a state matter, and some
states don't function. In the city of Athens the
death-rate from tuberculosis during the last three-
year period for which the figures are to be had,
1906-08, was 294 per 100,000, not as high as Belgrade
with its 720, but more than twice as high as in the
United States for the same period. In Athens one
death in six was from tuberculosis. There was a
beginning of an anti-tuberculosis society in Athens,
which had a dispensary and a small sanatorium with
twenty beds. Early in 1917 starvation conditions
began to exist throughout Greece, even in Athens.
They improved later, but for the civilians food con-
ditions remained very difficult until months after the
armistice. Undoubtedly food shortage and war con-
ditions in Greece had the same effects upon tuber-
culosis that they had in Serbia and elsewhere.

In Italy the figures are more complete and the
proof of war's guilt as a promoter of tuberculosis
is uncontestable. The tuberculosis death-rate had
been steadily decreasing. In the twenty-five years
ending 1914 there had been a reduction of 40 per
cent. In 1914 it was 145 per 100,000, the lowest in
the history of Italy. It responded immediately to
war conditions. From 145 in 1914, it increased to
157 in 1915, and to 168 in 1916, an increase of 16
per cent, in two years. Even these figures do not
include tuberculosis deaths among soldiers. This
immediate and striking increase in tuberculosis in
Italy is one of the startling facts in public health
history. But worse things were to come. In the

283

THE HUMAN COSTS OF THE WAR

130 cities in Italy the pulmonary tuberculosis death-
rate increased from 143 in 1916 to 160 in 1917.

Still worse things were to come. For 1918 we have
the figures for some of the larger cities. In several
the 1918 rate, as shown by the table on pages 186-7,
was double that of 1914.

We have, therefore, in the cities of Italy, a known
increase during the war in tuberculosis ranging from
30 to 50 per cent, and in some cities completely wiping
out the progress of the preceding twenty-five years.
We have to add tuberculosis deaths among soldiers
and among the famished prisoners of war. Truly a
depressing picture.

In France we must distinguish between the in-
vaded and uninvaded areas. As to the invaded
area, Professor Calette reported to the Academy of
Medicine at Paris in 1919: "The total mortality rate
[of Lille], which varied before the war from 19 to 21
per 1,000 inhabitants, steadily increased as follows:
In 1915 to 27; in 1916 to 29; in 1917 to 30; in 1918
to 41. The causes of this increase were, in the first
place, a terrible extension of tuberculosis. . . . Be-
fore the war there was an average of 330 deaths
from tuberculosis per 100,000. This rate has
steadily increased. In 1918 it was 573. Among
those under twenty years of age it was almost double
that of peace-time." This fairly reflects conditions
in all probability in the occupied area.

For unoccupied France detailed statistics are not
yet available.

In Belgium the tuberculosis death-rate increased
in Brussels from 177 in 1914 to about 390 in 1918,
and is believed to have at least doubled throughout
the country.

284

WAR, BEST FRIEND OF DISEASE

England did not suffer invasion by the Germans,
but the unseen tubercle bacilli were more successful.
Pulmonary tuberculosis deaths in England and Wales
in the three years before the war and the four fateful
years beginning 1914 are as follows:

DEATHS FROM PULMONARY TUBERCULOSIS IN
ENGLAND AND WALES

1911 39,232

1912 38,083

1913 37,055

Enter War

1914 38,637

1915 41,676

1916 41,545

1917 43,113

The deaths from pulmonary tuberculosis in Eng-
land and Wales in 1917 were 6,058 more than in 1913.
Moreover, tuberculosis deaths had been diminishing
at the rate of a thousand a year. This reduction
would almost certainly have continued, and the num-
ber of tuberculosis deaths in 1917, had there been no
war, would have been some 33,000 instead of 43,113.
There was an actual increase in 1917 of 16 per cent,
over 1913 and of 30 per cent, over what probably
would have been the rate in 1917 had there been no
war.

Isolated reports from a few Austrian and Hun-
garian cities also show a striking increase in tuber-
culosis, especially during the last two years.

In Germany the increase of tuberculosis is thus
described by such competent inquirers ^as Dr. Alice
Hamilton, now of the Harvard Medical School, and
Miss Jane Addams:

285

THE HUMAN COSTS OF THE WAR

The effects of underfeeding are registered chiefly in the in-'
creased tuberculous rate at all ages, and in the increased death--1
rate among the old as is shown in Germany 's statistics. During
the third quarter of 1917 the deaths from tuberculosis had
increased by 91 per cent, in women, only 40 per cent, in men.

Kayserling, one of Germany's foremost tuberculosis specialists,
told us that the fight of almost forty years against tuberculosis
was lost. The Germans date their anti-tuberculosis campaign
from about 1882 when Koch discovered the bacillus. Since
then their rate had fallen from over 30 per 10,000 of the popula-
tion to less than 14. In the first half of 1918 it was already
over 30 and is still rising and will continue to rise for some
years. Nor does the death-rate tell all the story. In Berlin the
infection rate among babies — shown by the von Pirquet test —
has increased threefold, the rate of tuberculous sickness among
little children, fivefold. These children will not all die. Many
will live on to puberty and then fall prey to the disease, or if
they are able to resist that period of strain, they will succumb
during the twenties, under the strain of child-bearing or heavy
work. For the whole period of this generation, tuberculosis
will claim a greatly increased number of victims, and how far
the health of the children of these war children will be affected
nobody can say.

Not only is the number of the tuberculous increased, but the
form of the disease is changed and German hospitals are now
filled with varieties of the disease which used to be regarded as
medical curiosities. We saw most pitiful cases among the
children, multiple bone tuberculosis with fistulas, multiple joint
tuberculosis, the slow, boring ulcers of the face called lupus,
great masses of tuberculous glands such as we never saw in
America, and that great rarity in civilized countries, caseatirtg
pulmonary tuberculosis in little children. Kayserling said
that the hunger blockade had shown that tuberculosis is a
disease to be combated chiefly by nutrition, not by the preven-
tion of infection, and that by long starvation it is possible to
break down racial immunity, if indeed there be such a thing.
The forms of tuberculosis now common in Germany were
formerly seen almost entirely among primitive peoples, and it
was supposed that the acquired resistance of civilized races made
such things impossible, but that is now an exploded belief.

There is no space to do more than mention some of the other

286

WAR, BEST FRIEND OF DISEASE

results of the long underfeeding of women, children, and old
people. "Galloping consumption," fatal in four to sixteen
weeks, used to be very rare; now it is almost the rule in
young adults who develop tuberculosis after a decided loss of
weight.

Even in America, far removed as we were from the
seat of war and late as we entered it, the rate of
decrease in the tuberculosis death-rate, which had
been fairly continuous for many years, was abruptly
reduced. The best that can be said for the last two
years is that, if we have made little progress, we at
least have not lost much ground.

We are, therefore, confronted by the fact that this
arch-enemy of mankind, this ever-present and
everywhere-present epidemic, which was slowly yield-
ing before the steady pressure of organized effort,
has quite broken loose from control. It is not only
Kipling's "comfort, content, delight" which have
"shriveled in a night"; it is vigor and health and life
itself. Hundreds of thousands, probably millions,
of human beings, who would otherwise have escaped,
are now seriously infected with tuberculosis. It will
be a long, slow road back to where we were in 1914.

Malaria Returns. — Malaria is not as well known
to us as was the "ague" or "chills and fever" of an
earlier generation. It still lingers in our Southern
states and in southern Europe. Since the anopheles
mosquito was definitely convicted of being the bearer
of the disease, great progress had been made toward
its control. In the Panama Canal Zone, as late as
1906, 878 per 100,000 of the employees died from
malaria, but in the last few years there have been
almost no deaths from this cause. Every traveler
has been warned against going to parts of Italy, on

$87

THE HUMAN COSTS OF THE WAR

account of malaria. Some years ago Italy recog-
nized malaria as a national menace. It drained
swamps, screened houses, and popularized the use of
quinine. It bought enormous quantities of quinine,
sold it through the post-offices, and carried on a
propaganda for its use. Success is easy on such
lines, and in 1914 the mortality from malaria was
only one-tenth of that of twenty years earlier.
When the war came it was almost impossible to se-
cure quinine. It seemed impossible to continue the
expense of drainage operations, and nobody thought
much about malaria, or such unimportant things.
The result was even more striking than in the case
of tuberculosis. The malarial death-rate increased
246 per cent, in two years. In one province it in-
creased fivefold and in another tenfold.

Malaria is directly fatal to only a very small pro-
portion of cases; for instance, in 1914 deaths were
only 2,072, but the number of cases reported was
129,482. In 1917, 304,216 cases were reported. In
the island of Sardinia, with a population of 880,000,
100,000 cases were reported in 1917.

Greece presents an even worse picture as to ma-
laria than Italy. Recall that Italy had decreased its
malarial death-rate from 81 in 1886 to 5.7 in 1914;
Athens, for the three years 1906-08, had a malarial
death-rate of 33; Patras, 54; Larissa, 179; and
Volo, 248. We do not know the figures as to ma-
laria in Greece during the war, but we know that the
Greek government, having adopted, in 1911, certain
of the Italian anti-malarial methods abandoned them
on account of the war.

The "Cootie" Spreads Typhus.— -Of all the jokes,
slang, and poems made in the trenches, a large per-

288

WAR, BEST FRIEND OF DISEASE

centage relate to the "cooties, " which seem always to
enlist with the soldiers. If there is any typhus
about, the "cooties" spread it. Under modern con-
ditions, typhus is almost wholly a war disease.
When large numbers of soldiers carrying typhus-
bearing "cooties" travel through a country and are
quartered with the population, conditions are ideal
for a typhus epidemic. This was just what happened
in Serbia late in 1914. A tremendous cleaning-up
campaign was carried on and vermin were hunted as
vigorously as enemy spies. The epidemic was under
control by midsummer of 1915, losses being about
150,000 — soldiers, civilians, and prisoners. There
were only between 300 and 400 physicians in all of
Serbia; 125 of them died of typhus. In an epi-
demic of the same proportions, the United States
would lose 3,300,000 persons, five or six times as
many as we lost from influenza.

At the end of the war hundreds of thousands of
prisoners were turned loose in Austria, Bulgaria, and
Turkey. Weary processions of refugees tramped
through the Balkans in every direction. Armies
marched hither and thither. An epidemic of typhus
was easily predictable. It came — in Serbia, Greece,
Rumania, and Poland. We know little as to the
numbers of cases or deaths, but we hear frantic calls
for help and accounts of whole areas stricken. We
are now so accustomed to horrors, so emotionally
overstrained, so tired of thinking about Europe, that
we are little impressed. Only in history will this
post-armistice epidemic of typhus be seen in its true
proportions.

Drinking Typhoid Sewage. — Sewage is not good to
drink, but every typhoid patient has drunk or eaten

THE HUMAN COSTS OF THE WAR

the essential, and objectionable, element of sewage.
Preventing typhoid means keeping water and milk
supplies free from human infection. This is dif-
ficult when soldiers and refugees are camping out all
over the country. It is not surprising, therefore,
that in Italy the typhoid death-rate, which had
fallen from 27 per 100,000 in 1911 to 19 in 1914,
immediately rose to 26 in 1915 and to 27.9 in 1916.

In Serbia the pre-war typhoid rate was seven and
a half times that of the United States from 1910 to
1915. There were epidemics in Belgrade in the sum-
mers of 1916 and 1917, with 60 cases reported in a
single week. Any such increase in the amount of
typhoid leaves a residuum of typhoid-carriers who
for years to come will make typhoid control more
difficult.

Influenza and War. — At the very height of the
Great War the world was startled by the appearance
of what seemed like a new plague. It originated,
according to Doctor Flexner, in that portion of
Russia next to Turkestan. It may be no accident
that in the atlas the name of this region is put down
as Hunger Steppe. The disease traveled across
Europe to Spain before it was recognized as an
epidemic, and hence it was called "Spanish in-
fluenza." Mystery still surrounds its origin and
mode of infection. Its being contemporaneous with
war may have been accidental, but war has given
a new lease of life to other diseases, and, so to speak,
wings by which to fly with all speed from one locality
to another. It is more than probable that in what-
ever nests of poverty and uncleanness its germs had
lived a quiet, if not a respectable, life for years,
its sudden flaring out into an epidemic is not unre-

290

A DISINSECTING PLANT

This Serbian -refugee mother was doing her part toward preventing the

spread of disease. This is a familiar sight in the Balkans.

REFUGEE CHILDREN AT SKOPLJE
These children are receiving milk from the American Red Cross.

WAR, BEST FRIEND OF DISEASE

lated to the great hardships through which all those
regions of Europe were passing. The constant
streams of prisoners, wounded soldiers, new recruits,
refugees, and laborers from every part of the world
to and from the seats of war easily account for the
speed with which influenza traveled east and west
around the world. An undefined but substantial
amount of the terrible "flu" is therefore to be put
down on the debit side of civilization's account with
war. As an agency of death, the "flu" leaves
fighting far behind. We are told that 6,000,000
deaths occurred from influenza in India alone. In-
fluenza deaths in the United States are estimated at
600,000. The losses in Italy were about a half-
million in a population about one-third that of the
United States. Serbia suffered heavily from the
influenza. Nobody could give figures, but we heard
everywhere that it had been very bad, comparable
to the typhus.

War, Baby-killer. — We have left to the last the
effect of war upon the lives of babies. When millions
of men were being killed, it was obviously important
that babies should be saved. The number of births
fell off tremendously. Ordinarily, this would mean
an improvement in the death-rate, for if there are
few babies the mothers can give them better care
than if there are many. But all rules fail in war,
and, with the exception of one or possibly two of the
Allied countries, even among the few children who
were willing to face a world at war and to take their
chances in such a crazy bedlam, the baby death-
rate was higher than before. Italy's experience is
typical. Before the war her baby death-rate was
not exceptionally high and in 1914 it was the lowest

291

THE HUMAN COSTS OP THE WAR

'on record — 130 per 1,000 births. The very first
year of the war, 1915, it rose to 146J4? an increase
of over 10 per cent. After that we have figures
for the cities only. Forgive a repetition of a table
of statistics. They are not figures; they are those
curly -haired, chubby-cheeked cherubs of Titian and
Tintoretto and Raphael:

BABY DEATHS PER 1,000 BIRTHS

Cities 1914 1915 1916 1917 1918

Genoa 120 150 126 149 134

Milan 107 132 123 138 167

Bergamo 186 223 259 243 246

Bologna 92 121 136 134 195

Florence 120 131 186 188 232

Pistoia 127 138 230 208 334

Pesaro 161 199 199 317 638

Perugia 115 142 155 217 ....

Rome 124 122 131 122 144

Naples 154 155 169 186 230

Fano 83 72 258 424 575

Use a little imagination on these figures. The
number of children born was from one-third to one-
half less than it had been. Even among these the
death-rate in some cities was doubled. How much
this table looks like the one about tuberculosis!
Life was hard in Italy. She paid a heavy price
for her new territory. Serbia and Greece tell a like
story, but haven't any figures to prove it. Even in
France the infant deaths went up and the birth-rate
down.

In marked contrast to these countries is the
experience of England. The fall in the birth-rate
showed that baby-saving, like munition-making,

292

WAR, BEST FRIEND OF DISEASE

should be a national industry. In spite of war ex-
penditures and the necessary absence of a great part
of the medical profession with the army, a compre-
hensive effort to save the lives of the babies was
made. Infant-welfare stations were set up in large
numbers, trained visitors were sent to visit the
babies' mothers, and the other things done which
would help to save babies. As a result, the infant
death-rate was actually reduced in England and
Wales from 105 in 1914 to 91 in 1916 and 97 in 1917
and 1918.

By similar means some localities even in occupied
Belgium secured similar results, though in Belgium
as a whole there was probably an increase in the
infant death-rate.

Health Aspects of Cave-dwellings. — There has yet
to go on the debit side of the account the effects of
the return of some millions of refugees to living-
quarters in the war zones which are astonishingly
like the habitations of the cavemen. These are not
able-bodied men with good food rations and con-
stant medical supervision, but women and children
with scanty rations, scanty clothing, and little or no
medical attention. We do not know exactly how
this wholesale reversion to the standards of a for-
gotten age will impair the vitality of the next genera-
tion, but we do know that the price will have to
be paid.

A Postponed Millennium. — These deferred ob-
ligations are, in fact, the most distressing aspect of
this matter of war and disease. Germs cannot be
demobilized by any armistice or peace treaty. Once
let loose, their recapture and control is a matter of
long effort. In a certain district in Serbia syphilis

293

THE HUMAN COSTS OF THE WAR

is extremely prevalent. It is believed to date from
an army occupation many years ago. The great in-
roads upon the world's health, of which we have
seen only a few glimpses, will project themselves far
into the future. There will still be living in the
year 2000 those who were orphaned by the Great
War. Perhaps not even they will see a world in
which the war's aid to disease has been overcome.
The forces fighting the age-long struggle for com-
fort and for a normal lifetime have been thoroughly
disorganized. The attainable millennium has been
postponed indefinitely.

Meeting the Situation. — Indefinitely, but not per-
manently; it is for us to say how long. If we
recognize the gravity of the danger and the greatness
of the opportunity, we shall regain the lost ground
and lost momentum very much more quickly than
if we fold our hands and say, "How terrible!" Eng-
land, with its new Ministry of Public Health and its
remarkable housing and town-planning enterprises,
is putting health into the very foreground of national
activities. America should do likewise. But Eng-
land and America cannot save themselves alone.
The world cannot remain half free and half pest-
ridden. We shall not have done our full duty as
an Ally unless we help the less fortunate Allies, not
simply to recover lost ground, but to bring the health
millennium much nearer to their peoples. For-
tunately, a clean-cut and very successful plan for
doing this has been worked out and has stood the
test of experience.

American Tuberculosis Work in France.- — The
Nineteenth Arrondisement (ward) of Paris is, by
common consent, one of the poorest, most unsanitary,

294

WAR, BEST FRIEND OF DISEASE

and altogether most helpless quarters of the city.
It is here that revolutions have repeatedly arisen.
Life here is so bare and hard and grim that those
who have taken up health or relief work in Paris,
almost without exception, have located elsewhere.
In July, 1917, the American Red Cross and the
Rockefeller Commission on the Prevention of Tuber-
culosis went to France to express America's sympa-
thy by constructive work. It was suggested that
they establish somewhere in the city model demon-
strations of how tuberculosis and child- welfare work
are done in America. The suggestion was accepted.
"Where shall we place it?" the Americans asked.
"In the Nineteenth Arrondisement," the French re-
plied. The Americans learned all the discouraging
things about the Nineteenth Arrondisement, but the
opportunity to try the most difficult possibility was
too good a sporting chance to be lost, and to the
Nineteenth Arrondisement they went. A visitor,
who was familiar with American public health, going
to the Nineteenth Arrondisement a few months
later, would have found four combined tuberculosis-
and child-welfare dispensaries in full operation;
rather better, if anything, than he would find in any
American city. They were fully equipped for
scientific work; they had the best of physicians on
full time, paid service; they had as good public-
health nurses as there are anywhere, and they had a
carefully developed relief work combined with the
nursing, so that whatever the doctors prescribed,
whether it were medicine, or food, or an additional
room, or a country vacation, was to be provided.
We were toldjbeforehand that we would not be able
to visit the French families; that they would not let

20 295

THE HUMAN COSTS OF THE WAR

us in. Our nurses and visitors found their dif-
ficulty was not to get in, but to get away. The
families were delighted to be visited and wanted to
talk on indefinitely. Schools for the training of
Frenchwomen as public-health visitors were set up,
French physicians came to study the work, and,
little by little, as fast as it could be done, without
losing efficiency, French personnel in American pay
replaced American personnel. From all points of
view, and in the opinion of every one, the experiment
was an unqualified success. It was repeated with
equal success in one of the regions some fifty miles
out of Paris, including several smaller cities and
towns and a large rural area. Exhibits on child
welfare and tuberculosis were prepared with all the
artistic directness of the French. They were tremen-
dously popular. The medical diagnosis and the
home visiting naturally brought to light a good many
patients who needed sanatorium or hospital care.
Very well — we proposed to the French that sanato-
rium and hospital care be provided. The French
gave the sites and, in some cases, existing buildings,
and the American Red Cross made all necessary
repairs, provided equipment, and agreed to operate
the hospitals for a certain period of tune. Following
these two demonstrations, tuberculosis dispensaries
and hospitals are being established rapidly in many
parts of France, quite as rapidly as is consistent with
careful and efficient work.

Health Agencies, America's Best Gift to the Balkans.
— This is exactly the kind of thing that needs to be
done all over southeastern Europe. In Serbia it
would be necessary to send a larger proportion of
American personnel because Serbia has almost no

296

WAR, BEST FRIEND OF DISEASE

doctors, and they will need to stay longer, but the
method is perfectly adaptable to the Serbian atti-
tude. They would love exhibits: they would have
almost too great confidence in American physicians
and nurses. They remember what the French, the
British, and ourselves did to the typhus. Dispen-
saries, public-health nurses, educational exhibits, hos-
pitals, and sanatoria should be put into operation
in as many different localities as possible, both to
meet an urgent immediate need and to lay a founda-
tion for a comprehensive permanent public-health
service.

The American Red Cross during the first half of
1919 sent food and clothing to the Near East to meet
the immediate emergency. It is now emphasizing
a comprehensive health campaign in eastern Europe.
The Serbian Child Welfare Association, under expert
direction, has sent skilled personnel and established a
program for Serbia very like that outlined above as
in effect in France. The American Red Cross had
a Tuberculosis Commission in Italy in 1918-19
which gave a great impetus to the anti-tuberculosis
and child-welfare movement there. The League of
Red Cross Societies, with headquarters in Geneva,
has for one of its chief objects the control of epidemic
diseases. The way is open for the American people,
through its own American Red Cross, through such
agencies as the Serbian Child Welfare Association,
and also through its participation in the League of
Red Cross Societies, to continue to do its bit toward
undoing the terrible losses inflicted upon the health,
the happiness, and the efficiency of the world by the
Great War.

CIVILIZATION'S INDICTMENT OF WAR

What civilization is; war its negation; ten million homeless; forty-
two million enemy subjects; sent into slavery; nine million
soldier dead; fifty million manless homes; ten million empty
cradles; war diseases; a submerged continent; a mortgaged future;
continental reconstruction and nobody to do it; what America
can do.

CIVILIZATION /^.-Civilization is
the net result of the efforts of the human
race for several hundred thousand years to make
life more comfortable, interesting, and satisfy-
ing. Many experiments in this direction are fruit-
less, but occasionally one succeeds and we in-
herit the sum total of the successes. Up to 1914 this
world-wide and history-long effort had met with a
fair degree of success. The race had learned how to
raise ample amounts of many kinds of food and how
to distribute them. The fight against cold had
measurably been won. We had learned how to
make warm clothes and how to build houses and keep
them warm. We had learned how to do these things
and still have time left over. Diffused education
was helping us to learn how to enjoy leisure. We
knew what was going on in the world. Life was
getting interesting and promised still better things.
In the general opinion of mankind, it was good to
live, when the storm broke in the midsummer of 1914.

CIVILIZATION'S INDICTMENT OF WAR, *

War Its Negation. — The essence of this war was
that it denied the validity of all toward which we
had been striving. It set up new standards and
declared that darkness, cold, hunger, poverty,
disease, crippling, killing, hate, orphanage, widow-
hood, were proper conditions of life. It enforced
these newer ideals, at first in limited areas and then
in ever-broadening circles, until in some degree they
had permeated the life of a continent. To-day the
world is full of strikes. We need not look for subtle
explanations. They are the direct legitimate suc-
cessors of war. They are simply carrying a step
farther the newer ideals of life. They are hunger,
insufficiency, and bareness of life expressing them-
selves, along with an implied reliance upon force
rather than persuasion and orderly procedure.

It is possible to sum up, imperfectly, a few of the
chief offenses of the Great War against civilization.
It will be only a few out of many of the crimes of this
habitual offender, but from these few we may infer
something of others. From events which have already
occurred, and of which we are able to make some
measurements, we gain impressions as to what is
yet before us.

Ten Million Homeless. — We put down as the first
offense against civilization the breaking down of
civilized living among the war exiles, hastily saying
good-by to home with its comforts and enjoyments,
leading a makeshift life for four or five years, and
returning to even more miserable and wretched
makeshifts for an indefinite time in the war zones.
We have seen that at least 10,000,000 people
passed and are passing through this experience.
At this moment, January 10, 1920, a Red Cross

299

THE HUMAN COSTS OF THE WAR

mission reports that 4,000,000 of Poland's 20,-
000,000 people are still refugees. Unless mankind
has been on the wrong trail, unless well-being is
undesirable, this volume of subnormal living on the
part of about one-twentieth of the Allied peoples of
Europe during four or five years of exile and an in-
definite period of reconstruction is a very serious
matter, from which recovery to normal producing
power and ordinary civilized living will be slow and
uncertain.

Forty-two Million Enemy Subjects. — We frame as
the second count of the indictment against war the
hardships of those who remained in the areas occu-
pied by enemy armies. When the invading tides
rolled into Belgium, France, Italy, Serbia, Greece,
Rumania, and Russia, not all the civilians fled before
them. In fact, the great majority remained. They
went into the cellars while the war tornado crashed
past. When the noise died down and they cautiously
came to the surface they found themselves in a
changed world. Its physical aspect might be little
changed, but everything else was absolutely topsy-
turvy. They were no longer their own masters;
they were under the rule of an enemy army. It
is bad enough to be a subject people in peace; it is
far worse to be the subjects of an enemy army in
war. They could no longer be sure of anything.
They had to do as they were told. All ordinary
business was at a standstill. They were behind the
blockade. If they raised food, it would very likely
be taken from them. If they labored, it was very
likely to result in benefit to those who were trying to
destroy their country. They were in a sense slaves,
for they had no freedom and no rights. On sus-

300

HOME-MAKING UNDER DIFFICULTIES

Site of the former village of Beauraine, on the road between Arras and
Bapaume, on the German front-line trenches, 1914-17.

IN THE HEART OF THE SOMME BATTLE-FIELD

No other habitation can be seen in any direction from this spot in the heart
of the Somme battle-field.

CIVILIZATION'S INDICTMENT OF WAR

picion they were thrown into prison; on little or no
evidence they were shot. Their cities were called
upon to pay large sums as fines or indemnities, which
for Belgium alone are stated by a Carnegie Fund
investigator to amount to about $2,000,000,000.
They had to see their factories torn down and the
materials shipped away. Anything they had which
the enemy wanted he took — especially food and
clothing. As the blockade became more and more
effective, they suffered even more than the enemy
civilians, for many of their supplies were taken and
shipped to the enemy countries to eke out their
failing stocks. Life was no joy ride in the occupied
territory. No wonder its tuberculosis and child
death-rates shot up to one and a half or twice what
they were before. It is not easy to realize that this
kind of life was the lot of 6,000,000 people in Belgium,
3,000,000 in France, 1,000,000 in Italy, nearly
5,000,000 in Serbia, 200,000 in Greece, 5,000,000 in
Rumania, and 22,000,000 in Russia. In all, some
42,000,000 people lived this life of exasperation, sub-
jection, and deprivation.

Sent into Slavery. — The third count in the indict-
ment is an offense which smacks of ancient rather
than of medieval or modern times — wholesale carry-
ing away into captivity.

From among these millions there were selected by
the enemy, as he grew short of man-power, some
hundreds of thousands, no one knows how many,
for a worse fate — deportation into enemy country.
They were to be real slaves, or worse. From Bel-
gium, from France, and, above all, from Greece and
Serbia, these deportations sentenced men and women
to wearying, brutal labor, exposure, hardships like

301

THE HUMAN COSTS OF THE WAR

those of army prisons. When there was also in-
volved, as in the Near East, a desire to change the
dominant national sentiment of some locality, even
the children were deported, to share all the hardships
of a Me pointing directly toward extermination.
When the war was over the survivors walked home.
We met them everywhere in Serbia — Greeks, Al-
banians, and Serbs — footsore, ragged, famished,
vermin- and disease-infected.

Nine Million Soldier Dead. — The fourth count in
the case of the people against war is that of whole-
sale murder.

The hardships of 10,000,000 refugees in their hur-
ried exile, their years of unwelcome sojourn, and
their decades of makeshift living during reconstruc-
tion, of 42,000,000 in occupied areas, and of hundreds
of thousands deported into slavery, are only a be-
ginning in the realization of the newer ideals of
human Me introduced by war. It has always been
considered that the death of a husband and father
is one of the most serious of tragedies. The highest
type of religion has been declared to consist of visit-
ing widows and the fatherless in their affliction.
Now, however, instead of being a rare exception,
this was to become almost the rule in wide areas of
the world. In France, for instance, we have reck-
oned that about 1,750,000 men were lost. From the
point of view of the emotional strain of sorrow and
mourning its volume is beyond our powers of under-
standing. France is literally soaked, inundated, per-
meated through and through by grief. Serbia is
even more so. The frequent suicides reported among
its women and children are easily understood.
England, Russia, Italy, Belgium, Greece, Rumania,

302

CIVILIZATION'S INDICTMENT OP WAR

and all the enemy countries are enduring the same
kind of strain. Our army authorities estimate the
battle deaths alone at 7,582,000. Adding deaths
among the missing, among prisoners, and excess of
deaths from disease in the armies, it is clear that
some 9,000,000 men laid down their lives on account
of the war. Each of these came from a home. The
number of widows, fatherless children, of parents
and of brothers and sisters in mourning, must be
counted in scores of millions. There are also the
permanent cripples, those who were snatched from
death by the miracles of modern surgery, who will
live, perhaps for a normal lifetime, a maimed and
partial life, shut out from many of the things that
make life worth living, and able only in part or not
at all to contribute as producers to the welfare of
their families, their communities, and their countries.
These we may estimate at 2,000,000.

Shall we stop a moment to recapitulate? Europe's
population was, roughly, 393,000,000, which during
the war was grouped approximately as follows:

Neutral 42,000,000

Central Powers 124,000,000 (not including

Turkey in Asia)
Allied peoples 227,000,000

Among the Allies the war victims already enumer-
ated may be totaled something as follows:

Homeless refugees 10,000,000

In occupied areas 42,000,000

Soldiers killed 7,600,000

Soldiers' orphans and widows 15,200,000

Permanently maimed 2,000,000

Total 76,800,000

THE HUMAN COSTS OF THE WAR

Of the tremendous mass of Allied population
(twice as numerous as the people of the United States
and its dependencies in 1910) almost exactly one-
third had either been made homeless, subjects of an
enemy army, killed, widowed, orphaned, or per-
manently crippled.

Fifty Million Manless Homes.

Indictment count No. 5 :

With war as an enemy of home life, we have still
other counts to settle. Something like 50,000,000
or 56,000,000 men, most of them, we may be sure,
being fathers or big brothers, were for the time
being almost as effectively separated from their
families as though they were never to return. And
for many of them it was a separation for four years,
broken by only very brief occasional leaves. Europe
was a continent of manless homes. Its home life
was thoroughly abnormal. It was a dull, gray,
uneventful life for, say, a hundred million children,
and an anxious, wearing, emotionally overstrained
existence for scores of millions of wives and mothers.

In the middle of Serbia in late December, 1918, I
saw a company of German prisoners in a village.
They had the use of a fairly comfortable building in
a large yard inclosed by barbed wire. I talked with
them of the war. They did not seem at all interested
in the Peace Conference; they did not care where the
Kaiser was or what he was doing, or who was in
control in Germany, or what America was going to
do. They wanted to get home to their wives and
children. They did not complain of their food or
shelter or work. They talked and thought of only
one thing — home.

For four long years scores of millions of homes in

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CIVILIZATION'S INDICTMENT OP WAR

Europe, instead of being centers and creators of
happiness and affection, of serenity and order, were
abodes of loneliness, anxiety, nervous apprehension,
and, in about nine million cases, of grief beyond
expression. Who can foresee the future effects of
such an environment for the children of a continent?

Ten Million Empty Cradles.

Indictment count No. 6:

But we have only begun in our survey of war on
homes. Ten million refugees, 42,000,000 under
enemy army rule, hundreds of thousands deported,
and 9,000,000 dead soldiers mourned by God knows
how many millions of widows and orphans — all this
is only a fair start. About 10,000,000 homes have
been deprived of that for which homes primarily exist.
Every home is built around a cradle. War has gone
very far toward emptying the cradles of Europe.
Looking backward some decades hence, this fact and
its consequences may appear as among the most
serious results of the war. The figures are clear.
France, with its pre-war stationary population,
shows a war deficit of births of about 1,500,000.
Italy, unlike France in that its birth-rate was high,
also shows a war deficit in births of about the same
number. Univaded Britain shows nearly 1,000,000;
Belgium, 350,000; Serbia, whose men were in exile
for four years, 760,000, and so on. A rough estimate
of the Allied countries' shortage in babies due to the
war is 6,000,000 or 7,000,000, and if we include the
Central Empires we have an estimate for Europe of
some 10,000,000.

The consequences of this wholesale race-suicide
project themselves far into the future and will have
many curious and far-reaching results, most of which

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THE HUMAN COSTS OF THE WAR

we probably cannot foresee. We can see that there
will be a partial hiatus in the ranks of school-children
for an age period of four or five years. There will be
a great falling off in the graduating classes of schools
and colleges in the years when those born in 1915-20
would graduate, except for the laggards of earlier
years who have fallen behind and the precocious ones
of later years who have forged ahead. If compulsory
military service should exist twenty years from now
there will be an alarming dearth of recruits in the
classes born in 1915-20. The industries and em-
ployments which ordinarily receive each year a cer-
tain number of maturing young men and women
will find a curious diminution in the labor supply
during the period, say, 1934-39. When the children
born in 1915-20 would be young men and maidens
the parish registers will record an extraordinarily
small number of marriages and the future popula-
tion will be correspondingly diminished.

Those who have reread Rupert Brooke's Letters
from America with added interest since he became
one of England's priceless contributors to the cause
of saving civilization will recall his description of the
procession of Harvard graduates on Commencement
day, arranged by years of graduation, and will re-
member that he noted that the orderly sequence of
the years from the new graduate to the veteran of
eighty-five or ninety was unbroken except at one
point. Here was a gap, large and arresting. There
seemed to be no one in the procession between sixty
and sixty-five. A Harvard friend told him the
reason — the Civil War. There will be two great gaps
in the procession of the men who will march across
the campus of the world a few decades from now.

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CIVILIZATION'S INDICTMENT OF WAR

One will recall the young men who perished in the
Great War; the other, the children who were not born
in the years 1915-20.

The case of Belgium is exceptionally interesting
and equally disturbing. In Belgium the birth-rate
had already fallen by the summer of 1916 to 60 per
cent, of its former proportions; by 1918 it had fallen
uniformly to about 50 per cent. This is about what
happened in the other Allied countries, but the
striking and very disturbing fact is that it is not so
readily accounted for. The gray German flood
overflowed Belgium so quickly that there was not
time to mobilize a large army. The heroic Belgian
army, which, without a moment's hesitation, op-
posed itself to the thrust of the German battering-
ram, happened to be only a small proportion of the
men of Belgium. The great majority of the Belgian
men remained to carry on their civilian duties as
best they could, and the war-tide passed by. In
occupied Belgium, therefore, unlike invaded France,
there was a large proportion of men left behind to
carry on the ordinary life of the community. This
50-per-cent. reduction in the birth-rate in Belgium,
then, could not have been due primarily to the
absence of men on military service. We must look
elsewhere for its causes. The suggestions which
naturally offer themselves are the lowered vitality
of the women, due to an insufficient food-supply;
their constant mental distress; the fear on the part
of women workers that absence due to childbirth
might reduce income very far below family needs,
and the consequent increase of abortions; in other
words, the subnormal standards of living which had
to be accepted. A very serious aspect of this is

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THE HUMAN COSTS OF THE WAR

that these subnormal standards did not disappear
from Europe at the end of the war. They continued
with little change for months after the armistice,
and still continue. With food prices as they still
remain, with millions of returned refugees living in
huts, basements, cellars, and improvised shelters of
every description, Europe is still leading a sub-
normal Me. Will the birth-rate also continue sub-
normal? It has been rather generally assumed
that it would not, and that soon after the armies
were demobilized the birth-rate would resume its
former proportions. The facts as to Belgium sug-
gest very strongly that this assumption will prove
to be unfounded, and that the reduced birth-rate was
due, in considerable degree, not only in Belgium,
but wherever subnormal conditions of living existed,
to such psychological and physiological factors as
anxiety, uncertainty, distress, grief, depressing sur-
roundings, insufficient food, and fear of unemploy-
ment. We know that these things are continuing
and must continue. We do not see any end of them.
Their further duration will be measured by years
and not by months. Agriculture must be re-
established. All the slow processes which entered
into the building up of industry must be retraced,
and all these things must be done by peoples who
have lost, in some cases, as high as one-fourth or one-
fifth of their entire efficient male population.

It is more than a conceivable possibility, it is a
definite probability, that a marked reduction in
births will continue after the war, and that former
conditions will return only slowly and over a period
of years.

Will they return at all? The question cannot be

CIVILIZATION'S INDICTMENT OF WAR

evaded. Even though, after a time, conditions of
industry and prosperity return, will the attitude of
mind, will the conditions of domestic life, be such
as they were before? It is at least doubtful.

Without speculating too far as to conditions a few
decades hence, what has already happened, is hap-
pening, and must continue for a few years at least,
is adequately disturbing. It means a reduction of a
great many millions in the population of Europe.
A reduced population, arising from a low birth-rate,
is not always necessarily undesirable. Generally
speaking, a lowering of the birth-rate means also a
lowering in the rate of infant mortality. There is a
large element of truth suggested by the phrase,
Fewer babies and better ones; or, fewer babies
and more of them kept alive. There is nothing to
be said for the idea of a baby every year and a baby
funeral every eighteen months. But one thing may
be very disturbing — a low birth-rate in some coun-
tries and a high birth-rate in others. If the white
man has carried the burden of the world it was
because he was better fitted to carry it, not because
there were more of him. But the extent to which
he can be depleted in numbers and still carry the
white man's burden is an unsolved question. There
are limits to his carrying powers. We may find a
parallel on a smaller scale, but one sufficiently im-
posing, in the history of France and Germany during
the past few decades. It is not so long ago since
France and Germany were not very far apart in
population. In 1860, in fact, France had about
37,000,000 people, while the country which later
became the German Empire had a population of
35,000,000. France had a steadily diminishing

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THE HUMAN COSTS OF THE WAR

birth-rate; Germany's birth-rate remained rela-
tively high. In one eighteen-year period, 1895-1913,
the tiny Fritzes who were born into the world num-
bered over 35,000,000, whereas during the same
period the cradles of France received only 14,500,000
babies. As a result, at the outset of the war,
France's 39,500,000 would obviously have been
speedily and completely overwhelmed by Germany's
65,000,000 unless powerful and numerous Allies
came to her rescue. Is there not a possibility that
history may repeat itself on an even vastly greater
scale? Has the white race of Europe, with its birth-
rate already cut almost in half for a number of years
by conditions some of which will continue for years
longer, entered upon the course which France has
been following for the past forty years? Will the
preponderance of the yellow race become relatively
and markedly greater and greater? It seems dis-
tinctly possible. How unfortunate that the mill-
ions of China are emerging from the Great War a
disillusioned people so far as their reliance upon the
justice, fairness, and disinterestedness of the white
race is concerned! No more cynical or more dis-
turbing document appeared in connection with the
Peace Congress than the statement made by the
Chinese delegation when the terms of the Peace
Treaty became known, which in substance amounted
to this: that they had come to realize that the
nations represented in the Peace Conference were
treated with a consideration directly in proportion
to their military power; that China, being peaceful
and unarmed, was without influence; that China had
now learned its lesson, and at the next conference of
peace would be prepared to enforce her claims by a

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CIVILIZATION'S INDICTMENT OF WAR

demonstration of what her enormous population, put
on a military basis, could do.

If the time should come when the white race of
Europe faces a hostile yellow race from Asia, per-
haps reinforced by a hostile black race from Africa,
it will be with numbers greatly depleted, not only
by the direct losses of the Great War, but in even
greater degree by the indirect effects of that war
upon its birth-rate.

It was very interesting in France to find that
among some of the most thoughtful and public-
spirited families the lessons of this situation were
clearly recognized. Here and there, in the more
intimate conversation between those who had be-
come well acquainted one heard remarks such as
these: "We have only two or three children. Of
course we will have more. Several, we hope. As
many as we can. We must — for the sake of France."
War has taken of the best everywhere. The ranks
of those who represent generations of education and
of training are fearfully depleted. The University
of Serbia reopens with two hundred students; five
hundred others will never return. Whether people
talk about such things or not, they must think about
them. The privilege of contributing serene, bal-
anced, thinking, sympathetic people to that genera-
tion which, a few decades from now, will be taking
charge of the affairs of a world full of promise and
full of danger is an enviable privilege.

War Diseases.

Indictment count No. 7:

We have seen how the war has given a new lease
of life to many plagues and pests that were well on
their way toward extinction. How many additional

21 311

THE HUMAN COSTS OF THE WAR

deaths have already been thus caused among civil-
ians, no one can say. We must include typhus and
typhoid epidemics, greatly increased tuberculosis
and infant death-rates, a great increase in malaria,
and other similar factors. We must include in-
fluenza as at least contributed to, if not caused by,
war. The excess of deaths from such causes as these
in Italy and in Serbia may be tentatively estimated
at 900,000 and 400,000, respectively. Elsewhere
we cannot make even a tentative estimate, except
that the totals will run far into the millions.

A Submerged Continent. — As the eighth and last
count in our incomplete and fragmentary recital of
war's offenses we point to its attack upon the entire
peoples of the continent of Europe. A great lawyer
once said that he did not know how to draw an
indictment against a whole people. On the other
hand, the language of every indictment recites that
the offense was committed against the people, in this
case the literal truth.

We have spoken thus far of those who were di-
rectly affected — refugees, residents of occupied re-
gions, those deported, widows and fatherless, and
the families of those mobilized. But this warfare
against civilization permeated every community in
Europe. With the able-bodied men diverted to war
for four years, it needed neither blockade nor sub-
marines to make life bare and hard, to make food,
clothing, shoes, coal, wood, shelter, medical care,
recreation, education, scarce and high in price.
When the bugles sounded the call for mobilization
workmen dropped their tools by the unfinished
buildings which were to have been comfortable
homes, or in which children were to be taught, or

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CIVILIZATION'S INDICTMENT OF WAR

business carried on, or the Creator worshiped. All
over Europe one saw these partly finished buildings
going to ruin. Farmers left their fields untilled and
their crops ungarnered. Salesmen and clerks left
their stores and offices. After tearful leave-takings
the women, the old men, and the boys tried to take
up the burdens which their able-bodied men had
dropped. They did their best, but it was only a
fraction of what is needed to keep the wheels of life
moving. The entire world went in sight of hunger,
and in whole nations its pinch was actually felt.
This falling away from the slowly and hardly won
condition of having enough food immediately regis-
tered itself in the death records everywhere in Eu-
rope and enabled disease to take a new hold upon
the human family.

We must revise our ideas of starvation. Most of
us have assumed that unless food shortage produces
actual starvation no serious or permanent harm is
done, though it may be uncomfortable to do without
the accustomed variety and quantity of food. If
there is one lesson, however, written clearly on the
face of the vital statistics of all the warring countries
it is that food-supply has a very intimate relation to
health, that any considerable diminution in the
supply to which the peoples have been accustomed
produces serious results in sickness and mortality
long before any obvious indications of starvation
appear. If we can imagine the food-supply of any
country being gradually diminished without that
fact being known, something like the following would
result: There would begin to be almost immediately
a slight but definite lessening of resistance to disease.
Health at best is a condition of unstable equilibrium,

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THE HUMAN COSTS OF THE WAR

a balance between constructive and destructive
forces. A slight diminution in the average power of
resistance means, therefore, an immediate increase in
illness and deaths from diseases which are ever
present in every community. Long before there was
any conscious hunger or evidence of any unusual
malnutrition there would be an increase of illness
and of deaths which probably no one would attribute
to the slight change in food-supply which had
occurred. When the shortage became more marked
the volume of sickness and mortality would rise more
sharply, especially from tuberculosis. It might at
this time become apparent to students of vital
statistics, and possibly to practising physicians, that
some new factor was at work, but the evil results
might readily be attributed to some other cause than
a diminution of food. As the supply was further
diminished, large increases in the number of deaths
from tuberculosis., from diseases of infants, and from
diseases of the aged would result, and very likely
evidences of under-nutrition would begin to be
obvious and conscious hunger would be widely
experienced. This excess of deaths appearing in the
records as due to tuberculosis and other particular
diseases would, in fact, be actually due to under-
nutrition — in other words, to partial starvation.

Only when the shortage had become more marked
would there appear what we ordinarily call "starva-
tion"— that is, emaciation, constant hunger, weak-
ness, a general breakdown, and death, not attribu-
table to any particular recognized disease. Only the
very toughest of the community, however, would
have survived to die of starvation; the others would
have died of tuberculosis or of other diseases, the

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CIVILIZATION'S INDICTMENT OF WAR

resistance to which had been diminished by lack of
food. Starvation is a relative term. We must think
of any appreciable diminution in the supply of vital
energy derived from food as sufficient to tip the
scales, at best very evenly balanced, the wrong way
for considerable numbers of people. We must
recognize that in any community the health of large
numbers of persons depends upon a very narrow
margin, that, so far as they are concerned, the
destructive forces are dangerously near at all times
to gaining the upper hand; particularly that the
ubiquitous tubercle bacillus awaits only a slight
diminution of bodily vigor to gain the ascendancy
over larger and larger numbers of people, and that,
in fact, a moderate diminution of food-supply in-
creases the volume of sickness and death long before
the average person would think of using the word
"starvation."

After the mobilization nobody had time to de-
vote to building homes, schools, churches, or hos-
pitals, or to making the world a safer and brighter
place for children. It was impossible even to carry
on such of these things as existed. There are those
for whom the simplification of life — doing without
servants and automobiles and having fewer courses
at dinner — was desirable, but such are numerically a
negligible minority. The great mass of mankind
have never gained so much that they can afford to
lose; they have never passed beyond the simple life.
For them diminution means hardship, and hardship
means reduced vitality and efficiency. This sub-
standard of living has been enforced over practically
the whole of Europe during the later stages of the
war, and still continues. How long it will continue

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THE HUMAN COSTS OF THE WAR

no one may say. It is easier to tear down than to
construct. The complex economic life, growth of
generations, must be slowly rebuilt. The world has
more work to do than before, and fewer men to do it.
There is a shortage in all manufactured articles, a
shortage in raw materials, a shortage in housing, and
there are enormous ruined areas to be rebuilt. The
prospect for a speedy regaining of the standards of
living of 1914, of such measure of comfort, well-
being, education, and enjoyment as the peoples of
Europe had attained to, is not good. All those cheer-
ful head-lines which one will read during the next
two years, to the effect that this, that, or the other
country has returned to normal conditions, may be
disregarded as based on misinformation, lack of in-
formation, blind and wilful optimism, or a desire to
float a loan or affect the exchange rate.

A Mortgaged Future. — Every nation has incurred
for future payment a huge debt which, for an in-
definite period, will claim all income except that
required for the most urgent of current needs. The
increasing amounts which were being devoted to
education, health, and, in general, to the enrichment
and betterment of life, can only be had from now on
in driblets. In a hundred million homes in Europe
there will be hopeless drudgery, constant and fruit-
less struggle against heavy taxation and high prices.
Europe will be in the treadmill for decades, slowly
and painfully grinding out the liquidation of war's
enormous obligations, incurred for destructive pur-
poses. She starts her post-war career with depleted
stocks of men and must propagate her future genera-
tions from the physically less fit. Intangible and
difficult of measurement as this race deterioration

316

CIVILIZATION'S INDICTMENT OF WAR

may be, it may easily prove to have been the most
disastrous of all the effects of the war.

War is indeed the great disaster. Earthquakes,
floods, tornadoes, explosions, may harm the whole
population of a locality; alcohol or vice may injure
a percentage of the people of whole countries, but
war can be compared only to all these things com-
bined and sown broadcast over a continent. We
may select from all these other enemies of human
life their worst features, combine them into one
quintessence of horror, intensify this to the nth
degree, scatter it continent-wide, and that is war.
War is the negation of all the race has striven for
through all the centuries. It denies that life is
worth while. It is the enthronement of unreason
and coercion. It is the supreme skepticism, both of
man and of God.

Continental Reconstruction and Nobody to Do It. —
Vast political, economic, and social changes caused
by the war can be seen only vaguely as in process,
but with no clear outcome in sight. The world will
be either more democratic or more imperialistic, but
as yet it is not clear which. Peoples have seen big
things done and are demanding that other big things
be done. One can feel the swell of the tides of
sweeping changes, but not their direction.

Such matters are for the future. Our concern is
that the world faces a sea of difficulties, with de-
pleted and deteriorated men. Of the causes and
forms of this deterioration we have caught glimpses.
Ten million people driven hurriedly from their homes
into exile, living a makeshift life for four years, and
returning to a still more primitive existence for an
indefinite period among the ruins of their former

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THE HUMAN COSTS OF THE WAR

homes; 42,000,000 subject to the rule of enemy
armies; hundreds of thousands deported into prac-
tical slavery in enemy countries, many of them into
conditions of deliberate extermination; 9,000,000
men, selected as among the fittest, killed in battle
or dying in army prisons or from army hardships;
millions of widows and more millions of fatherless
children left to do as best they can in a world pre-
occupied with every sort of trouble; 10,000,000
empty cradles that should be guarding the slumbers
of those who must take up the world's burden a
few decades hence; millions of deaths among civil-
ians due to war hardships and scores of millions of
illnesses past, present, and to come; 50,000,000
homes deprived for several years of the support
of fathers or brothers and of their companionship,
and inundated by loneliness, anxiety, and nervous
apprehension; all Europe on short rations of food,
coal, clothes, shoes, and the essentials of healthful
and efficient life.

What America Can Do. — This volume is not an
effort to answer the question as to what America
should do. It would require vastly more knowledge
of politics, industry, and commerce than the writer
possesses. Our object is to state certain undeniable
facts which should help to determine the state of
mind in which we approach the subject as to whether
we should help or not and, if so, as to what we can
do. Probably all we can do will be painfully little,
even though we are by far the strongest of the
nations. There are a few things which , for what they
are worth, seem clearly in the line of our duties :

1. We can at least look the facts in the face. We
can cease to think of these European peoples,

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CIVILIZATION'S INDICTMENT OF WAR

wearied and weakened by war, as our equals in
strength and vigor and readiness for production.
We should never forget that destruction is not only
material, but is also human; that ruins are as im-
portant as symbols as they are as realities. We can
be patient with peoples who have carried, and who
will have to carry for a long time, burdens far beyond
anything which have fallen to our lot. Instead of
scolding our European partner in the world's re-
construction for not working faster, we must recog-
nize that he is both sick and injured and is far from
being fit to do a full day's work. He is running a
temperature daily. He needs treatment and sym-
pathetic understanding rather than nagging. For
the time we must carry the heavy end of the load;
he carried it before we took hold.

2. We can continue our emergency relief where
needed. There is still plenty of war in Europe.
Let us hope that Mr. Hoover is right in thinking
that only $150,000,000 more is needed to supply
sufficient food to prevent starvation. The situation
as to clothing is probably worse than it has been at
any previous time. A careful observer just returned
from a trip through Serbia, when asked about the
Serbian peasant's costume, said he had not seen any.
He had seen only rags.

3. We can make larger and more adequate plans for
permanent constructive relief in the countries that
have been hardest hit. The Serbian Child Welfare
Association is planning for something like a five-
year campaign with $5,000,000, to help build up an
efficient permanent child-saving and health-pre-
serving organization. The other smaller and newer
countries in eastern and southeastern Europe should

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THE HUMAN COSTS OF THE WAR

be aided equally comprehensively to conserve what
human assets remain to them.

4. We can recognize that European civilization, to
which we are so closely bound, has passed through
a wholly unprecedented strain; that it is not yet
perfectly clear that it will soon recover; and that,
in any case, it could hardly stand another such
strain in the near future. Recognizing these facts,
we can make it plain that we mean to do our part
in guaranteeing peace. We can make it clear, not
only that we recognize that it is impossible for us
to live apart from the remainder of civilization, but
that we would not wish to do so if we could; that
we have no disposition to be either slackers or
quitters in the world's greatest crisis; that we have
not even thought of being passive onlookers, or of
passing by on the other side, or of considering
Europe's misfortunes from the point of view of the
degree to which they may contribute to our own
prosperity.

5. We can look squarely in the face a question
which has been asked very frequently in Europe,
but seldom in America — must we or ought we to
cancel some of the loans which we have made to
foreign countries? Of course, their first duty is to
retrench and produce. Granted. But when they
have done their best in both directions, suppose
there is still a deficit? Suppose that deficit arises
from the necessity of paying us interest and principle
for the food which we furnished them as an Ally
during and just after the war. Just how hard are
we willing to see the women and children and old
men in Serbia, for instance, work in the fields and
deny themselves and their children food and clothing

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CIVILIZATION'S INDICTMENT OF WAR

to repay us for meeting their war necessities? Have
we any continuing moral obligation as an Ally be-
yond that of selling things to them? I do not forget
the wonderful American Red Cross and other relief
organizations, but what all of them did, and could
do, was but a drop in the bucket, a temporary
emergency provision for the moment. Between good
friends, gifts are possible. How about a gift to
Serbia and to other nations whose need is at all
equal to hers?

APPENDIX

Outline of Survey of Conditions and Needs of Civilian Populations in
Belligerent Countries (October, 1918)

I. CONDITIONS BEFORE THE WAR

1. Population.

2. Annual number of births.

3. Classified annual deaths.

4. Chief occupations of population.

II. DISPLACED POPULATION

5. Number of refugees.

6. When displaced.

7. Where sent.

8. How housed.

9. How supported.

10. How employed.

11. Present conditions as to employment.

12. Present conditions as to health.

13. Present conditions as to food, and prospects

for this winter.

14. How many have returned and when?

15. Probable date of return of refugees.

III. POPULATION REMAINING IN OCCUPIED TERRITORY

16. Numbers remaining in invaded territory.

17. Number of those who have since been repatri-

ated or left in liberated regions.

18. Condition of those repatriated or left in liber-

ated regions as to health.

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THE HUMAN COSTS OF THE WAR

19. Chief immediate needs of those repatriated or

liberated.

IV. DEVASTATED AREAS

20. Area devastated — size, former population, gen-

eral character.

21. Nature and extent of devastation.

22. Extent to which now liberated.

23. Date on which population will probably return.

24. How temporary housing could best be provided.

25. How agriculture can best be reconstituted.

V. FOOD CONDITIONS AND NEEDS

26. What articles chiefly constituted the popular

diet before the war? Of these, what pro-
portion were locally produced, what pro-
portion were imported, and what food-
supplies, if any, were exported? How can
local production be quickly stimulated?

27. What foods are rationed, and size of rations?

What foods are altogether lacking? What
foods plentiful? Present prices to retail
consumers of the important articles of the
popular diet compared with pre-war
prices. Present wages of industrial classes
compared with pre-war wages.

28. What groups of population, geographical or

economic, are suffering from malnutrition,
and to what extent, as indicated by:

(a) Number and character of deaths.

(b) Notable changes in amount or character of

illness.

(d) Actual consumption in typical households on

given dates.

29. Additional food-supplies needed until the next

harvest other than those now in sight to
meet minimum requirements:

324

APPENDIX

(a) Kinds and amounts of food required.

(b) Where this food may be had.

(d) Its cost.

(e) Who should pay for it.

VI. HEALTH CONDITIONS

30. Classified statement of deaths each year dur-

ing the war, known or estimated for the
country as a whole or for selected areas,
indicating where greatest changes in death-
rate have occurred, and from what causes.

31. Infant welfare: compare number of births each

year during the war with pre-war condi-
tions; also death-rate under one year of
age, so far as known or estimated in
selected areas or entire country; existing
agencies, if any, for preventing infant mor-
tality; what preventive measures could be
taken quickly; money, personnel, and
equipment required therefor.

32. Tuberculosis: compare number of deaths with

pre-war conditions in entire country or in
selected areas; existing agencies, if any,
for preventing tuberculosis; what preven-
tive measures could be taken quickly;
money, personnel, and equipment required.

33. Other leading features in national mortality:

(a) Causes.

(b) Preventive measures, if any, in operation.

put in operation.

(d) Money, personnel, and equipment re-

quired.

34. Number of deaths of soldiers due to wounds or

disease.

35. Estimated present population of country.

325

THE HUMAN COSTS OF THE WAR

VII. SOLDIERS' FAMILIES

36. Amount paid to soldiers per month per capita.

37. Allowance to soldiers' families, if any; amount

and adequacy, present prices considered.

38. Special conditions of need, if any, among sol-

diers* families.

39. Effect of present conditions of soldiers' families

on army morale.

VIII. WAR ORPHANS

40. Number of war orphans.

41. Special provisions, if any, made for them:

(a) By allowance to widows.

(b) By special institutions.

42. Existing special needs for care of war orphans.

IX. CRIPPLES

43. Number of cripples, and their former occupa-

tion.

44. Facilities, if any, for re-education.

45. Needed additional facilities, if any.

X. PRISONERS OF WrAR

46. Number of soldiers taken prisoners, and by

what countries.

47. Number of prisoners since returned, if any.

48. Condition of those still prisoners, so far as

known, as to health.

THE END

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