“was to use sociomedical assistance as a medium through which to make contact with women, that is to say, to know, inform, educate, organize and guide them in preparation for their acceptance of the most French solution to the Algerian problem.”89 The EMSI and ASSRA staff were not benign agents of social change as the French tried to present them. They were responsible for diffusing French propaganda, educating women about emancipation, and carrying out psychological warfare.90 As we will see in the next chapter, the FLN and its health-services division used Algerian women for similar ends.
French government and military officials made frequent mention of SAS recruiting and mobilization challenges that they struggled to address throughout the war. For instance, in 1959, French general Jacques Allard admitted to a serious physician deficit.91 He estimated that one doctor was needed for every ten thousand inhabitants, and, at the time, there were only 220 French civil physicians in the entire country for a total population well over nine million. According to Allard’s calculations, the medical sector needed nearly six hundred more doctors to meet the demand.92 The military knew that even with six hundred more doctors participating in the Assistance Médicale Gratuite (AMG), a companion program created in 1956, and the SAS throughout Algeria, it would still require more staff to fill hospital positions in urban areas. The army counted on seven hundred reserve doctors to help alleviate the physician shortage. These statistics provide some perspective into the many recruitment challenges the SAS encountered and the dire need for more trained personnel willing to participate in the medical campaigns. Without them, Soustelle’s intentions of winning over the countryside could not be realized. If the SAS and AMG units did not have sufficient staff, their visits would become irregular; the lines for consultations would be longer. Those waiting for hours to see the doctor might not make it to the front of the line, and, as one general in Oran noted, this could “diminish [the unit’s] effectiveness” in the area.93 Without continuity and sufficient medicine to distribute, personnel risked losing any inroads they had made with Algerians during previous visits and hampered their chances at fostering support for Algérie française.
Government officials devised new recruitment strategies that ranged from asking friends to temporary contracts. If current medical professionals told a friend or family about their work, perhaps they would be able to convince them that their service was needed. Colonial administrators considered altering the terms and conditions of medical contracts for they thought that shorter contracts might encourage people to work for state-sponsored programs. They debated the merits of a recruitment day and suggested making a tour in Algeria mandatory for sixth-year medical students in France, framing it in terms of national service and duty. They even alluded to financially rewarding doctors for performing more consultations.94 All of these ideas could not mask the fact that the medical pacification programs were in trouble and in immediate need of reinforcements.
In response to this acute problem, the colonial administration amended medical decrees governing who was allowed to practice the profession and expanded the parameters to include foreign doctors, a group previously submitted to intense scrutiny when seeking employment in Algeria.95 The French minister for Algerian affairs issued several legal amendments, beginning with the 23 October 1958 ordinance and followed by the decrees of 28 March 1960 and 9 April 1960, which stipulated that French nationals in the medical and pharmaceutical professions who had practiced in Tunisia, Morocco, or Indochina were now eligible to practice in France and Algeria.96 Another decree issued on 19 April 1961 made additional concessions by authorizing foreign doctors with foreign diplomas to practice medicine in Algeria.97 French officials received applications from doctors in Spain and Morocco, and in many instances they were recommended to come to Algeria; the 19 April 1961 decree was often cited as justification for their approval.98 The scarcity of medical personnel was never eliminated during the war. However, French officials, realizing the potential advantages of medical pacification, increasingly broadened the health-care field by accepting individuals to serve their cause.
Another way the medical campaigns tried to compensate for insufficient staff and equipment was to improve coordination between military and civilian physicians who were already practicing in the country and did not require additional training. But the two groups, though linked conceptually, clashed over their approach to administering care. The SAS were instructed to visit remote locations and interact with Algerian locals. However, the military gave explicit instructions about guarding SAS safety and treating the population with caution. Due to the “subversive” nature of the conflict, the military inherently distrusted the Algerian people it was charged with helping and grew suspicious of their motives for coming to a mobile clinic; was it for medicine or an ambush? Therefore, the military advised medical personnel to be vigilant at all times. Army officials acknowledged that distributing medical care was an important French propaganda tool, but they insisted that medical personnel still approach Algerian patients as potential combatants. As such, sick Algerians were not to be brought to French hospitals, nor were they to be transported in French military vehicles.99 In the event of an epidemic, the SAS were told to notify the closest civilian physician and await his response before responding. Above and beyond their moral responsibilities, the SAS were told to intervene only “in perfect security conditions.”100
The French military grew increasingly suspicious of medicine and equipment requests submitted by medical teams, and letters and reports from top army officials reveal that they questioned whether doctors prioritized the military’s goals over the patients’ health. In June 1958, French general Raoul Salan wrote a letter stressing that “it is indispensable to recall [medication] requests must correspond to real needs,” and they should never “be simultaneously addressed to multiple establishments.”101 His central concern was that medication and supplies could end up in the wrong hands and benefit the FLN, a situation that did occur. Salan therefore reminded doctors that they should only request products that were not “already in their possession” and cautioned against submitting requests more than once per month.
French Military Propaganda
Decentralized reports and propaganda efforts helped mask the complicated landscape and competing medical and military missions, permitting some program heads and French leaders to think the medical campaigns were more successful than they were. Alongside a voluminous collection of letters criticizing the underfunded and understaffed programs were success stories from medical personnel heralding the number of consultations they performed, progress female assistants were having with local Algerian women, and warm receptions they received from local populations around the country. It is precisely this kind of evidence to which colonial administrators could point to claim that these programs were working and provided a level of care far superior to that offered by the FLN and its health-services division.
An Assistance Médicale Gratuite team that was part of a Tizi-Ouzou SAS unit kept detailed consultation notebooks over a two-and-a-half-year period, which shed light on contemporary illnesses and the nature of relationships between the mobile medical staff and the local population. Every single page of two large notebooks beginning on 9 July 1958 and ending on 12 October 1960 was filled with patients’ full names, their sex, age, date of visit, the town in which they resided, and their physical ailment. The first notebook, which chronicled a twenty-month period from July 1958 through March 1960, kept meticulous records that suggest during that time the AMG unit saw patients every single one of those days, well over five thousand patients in all. The second notebook, entitled Assistance médicale des musulmans: Registre des consultations journalières, begins on 21 March 1960 and ends on 12 October 1960, and, although the bookkeeping is not as consistent as in the first notebook, the records indicate that the medical professionals oversaw a total of 6,000–6,500 consultations, with consultations taking place nearly every day.102 The most common sicknesses were pulmonary problems, bronchitis, meningitis, eye diseases, diarrhea, and general body wounds. These illnesses were largely unrelated to wartime military assaults but rather derived from poor medical care and impoverished living conditions over an extended period of time. The AMG team in Tizi-Ouzou was not treating battle wounds. Instead their job called for basic
