The Battle for Algeria. Jennifer Johnson
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Figure 2. French medical personnel in Zemoura, Algeria. Dr. Resillot (seated, right) examines an Algerian infant, 1956. (Établissement de Communication et de Production Audiovisuelle de la Défense)
Figure 3. French medical personnel in Mecheria, Algeria. Chief of medicine Dr. Clément and Sergeant Heurtaux treating Algerian patients, 1957. (Établissement de Communication et de Production Audiovisuelle de la Défense)
Conclusion
The Special Administrative Sections were active through the end of the war, but some contend that the program was destined for failure once President de Gaulle came to power in 1958 and changed the political objectives of the war.109 His advocacy of self-determination beginning in September 1959, and ultimately his willingness to negotiate the Evian Accords, were in direct competition with the policy of integration and thus undermined SAS objectives. In Jacques Soustelle’s memoirs, he recalled how hopeful he felt about the possibility of integration in 1955 and 1956. At the time, he considered “the colonial phase” to be over and was committed to finding different solutions for France and its colonies.110 He firmly believed integration initiatives, such as the SAS, would fuse the Algerian economy with that of the metropole and ensure the “survival and the development of Algeria.” Additionally, “on the moral plan,” he suggested that integration “would put an end to inferiority complexes that fed nationalism.”111
When Soustelle created the SAS in 1955, he was drawing not only on his extensive political experience but also on an ideological tradition dating back over a century when French military physicians were sent to settle Algeria through medical pacification. The colonial administration launched the SAS and its complementary programs, Assistance Médicale Gratuite, Adjointe Sanitaire et Sociale Rurale Auxiliaire, and Équipe Médico-Sociale Itinérante, to reassert authority over the population through less violent measures and offer a viable alternative to the FLN. Medical personnel did not wear camouflage uniforms, and they were instructed to present themselves as “peaceful pacifiers.” But at their core, these medical programs were first and foremost a military project whose social services were a necessary means to a desired military end, crushing the Algerian nationalists’ war efforts and keeping Algeria under French control.112
But this tool of conquest did not lead to its intended goals. Even though the SAS grew to seven hundred units and the number of annual medical consultations exceeded several hundred thousand per year, persistent shortages of equipment, staff, and medicine curtailed the program’s effectiveness and exposed the harsh realities of the French administration’s long-term failure to develop and manage Algeria during the colonial period. The administration’s focus on rapprochement through health was not misguided. However, its intense focus on its own programs led officials to severely underestimate and overlook the FLN’s parallel medical initiatives that emerged simultaneously. The French did not have a monopoly on winning hearts and minds in Algeria. In fact, the FLN took advantage of this strategy and incorporated it into its domestic social outreach and went one step further by exporting it internationally.
Chapter 3
“See Our Arms, See Our Physicians”: The Algerian Health-Services Division
In March 1955, five months into the war, thirty-year-old doctor Michel Martini left Paris for Orléansville, a town 125 miles west of Algiers, to replace head surgeon Dr. Kamoun at the local hospital. This was not his first trip to Algeria. In 1946, he had accompanied his father, who went on business to oversee bank operations in Algiers, and it was during this initial visit that Martini “discovered” Algeria’s unique place within the French empire. He returned eight years later in May 1954 and spent one month working as a surgeon in Miliana Hospital. After exploring different employment opportunities, in December 1954 he took a surgical certification exam in Algiers that permitted him to take the position in Orléansville three months later.1
When Martini arrived at the hospital, he observed that the available equipment was sufficient for general surgery. However, the operating tables were old and outdated and the collection of operating instruments seemed to have been assembled piecemeal. If his hospital’s working conditions were any indication of the quality of public health in Algeria at the time, he wrote in his memoirs, then it bordered on rudimentary.2 For the first six months, he planned to get to know the residents of Orléansville (approximately 50,000 inhabitants, 8,000 of whom were European), who were still reeling from the massive earthquake the previous September. By and large, Martini was able to do this because, according to him, the region between Algiers and Oran was calm and outside the areas of military activity.3
Even though Martini claimed to be beyond the spheres of physical fighting through the summer of 1956, he confronted political and moral dilemmas that many medical professionals encountered during the war much sooner. On 22 December 1955, one of Martini’s Algerian colleagues, Masseboeuf, asked him if Mohamed Boudiaf, an FLN member, could stay with him. He was not seriously injured but he needed a place to hide for several days. Martini thought it prudent to check him into the hospital, where he could keep him over the Christmas holiday and run a number of tests. Reflecting on this incident many years later, Martini wrote that he was never convinced of the necessity of Boudiaf’s “hospitalization.” More likely, he thought, his comrades wanted to test his militant disposition before entrusting him with more important missions in the future.4
Michel Martini’s experiences, while unique, raise a number of important issues about the state of health services in Algeria in the early war years and the vacuum the FLN health services would try to fill. First, when he arrived in Orléansville, Martini was struck by the poor medical facilities and equipment at his disposal. For him, not only was this a clear indication that Algeria was underdeveloped but also that, “medically speaking, Algeria was not France.”5 As a result, the local population did not have adequate treatment centers or medical personnel to meet their needs. And second, the FLN did not yet have its own health-care division, and some of its members relied on medical staff to treat them and, in some cases, provide cover while they hid from French authorities. In the first twenty-one months of the war, the Algerian nationalists needed to call upon a diverse network of trained professionals in order to sustain their efforts.
But after the summer of 1956, the FLN was much more proactive about constructing its own health-services division in Algeria. Doing so was one of the ways in which the nationalists combated the French at home and carried out their domestic wartime strategy. Even though the French Special Administrative Sections medical sectors and companion programs aimed at winning the local population’s hearts and minds reported progress in this endeavor, they did not pose an insurmountable threat for the FLN. In fact, the Algerian leadership recognized that medicine and health care were vital necessities to claiming sovereignty of Algeria, and incorporated their provision into the national strategy.
This chapter argues that Algerian nationalists used the provision of medicine, health care, and personnel to win over the Algerian people and show them that the FLN was prepared to assume responsibility for their care. Nationalists built an organized and vibrant health-services division that they believed presented a viable alternative to that of the French administration and they anticipated that the Algerian people would choose its social services over those offered by the colonial state.6
The health-services division served two critical functions. First, it was a key component of the internal FLN strategy to establish and project state power in Algeria to Algerians. Consequently, the division’s duties targeted diverse groups within Algeria, including individuals who were sympathetic to the FLN as well as some who may have supported political rivals. Second, the health-services division sent a clear message to the people and the French administration that the nationalists were capable of building and running public welfare institutions, thus lending additional weight to their claims for sovereignty.
However, before the nationalists