Ringworm affair

Last updated

The ringworm affair refers to circumstances involving an alleged number of 20,000 to 200,000 Jews who were treated between 1948 and 1960 for tinea capitis (ringworm) with ionizing radiation to the head and neck area within Israel. The population suffering from the disease in Israel at the time was composed primarily of newly-arrived immigrants and populations who were expected to emigrate, mostly from North Africa, as well as some from Middle East and elsewhere, but many Jewish children were irradiated in their home countries regardless of their intent to emigrate. [1]

Contents

The irradiation of Mizrahi children is viewed by activists in Israel as the most salient example of injustices encountered in the 1950s as a result of shortcomings or irresponsibility on the part of authorities in the absorption in Israeli society of new immigrants.[ citation needed ]

A documentary about the affair, titled The Ringworm Children (Hebrew: ילדי הגזזת; Yaldei Hagazezet), was released in 2003. The film, which claims that 100,000 children received radiations doses thousands of times beyond what is safe, was lauded at film festivals. However, in 2018, the film's creator distanced himself from it, claiming that it "doesn't meet the scientific criteria." The exact number of Mizrahim who suffered health complications as a result of the treatment is unclear. A study by the Israeli Ministry of Health in coordination with UNICEF, who assisted in the purchase of x-rays for the project, estimated that 15,000 children were irradiated during this period. One non-profit established to represent patients asserts that the number is as high as 200,000.

Ringworm in Israel and Jewish communities

The scalp ringworm, also known as tinea capitis, mycosis, thrichophytia, and favus, was one of the most common fungal diseases in children in the Jewish communities in Israel and abroad since the 19th century. An X-ray treatment for ringworm has been used around the world as early as 1897. [2] An estimated 200,000 children worldwide received X-ray treatment for tinea capitis in accordance with the standard Adamson-Kienbock procedure between 1910 and 1959, until griseofulvin, the first effective anti-fungal agent for ringworm, was introduced. [3]

At the beginning of the 20th century, Hadassah Medical Center in Jerusalem treated ringworm disease among the religious Jewish community in Jerusalem using irradiation and the disease almost disappeared. [4]

With mass immigration from Arab and Muslim countries in the 1940s and 1950s, many new cases of ringworm surfaced, primarily among immigrant children from Asia and North Africa, due to crowded living conditions with deficient hygiene facilities. At this time, ringworm was still treated with irradiation, under the supervision of Hadassah Medical Center (Prof. Dostrovsky and Prof. Drukman).

The treatment regime increased the risk of cancerous and non-cancerous growths of the head and neck area years later among a portion of the patients. A number of research groups in Israel and the world have followed patients who were irradiated as children, in order to examine this group's susceptibility to cancerous growths. In Israel, this study was led by Professor Baruch Modan, who published an article in the medical journal The Lancet in 1974, in which Modan determined a strong causal linkage between irradiation of ringworm patients and the appearance of growths on the head and neck. [5]

In light of Modan's findings, in 1994 the Knesset passed a law requiring the Israeli government to provide compensation for damage to health resulting from exposure to such ringworm treatment. Compensation was available to patients (or their next of kin) treated with irradiation for ringworm between January 1, 1946, and December 31, 1960, and diagnosed with certain diseases as stipulated in the legislation. The law, however, placed the burden of proof on the claimant to submit factual evidence substantiating that they had received treatment – a proviso that generated public criticism.[ citation needed ]

The Ringworm Children

A documentary film in Hebrew entitled The Ringworm Children (Hebrew : ילדי הגזזת; Yaldei Hagazezet), produced by the Dimona Communications Center and directed by Asher Nachmias and David Balchasan, was released in 2003. In 2007, the film received the Best Documentary Film Award at the Haifa International Film Festival and was featured as a documentary at the Israel Film Festival in Los Angeles. [6] [7] The documentary harshly attacked Israel's medical establishment in the 1950s, branding the episode "the ringworm children's holocaust" (shoat yaldei hagazezet). It also harshly criticized the compensation law and the politicians involved in its passage.

Treatment of ringworm patients is viewed by Mizrahi activists in Israel as the most salient example of injustices immigrants encountered in the 1950s as a result of shortcomings, negligence, paternalism, or irresponsibility on the part of Israeli authorities in the reception and absorption in Israeli society of new immigrants.[ citation needed ]

It is stated in the documentary that the X-ray radiation used on the children was thousands of times beyond the maximum recommended dose [8] and it is suggested that the program was funded by the United States in order to test the effects of large radiation doses on humans.

The documentary states that 100,000 children were irradiated, and that 6,000 of them died shortly after receiving treatment. Therefore, the documentary alleged, the campaign against North African immigrants to Israel – prior to or following their arrival – was only part of an international phenomenon whose scope is still being uncovered.

In November 2018, the creator of the film, David Balchasan, stated in a television interview that the film was the result of "work that doesn't meet the scientific criteria", and that he "cannot stand behind it", as he considers himself an "honest man". [9]

Scientific findings

Research was conducted by medical historian Professor Shifra Shvarts, in the first decade of the 21st century, [10] Shvarts followed a handful of parenthetical references to international organizations in Israeli primary documents, uncovering a wealth of archival material in Hadassah and United Nations archives and subsequently in the archives of a growing list of countries.

During the years 1921–1938, there was a campaign among Jews in Eastern Europe (that is, among Ashkenazi Jews) in the course of which some 27,000 East European children were irradiated – in part to allow their families to emigrate, since ringworm was grounds for exclusion of immigrants to the United States and elsewhere. [11]

A key figure in formulation and organization of the ringworm campaign among the Jewish community in North Africa was Professor Moshe Prywes, who would later become president of Ben-Gurion University and the founding dean of BGU's Medical School. Prywes traveled to North Africa in 1947; following his findings there, he formulated a comprehensive program for eradicating contagious diseases among those planning to immigrate to Israel. The program was called T.T.T., for the three leading diseases the program would address: Tinea (Ringworm), Trachoma, and Tuberculosis. [12]

Parallel to irradiation for ringworm carried out during the 1950s in the State of Israel, irradiation for ringworm was also carried out among children in Yugoslavia (94,000), [13] in Portugal (30,000), and in Syria (7,000). [14] [15] About 4,600 children were irradiated for the disease between the years 1922–1958 in just one hospital in London. [16]

The primary agent behind these ringworm eradication operations was UNICEF, [17] which even assisted in the purchase of X-ray machines for this purpose. It supplied the two X-ray machines that operated in the immigrant intake and processing facility for immigrants in Israel, Sha'ar Ha'aliyah, nowadays part of Haifa. With the development of the drug griseofulvin for treating ringworm, UNICEF, as part of its policy devoted to eradicating contagious diseases among mothers and children, began funding the supply of the drug to all countries with a high incidence of ringworm.

There is a question of how many children of Moroccan origin actually suffered health issues as a result of X-ray ringworm treatment in childhood. Estimates in the aforementioned documentary film claim there were a hundred thousand persons or more. Others go even farther: a non-profit organization, established in 1999 to organize former patients and to ensure their compensation, [18] put the number of Mizrahi children irradiated at 200,000.

Reports submitted to UNICEF by the Israeli Ministry of Health, published in the medical news, state that the number of children treated with irradiation in Israel between 1948–1959 was approximately 15,000.[ citation needed ] Testimony exists that shows that children of Eastern European origin who were suspected of having ringworm were also irradiated. It is hard to know their numbers but they most likely numbered a few thousand.[ citation needed ] According to Giora Leshem, who was Professor Modan's statistical partner in his 1974 study (based on the Cancer Registry), it seems that the number of Moroccans who were irradiated was in the vicinity of 15,000 children.

See also

Related Research Articles

<span class="mw-page-title-main">Athlete's foot</span> Skin infection caused by fungus

Athlete's foot, known medically as tinea pedis, is a common skin infection of the feet caused by a fungus. Signs and symptoms often include itching, scaling, cracking and redness. In rare cases the skin may blister. Athlete's foot fungus may infect any part of the foot, but most often grows between the toes. The next most common area is the bottom of the foot. The same fungus may also affect the nails or the hands. It is a member of the group of diseases known as tinea.

<span class="mw-page-title-main">Griseofulvin</span> Antifungal medication used for dermatophytoses

Griseofulvin is an antifungal medication used to treat a number of types of dermatophytoses (ringworm). This includes fungal infections of the nails and scalp, as well as the skin when antifungal creams have not worked. It is taken by mouth.

<span class="mw-page-title-main">Terbinafine</span> Antifungal medication

Terbinafine, sold under the brand name Lamisil among others, is an antifungal medication used to treat pityriasis versicolor, fungal nail infections, and ringworm including jock itch and athlete's foot. It is either taken by mouth or applied to the skin as a cream or ointment. The cream and ointment are not effective for nail infections.

<span class="mw-page-title-main">Proton therapy</span> Medical Procedure

In medicine, proton therapy, or proton radiotherapy, is a type of particle therapy that uses a beam of protons to irradiate diseased tissue, most often to treat cancer. The chief advantage of proton therapy over other types of external beam radiotherapy is that the dose of protons is deposited over a narrow range of depth; hence in minimal entry, exit, or scattered radiation dose to healthy nearby tissues.

Dermatophyte is a common label for a group of fungus of Arthrodermataceae that commonly causes skin disease in animals and humans. Traditionally, these anamorphic mold genera are: Microsporum, Epidermophyton and Trichophyton. There are about 40 species in these three genera. Species capable of reproducing sexually belong in the teleomorphic genus Arthroderma, of the Ascomycota. As of 2019 a total of nine genera are identified and new phylogenetic taxonomy has been proposed.

<span class="mw-page-title-main">Tinea corporis</span> Medical condition

Tinea corporis is a fungal infection of the body, similar to other forms of tinea. Specifically, it is a type of dermatophytosis that appears on the arms and legs, especially on glabrous skin; however, it may occur on any superficial part of the body.

<span class="mw-page-title-main">Tinea capitis</span> Cutaneous fungal infection of the scalp

Tinea capitis is a cutaneous fungal infection (dermatophytosis) of the scalp. The disease is primarily caused by dermatophytes in the genera Trichophyton and Microsporum that invade the hair shaft. The clinical presentation is typically single or multiple patches of hair loss, sometimes with a 'black dot' pattern, that may be accompanied by inflammation, scaling, pustules, and itching. Uncommon in adults, tinea capitis is predominantly seen in pre-pubertal children, more often boys than girls.

<span class="mw-page-title-main">Chaim Sheba</span>

Chaim Sheba was an Israeli physician, notable for being the founder of Sheba Medical Center.

<span class="mw-page-title-main">Dermatophytosis</span> Fungal infection of the skin

Dermatophytosis, also known as ringworm, is a fungal infection of the skin (Dermatomycosis). Typically it results in a red, itchy, scaly, circular rash. Hair loss may occur in the area affected. Symptoms begin four to fourteen days after exposure. Multiple areas can be affected at a given time.

<span class="mw-page-title-main">KOH test</span> Test to differentiate between skin fungi

The KOH Test for Candida albicans, also known as a potassium hydroxide preparation or KOH prep, is a quick, inexpensive fungal test to differentiate dermatophytes and Candida albicans symptoms from other skin disorders like psoriasis and eczema.

<i>Trichophyton rubrum</i> Species of fungus

Trichophyton rubrum is a dermatophytic fungus in the phylum Ascomycota. It is an exclusively clonal, anthropophilic saprotroph that colonizes the upper layers of dead skin, and is the most common cause of athlete's foot, fungal infection of nail, jock itch, and ringworm worldwide. Trichophyton rubrum was first described by Malmsten in 1845 and is currently considered to be a complex of species that comprises multiple, geographically patterned morphotypes, several of which have been formally described as distinct taxa, including T. raubitschekii, T. gourvilii, T. megninii and T. soudanense.

Whitfield's ointment is an acidic ointment used for the topical treatment of dermatophytosis, such as athlete's foot. It can have a slight burning effect that goes away after a few minutes. It is named after Arthur Whitfield (1868–1947), a British dermatologist.

<i>Microsporum audouinii</i> Species of fungus

Microsporum audouinii is an anthropophilic fungus in the genus Microsporum. It is a type of dermatophyte that colonizes keratinized tissues causing infection. The fungus is characterized by its spindle-shaped macroconidia, clavate microconidia as well as its pitted or spiny external walls.

<i>Trichophyton tonsurans</i> Species of fungus

Trichophyton tonsurans is a fungus in the family Arthrodermataceae that causes ringworm infection of the scalp. It was first recognized by David Gruby in 1844. Isolates are characterized as the "–" or negative mating type of the Arthroderma vanbreuseghemii complex. This species is thought to be conspecific with T. equinum, although the latter represents the "+" mating strain of the same biological species Despite their biological conspecificity, clones of the two mating types appear to have undergone evolutionary divergence with isolates of the T. tonsurans-type consistently associated with Tinea capitis whereas the T. equinum-type, as its name implies, is associated with horses as a regular host. Phylogenetic relationships were established in isolates from Northern Brazil, through fingerprinting polymorphic RAPD and M13 markers. There seems to be lower genomic variability in the T. tonsurans species due to allopatric divergence. Any phenotypic density is likely due to environmental factors, not genetic characteristics of the fungus.

Non scarring hair loss, also known as noncicatricial alopecia is the loss of hair without any scarring being present. There is typically little inflammation and irritation, but hair loss is significant. This is in contrast to scarring hair loss during which hair follicles are replaced with scar tissue as a result of inflammation. Hair loss may be spread throughout the scalp (diffuse) or at certain spots (focal). The loss may be sudden or gradual with accompanying stress.

<span class="mw-page-title-main">Fungal folliculitis</span> Inflammation of hair follicles due to fungal infection

Majocchi's granuloma is a skin condition characterized by deep, pustular plaques, and is a form of tinea corporis. It is a localized form of fungal folliculitis. Lesions often have a pink and scaly central component with pustules or folliculocentric papules at the periphery. The name comes from Domenico Majocchi, who discovered the disorder in 1883. Majocchi was a professor of dermatology at the University of Parma and later the University of Bologna. The most common dermatophyte is called Trichophyton rubrum.

<i>Microsporum canis</i> Species of fungus

Microsporum canis is a pathogenic, asexual fungus in the phylum Ascomycota that infects the upper, dead layers of skin on domesticated cats, and occasionally dogs and humans. The species has a worldwide distribution.

<span class="mw-page-title-main">Carl Simon Fried</span> German doctor

Carl Fried was a medical doctor, who along with Lothar Heidenhain had systemized radiotherapy of benign diseases in the 1920s. In 1940 Fried wrote his book "Radium and Roentgentherapia". He was born in Bamberg to a Jewish family on July 22, 1889 and had two siblings, his sister Elsa and brother Stephan. His father, Wilhelm Fried was a hops-trader. He was one of the few published exile-poets in Brazil. In 2016, a special bronze plate was laid in memory of Dr. Carl Fried.

<span class="mw-page-title-main">Shifra Shvarts</span> Israeli professor

Shifra Shvarts, born in June 1949, holds the position of Professor Emeritus at the Center for Medical Education within the Faculty of Health Sciences at Ben-Gurion University. In addition to her academic role, she is a dedicated researcher specializing in the field of medical history. Shvarts holds significant positions as the Deputy Director-General of the International Society for the History of Medicine and as the Deputy Secretary General of the World Organization for the History of Medicine. Her research focuses on the examination of healthcare services' history and evolution in Israel, as well as the history of public medicine.

References

  1. ↑ Davidovich, Nadav; Zalashik, Rakefet (September 2011). "HEALTH, RACE AND NATION BUILDING: THE CASE OF MASS RINGWORM IRRADIATION IN ISRAEL". Korot: 135. ISSN   0023-4109. Ringworm treatment was not taking place only in Israel. Already abroad, either as part of the medical processing conducted before the arrival to Israel or as part of Jewish medical aid conducted by organizations such the JDC and OSE, Jewish children were screened and irradiated, if necessary. This time, the main group screened and irradiated was that of Jews emigrating from Muslim countries. After World War II, with the killing of the majority of European Jewry, the gaze of Jewish aid agencies shifted to the East. The JDC and OSE were very active in public health campaigns among the Jewish populations in Morocco, Libya, and Tunisia.
  2. ↑ Rosenthal, Theodore (1960-12-01). "Perspectives in Ringworm of the Scalp: Treatment Through the Ages". Archives of Dermatology. 9: 431–448. doi:10.1001/archderm.1960.01580060005001. ISSN   0003-987X. PMID   13743501. Archived from the original on 2022-02-21. Retrieved 2022-02-21.
  3. ↑ Shore RE, Moseson M, Xue X, Tse Y, Harley N, Pasternack BS (April 2002). "Skin cancer after X-ray treatment for scalp ringworm". Radiat. Res. 157 (4): 410–8. Bibcode:2002RadR..157..410S. doi:10.1667/0033-7587(2002)157[0410:SCAXRT]2.0.CO;2. ISSN   0033-7587. PMID   11893243. S2CID   11577550.
  4. ↑ Dostrovsky, Ringworm in Jerusalem’s Schools, Education (Ha'Chinuch, Hebrew), 9(1926) (p. 98.).
  5. ↑ Modan B, Baidatz D, Mart H, Steinitz R, Levin SG (February 1974). "Radiation-induced head and neck tumours". Lancet. 1 (7852): 277–9. doi:10.1016/S0140-6736(74)92592-6. PMID   4130470.
  6. ↑ "THE RINGWORM CHILDREN (20th Anniversary Israel Film Festival)". israelfilmfestival.com. Archived from the original on 2004-04-22.
  7. ↑ "The Ringworm Children (FANDANGO)". fandango.com. Archived from the original on February 11, 2010.
  8. ↑ Israel Insider - Ringworm and Radiation
  9. ↑ "פנים אמיתיות: סודות הגזזת" [Real face: The secrets of ringworm]. 10.tv (in Hebrew). Archived from the original on 2018-12-04. Retrieved 2019-01-21.
  10. ↑ Shvarts S., "Israel Health Policy and the Ringworm Case 1948–1959: New Findings - New Context", The 25th Association of Israel Studies Conference, Beer Sheva, June 2009
  11. ↑ Shvarts, Shifra; Romem, Pnina; Romem, Yitzhak; Shani, Mordechai (April 2009). "[The forgotten ringworm campaign of OZE-TOZ in Poland]". Harefuah. 148 (4): 265–270, 275, 274. ISSN   0017-7768. PMID   19630352. Archived from the original on 2022-02-21. Retrieved 2022-02-21.
  12. ↑ Moshe, Prywes (1995). Prisoner of hope. Jerusalem: Brandeis Univ. Press. pp. 178–190. ISBN   9780874516531.
  13. ↑ Grin, E. I. (1961). "Epidemiology and control of tinea capitis in Yugoslavia". Transactions of the St. John's Hospital Dermatological Society. 47: 109–122. ISSN   0036-2891. PMID   13901969. Archived from the original on 2022-02-21. Retrieved 2022-02-21.
  14. ↑ Shvarts S, Sevo G, Tasic M, Shani M, Sadetzki S (August 2010). "The tinea capitis campaign in Serbia in the 1950s". Lancet Infect Dis. 10 (8): 571–6. doi:10.1016/S1473-3099(10)70107-9. PMID   20670904.
  15. ↑ Ignjatovic B. [Mycotic diseases in Serbia (Tinea Capitis): Modern Campaign on their eradication.] Antimycotic Campaign in Serbia. [Library of the Institute of Hygiene of the People's Republic of Serbia.] Belgrade; 1959; 1–91. (In Serbian with English summary).
  16. ↑ Shanks, S. C. (April 1967). "Vale epilatio. X-ray epilation of the scalp at Goldie Leigh Hospital, Woolwich (1922-58)". The British Journal of Dermatology. 79 (4): 237–238. doi:10.1111/j.1365-2133.1967.tb11480.x. ISSN   0007-0963. PMID   5337583. Archived from the original on 2022-02-21. Retrieved 2022-02-21.
  17. ↑ UNICEF Archives, CF/HST/MON/1989-003.
  18. ↑ "אז מה זה גזזת?" [So what is ringworm?]. gazezet.org.il (in Hebrew). Archived from the original on 2018-12-20. Retrieved 2022-02-21.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.