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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 However, the operating tables were old and outdated and the collection of operating instruments seemed to have been assembled piecemeal.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 were able to offer medical services to the people, they first had to work through internal FLN party divisions between 1954 and 1956. The FLN-ALN domestic Services de Santé (hereafter referred to as the health-services division) developed slowly during this time but expanded significantly following the May 1956 strike and the August 1956 Soummam Congress. These events contributed to transforming the FLN-ALN health-services division by increasing the number and visibility of doctors, nurses, and medical assistants committed to fighting for liberation. Furthermore, it helped the FLN gain legitimacy over competing political groups in Algeria.

The domestic medical sector repeatedly encountered obstacles, including French officials’ seizure of medical supplies, Algerian doctors’ arrests, and limited skilled health-care professionals. These challenges are not surprising in an imperial context. However, the nationalists continually cast themselves as modern statesmen dedicated to managing public health. They did this by issuing detailed instructions and directives regarding medical protocol, surgical procedures, treatment plans, and hygienic practices, all of which presented a stark contrast and direct rebuttal of colonial representations of the FLN. Though not as extensive as the French health sector in Algeria, nationalists integrated the health-services division with its army and combined forces with international doctors to reach a large number of people across the country and documented their outreach in pamphlets and newspaper articles in a calculated attempt to bolster sovereignty claims. The FLN developed a medical sector before it had a fully functioning government, highlighting a vital component of the nationalists’ state-building project at home. Moreover, it demonstrates the leadership’s attention to the high stakes of being able to take care of the people’s welfare.

FLN-ALN Medicine and Health Care, 1954–1956

The FLN became the dominant mouthpiece of the anticolonial struggle but it did not start off that way nor did it enjoy uniform support. The lack of political consensus, especially during the first two years of the war, had far-reaching consequences on medical services in Algeria and hampered the kind of care the FLN was able to administer to soldiers and civilians.