In examining these data on the Middle East and North Africa, I have attempted to connect spatial patterns of disease incidence with characteristic fea tures of the local environments. The study has indicated how the geography, topography, and resulting climates have been used and misused by humankind over time. The negative aspects of all these factors led to low populations in this region until very recently. With the introduction of hydroelectric power and petroleum, the ensuing industrialization has enabled even greater proportions of the populations to live on the seacoast or river banks, and to develop urban centers.

The disease ecologies resulting from the peculiar rural environment, mainly with insufficient water; the specific problems of overcrowded, spatially limited living areas near water; and the general nutritional deficiencies of poor economies have now been augmented by increasing population. This phenomenal population rise following the establishment of post—World War II stability has especially aggravated conditions of overcrowding, substandard housing, and sanitation and poor nutrition in the urban communities. Although the economic and political patterns of the region vary among the countries, the interrelationships of many of the other factors remain similar.

LaVerne Kuhnke

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