Global Health Histories

New series of lunchtime seminars launched with Wellcome Trust support

2008

Seminar 19: The United Nations Relief and Rehabilitation Administration (UNRRA) and the 'world task in public health' after the Second World War
Jessica Reinisch (Birkbeck College, University of London), Sanjoy Bhattacharya (Wellcome Trust Centre for the History of Medicine), Thomson Prentice (Global Health Histories, WHO)

In the opening presentation to a capacity audience, Dr Jessica Reinisch, of Birkbeck College, University of London, drew a vivid and detailed picture of the enormous humanitarian crisis that emerged at the end of the Second World War.

She described the unique public health role of the United Nations Relief and Rehabilitation Administration, a predecessor to the World Health Organization, in providing medical and food aid to help many of the 60 million people left homeless or helpless across Europe's devastated landscapes.


Seminar 20: Climate change, health and disease in the forests of Africa
Dr James Fairhead, professor of social anthropology at Sussex University, England

New research in West and Central Africa suggests that the effects of climate change on forests there have been underestimated. The forests are far more sensitive to climate change than has been appreciated, with implications for modern analysis of links between climate, forests and health, particularly the risks of epidemic diseases linked to vegetation. The research also challenges a "hidden racism" in previous studies which wrongly represented huge numbers of African land users simply as destructive and failed to appreciate their skills in enhancing and shaping forest cover. Professor Fairhead discusses his findings.


Seminar 21: Marcel Proust and the global history of asthma
Prof. Mark Jackson, Director of the Centre for Medical History, University of Essex, England

The French novelist Marcel Proust (1871-1922) was plagued by asthma and hay fever from childhood. His ill- health reinforced contemporary beliefs that asthma and other allergic conditions were `aristocratic diseases', largely confined to the elite and educated. By the late 20th century, however, the social geography of asthma had shifted dramatically. It has become a disease of poverty, triggered by poor housing, polluted environments, unhealthy diets, and social deprivation.

What factors led to this apparent transition in asthma's character and social distribution? This paper considers evidence of rising levels of asthma in Western countries during the mid-20th century, increasing prevalence and severity among immigrant groups in post-war American cities; sharply rising mortality rates amongst young asthmatics during the 1950s and 1960s, and growing awareness of the global spread of asthma into developing countries. It also looks at evidence uncovered by surveys coordinated by the WHO's immunology unit.


Seminar 22: A Terminal Case? Cold War Politics and the 1951 Closure of the International Health Division of the Rockefeller Foundation
Professor Paul Weindling, Oxford Brookes University, England

In 1951 the Rockefeller Foundation abruptly closed down its International Health Division, which for almost 40 years had operated against malaria, yellow fever and other diseases in many countries. Did this closure signify weaknesses in the Division's approach to medical interventions, or a broader disillusionment with international health activities? How much did the Cold War cause a reappraisal of the Foundation's activities? To what extent did WHO take on some of its responsibilities? In this presentation, Professor Weindling, an expert on international health in the 20th century, reviews the background and causes of the closure, and goes on to raise wider issues of international health policies in the Cold War era.


Seminar 23: In Pursuit of the Nazi Mind: Psychology, Psychoanalysis and Politics 1940-1950
Professor Daniel Pick, Birkbeck College, University of London

Soon after World War II, WHO's first Director-General, Brock Chisholm, said: ‘The world was sick, and the ills from which it was suffering were mainly due to the perversion of man, his inability to live at peace with himself.’ In this presentation, Daniel Pick suggests that this so-called world ‘sickness’ or ‘perversion’, so deeply influenced by the experience of fascism, created an important new role for clinicians in war-time and post-war politics. Debates about Nazism and ‘denazification’ became linked with questions of individual and collective mental health.

Various post-war international organisations found themselves charged with restoring not just prosperity and social order, but a sense of collective sanity. Yet the idea of sanity itself also came under renewed scrutiny. Some claimed that Nazism required a new representation of the psyche, and of group psychology. What was the evidence for an ‘authoritarian personality’? What were the consequences of work on political psychopathology? How did specific case studies undertaken of Hitler, Hess and other leading Nazis contribute to post-war understandings of the mind and the group? And, finally, if fascism really was viewed as a kind of sickness, what prospects could there ever be of a cure?


Seminar 24: Towards a history of psychotherapy
Dr. Sonu Shamdasani, The Wellcome Trust Centre for the History of Medicine at UCL, UK

The promotion of mental health has always been a key objective of the World Health Organization. Indeed, WHO's first Director-General, Dr Brock Chisholm, was an internationally-renowned psychiatrist. For individuals in developed societies, mental health has been widely pursued through psychotherapy. Yet psychotherapy presents itself today in a plethora of forms, with little consensus as to its aims, procedures and rationales. This presentation questions how this situation arose. It reconstructs the rise of psychotherapy in medicine, neurology and psychology from the mid-19th century onwards in Europe and North America. It traces the rise of electrotherapy, hypnosis, moral treatment and transformations in medical and psychiatric practice. It explores how the term ‘psychotherapy’ increasingly became used as a label for a variety of practices, before coming to be perceived as a distinct entity in its own right through the rise of specific institutions. Today's presentation considers the contemporary implications of these issues.


Seminar 25: Professionalism and prestige: a British perspective on international nursing organization in the 20th century

For many years, British nurses were able to capitalize on the international reputation of Florence Nightingale (1820-1910), the "Lady with the Lamp" heroine of wounded soldiers in the Crimean War, as a model for nurse training. The nursing establishment took an unashamedly imperialist view of the relations between British nurses and those of other countries.

Presenters Anne Crowther and Susan McGann have been researching the history of the Royal College of Nursing, founded in Britain in 1916, and its extensive international connections, including educational courses provided by the College specifically to train an "elite" of foreign nurses in British nursing practice. However, this influence came under growing pressure by the mid- 20th century as more academic approaches to nurse training began to dominate.

This presentation explores the RCN’s relations with bodies such as the International Council of Nurses, the United Nations Relief and Rehabilitation Administration, and the World Health Organization, and raises questions on the status of nursing in national and international health services.


Seminar 26: The fruits of a new internationalism?: South Asian governments, the WHO and global smallpox eradication
Dr Bhattacharya (Wellcome Trust Centre for the History of Medicine), England

Smallpox eradication is widely regarded as the greatest triumph of global public health in the 20th century. The achievement – formalized by the World Health Assembly in 1980 – was a monumental one. Smallpox killed on a large scale and maimed many survivors for life. This lecture fcouses mainly on the national smallpox eradication projects in the South Asian sub-continent in the 1960s and the 1970s which received protracted attention from WHO and its international partners. Sanjoy Bhattacharya raises provocative questions often ignored by recent chroniclers of the programme. How did it develop, often in surprisingly unintended ways and directions? What were its organizational weaknesses and strengths? What strategies were deployed in the field and how were they adapted in different contexts? His presentation also considers lessons provided by the history of smallpox eradication – and the important strategic information it can provide to those involved in contemporary global health projects such as polio eradication and primary health care.

History of smallpox meeting, The Wellcome Trust Centre for the History of Medicine, London

Seminar 27: The rise of the global health consultant: The life and times of Brian Abel-Smith (1926-1996)
Dr. Sally Sheard, Liverpool University, England

Brian Abel-Smith, a health economist and political adviser, was closely connected with the development of international health and social welfare policies in the 20th century. From his seminal research on the cost of the British National Health Service in 1956, he quickly developed a reputation within WHO for his valuable reports and advice. His research focused on the determinants of health, health service planning and financing, and securing user-friendly services. He pioneered international comparisons on health services finance for WHO, and visited over 80 countries on WHO's behalf. From 1983-86 he was a senior adviser to WHO Director-General Halfdan Mahler on the economic strategy for the Health For All programme. This talk uses the historical context of Abel-Smith’s work to provoke discussion on contemporary issues for WHO: how it solicits advice from external consultants, how networks of knowledge develop, and the capacity of individuals to effect change within global systems.


Seminar 28: The urban animal: population density and social pathology in rodents and man
Dr. Edmund Ramsden, Research Fellow, The Centre for Medical History, University of Exeter

Laboratory rats undergo alarming changes in behaviour when their population density is increased, including violence, sexual deviance and withdrawal. The "social patholgies" of such experiments in the early 1960s, led by ecologist John B. Calhoun in the USA, provoked fierce debate about the implications for people who might find themselves under similar real-life stresses - with concerns about human population growth, environmental degradation, urban violence, and mental breakdown. Some experts and commentators argued for reducing population growth through the use of birth control. Others called for the design of cities with lower densities. This presentation looks back at efforts in the social sciences and policy professions to apply Calhoun's research to the problems of mankind in an increasingly overpopulated and urbanized world, and the lessons that can be learned.

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