Held at the Royal Society of Medicine over two days, After the End of Disease brought together historians of medicine and global public health, anthropologists and sociologists with policy makers to think past the conventional narrative curve of epidemics and disease in general. The overall aim of the event was to initiate a fruitful discussion on how various academic analyses and perceptions of what happens after the end of disease can inform current global health policies of eradication and epidemic management, and in turn, how the experiences of practitioners in global public health may provide insight and further the understanding of the historical trajectories and ethnographic, and sociological studies of ending diseases.
The conference opened with a public event at the Wellcome Collection’s Reading Room: a screening of the director’s cut of In the Shadow of Ebola, a film by Gregg Mitman (U f Wisconsin) and Sarita Siegel (Alchemy Films). The film was followed by a roundtable discussion with the participation of the filmmakers Patricia Kingori (Oxford), Jessica Reinisch (Birkbeck) and Karen Wells (Birkbeck).
The following two days gave way to discussions on epidemic preparedness, failure, experiences and theoretical concepts of temporalities, and problematic beginnings as well as endings. The first panel opened the discussion by placing in the focus and questioning what we understand under the terms after, end and disease and why thinking critically about these definitions and concepts matter. Jessica Reinisch (Birkbeck) addressed the complexity and fluidity of the postwar era, Catherine Kudlick (U San Francisco) argued for a disability history perspective when considering the end of epidemics, while Julie Livingston (NYU) turned to comorbidity to interrogate disease categories. Zooming in on particular problems and diseases, subsequent panels addressed global health issues from WHO reports to Cold War politics of freezing smallpox specimens. Anthropologist Frederic Keck (CNRS) unpacked storage and stockpiling in global flu management as techniques of perpetual beginnings and endings of epidemics. Sociologist Andrew Lakoff (U Southern California) analysed the post-choc report of the WHO on the Ebola crisis and argued that it is as much of a tool for retrospective allocation of blame, as a tool of preparedness for unknown future outbreaks in mapping potential organizational responses. Several papers dealt with polio epidemics: historian Naomi Rogers (Yale) addressed disability activism that rested on the ending and forgetting of polio epidemics in the United States, while Stephen Bance (U College Dublin) presented the Irish perspective on polio rehabilitation and the blurred endings of the disease, Juan Rodriguez-Sanchez (U Salamanca) argued that post-polio syndrome is at once a disease that never ended and the beginning of a new one, and Nadav Davidovich and Anat Rosenthal (Ben Gurion U) interrogated definitions of an outbreak through the case of a recent Israeli vaccination campaign. Many of these papers pointed to populations that are left out of, or are neglected in narratives of the end of disease. Robert Aronowitz (U of Pennsylvania) turned to another aspect of exclusion in epidemic and disease endings and demonstrated structural global disparities in infectious diseases, cancer and public health problems like tobacco use that arise from diseases disappearing in one part of the world – but shifting to another. Tuberculosis, a (mostly) curable disease that has mostly vanished from the global North and remains a major global public health problem in the South was the focus of another set of papers. Anthropologist Bharat Venkat (Princeton) analysed scenarios of a post-antibiotic era in tuberculosis treatment in India, while historian Sarah Blacker (MPIWG) turned to the ethnic politics of tuberculosis control in Canada. Janina Kehr (U of Zurich) took the case of a French woman’s astonishment and bodily experience of being diagnosed with TB to embark on a philosophical approach in applying Agamben’s concept of messianic time to understanding the temporalities of disease. The consequences of the disappearance of certain diseases from the global epidemic landscape led several Katherine Vongsathorn (U of Warwick) recounted changing attitudes and access to care in leprosy in Uganda, health policy expert and medical anthropologist Jennifer Palmer (LSHTM/U of Edinburgh) discussed the global development and local uses of rapid test diagnosis in sleeping sickness, while Jeremy Greene (Johns Hopkins) and Dora Vargha (Birkbeck) introduced the concept of ‘newly neglected disease’ through an analysis of faltering access to diphtheria antitoxin and the decay of global pharmaceutical infrastructure. Others focused on representations of diseases and their endings. Joanna Radin (Yale) showed how certain elements of the Cold War have been perpetuated in the frozen smallpox vials in Russian and American freezers, and placed fears associated with the return of the epidemic within science fiction, while Lukas Engelmann (Cambridge) analysed visual representations of AIDS and its “unseeing”. Many papers addressed the epidemic narrative in a broader sense and discussed beginnings of disease together with their endings. The complexity of distinguishing beginnings and endings of epidemic cycles was the focus of the paper presented by Christos Lynteris (Cambridge), Robert Peckham (Hong Kong U) showed convergences of beginnings and endings through SARS in SAR (“Special Administrative Region”, the official status of Hong Kong).
The panels, conversations and debates showed the manifold ways in which rethinking the epidemic narrative can contribute both to academic scholarship and to global health. Combining approaches from anthropology, sociology, philosophy, history and visual culture, the discussions marked the beginning of a meaningful, interdisciplinary collaboration that will surely continue in the future.
As part of the After the End of Disease conference, The Reluctant Internationalists and the Birkbeck Institute for Humanities are proud to present In the Shadow of Ebola, a film by historian of medicine Gregg Mitman and filmmaker Sarita Siegel on May 25 at Birkbeck Cinema. The film screening will be followed by a panel discussion with the participation of the directors of the film and Jessica Reinisch (Birkbeck), Patricia Kingori (Oxford) and Karen Wells (Birkbeck). The event will be free and open to the public.
For more information on the After the End of Disease conference, see website.
In the Shadow of Ebola is the gripping story of a Liberian family kept apart by the Ebola outbreak in a nation still reeling from the chaos of civil war. We follow a Liberian student and his family living divided between the United States and Liberia. As the crisis unfolds, loved ones are isolated in Monrovia where the government is shut down, schools and markets are closed, and food prices are rising.
Liberians find themselves fighting an invisible war that is painfully reminiscent of the chaos and confusion of the fourteen-year Liberian civil war, which ended a mere decade ago. When the Liberian government responds to the crisis initially with military-enforced quarantines and curfews, mistrust and anger among Monrovia’s residents grow.
As the death toll from Ebola climbs, and a quarantine results in the shooting and death of a 15-year old boy, mistrust and disbelief are replaced by compassion and inner resolve to combat the spread of the virus. With international aid slow to arrive, Liberians turn to each other for help, as healthcare workers, musicians, and artists join forces on the front lines in public health education campaigns. The steps toward community empowerment and action help to build trust and stabilize the number of new Ebola cases. But the ripple effects—food insecurity, overwhelmed medical infrastructure, and economic isolation—endure.
In a timely piece just two days after the terrorist attacks in Paris, Darcie Fontaine reflects on the place of non-white, non-Christian minorities in France and France’s vision of itself.
In the wake of the dramatic and deadly terrorist attacks across the city of Paris this past Friday night, for which the Islamic State claimed responsibility, the French public and politicians across Europe struggled to come to terms with the potential ties between the militants and the wave of Syrian refugees who have been flooding into Europe over the past several months. Reports that a Syrian passport belonging to a man who entered Greece with a wave of Syrian migrants in early October was found near the bodies of two jihadis at the Stade de France led European leaders to make the threat of ISIS infiltration among migrants and refugees a key topic at this weekend’s G20 summit in Turkey. Additionally, right-wing officials across Europe have renounced any future plans to aid Syrian refugees in Europe. On Saturday, Marine Le Pen, leader of France’s extreme right-wing National Front party spoke out in favor of tighter border controls in France and the European Union, while analysts suggest that French President François Hollande, a Socialist, will also take a similarly hard line on domestic security and border control. According to The New York Times, Le Pen also declared, “Fundamentalist Islam must be wiped out. France must ban Islamist organizations, close radical mosques, and kick out foreigners who are preaching hatred on our soil, as well as illegal immigrants who have nothing to do here.” News that at least one member of the three coordinated terrorist teams was a French-born Muslim of Algerian descent from the suburbs of Paris, who had been under observation by the French police for his ties to radical Islamists in France, further solidified the connections that many in France have long made between Muslim immigrants to France (and their children who are born there) and terrorism.
While these attacks will create an even more complicated situation for the Syrian migrants spread out all over Europe, it also does not bode well for the many thousands of migrants already housed on French soil. The precarious situation of these migrants was also highlighted this weekend when a massive fire broke out in the migrant camp in Calais in northern France, which currently houses nearly 6,000 migrants from the Middle East, North and East Africa, according to the prefect of the Pas-de-Calais region. Although French officials have repeatedly stressed that it had nothing to do with the Paris attacks (it was an electrical fire that was contained and did not cause any deaths), the living quarters of more than forty families were completely destroyed.
Although the dire situation in the sprawling migrant camps in Calais has recently received widespread international attention, it is not a new phenomenon, nor one that emerged primarily in response to the Syrian refugee crisis. As Jessica Reinisch discussed recently on this blog, the situation in Calais is an ongoing crisis that fits within a global geography of displacement. Yet, it is also a crisis rooted within specifically French contestations over immigration, asylum, and identity that have their roots in France’s colonial empires and the aftermath of decolonization.
Even with the closing of the Sangatte center in Calais in 2002 and the consistent dismantling and rebuilding of the “jungle” of camps that emerged in its place, the situation in Calais was tolerated because the “migrants” who went there were always in transit to somewhere else. But the situation has changed this year. In the past, unless you went directly to Calais or worked with migrants in the “retention centers” where they were administratively held pending deportation, the “migrant crisis” was an abstract political problem for the vast majority of the French population. This past summer, however, it became much more concrete, particularly for Parisians: as one Parisian friend reported to me, “Paris looks like a refugee camp.”
At dawn on June 2, 2015, French police evacuated a camp of over 350 African migrants, mostly Sudanese and Eritreans, that had been slowly building over several months under the metro bridge of La Chappelle in north central Paris. While the migrants were put onto buses and taken to emergency housing, their tents were bulldozed, for what the police chief claimed were “hygienic” reasons and to avoid “threats to public order.” A second massive camp near the Gare d’Austerlitz was evacuated in mid-September.
The fate of these migrants is dependent on their legal status in France. Marie Doezema of Al Jazeera reported in June that roughly 100 of the migrants from La Chappelle had presented documentation that they were seeking asylum in France. If they do not leave France imminently, the rest will be viewed as illegal immigrants, taken to retention centers, where they will risk deportation. But even applying for asylum is not a clear and easy proposition.
In the 1990s, France began to “crack down” on illegal immigration through both legislation and more active policing. The Pasqua laws of 1993 introduced what became known as the government’s “zero immigration” policy, which made it extremely difficult for foreigners to gain legal status in France. For instance, the law now required proof of uninterrupted housing and employment to renew visas. It also took away the right of those born on French soil to French citizenship; children born in France to foreign parents now had to wait until age 18 to request French nationality. These laws were aimed primarily at stemming the flow of immigration from France’s former African colonies, and the key target was North African immigrants. The Pasqua laws did not emerge in a vacuum but were the result of growing anti-immigrant sentiment both within right-wing political movements and within the population in general. For example, in 1988, the far-right National Front leader Jean-Marie Le Pen won more than fourteen percent of the vote in the first round of the presidential election while campaigning on an anti-immigration platform. The focus on stemming North African immigration was a reaction to the growing violence of the Algerian Civil War and the cultural tensions within France about the status of France’s Muslim community.
While North Africans had long formed the bulk of labor migrants to France, beginning in the First World War, the decolonization of Algeria in 1962 set in motion larger waves of both labor and permanent migration, including family reunification. Migrants from France’s other former colonies, including sub-Saharan Africans and refugees from Vietnam also sought both economic advancement and political asylum in their former colonial metropole. After World War II, France experienced booming economic growth of the so-called “trentes glorieuses,” which meant three decades of underemployment. France accepted hundreds of thousands of labor migrants in this period. The economic crises of the early 1970s, however, transformed France’s relationship to immigration. In 1974, France officially ended its labor migration policy. Although immigrants continued to arrive in France after 1974 – some through family reunification, some seeking asylum, and some illegally – the discourse on immigration began to shift in the 1980s away from labor. Instead, officials were concerned about social tensions and the dangers of second-generation “immigrant” youth who failed to assimilate into French society. In the early postwar period, many thousands of migrants who came to work in French factories lived in shantytowns on the outskirts of major industrial French cities, but by the early 1970s, they began to move to the HLMs, or French subsidized housing in the banlieues, or the suburbs. The concentration of immigrants in public housing in the banlieues, many of which lack good access to public transportation, has come to signify their exclusion from French society; the term banlieue itself has come to mean “ghetto” rather than “suburb.” Numerous incidents over the past few decades have inflamed tensions between residents of the banlieues and French police, and the prevalent conception within French society is that the banlieues spawn political and religious radicals, notably islamists.
The perception that the growing numbers of immigrants are Muslims whose religious practices and beliefs seem foreign to French Republican values has fueled the sorts of terminological confusions in which the word “immigrant” stands in for “Muslim,” and “Muslim” stands for “danger” to French national culture, which is defined as secular. Treating French Muslims as perpetual “immigrants,” even those who have been citizens and assimilated into French society for generations, has led to growing cultural conflicts between France and its non-white citizens. These conflicts have ranged from French legislation that regulates visible religious symbols, more colloquially known as “headscarf laws,” to the 2015 Charlie Hebdo attacks. While the Pew Research Center has noted that there was no public backlash against French Muslims in the wake of the Charlie Hebdo attack, and that French opinion toward Muslims marginally increased (rising to 74% of the French population who have a favorable view of Muslims living in their country, from 72% in 2014), the assimilation of non-white, non-Christian immigrants into French society continues to be a major political issue. It also directly affects the contemporary migrant crisis in Europe.
Because France’s immigration policies since the 1990s have been framed largely in terms preventing the arrival of new immigrants, the current migrants who are seeking refuge in France are not finding a particularly hospitable environment. In a poll conducted by Odoxa for the French newspaper Le Parisien-Aujourd-hui in September 2015, 55% of those surveyed opposed easing rules for Syrian migrants seeking refugee status in France. The divisions were quite stark, however, along the political divide, with 69% of those identifying as politically “left” and 30% on the “right” supporting easing the rules. The French population generally seems to see the migrants not so much as political refugees but rather as potential economic migrants or simply as Muslims, who will not integrate into the French nation because of their religion. French National Front leader Marine Le Pen has also stirred up anti-immigrant sentiment, arguing that the plight of Syrian refugees, and specifically the photo of the drowned Syrian toddler Aylan Kurdi washed up on a Turkish beach, was not enough to change French policies toward migrants or political asylum. Le Pen instead claimed the refugee crisis was a plot by Germany to “rule” the French economy and “recruit slaves” and that France did not have the means to provide aid for “the world’s misery.”
As anthropologist Didier Fassin and sociologist Estelle d’Halluin have argued in a 2005 article in American Anthropologist, the shifting political situation and immigration laws in France during the 1980s and 1990s directly affected the meaning and politics of asylum as well. They write, “Although in France, during the 1970s, up to 95 percent of all seekers were granted refugee legal status, this rate rapidly declined in the 1980s and 1990s—dropping to as low as 12 percent for the administrative evaluation and 18 percent when taking into account the appeals. This dramatic evolution has lead to (1) an unprecedented increase in undocumented foreigners, corresponding to dismissed asylum seekers; (2) a worrying development of spaces of exception at the national borders, to contain the unwanted immigrants before they can even present their case; and (3) a growing suspicion toward all asylum seekers.” In granting asylum, France now considers the body and visible medical trauma as the main evidence of need to grant asylum. Those without that evidence are often rendered uncredible, and not granted political asylum. If they stay in France, they simply become illegal immigrants and subject to deportation. According to Eurostat, in 2014, France received 37,085 asylum applications, of which only 4,245 (or 11.4%) were given Geneva Convention asylum status. Whether that will number will increase in the future, especially given the specific conditions of the growing migrant crisis is difficult to say.
Certainly there are numerous immigrant rights associations and even strong suggestions of political will within the French population to help migrants and refugees. However, the current crisis cannot be understood outside the context of the decades-long series of cultural debates and political policies that reflect a deep division within French society over how non-white, non-Christian minorities fit within French society and within French conceptions of national identity. While migrants in Calais were out of sight and consistently perceived as “in transit,” they posed less of a threat than did Muslim French citizens, who were treated as “immigrants.” While accepting Syrian and African refugees into France and potentially even granting them political asylum could ease their immediate material concerns, simply shoving them into HLMs, which are very often in the banlieues of major cities, would not improve their political or social status in the eyes of those who fear that these refugees or migrants will bring Islamic terrorism to France or seek their jobs. The current migrant crisis for France is not just a material crisis but one that will test France’s vision of itself and its place in the world. For the migrants themselves, the path to a permanent life in France is paved with roadblocks, especially after this newest wave of terrorist attacks.
Darcie Fontaine is assistant professor working on French colonial history and women and gender history at the University of South Florida.
In this post, Dora Vargha examines the battles over historical traditions and memories as fought out in Hungarian politics today. The refugee crisis is just the tip of the iceberg.
As Jessica Reinisch pointed out in her essay, using historical precedents and applying a simplistic “history repeats itself” outlook is often more harmful than beneficial in informing public discourse and policy making. Quite rightly so, we should be wary of political commentary and reporting that does away with particular historical contexts and disregards social, cultural and political complexities of past situations: through a simple analogy, this kind of historicizing presents currents issues in a clean-cut way, which can be simplistic or downright misleading.
But what happens when history is completely missing from the conversation and historical references are consistently skewed or resisted in political discourse? What is the significance of a government’s outright refusal to engage with certain historical precedents at the expense of others? The stakes of not addressing some central historical aspects of a crisis, such as the case in the refugee situation in Hungary, are as high as those that lie in the “misuse” of historical context. In the following I take a closer look at an issue Friederike Kind-Kovacs raised in her blog post to explore these questions, particularly why, as she argues, “the Hungarian government refuses to draw any comparisons between Hungary’s own refugee crisis and the current situation that could possibly trigger feelings of solidarity or compassion”. At a closer look, the historical references and absences surrounding the refugee crisis in Hungary reveal broader questions of political ownership over certain historical events and the flexibility of historical narratives in constructing political identity.
The past refugee crisis in focus is, again, the 1956 revolution in Hungary. Over 200,000 people left the country in a matter of days in the upheaval of the revolution that broke out 59 years ago on October 23. Particularly in recent months, international and Hungarian press and activists have frequently cited this historical precedent as the Hungarian government pursued anti-immigration campaigns and built a fence on the southern border of the country. Former Hungarian refugees, like the co-founder and past CEO of American computer company Intel, Andrew Grove (born András Gróf), have been put forth as examples of the contribution refugees can make to economies and societies. Moreover, 1956-ers themselves have spoken out against current Hungarian policies and practices, recalling the great importance of a welcoming hand in their plight.
The reason why the story of the 1956 refugees has occupied center stage, both on the national Hungarian and international scale, is the same reason why the government of Viktor Orbán has consistently refused to participate in any conversation regarding the revolution in the context of refugees: the revolution of 1956 has always featured prominently in the self-definition of Fidesz, the popular conservative party of Viktor Orbán, which has used it as ‘their’ historical legacy throughout the past 25 years. And it is precisely this central role of the 1956 revolution in the governing party’s historical memory that can explain the silencing of this history now: any kind of engagement with the 1956 refugee narrative would bring forth questions that would challenge the party’s political identity and heritage to the core. To understand this we need to take a closer look at the current Hungarian political landscape.
Hungarian national politics is built upon the historical interpretations and legacies of the fascist and communist regimes of the 20th century. Since 1989, political parties have defined themselves and criticized each other through mnemonic battles over historical legacies, traditions and precedents.
As heir to the Hungarian Socialist Workers’ Party (MSZMP,) the ruling state party in the communist era, the Hungarian Socialist Party (MSZP), the largest party on the left, has wanted nothing more than to forget its past, or to at least leave it behind. At the same time, it has aimed to position itself as an important force in the democratic turn (see Gyula Horn cutting the iron curtain in 1989) and has been striving to discredit its political opponents by drawing direct lines between the late 1930s and 40s and the present, connecting the contemporary right with mid-century fascism. Fidesz, on the other hand, has aimed to represent the 1980s as another version of the Stalinist years of the early 1950s, depicted in the shape of symbolic institutions like the House of Terror Museum. Although it also has its fair share of communist party functionaries and ex-members of the politburo among its ranks,it has used this particular historical representation to delegitimize the left and strengthen its claim as the truly democratic power. It has tried to increase its political leverage in opposition to communism as a legitimate, democratic party. Most probably due to the same reasons, the two parties have been united in their resistance to allow access to secret police archives from the communist era and have consistently blocked historians’ attempts for open research. The new kid on the block, the far-right party Jobbik, emerged from the largest and most renowned History department of the country and has been building its political discourse directly on the interwar romanticism of Hungarian greatness. The fourth party in parliament, the new liberal-green LMP (short in Hungarian for Politics Can be Different), a very young party with no ties to previous regimes, has been trying to balance between left and right in its interpretation of current historical controversies.
In this post-communist setting, the 1956 revolution has occupied a prominent place in Hungarian historical memory and became a foundational myth of the new democratic era. It was on October 23 that the Republic of Hungary was proclaimed in 1989, and the anniversary of the revolution has been the most important national holiday ever since. The first democratically elected president of the country, Árpád Göncz (who died recently at the age of 93), had been sentenced to life for participation in the 1956 revolution. Former revolutionaries, especially those with prison sentences, have given historical legitimacy to political parties on left and right. Year after year, October 23 has been the date for major political rallies combined with mass commemoration. On the revolution’s 50th anniversary, a right-wing rally turned into a violent protest against the governing left and was met with police brutality.
It is precisely because of the importance of the revolution in the historical memory of the country, and especially of that of Fidesz, that many Hungarian critics of Orbáns’s government are reaching back to the stories of the 1956 refugees. Drawing an analogy in this case is a method of shaming, and aims to highlight that the governing party is on the way of becoming the state that it established itself against. While these analogies may be flawed in the eyes of an astute historian, they need to be understood in the particular context of how historical memory is used (and abused) in Hungary. This is also the reason why no one on the right will mention the revolution in relation to the refugee crisis. Instead, they reach far back to medieval history and pose as the protectors of Christian Europe against Muslim forces. The amnesia of all the historical circumstances when Hungarians themselves were refugees (and there have been many) serves the purpose of explaining away the lack of basic services and assistance to refugees by the Hungarian state.
But this historical shift of focus also seems to be part of something bigger. The recent years have witnessed a change in Fidesz’s political use of 20th century history. Since the opposition on the left crumbled away or self-destructed, the major threat to power now comes from the far-right. The conventional anti-communist rhetoric has little use here, as the leaders and key party members of Jobbik came of age in the nineties. Political discourse has moved to meet the far-right’s claims, in this particular case with a heavy-handed anti-immigration campaign and the building of fences around the borders of the country.
Historical memory, a central element in political identity, has shifted accordingly. The hallmarks of this change are not only visible on the streets in the form of interwar street names and monstrous memorials, such as the controversial Memorial for the Victims of the German Occupation. In 2012 the government dissolved the public foundation that supported the 1956 Institute, a center for historical research that had been focusing on the revolution and the era of state socialism in Hungary. A year later, a new historical research center was established: the Veritas Institute, which aims to reinterpret the history of the past 150 years “without distortion”, and operates directly under the direction of the Prime Minister’s Office. The professional community of historians is mostly appalled by these recent changes, while right wing historians argue that political involvement has been known to go the other way as well in the past. In a way they are certainly right: in Hungary history writing has been decidedly a political act in the last 25 years.
The Hungarian refugee crisis has thrown light on this troubled relationship of politics and history in the country. When reaching to historical precedents or evaluating the use of historical arguments, like the 1956 revolution, we have to bear in mind that in Hungary history has not merely been used in making political claims, but it has been the essence of politics itself. Political dividing lines have been drawn around interpretations of historical legitimacy, and history figures as a foundational element in parties’ identities. Many of these deliberations are aimed at the domestic political scene and don’t make much sense outside of Hungary, as the occasional puzzlement in international press over Viktor Orbán’s statements attest to it. However, the particular way in which history is drawn upon in shaping politics and policy in Hungary does have a very real impact with very high stakes for the people who arrive at the border after a long and perilous journey, and certainly has an impact on Hungary’s political maneuvering in the European Union.
In this post, Friederike Kind-Kovacs discusses the Hungarian legacy of train stations as hubs for refugees, and considers the place of children in the refugee crisis.
In the past month, Budapest’s Eastern train station (Keleti Pályaudvar) became an evocative symbol for the unwillingness of the Hungarian government to respond to the current refugee crisis through humanitarian means. The Hungarian government neither pursued a coherent emergency strategy nor did it provide any humanitarian relief to the thousands of asylum seekers who were stranded at Budapest’s major train station. Yet, this train station is not just a symbol of today’s refugee crisis. It also reminds us of one of Hungary’s ‘own’ past refugee crises. It was at the end of the First World War and around the time of the signing of the treaty of Trianon that Budapest’s major train stations became the emergency shelter for thousands of Hungarian refugees from the cut-off Hungarian territories. Train stations — like harbors, airports or bus stations—historically serve as urban venues of migration. Budapest’s major train station witnessed countless flows of migration. While most everyday migration happens without much notice, train stations and other nodes of migration gain only then public attention when mobility is abruptly interrupted or entirely unwanted. Then train stations turn into deadlocks of mobility that are unable to further handle the massive influx of people. This was the case both at the end of WWI and in the summer of 2015.
Hungarian Refugees after WWI
Almost a hundred years ago a great number of Hungarian refugees were stranded at Budapest’s major train stations after being expelled from the former Hungarian territories. Due to the disastrous housing situation in Budapest at the time, the refugees were housed in dysfunctional cattle cars that were standing for months and even years at the train stations. These refugees became known as the “Railway Dwellers” (Vagonlakók), whose everyday life was closely documented by photographers at the time.
As the Hungarian state was unable to stem the social and financial burden of the influx of these refugees, many railway dwellers were dependent on humanitarian help from organizations, such as Herbert Hoover’s American Relief Administration (ARA) or the American Red Cross who provided large-scale relief in post-WWI Central Europe. Most refugees and their children were eligible to receive a free lunch or a portion of milk at the ARA’s many feeding stations and obtain a new set of clothing.
The train stations in and around Budapest were also the place where humanitarian relief donations arrived, such as medical equipment, clothing or food, and were then further distributed.
In response to Budapest’s severe hunger crisis at the time, the Hungarian League of Child Protection also arranged for so-called ‘summer vacations’ for Budapest’s impoverished children in better-off families in Belgium, Holland, Britain or Switzerland. These child holiday trains departed as well from Budapest’s Eastern station, where photographer János Müllner captured the departing and arriving children.
Although displacement has been an essential part of Hungarian history and still dominates the public discourse today, the Hungarian government refuses to draw any comparisons whatsoever between Hungary’s own refugee crisis and the current situation that could possibly trigger feelings of solidarity or compassion.
This is even more noteworthy when we consider the role of children in the current crisis. The Hungarian government appears immune even to the plight of today’s refugee children. Although Hungary’s government highly values the role of the ‘Hungarian family’ and the value of children, it refuses to apply these principles to the newly arriving refugee families and their children. At the same time, the absurdity of Orbán’s fear of a dangerous Muslim invasion becomes apparent when meeting some of the many refugee families that arrived with their small children, babies and toddlers. The majority of these children not only have to deal with the memories of the life-threatening journey across the sea but also with trauma of war in civil-war-stricken countries like Syria.
The Current Child Refugee Crisis
The refugee and migrant crisis, as Save the Children states, has turned into a ‘Child Refugee Crisis’. The tragic image of the 3-year old Syrian-Kurd toddler Aylan Kurdi, who drowned in the sea and whose body stranded in Turkey, captures the particular vulnerability of the child in this refugee crisis. The image of this child lying “face down, his head to one side with his bottom slightly up — the way toddlers like to sleep” visualizes the defenselessness and innocence of the children. While the boy died on his travels to Europe, other “children on the move” did manage to arrive in Europe. In 2014 603 and in 2015 8420 children were counted to have arrived in Hungary without their parents; they were either by their parents alone or accidentally separated from their families, which leaves them particularly vulnerable to neglect or exploitation. Those children who arrive without their parents are transferred to the “Children’s City” in Fót, where they are kept for an extended time. During their journey or in refugee camps, children are unable to attend school and are instead often needed to contribute as breadwinners to the family’s survival, as UNICEF and Save the Children stated in a recent report.
But even when children do manage to reach Europe with their families, they can’t claim their “right to protection,” as UNICEF recently reminded some of the – rather reluctant— member countries. Before Hungary closed its border on September 15th thousands of refugee children had already reached Hungary. Yet their plight has not yet triggered any humanitarian response by the Hungarian government. Even after their arrival at Budapest’s train stations, refugee children were not considered eligible for any kind of special governmental protection or emergency relief. As early as 1924 the League of Nation’s Declaration of the Right of the Child stated that “[t]he child must be the first to receive relief in times of distress,” but then and now governments tend to see a fundamental difference between the cause of their ‘own’ and the ‘other’s’ children.
At the Budapest train stations the government has not provided adequate shelter and is not ensuring basic hygienic standards. The limited sanitary facilities do not allow parents to secure their children’s cleanliness and health; babies’ nappies are often changed on the bare floor. It happened several times that children got lost and could not find their parents. A mother even gave birth to her child at the train station, while only supported by a voluntary doctor. In response to the governmental lack of interest in the plight of refugee children, UNICEF Hungary sent on September 4th a written request to the national agencies: it was their duty to ensure that the “children receive adequate assistance and adequate protection”, and that they are welcomed in a “non-prejudiced, non-discriminatory and inclusive environment” while “temporarily or permanently residing in our country”.
Civil Activism for Refugee Children
Children’s relief at the station was entirely in the hands of non-governmental organizations, such as Migration Aid and the Let’s Help refugees in Hungary Facebook group, or individual civil activists or volunteers who did everything to meet the refugees’ most basic needs, including food, clothing information, medical care as well as practical and emotional support. With the help of the volunteers, who brought toys and sweets, the train station turned in the afternoons “into a playground” where the children started to engage in common plays.
When Migration Aid volunteers started to draw with refugee children with colorful chalk on the asphalt, as a creative means to deal with their traumas, the police reminded them that thereby the children could be made liable for the “violation of public order”. Other children were encouraged by volunteers to simply draw about their life back home, showing the “horrible experiences they endured.” Another day volunteers brought ”a brief smile to the faces” of the children, when they were setting up a projector to show “Tom and Jerry” at the train station. Little is actually needed to make the children forget their past and present reality at least for a little moment.
In contrast to this civil engagement with children, the Hungarian government tries hard to undermine and limit the population’s sympathy with the refugee families and children. Images of suffering children can convey the drama of any humanitarian crisis particularly effectively; employees of the Hungarian state television were recently told “not to broadcast images of refugee children.’ It is up to volunteers and Facebook activists, such as the photo blogger Budapest seen, to visually capture the everyday life of the refugee families and their children at the train station and thus to bridge the distance between the refugee and the receiving societies.
Memorializing Hungary’s Refugees
The political discourse about today’s refugee crisis could not differ more from the way in which Hungary’s ‘own’ past refugee crises are publicly remembered today. When it comes to the memorialization of the suffering of Hungary’s ‘own’ refugees after the “Tragedy of Trianon,” throughout the whole country Trianon memorials have been inaugurated and the 95th anniversary of the signing of Trianon, June 4th 2015, was symbolically remembered in front of the Cathédrale Saint-Louis in Versailles and used to call for the revision of the peace treaty. The so-called Trianon Museum even inaugurated on July 8th 2015 an exhibition about the “Life of the railway dwellers: an open exhibition at the Trianon museum” (Vagonlakók élete: új kiállítás nyilt a Trianon Muzeumban). Restaging one of those cattle cars where Hungarian refugees were housed, without running water, electricity or effective heating, allows the visitor to re-experience today the everyday suffering of Hungary’s ‘own’ refugees in the past. Exhibiting the disastrous social consequences of the “Hungarian exodus” from 1918-1920 perfectly fits the current trend to rewrite Hungary’s history and allows evoking feelings of compassion for refugees in the past. Yet, when facing todays’ thousands of non-Hungarian refugees and their children the Hungarian government closed its borders, introduced laws to prevent any special legal treatment of refugee children and simply watched as this situation developed into a humanitarian crisis.
Resisting Today’s Refugees
While the refugees after WWI were Hungarians and thus welcome, today’s Muslim refugees are not welcome in Hungary. “We don’t want to change,” was Victor Orbán’s recent statement, making clear that Hungary would never want to repeat Western Europe’s supposedly failed experience with multiculturalism. Instead, Orbán fuels fears about the unforeseeable consequences of this wave of Muslim immigration, namely a war of cultures, which his “old” Christian Europe would loose. Presenting himself as the savior of Europe’s Christian culture and of Hungary’s national homogeneity serves him to incite fear and hatred of Muslim immigrants. Trianon and the Holocaust could have taught him the dangers of an ongoing “quest for homogeneity.”
Hungary’s post-1956 refugee crisis could have helped the Hungarian government to see the commonalities between Hungary’s own history and today’s refugee crisis. In reaction to the government’ insensitivity, a number of civil actors, such as OSA Archivum in Budapest, have publicized images of Hungarian refugees after 1956, or even contrasted them in video footage with images of the Syrian refugees. Hungary is happy to commemorate its own refugees, but does not want to be reminded of its past dependencies on other countries. It would also be too difficult to remember that the Canadian government warned in 1956 of the “Hungarian refugees’ religion, ethnicity and tendency to political extremism” that were feared to be “incompatible with what they saw as Canadian values.” Yet, Canada overcame her ungrounded fears and accepted Hungary’s refugees.
By contrast, the Hungarian government prefers to pursue its defensive politics and safeguard its national-Christian ideals. It prefers to rather seek to protect Europe’s physical borders than its values, and denies the refugees their most basic human rights. The Hungarian government misses here the chance to realize that this is “a moment when history will look back on the world’s treatment of these refugees, just as we look back on how nations treated those fleeing the Holocaust,” as Miles Gerety recently wrote. Hungary could have chosen “a nobler path, a path of compassion and decency,” as “no democracy is weakened when it offers a helping hand to those who have learned from bitter experience the virtues of freedom.”But while the Hungarian government continues to blame Germany for its “moral imperialism,” hundreds of Hungarian volunteers and activists reaffirm their ‘moral imperative’ by turning feelings of solidarity and compassion into civil and humanitarian action.
Friederike Kind-Kovács is assistant professor at the department of Southeast and East European history at Regensburg University and currently works on humanitarian child relief in Central Europe after WWI. Her book, Written Here, Published There: How Underground Literature Crossed the Iron Curtain, recently received the 2015 USC Book Prize in Literary and Cultural Studies.
It is with great pleasure we share the news that Ana Antic has received the prestigious Fraenkel Prize, for her book manuscript:Psychiatry at war: Psychiatric culture and political ideology in Yugoslavia under the Nazi occupation. The Fraenkel Prize, founded by the late Ernst Fraenkel OBE, is awarded by The Wiener Library for an outstanding work of twentieth-century history.
“Antic has written a remarkably original case study in the psycho-social impacts of sustained exposure to violence, both on traumatized individuals and on the psychiatric professionals who treated them as patients. Relying on an unusually rich record of patient files and case notes from wartime and immediately postwar Yugoslavia, Antic opens an unexpected window onto the mental and affective experience of everyday life in conditions of war, occupation and regime change, while also demonstrating the significance of this period as a key transitional moment in the intellectual history of psychiatry. The study stands out for its deft balancing of the ideological, social and professional dynamics at work in this period, and offers us novel and compelling perspectives on Yugoslavia’s social and political history.”
Guest Post by visiting fellow Francesca Piana, Swiss National Science Foundation
Among the many research interests that I share with “The Reluctant Internationalists” is the understanding of internationalism as a varied and multifaceted phenomenon. This is one of the many ways in which my research on the history of international responses to the needs of prisoners of war and refugees in the 1920s connects with the interesting discussions that I have had over the past three months at Birkbeck College.
Coming from the history of Western liberal internationalism and, in particular, the history of the international organisations such as the League of Nations, I enjoyed learning about the history of other internationalist projects, such communism, socialism, or Catholic internationalism. Despite the singularity of each historical process, there are communalities in the creation and development of structures as well as in the centrality of expert knowledge in international networks.
Mapping the geography of internationalism is also a productive way to think at the refugee question after the end of the First World War. Something that has spurred from the discussions is to think of internationalism in terms of “center” and “peripheries.” For instance, in the case of refugees, there are the places where decisions are made, such as national cabinets and the headquarters of international organisations, while these same places are also the hub of initiatives developed in other spaces, such as the local, national, regional, and transnational. The local – such as a refugee camp – is no less international than the decision-making process at the headquarters of international organisations. Implementing projects locally or distributing technology is highly international.
It has been also essential for my own research to think how to recover the experiences of prisoners of war and refugees themselves. Internationalism is not only a history of institutions but it is also embedded in people’s lives. Migrants and refugees choose or are forced to go international. For others such as relief workers, health professionals, or international civil servants, internationalism is often a professional choice.
There are many perspectives, geographies, scales, and methodologies to look at the history of internationalism in the 20th century. By recognizing the malleability and plurality of internationalism, there is the potential to write more interesting stories, connect different historiographies, and, as such, complete and challenge the history of the 20th century.
In 1930, Bernard Long of the British Esperanto Association published a compact booklet titled, Esperanto: Its Aims and Claims. A Discussion of the Language Problem and its Solution. Humankind, Long argued, was not fated to remain helpless prisoner to “the confusion of tongues” that had for so long stood obstinately in the way of international understanding and cooperation. Just like bridges built to cross rivers, or like tunnels carved through treacherous mountains, language could be designed in such a way as to facilitate not merely human interaction, but also international cooperation of the type that the world’s proud optimists, worrying statesmen, and enterprising businessmen so desperately craved. Esperanto, Long insisted, was just such a language. Designed not to replace the world’s national languages, but instead to transcend them, Esperanto presented itself as “an easy, expressive, neutral form of speech for international use.” Esperanto’s appeal spoke to “the practical and idealistic alike,” Long argued, and Esperantists eagerly invited “all thinking people” to join the growing and avowedly global Esperantist movement. Esperantists welcomed “all progressive men and women whose vision extends beyond their national frontiers, and who feel, or desire to feel, that they are also citizens of the world.”
Long’s celebratory booklet was but one of countless broadsheets, pamphlets, journals, and books that had been published worldwide to extol and to popularize Esperanto since the international auxiliary language’s debut in 1887. In that year, a Polish Jew of the Russian empire, L.L. Zamenhof, published the first Esperanto primer – the product of this precocious polyglot’s years of painstaking efforts to create an effective, logical, and felicitous international auxiliary language. In the avowed name of hope, Zamenhof unveiled his creation as the easily assimilable answer to the linguistic, ethnic, and ideological fractures that divided not only tsarist Russia, but also humankind. In so doing, Zamenhof launched what rather quickly developed into a global movement and, ultimately, global movements, to deploy Esperanto as the key to lived internationalism, variously conceived.
The understudied history of Esperanto, and of the diverse array of adherents and political entrepreneurs whom Esperanto inspired in the late nineteenth and twentieth centuries, is where my research interests coincide with those of the Reluctant Internationalists project. In June 2015, I joined the Reluctant Internationalists Project Team in London for a month of scholarly collaboration and conversation. My month as a Visiting Fellow at Birkbeck College also enabled me to conduct essential primary source research at the British Library and Cambridge University Library for my current book-length research project, tentatively titled Speaking Transnationally: Esperanto, Citizen Diplomacy, and Internationalismin Russia, 1887-1939.
Speaking Transnationally places Russian and Soviet history in global perspective. It is a study of how tsarist Russian subjects and Soviet citizens communicated transnationally via Esperanto in pursuit of a variety of ideological aims. My project highlights Esperanto as a cultural tool with which “ordinary” citizens pursued global efforts to variously promote “international brotherhood” and mutual understanding. I focus on the underappreciated story of how Esperantists from Russia and the USSR met, face-to-face, with fellow Esperantists from abroad. It explores how Esperantists shared ideas, commodities, as well as the sheer joy of communicating via an international auxiliary language. It is also a patently modern story of Esperantists forging affective bonds and ideological solidarity by means of the postal service, telegraph, radio, and rail. My project illuminates the unique transnational encounters that Esperanto made possible by focusing on how Esperantists in late imperial Russia and the early Soviet Union imagined and asserted themselves as members of global communities with global concerns.
Although “reluctant” may not be the first adjective logically applied to the Esperantists whom I study, their visions and experiences of lived internationalism as Esperantists do raise questions that sync well with those of my colleagues of The Reluctant Internationalists project. In particular, my research not only looks into the ambitions of my historical subjects to collaborate with fellow Esperantists (and others) on an international basis, but also focuses on their practical ability to communicate via their chosen international auxiliary language, or via any other language for that matter. Historians who study internationalism cannot escape the literal question of (mis-)communication. Agents of internationalism – reluctant or otherwise – themselves inescapably confront the challenges and the opportunities that language presents to them in pursuit of their global endeavors. At a fundamental level, language is crucial to the lived experience of internationalism (or any attempt thereof). Arguably, the success or failure of an internationalist project hinges on its participants’ ability to effectively communicate amongst themselves and with others.
With this in mind, I also worked with the Reluctant Internationalists Project Team during my residence at Birkbeck College to begin planning for a “Languages of Internationalism Conference” to be held in May 2017. The conference will bring together scholars whose work examines how language has enabled and/or frustrated human efforts to communicate and collaborate on an international basis. A formal call for papers will be announced in due time, but I join the Reluctant Internationalists Project Team in looking forward to what is bound to be a stimulating “Languages of Internationalism Conference.”
My incentive for proposing a joint network meeting between the research network “Health and Social Welfare in Eastern and Southeastern Europe in the Long 20th Century” coordinated at Regensburg University and Birkbeck’s “Reluctant Internationalist” project was to bring together two diverse groups of young and international scholars that are dealing in their research with questions of public health, social welfare, humanitarianism and internationalism. The researchers of both networks investigate practices and discourses of public health and social welfare, focusing on historical continuities, discontinuities and processes of transnational transfers. The geographical focus stretches from Eastern and Southeastern Europe to Western Europe and beyond, and embraces research on Bosnia-Herzegovina, Soviet Russia, Armenia, Spain, Germany, the GDR, Serbia, Belarus, Hungary, Poland, Kosovo, Russia to Czechoslovakia, Romania and Greece. While the main interest of the Reluctant Internationalists lies in public health in Europe as an arena of internationalism, the Health and Welfare network centers its attention on the local enactment of health and welfare in the – often overlooked region of – Central, Eastern and Southeastern Europe from the end of the nineteenth century until recent times.
Yet, both networks have a lot in common. Both research networks do ‘extra’-ordinary research in the way that they test the boundaries of the widespread and conventional understanding of the history of medicine. While the history of public health and social welfare is often just perceived as a negligible and marginal part in modern history, we aim to challenge this perspective in three main ways. First, we propose to approach public health and social welfare as a centerpiece in historical processes of state-and nation building as well as an arena of international cooperation. When looking at global health crises such as Ebola, we see the dramatic impact on entire populations and the need for common global responses. Second, by geographically expanding our research also to the eastern and southeastern peripheries of Europe we hope to counterbalance the ongoing trend to focus exclusively on Western Europe when talking about Europe. A main aim is to understand the history of health and welfare in Eastern Europe as a core component of an integrative all-European history of public health and welfare. Third, we want to enrich the still widespread top-down approach to the history of internationalism, humanitarianism and health by means of agent-centered research. This approach moves away from the exclusive focus on the institutional history of health and welfare that focuses largely on medical elites and international organizations. Our projects equally value and closely examine local responses of health and welfare recipients, such as patients, the elderly, the disabled, children, the poor, veterans, minority groups or nurses. By pursuing research in these three ‘extra-ordinary’ ways, we are hoping to contribute to the field of an inclusive and social history of health and welfare. I believe that the encounter between both networks has created possibilities for future cooperation, as the members of both networks share not only common research interests but also an alternative understanding of the history of health and welfare.
On May 9th, 2015, after months of fighting the outbreak, the World Health Organization (WHO) declared Liberia to be Ebola-free. While this success demonstrates that both local public health services and international organizations did something right, the experience of the past year—along with the ongoing epidemic in Sierra Leone and Guinea—also demonstrate a number of important things they did wrong. A slow global response compounded a crisis sparked by poorly developed public health infrastructure—a legacy of European colonial rule in Africa—and a limited local understanding of the ins and outs of how the disease is transmitted. To date, the outbreak has resulted in over 11,000 deaths, and, even if fully eradicated, will have social and economic consequences for years to come. The Ebola epidemic in West Africa reminds us that the role politics inevitably plays in shaping public health often has catastrophic consequences for the affected populations, something that historians of public health know all too well. In the case of Ebola, the political concerns that stopped the WHO from responding quickly and effectively to the outbreak resulted in thousands of deaths, often-inhumane quarantine measures, and, in certain cities, even widespread riots.
Criticism of the WHO’s inaction has focused on the decision to hold off on declaring the epidemic a Public Health Emergency of International Concern (PHEIC), a declaration that comes with legally binding recommendations for the 194 member countries and can help to facilitate a coordinated global response. In internal emails and memos from June 2014, senior officials in the WHO cited fears of disrupting African economies, interfering with the pilgrimage of African Muslims to Mecca, and the pressure that such a declaration would have on the already-overextended WHO emergency response services, who were in the midst of dealing with a resurgence of polio and the spread of Middle East Respiratory Syndrome (MERS). (The resurgence of polio was declared a global health emergency in late spring, while MERS was not given this designation.) Dr. Michael Osterholm, a disease expert at the University of Minnesota, likened the decision to not declare the outbreak an international health emergency to “saying you don’t want to call the fire department because you’re afraid the trucks will create a disturbance in the neighborhood.”
Several news sources registered shock at this apparently deliberate decision to delay the process of enacting emergency measures. After all, both the 1946 constitution of the WHO and its current mission statement suggest a staunch commitment to put the physical, social, and psychological needs of its global constituents first. Indeed, one of the founding principles, according to the constitution, was that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” But as Dr. Thomas R. Frieden, the director of the Center for Disease Control, recently stated: “Too many times the technical is overruled by the political in W.H.O.”
While contemporary media sources expressed surprise at the way politics shaped the Ebola response, for historians of global public health this story is a familiar one. In this particular context we can easily trace the entanglement of political imperatives and public health responses back to the earliest days of the World Health Organization’s involvement on the Africa continent. When the WHO was founded in 1946, it also created six regional offices to respond to varying health needs on the ground in different places. Of the six regional offices (Europe, the Americas, Western Pacific, Eastern Mediterranean, Southeast Asia, and Africa), the creation of the WHO Africa Office was the most rife with political drama and backroom diplomatic maneuverings. In colonial Africa, imperial powers feared that opening the door to the WHO would be akin to inviting international criticism of colonialism. Doctors and government officials worried that international health workers might use their work in Africa as a chance to spy on the inner-workings of their African empires. One French official wrote that a WHO Africa office would become a meeting ground for various kinds of “troublemakers: African, political, and medical.” He worried that by allowing the WHO to operate in Africa, they would be allowing outsiders a chance to create “a political climate unfavorable to French rule.” Instead of thinking first about how to stop the spread of epidemic disease, these doctors and bureaucrats were thinking first about how to stop the spread of decolonization.
Despite their best diplomatic efforts, the French, British, and Belgians ultimately failed to keep the WHO out of Africa and a regional office was established in Brazzaville (French Congo) in the late 1940s. The decision to build the headquarters in Brazzaville was based on the idea that one should “keep one’s friends close and one’s enemies closer.” Colonial doctors thought that by setting up the office in the capital of French Equatorial Africa they would be able to more closely regulate the office’s programs. The first few years of the Africa office’s existence were not spent setting up the kinds of public health programs we have come to associate with the WHO. Instead, these years were plagued by bickering between WHO officials and colonial doctors about things like the creation of a public relations position, a role that the French administration claimed would allow the WHO to spread anti-colonial propaganda. It was not until the late 1950s, as European colonial rule in Africa was winding down, that the WHO was able to launch large-scale disease eradication campaigns in sub-Saharan Africa.
Both the current Ebola epidemic and this longer history of public health cooperation in Africa remind us that international health organizations like the WHO are often driven by broader local, regional, and international political contexts. As we consider the lessons that we can draw from the WHO’s failure to effectively respond to the current public health crisis brought on by the Ebola virus—and as the WHO considers reforms that will shape the way it responds to future public health emergencies—we should also consider the longer history of the way that politics have constrained the organization’s ability to execute its crucial mission.
This week you can find The Reluctant Internationalists in Lausanne, Switzerland at the “Globalization of medicine and public health: economic and social perspectives (1850-2000)” conference organized by Sanjoy Bhattacharya (University of York), Thomas David (University of Lausanne, EPFL), Pierre-Yves Donzé (Kyoto University), and Davide Rodogno (Graduate Institute of International and Development Studies).
At this exciting event Jessica Reinisch will be chairing the panel “Global Public Health After The Second World War: Non-Western Visions”, Johanna Conterio will be presenting a paper titled “The Global Botanical Roots of the Soviet Pharmaceutical Industry: The Case of Quinine” and Dora Vargha will be talking about “The Globalization of Vaccine Trials: Networks and Rivalries in Live Poliovirus Vaccine Development”.
For more information about the conference and the detailed program, see the official website.
Academic life, as I have learned, makes you painfully aware of the many different regimes of immunization across the globe. Moving between fellowships and jobs, our first son got his vaccines in four different countries – that means four distinct healthcare systems, vaccination schedules, payment structures and vaccination records in three different languages. I think it is safe to say that he has become a reluctant internationalist in his own way. As for us, parents, we pretty much did what we usually do in our working life. We spent hours after each vaccination appointment to analyze the microcosm of public health systems: the doctor-patient encounter. We have been fascinated by the carefully crafted pro-vaccination speech prepared by our American paediatrician, the kind, but firm approach of the German doctors, the inescapable abundance of posters and leaflets on vaccination in the British surgery, and the lack of any kind of publicity and a matter-of-fact discourse in the district paediatrician office in Hungary.
This personal experience has also made me particularly interested in the way childhood immunisation is conceptualised and the points when it is contested or even seems to break down, such as the current ‘anti-vaxx’ controversy prompted by the Disneyland measles outbreak. As I am currently finishing a chapter on debates surrounding the Salk vaccine in Eastern Europe in the 1950s, I started thinking about how communist public health officials would have made sense of debates like this.
An excellent analysis by Jennifer Reich, published in Gender& Society has brought up an important point that would surely have sparked the interest of the communist vaccinators. In this study Reich is speaking to a debate that, in broad brushstrokes, posits crazy and irresponsible people (mainly women) against rational and responsible parents, physicians and public health experts. Reich is arguing that the ‘anti-vaxxers’ are far from being ‘crazy’: in fact, they base their decision on time-consuming research and their choice reflects their social and economic privilege. Not only is this analysis important in understanding current American anti-vaccination movements and their consequences, it also makes clear that behind this potential public health crisis is the primary role of the patient-consumer and an interpretation of personalised medicine. According to Reich’s study, mothers who decided not to vaccinate their children were unconvinced by arguments that they should be participating in public health and expressed that their responsibility was to their own children, not others’. This is along the lines of what popular satirical outlets, such as The Onion have picked up on.
Responsibility for health was exactly the thing in the crux of Cold War attitudes towards public health. Eastern European party dignitaries and public health officials were always happy to boast that countries like Czechoslovakia and Hungary triumphed over polio years before the West and about a decade before the United States did. Their Western colleagues acknowledged the feat, and explained this with totalitarian state organisation – effective epidemic management tends to be authoritarian. The Eastern Europeans had a different explanation, however: the socialist model of organising public health, where prevention is seen as key to the health of the population, healthcare is available to all, vaccines are free, and the paternal state takes responsibility over children’s health. They pointed to the ‘backwardness’ of America for sacrificing the health of children to selfish and market-driven agendas.
Vaccine coverage of course is a marker of superiority only in Cold War rhetoric. It does not reveal much about the quality of healthcare, access to it, or the overall health of a population. Coverage rates can also quickly change due to political unrest and/or economic problems, like in Ukraine, where vaccination has hit critically low rates in the past decade. However, when comparing politically and economically stable countries in the Global North, this difference between East and West does reveal Cold War legacies and attitudes towards the responsibilities of citizens. In much of Eastern Europe, the state expects physicians and parents to comply with vaccination policies without much debate or contestation, and parents expect the state to provide free vaccine and to guarantee its safety. The ‘social’ in medicine is very much still present and high vaccination rates are still a point of pride for Eastern European governments.
Vaccine resistance is also not a new phenomenon. Since there had been vaccines, there has been resistance to it – revealing a wide variety of reasons, usually connected with a much larger issues regarding power relations, distrust, religious integrity, etc. In some societies, like Britain, vaccine resistance has a long history, since the introduction of Jenner’s vaccine.But resistance to vaccines is not even something particularly Western, even if we limit our view to the Global North, although it is slightly more difficult to spot on the Eastern side of the Iron Curtain in the Cold War era. Archival sources give a glimpse of resistance to the Salk vaccine in Hungary, which had to do mostly with opinions that the state was not fulfilling its public health provider role adequately, either by following the ‘wrong’ method of injection, or supplying vaccine lacking in quality and quantity.
There are, of course, new aspects of today’s vaccine resistance in the Global North. Parents have easy access to information online and can establish ties with each other over social media. These ties and the flow of information does not stop at borders, making vaccine resisters at once national agents – in that they respond to a particularly local set of problems of state, public health and culture – and internationalists who participate in shared networks across the globe. Over 25 years after the fall of the Berlin wall, the wind of change might finally reach public health organisation and vaccination in Eastern Europe. In Hungary, where vaccination is compulsory and free, the voice of vaccine critics seems to be growing steadily, drawing mostly on social media, supported by arguments based on translations from English language materials. With a healthcare system that perpetually seems to be on the verge of breakdown – another Cold War legacy -, questions of responsibility for health keep bubbling up to the surface. But for now, the legacy of a previous century is imprinted on my child’s body, who has moved with ease back and forth between East and West, unknowingly becoming a vaccine cosmopolitan.
Researchers from all over the world, from Australia through Bulgaria came together in Paris for a two-day workshop titled ‘Medicine and Public Health in the USSR and the Eastern Bloc 1945-1991‘ on January 23-24, 2015. Convened by Grégory Dufaud (l’EHESS, LabEx TEPSIS, France) and Susan Gross Solomon (University of Toronto, Canada), the workshop’s aim was to explore the intersection between Soviet medicine and public health and that of the Socialist Bloc in Eastern Europe after World War II. The papers focused on knowledge circulation, the transfer and local adaptation of public health practices and scientific interaction. Many participants addressed these issues through a comparative perspective, either between the Soviet Union and individual Eastern European countries, East and West or among the members of the Socialist Bloc.
Setting up the theme of the workshop, Lion Murard (Cermes3, France) gave an overview of the “Story Before the Story” and demonstrated the significance of Eastern European public health practitioners and experiences in shaping international public health in the Interwar era. Alain Blum (l’EHESS, Cercec, France) followed with an analysis of the methods of Soviet demographers and the accessibility of demographic data for contemporary and historical researchers.
Focusing on the emphasis of PREVENTION in Soviet and Eastern European public health policy,Donald Filtzer (University of East London, UK) revealed a fascinating story of factory medicine in the Soviet Union during and after the war. He highlighted how the Soviet health system attempted to counter lost work time due to starvation and illness, the prominence of skin infections due to lack of access to hygiene and the long term consequences of the home front experience on both the health of workers and the organization of medical practice. Chris Burton (University of Lethbridge, Canada) argued that the particular direction of Soviet medicine may have been a result of practical solution and intended as temporary, as much as it was based on ideology. For instance, the synthesis of preventive and clinical work, promoted from the beginning of the Soviet regime, stemmed from an insufficient number of doctors in the Civil War. In her talk titled ‘Personal hygiene and public health care in the Polish countryside after 1945 – confrontation of propaganda and reality’, Ewelina Szpak (Institute of History, Academy of Sciences, Poland) argued that the end of the 1950s and 60s was a time of crucial social changes and attitudes toward hygiene in Poland. This was especially the case in Polish villages that were seen as a bastion of backwardness, and therefore became the focus of an experimental top-down program of village hygienisation.Tricia Starks (University of Arkansas, US) investigated what addiction means and how that meaning affects the image of the addict. Looking at cigarette addiction and alcoholism, she contended that throughought the 20th century, Russian addiction therapies remained rooted in the mind and the will, not the brain and body. Starks’s presentation was guided by the question that if will is based upon Enlightenment concepts of freedom, how is this will in addiction conceptualized in the USSR.
The second large theme explored in the workshop was PRO-NATALISM AND REPRODUCTIVE POLICIES. Paula Michaels (Monash University, Australia) presented a comparative research project jointly conducted with Ema Hresanova (University of West Bohemia, Czech Republic) on Pain and Paternalism in Soviet and Czechoslovak Maternity Care. The paper explored the circulation and adaptation of psycho-prophylaxis in the respective medical and social contexts and demonstrated a heterogeneous pattern of practices that do not map on to the concept of Sovietization. Muriel Blaive(Charles University in Prague, Czech Republic) shifted the temporal focus of the birthing experience to post-communist Czech Republic and placed it in comparison with North American feminist and patient’s rights movements, hospital practices and power structures in maternity care. Sylwia Kuzma-Markowska (University of Warsaw, Poland) examined contraception and abortion law and practice in postwar Poland as situated between East and West. She showed that Polish legislation followed a Soviet type of abortion culture, and at the same time professional contacts with the West were facilitated by the International Family Planning Organization, which Poland joined as the first Eastern European country in 1959. In the case of Bulgaria, Anelia Kassabova (Sofia University, Bulgaria) pointed out that the legalization of abortion was based on the civil rights of the socialist woman, that is the right to take independent decisions on the matter of motherhood according to her own conscience. The gradual tightening of the law towards prohibition did not reduce the number of total abortions significantly, but raised the proportions of medically justified ones – with the lack of access to contraceptive technologies, abortion remained the main method of family planning.
The second day brought the workshops focus to clinical trials, treatment and international collaboration in public health and medicine. Grégory Dufaud’s paper analyzed the ways in which Soviet psychiatrists reconsidered psychiatry and its therapeutic ambitions in the context of the competition between clinical and experimental models after World War II. In her paper, Galina Orlova (The Russian Presidential Academy of National Economy and Public Administration) looked at the discursive practices and shifts of nuclear physicists on the subject of the health risks of radiation. Pascal Grosse (Charité, Germany) presented a paper on clinical trials conducted in East Germany by Western pharmaceutical companies in the 1970s and 80s. Grosse argued that the trials were part of the GDR’s trade with the West, in this case the expertise of clinical staff and the bodies of patients were the commodity provided by the state in exchange for hard currency. The clinical trials were situated in a complex network of state bureaucracies and became sites of power struggles among their different factions. Jessica Reinisch (Birkbeck, University of London, UK) focused on the interactions of local German policymakers and their Soviet counterparts in the Soviet Occupation Zone after World War II. She argued that the public health policies heralded by the Soviet military and public health experts found fertile ground in Germany, since its core ideas were considered to be inherently German by the local experts. Finally, Dora Vargha(Birkbeck, University of London, UK) gave an overview of Sabin vaccination trials conducted in Eastern Europe and investigated how ideas about socialist public health and Cold War politics in general propelled the region to a prominent place in polio prevention and eradication.
In her concluding comments, Susan Gross Solomoncalled to attention the importance of the prewar legacy in public health and medicine and to examine what was carried forward to the postwar era and by whom, what was resisted or scrubbed, and who debated what was to be kept. Sheinvited the researchers of Soviet and Eastern European health and medicine to investigate the assumptions that influence research through archival research and in order to critically approach the concept of Sovietisation and to see what the dynamics was in acceptance, pseudo-acceptance, adaptation, resistance, etc. of Soviet ideas. Solomon also pointed out that many papers addressed collaboration and interaction between East and West, the existence and intensity of which seemed to depend on the scientific field, the presence of intermediators, the number of players and changed over time, e.g. intensified as the Iron Curtain wore out and became more porous.
Do not miss Ana Antic’s talk titled “Parenting the Nation: Child Psychiatry, ‘Therapeutic Violence’ and Political Reeducation in WWII and Cold War Yugoslavia and Eastern Europe”
Oxford Brookes on December 9, 2014 from 4:30pm, JHB 204 Headington Campus
Following the Soviet-Yugoslav split in 1948, the Yugoslav political and military authorities devised an exceptionally violent yet psychoanalytically informed political ‘re-education’ programme for those Communists who ‘failed’ to understand the meaning of the break with the USSR and who might have remained loyal to the Soviet Party. The history of this brutal psychological experiment is at the centre of my lecture: in a series of labour camps and prisons, tens of thousands of Party members and military functionaries underwent torture and violence, but the ‘re-education’ effort also involved participation of psychiatrists, psychotherapists and psychoanalysts. The Yugoslav ‘re-education’ experiment was hardly unique: throughout the 1950s similar camps and projects emerged in other countries of the Eastern bloc (Romania in particular) as well as in places as far away as China and Korea, and my talk aims to place Eastern Europe in this global web of psychological experimentation. In that sense, the focus on ‘re-education’ camps opens up a number of core questions regarding the history of mental health sciences in the context of authoritarianism. Firstly, it highlights the tremendous role of WWII in the history of psychiatry and psychoanalysis, and reveals unexpected continuities in conceptualizations of psychological ‘re-education’ across the year of 1945. Secondly, it emphasises the significance of ‘psy’ professions for the political history of communism and anti-communism. Thirdly, these authoritarian applications of psychiatry and psychoanalysis sat uncomfortably with the intense trend of Westernization and liberalization of Yugoslav mental health sciences – child psychiatry and psychoanalysis in particular – after the 1948 split. Psychiatry and psychoanalysis then emerge as the lens through which to study the complicated history of Cold War alliances. After Yugoslavia dropped out of the Soviet sphere of influence, it developed a rich scientific and professional cooperation with Western Europe and the US. But Yugoslav psychoanalysts and progressive psychiatrists were also tightly – and centrally – involved in violent anti-Stalinist processes, purges and ‘re-education’ projects, and in the subsequent East European psychiatric and pedagogical networks. Therefore, it is in the fields of psychoanalysis and psychiatry that unexpected alliances formed and crossed the traditional Cold War faultlines: the history of postwar mental health professions in Yugoslavia opens up a much larger social and political story of liberalization and authoritarianism in socialist Eastern Europe.
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