Hard Right, Soft Power: fascist regimes and the battle for hearts and minds

A new global “soft power” ranking recently reported that the democratic states of North America and Western Europe were the most successful at achieving their diplomatic objectives “through attraction and persuasion”.

Countries such as the US, the UK, Germany and Canada, the report claimed, are able to promote their influence through language, education, culture and the media, rather than having to rely on traditional forms of military or diplomatic “hard power”.

The notion of soft power has also returned to prominence in Britain since the Brexit vote, with competing claims that leaving Europe will either damage Britain’s reputation abroad or increase the importance of soft power to British diplomacy.

Although the term “soft power” was popularised by the political scientist Joseph Nye in the 1980s, the practice of states attempting to exert influence through their values and culture goes back much further. Despite what the current soft power list would suggest, it has never been solely the preserve of liberal or democratic states. The Soviet Union, for example, went to great efforts to promote its image to intellectuals and elites abroad through organisations such as VOKS (All-Union Society for Cultural Relations with Foreign Countries).

Perhaps more surprisingly, right-wing authoritarian and fascist states also used soft power strategies to spread their power and influence abroad during the first half of the 20th century. Alongside their aggressive and expansionist foreign policies, Hitler’s Germany, Mussolini’s Italy and other authoritarian states used the arts, science, and culture to further their diplomatic goals.

‘New Europe’

Prior to World War II, these efforts were primarily focused on strengthening ties between the fascist powers. The 1930s, for example, witnessed intensive cultural exchanges between fascist Italy and Nazi Germany. Although these efforts were shaped by the ideology of their respective regimes, they also built on pre-fascist traditions of cultural diplomacy. In the aftermath of World War I, Weimar Germany had become adept at promoting its influence through cultural exchanges in order to counter its diplomatic isolation. After 1933, the Nazi regime was able to shape Weimar-era cultural organisations and relationships to its own purpose.

Leni Riefenstahl, Hitler’s film-maker.
Bundesarchiv Bild, CC BY

This authoritarian cultural diplomacy reached its peak during World War II, when Nazi Germany attempted to apply a veneer of legitimacy to its military conquests by promoting the idea of a “New Europe” or “New European Order”. Although Hitler was personally sceptical about such efforts, Joseph Goebbels and others within the Nazi regime saw the “New Europe” as a way to gain support. Nazi propaganda promoted the idea of “European civilization” united against the threat of “Asiatic bolshevism” posed by the Soviet Union and its allies.

As seen in Poland: a BNazi anti-Bolshvik poster.

Given the lack of genuine political cooperation within Nazi-occupied Europe, these efforts relied heavily on cultural exchange. The period from the Axis invasion of the Soviet Union in June 1941 until the latter stages of 1943 witnessed an explosion of “European” and “international” events organised under Nazi auspices. They brought together right-wing elites from across the continent – from women’s groups, social policy experts and scientists to singers, dancers and fashion designers.

All of these initiatives, however, faced a common set of problems. Chief among them was the challenge of formulating a model of international cultural collaboration which was distinct from the kind of pre-war liberal internationalism which the fascist states had so violently rejected. The Nazi-dominated European Writers’ Union, for example, attempted to promote a vision of “völkisch” European literature rooted in national, agrarian cultures which it contrasted to the modernist cosmopolitanism of its Parisian-led liberal predecessors. But as a result, complained one Italian participant, the union’s events became “a little world of the literary village, of country poets and provincial writers, a fair for the benefit of obscure men, or a festival of the ‘unknown writer’”.

Deutschland über alles

Despite the language of European cooperation and solidarity which surrounded these organisations, they were ultimately based on Nazi military supremacy. The Nazis’ hierarchical view of European races and cultures prompted resentment even among their closest foreign allies.

Jesse Owens after disproving Nazi race theory at the Berlin Olympics, 1936.
Bundesarchiv, Bild, CC BY-SA

These tensions, combined with the practical constraints on wartime travel and the rapid deterioration of Axis military fortunes from 1943 onwards, meant that most of these new organisations were both ineffective and short-lived. But for a brief period they succeeded in bringing together a surprisingly wide range of individuals committed to the idea of a new, authoritarian era of European unity.

Echoes of the cultural “New Europe” lived on after 1945. The Franco regime, for example, relied on cultural diplomacy to overcome the international isolation it faced. The Women’s section of the Spanish fascist party, the Falange, organised “choir and dance” groups which toured the world during the 1940s and 1950s, travelling from Wales to West Africa to promote an unthreatening image of Franco’s Spain through regional folk dances and songs.

But the far-right’s golden age of authoritarian soft power ended with the defeat of the Axis powers. The appeal of fascist culture was fundamentally undermined by post-war revelations about Nazi genocide, death camps and war crimes. At the other end of the political spectrum, continued Soviet efforts to attract support from abroad were hampered by the invasion of Hungary in 1956 and the crushing of the Prague Spring in 1968.

This does not mean that authoritarian soft power has been consigned to history. Both Russia and China made the top 30 of the most recent global ranking, with Russia in particular leading the way in promoting its agenda abroad through both mainstream and social media.

The new wave of populist movements sweeping Europe and the United States often also put the promotion of national cultures at the core of their programmes. France’s Front National, for example, advocates the increased promotion of the French language abroad on the grounds that “language and power go hand-in-hand”. We may well see the emergence of authoritarian soft power re-imagined in the 21st century.

The Conversation

David Brydan, Postdoctoral Researcher, Birkbeck, University of London

This article was originally published on The Conversation. Read the original article.

Conference Report – Crossing Borders: The Spanish Civil War and Transnational Mobilisation

Conference Report – Crossing Borders: The Spanish Civil War and Transnational Mobilisation, Birkbeck, 30 June-1 July 2016

civil-war-imageEarlier this summer, Birkbeck played host to a two-day conference on the international history of the Spanish Civil War. Crossing Borders: The Spanish Civil War and Transnational Mobilisation was funded by The Reluctant Internationalists research group, Birkbeck, Queen Mary, the University of Kent and the Royal Historical Society, and was organised in collaboration with the Cañada Blanch Centre for Contemporary Spanish Studies at the LSE. Bringing together over thirty scholars from the UK, Europe, the US and further afield, it set out to explore the origins and experiences of transnational mobilisation during the conflict and the immediate post-war period.

The first day began with a panel on the wide range of transnational actors involved in the war, from the Republican politicians who helped to establish the Popular Front movement whilst in exile in Paris in 1934 and 1935, to the international peace activists whose campaigns against aerial warfare encompassed both the Spanish and Chinese civil wars. Complicating the traditional focus on transnational mobilisation in favour of the Republican cause, the panel also discussed the involvement of fascist-dominated veterans’ networks in debates about international intervention, and the international left-wing mobilisation in favour of POUM activists imprisoned by the Republican regime.

The remainder of the day focused on the humanitarian and medical dimensions of transnational mobilisation during the Civil War. A number of papers focused on the thousands of Spanish refugees who were evacuated from Republican zones during the conflict, or who fled to France in 1939. Wartime evacuations were organised both by the Republican government and its allies, and by international humanitarian groups, but were hampered by the political tensions surrounding the conflict. The huge numbers of refugees stranded in France at the end of the war were housed in overcrowded and insanitary camps, with care provided by exiled Spanish medical professionals and by humanitarian organisations. For the international humanitarian community, the Spanish Civil War represented both an intense political, financial and logistical challenge, and a crucial step in the development of new models of humanitarian activity. The conflict itself left thousands of people exiled, bereaved or permanently disabled, with its legacies living on both inside and outside Spain through such individuals well beyond 1939.

The second day shifted focus towards the military dimension of transnational mobilisation. The first panel on propaganda highlighted the ways in which the thousands of Moroccan troops who fought with rebel forces were portrayed and instrumentalised in propaganda on both the Republican and rebel sides. It also demonstrated how the Spanish Civil War came to play a central role in the anti-Bolshevik cultural activities of Nazi Germany. This was followed by two panels which focused on the experiences of the transnational military volunteers who took part in the conflict. The first focussed on the International Brigades, providing a new perspective on this oft-studied topic by highlighting the relations between volunteers of different nationalities within individual battalions, and on the experiences of international volunteers after their return home. It also featured a fascinating presentation on SIDBRINT, a new digital archive on the International Brigades hosted by the University of Barcelona which provides an invaluable resource for scholars interested in the transnational history of the Spanish Civil War. The second panel took a global perspective on transnational military mobilisation, examining the experiences of Arab and Jewish volunteers who fought with Republican forces, and the experience and memory of a Basque town which played host to both German and Italian troops during the conflict.

The final panel of the conference focused in on the transnational lives and experiences of individuals involved in the Spanish Civil War.  Artists such as the Hungarian photographer Kati Horna drew on their experiences of the war to explore the importance of internal and external borders for those who had lived through it. The lives of other individuals and groups continued to be affected by the Spanish Civil War long after formal hostilities had ended, including the Spanish and Catalan women imprisoned by the Nazis at Ravensbrück during the Second World War, and the Czech and Slovak communist volunteers whose post-war political and emotional lives were shaped by their experiences in Spain.

The theme of transnational lives also lay at the heart of the conference’s keynote delivered by Helen Graham (Royal Holloway). A well-attended public lecture hosted by the Institute of Historical Research and introduced by Paul Preston (LSE), this fascinating lecture used the lives of five individuals to explore the significance of the Spanish Republic cause to the continental wars of social change which took place between 1936 and 1948. A podcast of the lecture is available online, and you can find abstracts for all of the conference papers and information about individual speakers here.

Conference report: Globalization of medicine and public health

On March 12 and 13, the University of Lausanne hosted a thought-provoking and intellectually rich conference on the ‘Globalization of medicine and public health: economic and social perspectives (1850-2000).’ Convened by Sanjoy Bhattacharya (University of York, UK), Thomas David (University of Lausanne, Switzerland), Pierre-Yves Donzé (Kyoto University, Japan), Davide Rodogno (Graduate Institute of International and Development Studies, Geneva, Switzerland), this inter-disciplinary meeting aimed to explore the roots, development and consequences of the intensive globalizing trends in medicine and public health since the mid-nineteenth century. As Davide Rodogno and David Thomas said in their opening remarks, the conference sought to provide a critical analysis of the emerging historiography of global health and narratives of globalization, primarily by connecting the history of public health with other approaches such as business and economic history, history of medicine, international history etc. Moreover, the conference aimed to move away from linear and simplistic narratives of international cooperation and harmony, and to study international health organizations as spaces of interrogation, contestation, opposition and imposition of ideas.

The first panel addressed a score of these themes and opened up a number of key questions in the historiography of global public health. Anne-Emanuelle Birn (University of Toronto, Canada) discussed complex ties between philanthropic organizations and global health agencies through the prism of the fraught relationship between two of the most important actors in this field – the Rockefeller Foundation and the WHO. In her analysis of the ups and downs in their cooperation between the 1940s and 1980s, Birn examined the RF’s (often indirect) role in defining the WHO’s approaches and priorities, its participation in the WHO’s personnel, and emphasized the key moments as well as tensions, conflicts and dilemmas in the relations between the two institutions. Her paper explored how these developments affected global health initiatives in the second half of the twentieth century, and how they shaped the current role of philanthropy in the field of global health. Erez Manela (Harvard University, USA) discussed the WHO’s campaign for the global eradication of smallpox in the 1960s and 1970s. Focusing primarily on the US perspective, Manela examined the circumstances of this signal event in the history of global health in the second half of the twentieth century, and asked how this programme managed to achieve its goal of eradication on a global scale in the midst of international conflict, when so many similar initiatives had failed. Manela placed the smallpox eradication programme in the context of the US-Soviet Cold War rivalry and the growing role of the global South in international politics following the de-colonization. A transnational network of experts succeeded in co-opting governmental power and the backing of inter-governmental agencies for the project of small pox eradication at the very moment when the US sought to improve its vulnerable international status, while the programme of international development gained increasing importance for the US government as a tool for containing the spread of Communism in the newly independent countries in Asia and Africa. Nitsan Chorev (Brown University, USA) presented her research on the emergence in the 1970s and 1980s of remarkable local pharmaceutical sectors in East Africa, and explored the structure and development of local pharmaceutical production in Kenya, Uganda and Tanzania in a comparative perspective. According to Chorev, the development of local pharmaceutical manufacturing was seen as an important industrial goal in these countries, as they hoped to free themselves from their dependence on multinational companies and to secure access to necessary medicines. Chorev emphasized three interrelated factors that contributed to significantly different levels of success of local pharmaceutical industries in the three countries: state policies, transnational ties and foreign aid in support of state policies, and capable local entrepreneurs with cross-national ties (the key role was here played by ethnic minorities, for instance Indian Kenyans with their educational ties to the UK and India and work experience multinational pharmaceutical companies). The discussion following the panel was rich and vigorous, and it explored the difference and similarities between the concepts of global and international, but also emphasized the missing link in all three presentations – the Soviet perspective.

The second panel sought to focus on “non-Western visions” in the history of global health. Marcos Cueto (Casa Oswaldo Cruz, Brazil) shed light on the establishment and role of the WHO’s African Regional Office (AFRO) in the 1950s and 1960s, and placed the history of this important regional health agency in the context of the Cold War rivalries and the ongoing struggle for independence in sub-Saharan Africa. While initially this office was led by European experts in tropical medicine, its activities and personnel soon reflected the changing political and social realities in Africa, and this led to the increasing number of African personnel and African member-states. AFRO produced important studies on malaria, yellow fever and onchocercasis, and contributed to the revival of tropical medicine as a discipline, but Cueto’s presentation offered a critical analysis of the complex political role and achievements of this regional agency. On the one hand, the existence and activities of AFRO may have indirectly helped the independence processes in the 1960s, but it also re-produced the dependency of the south of Africa on Western, colonial models, and encouraged problematic discourses in which the newly independent countries of sub-Saharan Africa were constructed as the most underdeveloped and anarchic region in the world in need of a new form of humanitarianism, while AFRO was constituted as an island of (Western-style) modernity and progress. Monica Saavedra (University of York, UK) presented her research on the involvement of Portuguese India in the WHO’s South-East Asia Regional Office, in the final years of the Portuguese colonial rule. Saavedra showed that the WHO and SEARO were not merely forums for scientific and technical exchange and cooperation in the area of health, but also an international political stage where Portugal struggled to lay claim to Portuguese India and to legitimate its rule. This ambiguous relationship with SEARO resulted in political interests overshadowing the health needs of the population, so that official sources were dominated by political manouvres and agendas. The SEARO archive reveals a selective way of dealing with the international health affairs, and illustrates Porugal’s efforts to keep a flimsy balance between international approval and self-interest.

The third panel dealt in some detail with the history of pharmaceutical practices, initiatives and marketing in a global perspective. Jeremy Greene (Johns Hopkins University, USA) presented his research on critical discourses regarding the uneven distribution of access to life-saving pharmaceuticals in different parts of the world between the 1960s and 1980s. Greene explored the key discussions of the role that access to medicines played in international political and health development, and looked at positions of a number of stakeholders – doctors, policymakers, lawyers, manufacturers – in this global mapping of therapeutic inequalities. Julia Salle Younge (Hosei University, Japan) traced the emergence of a global vaccine industry model. According to Yongue, combination vaccines have become the global standard of vaccination in all developed nations — save one. Her presentation then traced the process that led to the formation of a global model for the vaccine industry while comparing two distinctively different cases, the French vaccine industry, which played a central role in the acceptance and propagation of combination vaccines and the Japanese vaccine industry, whose government, until only recently, has promoted the ‘de-combining’ of vaccines as the best means of preventing adverse reactions. The final speaker of the panel, Johanna Conterio Geisler (Birkbeck, UK), provided the sorely missing Soviet perspective and countered the historiographical narratives of the Soviet Union as increasingly isolated and isolationist in the interwar years. Her research explored the development of Soviet pharmaceutical industry in the global context of the 1920s and 1930s, and looked at how Soviet medical and health experts engaged with Western networks and approaches. They actively sought external influences and Western – US – models in order to spur the development of pharmaceutically crucial agricultural products and raw materials in the Soviet peripheries, and aimed to prevent the Soviet dependence on international pharmaceutical monopolies. While Soviet borders were closing down, outside influences continued flowing in.

In the fourth panel, focusing on actors and networks, David Thomas and Davide Rodogno discussed their ongoing project on the history and genealogy of public health fellowships in the twentieth century. They sought to connect the post-WW2 WHO international fellowships programme to its predecessors – the Rockefeller Foundation and UNRRA fellowships. Their research explored continuities and ruptures in this history, and focused on the concepts of human capital and development which informed and shaped the structure and goals of the different health fellowship programmes across the twentieth century. Clifford Rosenberg (CUNY, USA) analyzed the RF International Health Board’s attempt to establish a field programme in French Algeria in the 1920s, following the successful anti-TB programme it funded and ran in France during WWI. Rosenberg’s research explored this failed attempt in a political and colonial perspective, and placed the RF’s initiative in the context of the emerging international institutions and French and Algerian colonial patronage networks. Paul Weindling (Oxford Brookes, UK) presented his research on the RF’s social medicine healthcare experiments in the twentieth century. His paper focused on the RF-funded schemes in Natal, South Africa, in the 1950s. Weindling traced the RF’s efforts to establish a Department of family practice at Durban, the University of Natal, in a new medical faculty for non-white students, and its attempts to obtain guarantees that the non-white graduates would get government posts. While the Durban scheme ultimately failed in the context of the South African apartheid, Weindling argued for its great significance for understanding the history of the RF’s involvement in social medicine healthcare experiments, and he related the Natal health centre to other earlier attempts of the RF to combine primary healthcare with rural development and cultural and social factors.

The subsequent panel dealt with a variety of historical approaches to analyzing ‘Diffusions and models’ in global healthcare. Thomas Zimmer’s paper addressed the history of the Malaria Eradication Programme in the 1950s and 1960s, and specifically explored the role of the World Health Organization in the development and implementation of this initiative. Zimmer (Freiburg University, Germany) argued that, although the WHO financial and material contributions to the MEP were significantly lower than those of the main donor countries (such as the US), the WHO played a fundamental role in coordinating and codifying the Programme by establishing pilot projects which served as future models, lent legitimacy to the very idea of eradication, served as an intermediary between donor and developing countries, and was pivotal in evaluating ongoing projects. The paper concluded that the global malaria eradication was ultimately a WHO project, although the WHO could not have possibly launched or run it by itself and was at mercy of the ebbs and flows of international politics. Pierre-Yves Donze discussed the theme of diffusion and globalization of health models from a slightly different perspective – that of economic entrepreneurs and the history of industrial business. At the centre of Donze’s story was the German electro-medical equipment maker Siemens-Reiniger-Werke and its attempts to re-enter non-European (Latin American, as well as Asian and African markets) in the aftermath of WWII through the project of hospital construction. Instead of merely exporting goods, SRW organized and directed an informal association called Deutsche Hospitalia, which gathered around thirty German manufacturers. They were all involved in constructing and fully equipping the final product – the German hospital, which was then offered to the local governments. Donze analysed the initiative in the context of globalizing trends in medicine, and discussed how SRW contributed to these trends. Yi-Tang Lin (University of Lausanne, Switzerland) critically analysed the nature and production of WHO health statistics in different regions and areas, questioning the value of statistics as neutral markers of local health programmes and placing them in proper socio-political contexts. Lin concluded that the WHO’s strategy of standardization was not making a unique standard, but giving different instructions to countries with different public health administration capacities, and using statistics as a tool for legitimizing health programmes in different countries. Moreover, the WHO forged a network of knowledge transfer by providing fellowships for national health statisticians, inaugurating short-term training centres, and employing a statistician or economist for every regional office.

The final panel of the conference was titled ‘The world as a laboratory.’ Agata Ignaciuk (University of Granada, Spain) presented a comparative study of the leading European and US pharmaceutical companies’ strategies and practices for marketing the contraceptive pill in Francoist Spain and socialist Poland in the 1960s and 1970s. Although the two markets were radically different from the West European and American ones, as well as form each other, Ignaciuk was able to identify striking similarities. In the Spanish case, although sale and advertising of contraception had been banned until 1978 and the pill was marketed as a therapeutic drug, the pharmaceutical strategy was not fundamentally different from that practiced in Western Europe or the US, and focused on normalizing the idea of family planning among physicians and the broader public. According to Ignaciuk, this helped legitimize the idea of contraception in Spain, and aided its social and medical acceptance well before 1978. On the other hand, although the Western pharmaceutical companies were significantly less successful in the context of Poland’s nationalized industry and state markets, their marketing strategies and persistent attempts to approach Polish institutions throughout the 1960s and 1970s prepared the market for a massive expansion in the 1990s. Dora Vargha (Birkbeck College, UK) discussed the development and coordination of polio live vaccine trials in the late 1950s and early 1960s in as many as fifteen different countries on four continents. Vargha’s presentation revised the common historiographical understanding of the globalization of pharmaceutical research, and demonstrated that the 1950s and 1960s were in fact the crucial decades for the internationalization of drug testing, while polio vaccine trials were among the first truly global phenomena in twentieth-century medicine. Her paper shed light on the nature, assumptions and mechanics of international cooperation between health institutions, governments and individual researchers in organizing polio vaccine trials and evaluating their results. Sarah Hartley (University of York, UK) focused on the international, regional and colonial politics of nutrition in British Colonial Fiji over the two decades after WWII in order to assess how the relationships between various health agencies – UN, WHO and FAO bodies, as well as regional and colonial administrations and offices – affected the design and delivery of nutrition programmes, and the development of international health. Hartley showed how the South Pacific Commission (a Western dominated multi-governmental agency), the South Pacific Health Service (the British and New Zealand colonial health service), and the regional offices of WHO and FAO sought to shape health policy in accordance with their individual ideological and security needs in the South Pacific region. The resulting networks of political and professional allegiance created a patchwork of practice in the field of nutrition across the South Pacific.

In the final analysis, this conference offered a rich and sophisticated account of the complex political and economic circumstances in which twentieth-century international health projects and initiatives emerged and developed – the vagaries of the Cold War constituted the core theme of most presentations. Many papers successfully explored the convoluted relations between pharmaceutical businesses and health organizations; others sought to evaluate the role of experts, their intellectual trajectories and meeting places, as well as their attempts to co-opt political governments for various unorthodox international health endeavours in the context of extreme political rivalries. The conference also emphasized the multiple effects of colonialism and de-colonization on the development of international medicine and health, and several participants attempted to move away from exclusively Anglo-American and Francophone accounts of health globalization. At the same time, while the conference aimed to engage the discussion of scales of historical analysis and to shed light on how international public health programmes were implemented at the local level, it did not devote enough attention to exploring the wealth of social and cultural consequences of such globalizing forces in different parts of the world. Most papers addressed institutional histories or discussed the role and discourses of individual experts, researchers or health administrators, and offered almost exclusively top-down accounts. Many of these narratives would have likely been significantly different – or at least enhanced – if told from the perspective of cultural and social history, history from below and medical anthropology: how did such important international medical and health projects, plans and initiatives transform the social micro-universe of those on the receiving end? did these health programmes induce any significant cultural shifts in how people – patients, physicians, lawmakers – in different parts of the globe thought of and defined illness, death, medicine, political ideology or nation and internationalism? how did the globalization of healthcare and medicine change everyday lives and human interactions? Some of these themes were occasionally touched upon in the course of the conference, but they certainly remain important potential topics for future meetings.

A brief history of World Health Day

WHO headquarters on World Health Day

WHO headquarters on World Health Day

The 65th annual celebration of World Health Day took place last week on 7th April, with a global launch of the Small Bite: Big Threat campaign against vector-borne diseases at the WHO’s Geneva headquarters. Over half of the global population is at risk of diseases such as malaria, dengue and yellow fever, all of which are preventable but which but have the biggest impact on some of the world’s poorest people. To highlight the risks to travellers, WHO staff installed a 3-D illustration of a giant mosquito at Heathrow Airport and distributed World Health Day boarding passes to passengers, drawing attention to the danger of vector-borne diseases and the simple measures they can take to protect themselves.

‘World Health Days’, the WHO’s Director-General Margaret Chan told visitors to the launch event in Geneva, ‘provide an opportunity to focus world attention on a health problem or issue that deserves special attention.’ Celebrations over recent years have focussed on antimicrobial resistance, climate change and road safety among other issues.

The first World Health Day took place in 1949, not on 7th April but instead on 22nd July, the date that 61 nations had signed the charter of the World Health Organization at New York in 1946. Documents in the WHO archives suggest that the goal of these early events was less to raise awareness of specific health issues, and more, in the words of the first Director-General Brock Chisholm, ‘to encourage public interest in and support of the aims of the Organization.’[1]

World Health Day Stamp PalestineIn 1949, individual governments were charged with organising events in their own countries and they took up the challenge with varying degrees of zeal. New Zealand led the way with a range of national and local events organized by branches of its United Nations Association. Ireland, Turkey, Austria, Italy and South Africa also responded, organising radio and cinema broadcasts, concerts, press releases and government-directed bible readings amongst other activities. The WHO headquarters in Geneva provided information about the organisation’s early success in combatting malaria in Italy and Greece, providing tuberculosis vaccines in India and responding to a typhus epidemic in Afghanistan. It also distributed a range of publicity materials and suggestions to national government, including a call to issue commemorative postage stamps (a perennial favourite of international organisations at the time).

Not everyone greeted the event with such enthusiasm however. Some countries felt they hadn’t had enough time to prepare suitable activities, whilst others sensibly pointed out that holding such a celebration when most children were on school holidays would severely blunt its impact. The WHO agreed, and the Second World Health Assembly decided that from 1950 World Health Day would be celebrated on April 7th, to commemorate the date in 1948 when the WHO constitution had officially come in to force.

The decision to link World Health Day to the foundation of the WHO highlights some interesting tensions in the early history of the organisation. In 1949 the US and Venezuela protested that they had been successfully celebrating Pan-American Health Day on 2nd December ever since the foundation of the Pan-American Sanitary Bureau (PASB) in 1902, both suggesting that World Health Day should share the same date. The relationship between the PASB and the WHO was one of the biggest areas of debate at the 1946 New York conference that drew up the WHO constitution. Whilst many delegates, particularly from Europe, emphasised the importance of having a single global health organisation, American states were keen to see the work of the PASB continue. The debate around the issue created significant divisions within the conference, including between Britain and the US. Eventually it was agreed that the PASB would continue as the WHO’s regional office for the American continent, although the exact timescale for its incorporation was left deliberately vague.

Implicit in the connection between World Health Day and the foundation of the WHO was the idea that action in the realm of global health somehow began when the organisation was founded, potentially underestimating the legacy of the various international health bodies such as the PASB which had preceded it. To mark this year’s World Health Day, the in-house magazine for the WHO and the UN in Geneva, UN Special, published an article on the birth of the WHO. It focusses on the meeting between three medical men, Szeming Sze, Geraldo de Paula Souza and Karl Evang, at the United Nations Conference on International Organization in San Francisco in 1945. It quotes Szeming Sze’s memoirs as saying the formation of the WHO “all came about quite accidently”, with the first mention of a new health organisation at the conference coming from Dr. Evang at a lunch meeting between the three men, and that it was their efforts to persuade other delegates that led to the decision to create a world health body.

Microfiche copy from the WHO archives of an early WHO document written on an old League of Nations template

Microfiche copy from the WHO archives of an early WHO document written on an old League of Nations template

Whilst this account is perfectly accurate, it somewhat downplays the extensive debates that had been taking place for at least the previous three years about the design and role of a future international health body, both within Allied governments and international organisations such as UNRRA. Central to these debates was the example of the League of Nations Health Organization, a body which had made significant contributions to the field of international health in the interwar period and which ultimately provided much of the template for the design of the WHO. It had continued to function in a much reduced form throughout the Second World War and its leading members were active participants in the debate about the shape of a post-war world health body. When the WHO Interim Commission began its work in 1947, it based itself in the same building as the League’s health section, employed many of the same personnel, and as we can see from the document above, even used the same stationery.

Indeed the same vector-borne diseases that the WHO was and is working to combat were also a key focus for the League, which established its own malaria commission in the 1920s. The fact that after nearly a century of international activity these diseases remain such a problem highlights the relevance of this year’s World Health Day campaign.

 

Further Reading:

Yves Beigbeder et al., The World Health Organization (Dordrecht: Nijhoff, 1998)

Iris Borowy, Coming to Terms with World Health: The League of Nations Health Organisation 1921-1946 (Berlin: Peter Lang, 2009)

Neville Goodman, International Organizations and Their Work (Edinburgh: Churchill Livingston, 1952)

Szeming Sze, The Origins of the World Health Organization: A Personal Memoir 1945-1948 (Boca Raton: L.I.S.Z. Publications, 1982)

Paul Weindling (ed.), International Health Organisations and Movements, 1918-1939 (Cambridge: Cambridge University Press, 1995)



[1] Documents relating to the history of World Health Day can be found in the WHO archives, Centralized Files First Generation, section 400-1-2. All unattributed material from this post comes from these files.

Taking the Waters in Sochi

 

Patients on their way to the Matsesta baths from the Sanatorium Krasnaia Moskva in 1928 or 1929. From Sochi: Stranitsy proshlogo i nastoiashchego, ed. A.V. Guseva (Sochi: Muzei istorii goroda-kurorta Sochi, 2007).

Patients on their way to the Matsesta baths from the Sanatorium Krasnaia Moskva in 1928 or 1929. From Sochi: Stranitsy proshlogo i nastoiashchego, ed. A.V. Guseva (Sochi: Muzei istorii goroda-kurorta Sochi, 2007).

The Olympic website for Sochi 2014 (http://torchrelay.sochi2014.com/en/city-sochi) and media coverage occasionally detail the history of the development of Sochi, tying it in the main to the growing popularity of sea bathing in Russia in the early twentieth century. The rise of sea bathing certainly did increase the popularity of the resort, in the context of the rise of tourism on the entire Black Sea coast. But that is only part of the story. The resort was also developed, after the discovery of the presence in Sochi of sulpheric mineral waters at the source “Matsesta,” as a resort for mineral water cures. Many of the first tourists to Sochi were actually patients.

While “taking the waters” is  unfamiliar  to many people, it was at the time of the first and second waves of development in Sochi – in the 1910s and mid-1930s –  still mainstream medical therapy throughout Europe, and continues to be in many places to this day. The mid- to late-nineteenth century saw the rise of the baths, tied to the spread of the railways and increasing accessibility of  travel to an expanding bourgeoisie. The circulation of visitors to baths in Central Europe increased dramatically in the 1850s, in the wake of railway construction. The leading baths of Central Europe were Wiesbaden and Baden-Baden, which saw about 30,000 visitors a year each in the 1850s. In Imperial Russia, the railway reached from Rostov-na-Donu to the Caucasian Mineral Waters, an established military resort, in 1875, leading to a burst in the construction of hotels, dachas (summer cottages) and restaurants. That decade the railways also reached the baths of the Austro-Hungarian Empire. In 1888, the railway reached the Black Sea port of Novorossiisk, opening the Black Sea coast of the Caucasus, where Sochi is located, to a new wave of development. As the railways reached out into the flesh of the empires, circulation began to flow domestically and internationally.

As today, the development of the Black Sea coast was spurred by state intervention and investment. The region was in the early twentieth century scarcely populated, and attempts to settle peasants from other places in the empire there as farmers, through various economic and social incentives, were not a success. A particular problem was that malaria was endemic to the region. In the late nineteenth century, Tsar Nicholas II began to ponder targeting the coastline as a site for the development of tourism. But what would draw people to the region?

In 1912, the Tsar sent a large delegation of scientists, including the leading balneologists of the empire, to the region to search for mineral water sources. If mineral waters could be found, perhaps they could serve as a nucleus to draw tourists to the region (and away from rival baths in Central Europe). The delegation reported back that their greatest hopes had been answered. The region was laden with rich deposits of mineral waters, largely untapped. The scientists compared the baths of Matsesta  to the baths of Aachen in Western Germany, due to their sulpheric content, a mineral water source called the Kaiserquelle.

The news of the riches of the region, and imperial approval for their development,  spread quickly. The first development of the Matsesta waters rested on private capital. A joint stock company was formed to fund the development of the Matsesta mineral waters and in 1912, the first bath house there was opened. Sochi-Matsesta was an ingénue among resorts – aristocrats largely remained loyal to the more established Crimean resort of Yalta or the Caucasian Mineral Waters resort. The Black Sea Coast was particularly attractive to a middle class health resort patient, or kurortnik, as well as patients of the Jewish faith (whose presence was banned  at established Imperial Russian resorts). Dachas and villas as well as modest pensions and inns began to be built and there was even some land speculation. Sochi-Matsesta boomed, very briefly, and the development of spa medicine improved when imperial resorts served the front during World War I. The resorts on the Black Sea coast grew from almost nothing at the beginning of the twentieht century through the help of speculators and developers to receive 75,000 visitors in 1912.

 

A Patient at the Matsesta bath house in the 1920s. From L.G. Gol’dfail’ and I.D. Iakhnin, Kurorty, Sanatorii i doma otdykha SSSR 1928 (Moskva: Gosudarstvennoe izdatel’stvo, 1928).

A Patient at the Matsesta bath house in the 1920s. From L.G. Gol’dfail’ and I.D. Iakhnin, Kurorty, Sanatorii i doma otdykha SSSR 1928 (Moskva: Gosudarstvennoe izdatel’stvo, 1928).

With the Bolshevik revolution of 1917, the fate of the resorts of the empire seemed unclear. In the nearby Weimar Republic in Germany, for example, despite revolution, the celebrated baths remained largely in the hands of the elite segments of society, beyond the reach of the state. But the Communist party and  state was determined to develop health resorts “for the workers.” In 1919, Lenin signed a decree nationalizing all health resorts, which reserved them for the use of the workers, peasants and Red Army soldiers in first order, for medical treatment. Filling the old Tsarist palaces with workers and peasants had obvious propaganda value. In Sochi, sanatoria were established in pre-revolutionary villas, hotels and private clinics (see Figure 1). But the level of state investment in the network of health resorts, and of medical services there, make it clear that this was not a mere “Potemkin village.” The state, and particularly the committed physicians at the head of the new, state public health ministry, the Commissariat of Public Health, took health resort medicine seriously, not least mineral water treatments, as a way to improve the health of the entire population.

The use of the Matsesta waters increased dramatically, largely due to patients sent for a “cure” by the Commissariat of Public Health (See Figure 2). In the 1920s, a cure usually lasted from four to six weeks, and included from 15 to 30 baths with Matsesta waters. Physicians sent patients  to Matsesta to cure chronic eczema and other skin conditions, gout, various nervous ailments, syphilis, chronic rheumatism, gynecological ailments and ailments of the heart, circulation and digestion, but patients also took the waters of their own accord, “off label,” for whatever ailed them. The number of patients using the Matsesta waters increased from 67 in 1920, to 3,921 patients in 1925. The most rapid expansion, however, came during the years of industrialization of the late 1920s and 1930s: from 1927 to 1932 the number of patients taking the Matsesta cure increased from  7,980 patients to 48,574 patients. The number of baths taken increased from 1921 to 1932 from 1,345 baths  to 731,218 baths. A second bath house was built. But demand outpaced supply. By 1937, the Matsesta bath houses were working from 6 a.m. until 11 p.m.

The Soviet leaders were justifiably proud of their accomplishment, but rather overstated their role in developing the resort. Frequently not included in Soviet statistics were numbers from the pre-Revolutionary period: 18,604 baths were administered in 1913, 17,395 baths in 1914, 16,982 baths in 1915 and 21,586 baths in 1916.  Indeed, the pre-revolutionary peak in 1916 was not reached in the Soviet Union until 1923. In the 1920s and 1930s, as now, the idea that  the resort was “new”  served the  symbolic project of treating their development as a  display of state power. Patients continue to take the cure at the Matsesta waters  to this day (See Figure 3). 

 

The bath house “Staraia Matsesta” in 2009. Photograph taken by the author

The bath house “Staraia Matsesta” in 2009. Photograph taken by the author

 

For Further Reading:

Diane P. Koenker, Club Red: Vacation Travel and the Soviet Dream (Ithaca: Cornell University Press, 2013).

Mirjam Zadoff, Next Year in Marienbad: The Lost Worlds of Jewish Spa Culture (Philadelphia: University of Pennsylvania Press, 2012).

Douglas Peter Mackaman, Leisure Settings: Bourgeois Culture, Medicine and the Spa in Modern France (Chicago: Chicago University Press, 1998).

John K. Walton, ed., Mineral Springs Resorts in Global Perspective: Spa Histories (London: Routledge, 2013).

Eric Thomas Jennings, Curing the Colonizers: Hydrotherapy, Climatology and French Colonial Spas (Durham: Duke University Press, 2008).

To Hungary with Love

Dora Vargha’s blog post on November 25th discussed the current financial difficulties faced by the Peto Institute in Budapest in the context of historical approaches to disability in Hungary. The Institute may be familiar to British readers who remember its rise to prominence in the late 1980s and its role in the debate around conductive education in the treatment of children with neurological disorders. The links between the UK and the Peto Institute provide a fascinating example of patient-led transnational history in Cold War Europe.

Princess Diana at the Peto Institute (1990)

The Institute first came to public attention following the broadcast of the BBC documentary Standing up for Joe in April 1986. The documentary followed the story of the Hadley family who had taken their severely disabled son to Budapest for treatment. The Institute pioneered the system of conductive education developed by its founder, Andras Peto, in the aftermath of the Second World War, which involved an intensive programme of physical and speech therapy under the supervision of “conductors” combined with very high expectations of the progress children could achieve.

The documentary, broadcast at prime time on BBC1 and watched by over five million people, caused a national stir. The BBC received 11,000 letters of enquiry, questions were asked in parliament, and a lobby group, the Foundation for Conductive Education, was set up to promote its use in the UK. The system was presented in the media as more holistic than the medicalised approach to treatment in the UK, and many parents were attracted by the positive expectations it had of potential progress against a perceived negativity and conservatism amongst UK medical staff. Over the following years UK families flocked to Budapest, often supported by national and local campaigns to raise funds for treatment. The Times estimated that over 600 UK children had visited the centre by 1990.

However, the treatment was not without controversy. Many within the British medical establishment felt that the claims for its success were overblown, and that the appearance of progress owed much to the fact that the Institute was selective in the cases it accepted. The Chartered Society of Physiotherapy published a report in 1988 questioning many of the Institute’s claims, whilst the Spastics Society, initially wary of the programme, was picketed by the Foundation for Conductive Education over claims that its own conductive education schemes weren’t the real thing.

One of the most interesting features of the coverage of the Institute is its presentation in the context of the Cold War. Andrew Sutton, the Director for the Foundation for Conductive Education, described it as a ‘Len Deighton Cold War story, coming from a street near you’, with the media frequently describing families moving “beyond the iron curtain”. It certainly represents one of the most widespread and high profile instances of UK residents experiencing life in the Eastern Bloc prior to the end of communism. The BBC’s follow-up documentary to Standing up for Joe broadcast in 1987, which tracked the story of the British families who had followed in the Hadley’s footsteps, was entitled To Hungary with Love.

The Peto Institute also played a role in Anglo-Hungarian relations during the transition to democracy. In December 1989 the UK government announced £5 million of funding for the Institute’s new international centre to guarantee places for British children and pay for training of a group of British conductors. This funding was discussed as part of a wider package of support when Hungarian Prime Minister Miklos Nemeth visited Margaret Thatcher on December 14th. In an article on the 6th January, The Times presented the funding as part of a range of government measures to form closer medical and scientific links with the Soviet Union and Eastern Bloc countries. Following the first free elections in March 1990, Princess Diana made a high profile visit to the Institute as part of a four-day tour of Hungary where she presented an honorary OBE to its director, Dr Maria Hari.

The controversy around conductive education has never entirely gone away. In 1993 the government-commissioned Birmingham Project indicated that it was no more effective than comparable UK treatments, a claim that continues to be challenged by its adherents, whilst in 2003 Peter Randall from Kent attempted to sell his kidney on ebay to fund conductive education for his daughter. Although conductive education is now more widely available in the UK, British children continue to visit to Peto Institute for treatment.