At the end of May, Birkbeck hosted the ‘Languages of Internationalism’ conference, the last major event of the Reluctant Internationalists project. Co-organised with our former Visiting Fellow Brigid O’Keeffe (Brooklyn College, CUNY), the conference aimed to shed light on the centrality of language to people’s pursuit and experiences of internationalism. The full programme from the conference can be viewed here, and all of the papers are available to listen to as podcasts via SoundCloud or through the central Birkbeck College iTunes channel.
Language is at the heart of every international enterprise, but as the conference showed, it presents obstacles and dilemmas, as well as opportunities. Many of the papers emphasised frictions and tensions which emerged over the use of languages in international settings. In socialist youth camps during the Cold War, for example, Eastern European delegates displayed resentment towards Soviet translators and Russian speakers as symbols of Soviet cultural imperialism (Diana Georgescu, UCL). In international Jewish congresses during the nineteenth and early twentieth-centuries, fierce debates broke out over the role of German, Yiddish and Hebrew as languages of transnational Jewish communication (Marc Volovici, Princeton). Many of these tensions stemmed from attempts to deploy language as tools of national or imperial dominance.
As other speakers argued, ideologies could act as languages through which adherence could build transnational solidarities. The language of socialism was explored by a number of speakers. Although Russian was promoted as the common language of the socialist world by the Soviet Union, particularly in Cold War Eastern Europe, socialists from different parts of the world could also find ways of communicating through the language of socialist solidarity without using Russian (Elidor Mëhilli, Hunter College, CUNY). The language of feminism also served to build ties between women from very different cultures and backgrounds, although language difficulties were one of the factors hindering understanding at international events such as the 1975 International Women’s Year conference in Mexico (Jocelyn Olcott, Duke).
The problems of translation and miscommunication have driven many attempts to construct new international forms of communication, most famously in the case of international languages such as Esperanto. The growth of international organisations over the course of the twentieth-century, as well as the expansion of global communication technologies such as the telegraph, encouraged the use of statistics as a tool of international communication, particularly in technical fields such as health (Heidi Tworek, British Columbia). In the cultural field, writers and publishers saw the ‘language of action’ and simplified writing styles of children’s books such as the Curious George series as a medium which could be easily translated across borders, although cultural, political and national differences still continued to pose problems (Yuliya Komska, Dartmouth College).
The conference showed how language could be a tool of communication, solidarity and unity, as well as a force of division and alienation. But it also made clear the centrality of language in the performance, experience, and pursuit of internationalism.
This blog post by David Brydan is part of, and has been cross-posted from, Remedia blog which examines the history of medicine in dialogue with the present. The project focuses on areas of the history of medicine with particular contemporary relevance. The original post can be accessed here.
In November 1941, health officials and experts from 20 states attended an international tuberculosis conference in Berlin, founding a new international association to fight the disease.[i] On the surface, it appeared to be a straightforward example of the type of international health cooperation that had become increasingly common since the mid-nineteenth century.
The reality, however, was very different. The conference was organized by the Reich Health Office, and involved only Axis, occupied, or neutral states. It took place in the context of a European public health crisis provoked by the Nazi war effort and occupation, a crisis which witnessed the deliberate starvation of millions of Soviet prisoners, restriction of food, fuel and medical supplies across the occupied territories, and the unchecked spread of disease in Jewish ghettos.
In the midst of this political, military and public health crisis, experts from across Europe continued to cooperate under the rubric of the Nazis’ European ‘New Order’, working together on tuberculosis, typhus, health insurance, and other issues.[ii] Their conferences and meetings consciously echoed the language and practices of pre-war international health. Participants emphasized the technical and humanitarian credentials of international cooperation, and their shared interest in tackling diseases which transcended national borders.
But what, if anything, was distinct about these forms of fascist international health? And how do we square them with the implacable hostility European fascists felt towards the internationalism embodied by organizations such as the League of Nations?
Totalitarian Public Health
For many of those involved, the restructuring of European political life under Nazi dominance provided the opportunity to forge a new, more effective form of international health. Speaking at the 1941 conference, the president of the Reich Tuberculosis Committee, Otto Walter, lamented that international efforts to tackle the disease in the past had not always been effective. The war, he argued, had brought the people of Europe into much closer contact than ever before, ushering in a new era of ‘intimate collaboration’ which would allow them to move beyond the sterile debates of the past and implement real change.[iii] Under the Nazi New Order, the talking shops of pre-war international health would be replaced with vigorous, effective action to stamp out disease.
The flip side of this argument was that cooperation between health experts would act as a stepping-stone towards wider European integration under Nazi dominance. For Walter, public health was the ideal vehicle for strengthening international cooperation, because ‘no state wishes to become better than the others in preserving the health of its own people.’[iv] The Reich Health Minister, Leonardo Conti, compared the new anti-tuberculosis organisations to the political mission of the Anti-Comintern Pact, which reflected the unity of ‘intimately connected peoples, who constitute a bloc with a common destiny.’[v]
Some participants argued that this unity was underpinned by a shared commitment to a new form of ‘totalitarian’ public health. Spanish experts in particular argued that the totalitarian states of the New Order had rejected the individualistic medicine of pre-war liberalism. In its place, they argued, these states were creating health systems geared towards the ‘imperious necessity to attend sufficiently to the multitude’, harnessing the power of the state in the interests of the Volk or pueblo as a whole, rather than the priorities of individual patients and doctors.[vi] Others identified a new ‘totalitarian theory’ of health insurance emphasizing labour and the family, which had ‘come to fill a void and resolve a problem which has never, until now, been solved within the framework of national legislation.’[vii]
Widely shared enthusiasm for the idea of totalitarian public health in part reflected the political sympathy many of Europe’s health experts felt towards fascism and the Nazi project. But not all of those involved in these forms of wartime international health cooperation were fascist fellow-travellers. Many had worked with groups such as the League of Nations Health Organisation and the Rockefeller Foundation before the war, and would go on to cooperate with the WHO and UNICEF after it.[viii] Others, including Spanish participants in the 1941 tuberculosis conference such as José Palanca and Gerardo Clavero, belonged to more conservative factions within authoritarian national regimes, and consciously distanced themselves from fascist politics.
For these individuals, however, cooperating with Nazi Germany on public health conveyed a range of benefits, including professional prestige, access to international networks, and the opportunity to negotiate with German authorities for scarce supplies of drugs and vaccines. These professional and practical benefits outweighed political concerns about collaborating with the Nazi regime.
‘The Nazis despised me’
Perhaps unsurprisingly, these forms of fascist international health were beset by tensions between the nations involved. Some of the tensions stemmed from ideological differences, including over Nazi attitudes to race, religion and eugenics. Experts in Italy and Spain were more comfortable with the idea of a ‘positive’ Latin eugenics underpinned by Catholic values than with the hard, biological eugenics of the Nazi regime.[ix] This was reflected in patterns of international cooperation in the fields of population policies and racial hygiene. Generally, Spanish, Italian and Portuguese experts were keener to work with each other rather than with their counterparts from Nazi Germany.
These ideological differences, however, should not be overstated. Far more significant were the tensions stemming from the hierarchical nature of the Nazi New Order. International health under the New Order was largely planned and coordinated from Nazi Germany, and was designed to cement German leadership within the new European scientific community.
Although Italy remained a relatively equal partner until Mussolini’s fall from power in 1943, other countries were emphatically subordinate. The head of the Italian Anti-Tuberculosis Federation, for example, was appointed president of the new International Association Against Tuberculosis established in 1941, but the organization was based in Berlin and run by German health officials with only minor roles reserved for Spanish and Hungarian experts.
Like many of the Europeans who visited Nazi Germany during the war, non-Germanic health experts were conscious of their subordinate status in Nazi racial hierarchies. ‘As a southerner and Mediterranean’, wrote one Spanish expert in his memoirs, ‘I knew at the end of the day that the Nazis despised me.’[x]
The Politics of International Health
International health cooperation during the Second World War represented an effort to forge a new European health system under German control, part of a wider attempt to establish a New Order for science and culture in Europe.[xi] At its peak between mid-1941 and the end of 1942, the future of this New Order seemed assured, attracting the willing participation of health experts and officials from across the political spectrum of the European right. The project failed, however, and left little lasting trace on the international health landscape. Despite the tensions between the participating countries, this failure was the result of Axis military defeat rather than inherent scientific or ideological contradictions.
The history of fascist international health suggests that we should be wary about the rhetoric which often surrounds cross-border medical cooperation. The humanitarian and scientific benefits of effective international cooperation cannot be denied. But as the recent case of the British medical students who volunteered to serve with Islamic State in Syria suggests, such work can be harnessed to a wide range of political and ideological projects, from liberal internationalism, to fascism or religious fundamentalism. International health is indeed a technical and humanitarian endeavour, but it is also a deeply political one.
[i] ‘La fondazione dell’Associazione Internazionale contro la Tubercolosi’, Lotta Contro La Tubercuolosi, 13:3 (1942): 236–59; ‘L’associazione internazionale contro la tubercolosi’, Rivista Italiana d’Igiene, 2:1 (1942): 78–9.
[ii] David Brydan, ‘Axis Internationalism: Spanish Health Experts and the Nazi “New Europe”, 1939-1945’, Contemporary European History 25:2 (2016): 291–311.
[iii] ‘La fondazione dell’Associazione Internazionale contro la Tubercolosi’, Lotta Contro La Tubercuolosi, 13:3 (1942): 244.
On February 3rd over twenty researchers gathered at Birkbeck to discuss the history of socialist internationalism during the Cold War, a field which has seen increasing scholarly interest over recent years and which has been of particular interest to the Reluctant Internationalists project.
As Johanna Conterio (Birkbeck) explained in the introduction to the conference, recent historiography has complicated traditional images of the Cold War as a period of blocked mobility, revealing the extent of cooperation and exchange both behind and beyond the Iron Curtain. The conference aimed to discuss these patterns of mobility, promote dialogue between Soviet and East European historiographies, and explore the global dimensions of socialist exchange.
The first panel focused on culture within and beyond the socialist world. Kristin Roth-Ey (SSEES) questioned the traditional focus on the exchange of high culture in the socialist world, arguing that it was less important than the objects of mass culture – Bollywood musicals, Latin American melodramas, radio broadcasts and the press – which circulated between the Soviet Union and the Third World. Soviet cultural production, like its technology and industry, was dominated by the ‘aesthetic of the big’, and it was through this mass culture that ideas about the Second and Third Worlds were exchanged. Paul Betts (Oxford) introduced material from a forthcoming photo exhibition organised by the Socialism Goes Global project on Tito’s diplomatic missions to Africa. Official images of Tito on safari, signing trade deals, watching traditional dancers and opening new hospitals presented an aesthetics of equality, highlighting the fraternal mixing which supposedly characterised relations between Yugoslavia and socialist-leaning Africa, in contrast to the racial hierarchies of the former imperial powers. Simon Huxtable (Loughborough) discussed Cold War television as a transnational phenomenon. Intervision, the Eastern Bloc’s broadcasting organisation, was designed as a vehicle for socialist internationalism, promoting programmes such as the Intervision song contest. But while viewers in Eastern Europe were exposed to programmes from the Soviet Union and other socialist countries, they also had access to western programming, in some cases broadcast directly from the West, in others cases purchased or copied by socialist broadcasters. Intervision thus created a broader space of socialist identity, while at the same time introducing Polish viewers to Sesame Street. Katarina Lichvarova (Courtauld Institute) discussed Soviet avant garde art movements, using the Dvizhenie group to explore the circulation of ideas and exhibitions both within the Eastern Bloc and across the Iron Curtain. Dina Fainberg (City University) concluded the panel by showing how Soviet journalists presented the US counter-culture protests of 1968 as evidence of the growing hold of socialist values. Appearing alongside reports of the Soviet intervention in Prague, however, these accounts lent themselves to subversive readings and risked undermining the notions of socialist international community they were intended to promote.
The second panel shifted focus to trade and exchange. Alessandro Iandolo (Oxford) used relations between the Soviet Union and Ghana in the early 1960s to explore the role of development cooperation in Cold War socialist internationalism. Soviet attempts to promote a model of economic development based on industrialisation and mechanised agriculture appealed to the Ghanaian government, which was keen to gain support for its hydroelectric and infrastructure projects, but were met with suspicion from the former imperial powers in West Africa. Kristy Ironside (Manchester) discussed the difficulties in comparing money and prices in the communist and capitalist worlds. Soviet officials systematically drove down prices for everyday goods from the early 1950s, but were frustrated by their inability to promote these achievements to the rest of the world because of the difficulty of translating socialist economic indicators to western price models. Katarzyna Jezowska (Oxford) showed how the Polish pavilion at the 1956 Damascus trade fair was designed to convey a specific sense of socialist modernity, using modernist aesthetics and technological innovation to promote the achievements of Polish reformers. Yakov Feygin (Pennsylvania) examined the history of ‘mathematical internationalism’ – economic experts in both socialist and capitalist economies united by a belief in the power of maths and computing to secure economic development. The diplomatic thaw of 1967 created a space for Soviet experts to participate in international exchanges on economic reform and development, but their attempts to introduce markets and elements of supply and demand into the Soviet economy broke down in the early 1980s.
The third panel explored models of socialist development, focusing particularly but not exclusively on medicine, urban planning and the environment. Kate Lebow (Oxford) presented her research on the memoir-writing competitions organized by Polish sociologists among workers and peasants in the interwar period, which unveiled, among other things, a number of assumptions about the place of home and homeland in global networks, and about rights and justice, in personal narratives. Timothy Nunan (Freie U, Berlin) used the case of the Afghan regime of the 1980s to explore the overlap between socialist and Islamist internationalisms. Rather than making a distinction between the two, Afghan socialists argued that they were also Islamists. Although socialist internationalism was important to them, it also acted as a bridge to wider debates about anti-imperialism and pan-Islamism. Robert Balogh (Budapest) explored Hungarian forestry research into Scots pine, showing how experiments into agricultural, industrial and environmental aspects of pine cultivation circulated between Eastern Europe, Western Europe and international organisations such as the FAO. Jo Laycock (Sheffield Hallam) examined the complex network of non-governmental actors, governmental administrators and recipients of relief and their interactions in post-genocide Armenia. Dora Vargha (Exeter) concluded the panel with a discussion of the polio vaccination campaigns of the 1950s and 1960s, which developed at the intersection of liberal internationalism, international scientific networks, and socialist internationalism. The socialist world was seen as the perfect place to carry out global vaccination trials because of the nature of socialist health system, while international experts argued at the same time that there was ‘no Cold War’ in the fight against disease.
The fourth panel continued discussions about the global spread and reach of socialist projects. James Mark (Exeter) discussed changing representation of Cubans in Hungary through photographs and photo journalism, where he detected a shift from Cubans being portrayed as heroes to featuring as poor workers on the periphery. Tobias Rupprecht (Exeter) explored the East European fascination with global forms of free-market authoritarianism in the late 1980s and early 1990s. For many reformers across the region, he argued, ‘the West’ was not the only source of inspiration; economically successful dictatorships as Chile, South Korea and Singapore also provided crucial lessons. Ana Antic (Exeter) talked about Yugoslav psychiatrists’ technical aid missions to Guinea in the 1960s, and considered the extent to which they contributed a Marxist perspective to transcultural psychiatry. Psychiatrists’ discussion of African ‘primitivism’, she pointed out, mirrored their perceptions of ‘primitive’ patients in Yugoslavia itself.
Socialist Internationalism Conference, Birkbeck College, University of London
3rd February 2017
Research on the global history of socialism has been growing, but the majority of narratives and frameworks for approaching the history of the so-called ‘socialist world’ are still focused on the relationship of the United States and the Soviet Union. In a one-day workshop, to be held on Friday 3rd February at Birkbeck College, discussion will take stock of recent historical contributions that shift focus away from the superpowers and from Washington and Moscow, and instead consider the circulation of ideas, goods, people, and practices within and beyond the socialist and communist worlds on their own terms.
Which conventional Cold War concepts does taking a global approach to the history of socialism and communist reinforce, and which does it contest? What are the conceptual and methodological challenges of constructing an alternative history of internationalism from a global socialist perspective? Was there such a phenomenon as ‘socialist globalisation’ and what did it entail in the context of the Cold War and decolonisation? How do we understand the global boundaries and exchanges between the communist world in the East and the institutions of (non-communist) socialist internationalism in the West? How does shifting perspectives away from the US-Soviet binary change our understanding of socialist networks? To what extent can we leave the view from the West behind?
The Socialist Internationalism workshop aims to foster discussion around these central questions through short presentations in a roundtable format. Presenters shall each discuss a primary source and explain the approach they take to transnational, global, and international history. Topics that will be addressed in the workshop will encompass: trade and exchange in the socialist world, the role and definition of development and humanitarianism in the socialist world, the roles of experts in socialism across the globe, and exchanges in culture and knowledge production among socialist countries and beyond.
Further details of the workshop are outlined below:
Johanna Conterio (Birkbeck)
Panel 1: Culture within and beyond the Socialist World 9.45 – 11.15am
Chair: Ana Antic (Exeter)
Kristin Roth-Ey (UCL School of Slavonic and East European Studies)
Paul Betts (Oxford)
Simon Huxtable (Brunel)
Katarina Lichvarova (Courtauld Institute of Art)
Dina Fainberg (City, University of London)
Panel 2: Trade and Exchange within and beyond the Socialist World 11.30am – 1.00pm
Chair: Johanna Conterio (Birkbeck)
Alessandro Iandolo (Oxford)
Kristy Ironside (Manchester)
Katarzyna Jezowska (Oxford)
Yakov Feygin (U Pennsylvania)
Panel 3: Medicine, Urban Planning, and Environment 1.45 – 3.15pm
Chair: Jessica Reinisch (Birkbeck)
Katherine Lebow (Oxford)
Timothy Nunan (Freie U, Berlin)
Robert Balogh (Budapest)
Jo Laycock (Sheffield Hallam)
Dora Vargha (Exeter)
Panel 4: Global Socialism 3.30-5.00pm
Chair: Dora Vargha (Exeter)
James Mark (Exeter)
Rowena Razak (Oxford)
Tobias Rupprecht (Exeter)
Ana Antic (Exeter)
A limited number of spaces are still available for the two-day working symposium ‘Writing “Outsiders” into the History of International Public Health’.
The workshop will examine what impact would factoring in “outsiders” make to the way we write the history of international public health and what can close study of “outsiders” tell us about the international system of public health – its rules (written and unwritten), its reach, and its commitment to inclusiveness?
Histories of the development of international public health in the twentieth century tend to be celebrations of achievements – whether the enrolling of an ever-widening number of nations in programs to improve health and prevent disease, the adoption of shared standards and measurements to track health status, or the circulation of health researchers and statesmen across national frontiers. Justified though it often was, this may have relegated to the background “outsiders” in the international health arena. This workshop will therefore address how to factor in ‘outsiders’ into the history of international public health through a series of panels and a concluding roundtable discussion.
The workshop will be held on Thursday 27th and Friday 28th October at Birkbeck College, University of London. The workshop is free and open to all – to book a place please email email@example.com.
Histories of the development of international public health in the twentieth century tend to be celebrations of achievements – whether the enrolling of an ever-widening number of nations in programs to improve health and prevent disease, the adoption of shared standards and measurements to track health status, or the circulation of health researchers and statesmen across national frontiers. Justified though it often was, the repeated sounding of trumpets may have relegated to the background “outsiders” in the international health arena.
What impact, we wonder, would factoring in “outsiders” make to the way we write the history of international public health? What can close study of “outsiders” tell us about the international system of public health – its rules (written and unwritten), its reach, and its commitment to inclusiveness.
These questions will form the basis for discussion in a working symposium on ‘Writing “Outsiders” into the History of International Public Health.’ The workshop will be held on Thursday 27th and Friday 28th October at Birkbeck, University of London.
The workshop is free and open to all. A limited number of spaces are available for both days of the workshop. To book a place, please email firstname.lastname@example.org. Full details of the workshop programme are outlined below.
THURSDAY, 27 OCTOBER
Introductions 09.30 – 10.00am
Panel 1: Giving and Taking 10.00 – 11.30am
Jessica Reinisch, The ‘haves’ and ‘have nots’: the political geography of UNRRA’s donating and receiving countries
Lion Murard, Ironies of Technical Assistance: Greece, Eastern Europe and Health Internationalism in the interwar period
Davide Rodogno & Thomas David, Fellows and Fellowships in Public Health: an overview and a focus on the case of China
Panel 2: Neither Centre nor Periphery: Soviet Russia in the inter-war years 12.00 – 1.30pm
Susan Gross Solomon, Making the case: the USSR in Geneva and New York
Johanna Conterio, Socialist Design around the Black Sea
Sarah Marks, Czechoslovakia as insider and outsider in early Cold War era
Panel 3: Public Health in ‘Outsider’ States 2.30 – 4.00pm
David Brydan, Franco Spain as outsider and insider
Paul Weindling, Germany as an outsider in international health under Nazism
Maria Zarifi, Public health and the construction of Greece
FRIDAY, 28 OCTOBER
Panel 4: Inclusion and Exclusion in International Health Networks 10.30am – 12.00pm
Jessica Pearson-Patel, Colonial Politics of Global Public Health
Dora Vargha, Insiders and outsiders in the WHO
Ana Antic, Communist medicine and psychiatry and its links to the global South
Final Roundtable: Internationalism and Public Health 12.00 – 1.30pm
What difference does adding outsiders make to the way we write the history of public health? How does it change the writing of international history?
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.
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.
On October 16, Dora Vargha will give a talk at the London School of Hygiene and Tropical Medicine, as a part of the Centre for History in Public Health and the Vaccine Centre lunchtime seminar series. Dora’s presentation, titled ‘ When polio became global: a pre-history of the Global Polio Eradication Initiative’, addresses the development of international concepts and practices in polio prevention in the post-war decades and explores the ways in which the scientific practices, intertwined with Cold War politics of the 1950s and 1960s, were formative to the current polio eradication campaign (the full abstract is available here). This paper forms a part of Dora’s new research project undertaken under the auspices of ‘Reluctant Internationalists’, and will be a great opportunity for anyone interested to engage with this exciting topical theme. The talk will take place at LG9, LSHTM, Keppel Street Building, at 12:45-2pm. Admission is free and open to all. For more information, please visit the LSHTM seminar website.
In November 2013, possibly the largest mass grave from the recent Bosnian war was discovered in the village of Tomasica in the vicinity of the East Bosnian city Prijedor – over 470 bodies of Bosniaks and Croats killed by the Serbian forces have been excavated so far, and the excavations are continuing. It is now estimated that the grave contains between 700 and 1000 bodies. The discovery of the Tomasica grave, in a country where over 8000 people are still missing and many war-related issues remain painfully unresolved, provoked a potent reaction of horror, grief, and anger; it forced thousands to re-live their wartime experiences, loss of family members, memories of mass murders and tortures conducted in eastern Bosnia in the early 1990s. In a divided country, the Tomasica events once again brought to the fore the silence of the Serbian political structures on the issue of war crimes, and directed the public’s attention to the numerous problems in the recent functioning of the UN’s ICTY [International Criminal Tribunal for Former Yugoslavia] in The Hague (which, in 2013, marked twenty years since its foundation in). But Tomasica, quickly becoming a most powerful symbol for the trauma of the Bosnian war, has also been symptomatic of the persistence of mental suffering in the war’s aftermath: the person who led the International Commission of Missing Persons investigators to the site of the grave was a Serbian witness – an army conscript ordered to unload dead bodies into the grave from a truck in 1992. He reportedly testified that he could not bear to fight his own demons any further, that he had been seeing a killed Bosnian man’s open eyes following him everywhere, and that his testimony brought him relief. How have the Bosnian and other former Yugoslav societies dealt with psychological traumatization caused by the 1990s wars? How has war trauma shaped the development of those societies in the aftermath of the conflicts?
From the beginning, the Bosnian war has been coached in clear psychiatric terminology. The ideological explanations of the outbreak of the war were tightly related to the discourse of psychiatry and psychoanalysis, and, at the beginning of the conflicts, the central role was played by psychiatrist politicians and their references to trauma and insanity. Serb war politics in both Croatia and Bosnia-Herzegovina was designed by a prominent psychiatrist of Freudian orientation turned Croat Serb leader Dr. Jovan Raskovic and his protégé in Sarajevo Dr. Radovan Karadzic. It was within a decidedly psychiatric and psychoanalytic discourse that both Raskovic and Karadzic conceived of their respective political roles. Both attempted to introduce madness and trauma as central political categories, with the result that post-Communist politics in Yugoslavia became defined as a form of ‘mass psychiatry.’ In Raskovic’s view, ‘For the Serb, the unconscious desire for nation is paramount and has been suppressed by the ideology of class consciousness;’ post-Communist politics thus needed to forge a proper ‘path to the Serbian Oedipal emancipation.’ A proper psychiatric political leadership was thus critical for the success of this project of political transition and national liberation. Within such a carefully crafted medical discourse, even a planned and coordinated act of genocide could be interpreted as the final expression of ‘healthy madness,’ an irrational delirium which emancipated the nation from its own archaic, primitive Other – the Ottoman legacy, the Muslim presence – and set it firmly on the road to modernity and healthy nationalism.
In a very different context, the psychiatric language has persisted well after the war’s end: the interpretations of the conflict and its aftermath still revolve around the theme of open wounds and psychological re-traumatization. The universality of psychological discourse about the Bosnian war has indeed been one of its most striking characteristics: almost every war crimes-related legal decision in both local and international courts tended to provoke a psychologically-termed response from different victims’ groups. The recent acquittals of high-ranking Serbian and Croatian military and political functionaries at The Hague Tribunal led to a number of negative reactions, especially from Bosniak associations, who reported their loss of faith in the tribunal and considered its decisions an insult to their traumatic experiences. The November 2013 decisions of the European Human Rights Court in Strasbourg and the Constitutional Court of Bosnia-Herzegovina to release ten Bosnian Serb war crime convicts – six of whom were accused of participation in the Srebrenica genocide – due to a procedural issue and re-try them, further reinforced the negative atmosphere among survivors: Munira Subasic, who lost twenty-two male family members in Srebrenica, said that she felt victimized all over again, and that the criminals ‘could even be standing behind [her] back.’
However, in spite of the potency of such language of psychiatry, the post-Yugoslav states have consistently demonstrated their disregard for the actual psychological problems of their populations. In the aftermath of such a brutal war which primarily targeted civilians, psychological traumatization has remained the subject of non-governmental organizations or autonomous victims’ associations and mainly depended on personal initiative, while no organized or systematic state medical assistance was ever implemented; as a result, a great majority never received any psychological help whatsoever. No meaningful policy for dealing with the war trauma was ever formulated, and masses of traumatized citizens were rarely offered any help in dealing with their persisting mental issues – other than the diagnosis of PTSD and meagre financial aid in the case of certain groups of military veterans.
Part of the reason has been, of course, that the wartime destruction has left these states economically impoverished, with state medical services shrinking, of low quality and increasingly corrupt (particularly in Bosnia, whose complex institutions are often paralyzed as a result of manipulations of ethnic politics). But perhaps even more importantly, the countries most deeply involved in the conflicts of the 1990s – Bosnia and Serbia – have failed, for a number of structural reasons, to integrate the memory of the war into their post-conflict self-image and identity narratives. As a consequence, no stable politics towards understanding and treating the 1990s war trauma has emerged: medical interpretations of war-related mental wounds exist in specific social and cultural contexts and tend to be determined by the collective memory of the conflicts in question, reflected through a collective understanding of the place of those conflicts in the society’s history.
Psychiatric and psychological definitions of war trauma in any particular society tend to reflect the dominant socio-political narrative, and are symptomatic of the most pressing problems the society is dealing with. Dealing with psychological traumatization after war involves attempts to fit potential solutions to lingering problems within the dominant narrative. Twentieth century war psychiatry has proven this numerous times, not least in Yugoslavia itself. For example, in the aftermath of WWII, when various Yugoslav populations were dealing with different forms of profound psychological traumatisation, it was soldiers’ trauma that attracted the state’s undivided attention and became the symbol of wartime psychological suffering. What became known as ‘partisan hysteria’ or ‘partisan neurosis’ was a complicated and apparently unique psychiatric condition, which, according to leading Yugoslav psychiatrists of the era, only affected the victorious soldiers of the Communist resistance movement. While in other combatant countries soldiers’ neurosis mainly comprised anxiety states, shivering or combat fatigue, ‘partisan hysteria’ presented a radically different clinical picture. British, American, Canadian or French soldiers, although on the winning side, suffered from a psychiatric disorder which signified their wish to withdraw from the frontlines, and was symptomatic of their fear of and emotional distance from the battles; by contrast, the Yugoslav partisans’ dedication to the war’s causes was reportedly never compromised, not even when they clearly suffered mental consequences: ‘partisan hysteria’ consisted of epileptiform trance-like seizures, during which soldiers re-enacted their battle experiences, yelled, ‘shot’, ran, even gave political speeches, and thereby expressed their ‘fighting spirit’. Once they recovered from their attacks, the ill partisans would usually not remember anything they did or said during the seizures.
According to Yugoslav psychiatrists and members of the political authorities of the new socialist state, the most striking feature of ‘partisan neurosis’ was that it revolved around this ‘fighting spirit’, the partisans’ continued willingness to fight and re-live battlefield experiences. Instead of being a symptom of fear or exhaustion, it demonstrated the Communists’ continued dedication and courage. The constructed uniqueness of partisan neurosis served very well to underline the uniqueness of Yugoslavia’s postwar political and military position – as a socialist country which bred a large, independent and ultimately victorious Communist resistance guerrilla movement. In many ways, the official interpretation of ‘partisan hysteria’ was an advertisement for Marxist politics and what it could do for the military morale: it created soldiers whose commitment did not falter even when they were facing the worst of their demons. While Western armies conscripted soldiers and forced them to the frontlines to fight for the interests of the capitalist state, the Yugoslav partisans were volunteers in a uniquely egalitarian people’s army and their interests were identical to those of their new socialist homeland.
However, the postwar revolutionary Yugoslav realities were also fraught with a series of problems as reflected in political and psychiatric interpretations and clinical treatment of partisan neurosis. While the ‘partisan hysterics’ were heroes, they also became a symbol of the pitfalls and complexities of an increasingly socially mobile society. One of the most pressing concerns of the postwar period concerned massive social and economic dislocations and elite turnover – this was indeed what made the Yugoslav postwar transformations into a veritable social revolution. But difficulties were still rather formidable, and the Communist Party worried about some of its own members, including those with little education and of peasant origins, and their capacities for contributing their fair share to the revolution. This became particularly important since the new political and military elite was now to be recruited from the ranks of peasants and workers. So it turned out that ‘partisan hysteria’ reportedly only affected partisan soldiers of peasant origin and with little if any formal education – precisely those about whose potential the Party itself was so ambivalent. As psychiatrists and psychoanalysts explained, and the Party tended to agree, it was those undereducated and immature (‘primitive’) young soldiers who simply could not deal with the pressure of their new high-ranking positions, and then broke down, using their neurotic seizures to remind others of their past military achievements and abilities. ‘Partisan hysteria’ was thus portrayed as the pathology of the social revolution. Therefore, the psychiatric understanding of WWII soldiers’ trauma and its treatment reflected the official narrative of the war and resistance, and ‘partisan hysteria’ was seen through the lens of Yugoslav society’s main preoccupation. The concept was a symptom of its time, and its psychiatric and political connotations served socio-political and economic functions in the turbulent postwar times.
However, fifty years later, the political and social situation following the wars of Yugoslav secession was radically different, and the wars’ effects, meanings and interpretations remain far from clear. In Bosnia, the divided state structure prevented the emergence of a unified narrative of the conflict, as different groups and political alliances within the country constantly challenge each other’s interpretation of war events and wartime suffering, while victims’ associations remain in the lurch, manipulated, impoverished, forced to regularly re-live their worst experiences and to prove the authenticity of their pain. Indeed, the post-1995 set-up of Bosnia-Herzegovina did not do much to alleviate the re-traumatizing feelings of injustice: the political leadership of one of the two entities, Republika Srpska, remains stubborn in its chauvinistic rhetoric and refusal to take responsibility for wartime massacres and crimes against humanity, and regularly strives to prevent commemorations of the dead and memorializations of war crimes sites (such as former concentration camps) on its territory (in the most recent example of this trend, Hatidza Mehmedovic, of the association ‘Mothers of Srebrenica’, was summoned to the police of the Serbian entity to make a statement regarding her ‘illegal entrance of private property’ after she went to the agricultural cooperative’s hangar in the village of Kravica to pay respects to over one thousand Bosniak men and boys killed there in 1995). Wartime concentration camp internees can still run into their former guards and interrogators in the streets, because only the highest-ranking perpetrators have ever been legally prosecuted. Hundreds of families have been unable to close the war chapter in their lives because the remains of their missing relatives – children, parents, siblings, spouses – have not yet been found or identified. During the war, the Serbian armed groups conducted a campaign of systematic rape, but this crime remains somewhat of a taboo, even now that rape victims have finally been recognized as civilian war victims, after the 2006 Berlin Golden Bear winner film ‘Grbavica’ by Sarajevo’s Jasmila Zbanic brought the issue to the forefront of the country’s political debate.
In Serbia, war veterans from the recent conflicts face similarly formidable obstacles to reintegration in civilian society and especially to receiving sustained state-sponsored medical and psychological help. In this country, the role of perpetrators and questions about individual and social responsibility for mass war crimes has complicated the process of dealing with the memory of the wars. The Serbian state’s ambivalence about its own role in the 1990s wars has resulted in its failure to address the responsibility issues squarely; instead, the country’s governments have continuously chosen to distance themselves from past military involvements and human rights violations, and focus on the (rather uncertain) future of European integration. But this does not only harm the country’s relations with the rest of the region but also leaves former Serbian soldiers in the lurch. Many of the veterans who are now in dire need of psychological assistance have been struggling unsuccessfully with what they saw and did in Bosnia, Kosovo and Croatia, as well as with developing a stable self-image. How do perpetrators mourn their losses and suffering, and how does a society come to terms with its own citizens whose war participation has been marred by mass war crimes? According to her recent PhD dissertation on Serbian war veterans with PTSD, Belgrade clinical psychologist Olivera Markovic noted that the majority were extremely dissatisfied with their current social and economic position, and resented the state’s neglectful treatment of them as a group (as one of her interviewees said, ‘I defended my country as a patriot and became war invalid, but now I see that this is of nobody’s concern …’). The core problem, in Markovic’s opinion, is that their own relationship to their war activities has become deeply ambivalent, due to the Serbian society’s negative evaluation of the wars of Yugoslav secession, and in particular of the wars’ achievements. This in turn shaped the veterans’ perception that their suffering was in vain, which was reinforced by the state’s sustained neglect of their needs or indeed of their existence. In the absence of any sustained official attempt to come to terms with the wars, war veterans have largely remained unable to make much sense of their involvement in the conflict and of their role in postwar society. Quite ironically, it is one of the most staunchly anti-war non-governmental organizations in Belgrade that developed the only meaningful program aimed at war veterans, and helping them deal with their own psychological issues.
The treatment of ‘partisan hysteria’ in the 1940s Yugoslavia demonstrates the extent to which perceptions of and programs for psychiatric treatment of war trauma depend on the political understanding of wars. In the twentieth century’s culture of universal psychologizing of society and the self, memories of wars tended to be formulated and reinterpreted through the lens of psychological trauma, so that perceptions and the fate of traumatized war veterans or civilians were tightly related to their societies’ collective understanding of the conflicts in question. What happens, though, when the war, which has left hundreds of thousands of victims with severe psychological wounds, has no place in the official memory? Or when, as in Bosnia, over twenty years after it started, the war hasn’t quite ended for so many of its victims? The close relationship between historical memory and treatment of psychological trauma helps to explain the official disregard of mass psychological suffering in the aftermath of the Yugoslav wars in the 1990s. Neither Serbia nor Bosnia has created a stable and coherent political framework for understanding the war, which would make it possible to integrate the issue of war trauma and psychological victimization in the life of the two societies. Certainly, the example of ‘partisan hysteria’ is not one to be followed, but it nevertheless shows that society’s relevance for providing psychiatric and psychological help to war victims and veterans can be intensive and sustained. Maybe there is a way to avoid the overtly political implications of such involvement, and to change the relationship between the politics of memory and the politics of war trauma treatment. It would have to result in the provision of meaningful and considerate psychological assistance to troubled individuals, which would also equip them to become fully-fledged democratic citizens and gain their voice in public discussions of the wars, and it might help these societies overcome their own collective traumas, confusions and denials. This might happen through activities of both the states and a variety of NGOs active in the field of psychology or war memorialization. In this way, re-thinking the meaning and implications of the 1990s war trauma on an individual level could eventually re-shape the collective understanding of the war in a more constructive way.
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