Blog Archive

What Makes Health Special?

Guest Post by visiting fellow Heidi Tworek, University of British Columbia

I had the good fortune and great privilege of spending a month as a visiting fellow at the Reluctant Internationalists project earlier this year. As someone who has only recently started to work on the history of health, I found our discussions tremendously helpful for understanding how to think about health as an international phenomenon. One of the main recurring questions throughout our discussions revolved around the place of health in international interactions. What, if anything, made health different from other international concerns like labour, communications, war or trade?

Health stood for me as an area that bureaucrats often designated as “technical” to enable broader participation in health-related organisations. The designation of “technical” allowed experts to claim that health concerns existed beyond politics and could thus include non-members of international organisations.

In the interwar period, countries like Germany or the Soviet Union were critical players in the League of Nations Health Organisation. Germany continued to send out epidemiological bulletins over wireless after Hitler rescinded the country’s membership of the League in October 1933. The Rockefeller Foundation provided the majority of funding for the Health Organisation, even though the United States never joined the League. Similarly, David Brydan’s recent PhD thesis has shown how Spanish health officials remained deeply involved in the World Health Organisation although Spain was not allowed to join the United Nations until 1955. Disease crossed borders and did not discriminate between members and non-members of an international body. Despite political differences, nation-states often recognised that and cooperated accordingly.

Our discussions about how labels like “technical” enabled broader participation in health matters reminded me of my earlier work on the history of communications, where the label had performed a similar function. Calling communications standards “technical” enabled officials from the nineteenth centuries onwards to reach agreements about cross-border connections. A special issue that I co-edited for Journal of Policy History found that communications standards have succeeded historically when they regulated technical issues like frequencies, but not when they tried to regulate content.

If I apply that distinction back to the history of health, it implies that standardisation in health was likelier to occur when officials could designate something as “technical” (like causes of death) than when it required agreement on broader social issues. Social issues took health out of the purportedly technical into the very definitely political.

What made health different than communications was the very obvious stakes of life or death. In this sense, health was more like war. Health and war have long been linked metaphorically. We talk about “battling” disease or the “war on AIDS.” Conversely, health metaphors are tremendously virulent. We talk about the “health” of the economy or memes going “viral” online. These metaphors had real consequences. Robert Peckham’s work has shown, for example, how the metaphor of contagion in financial crises affected assessments of risk and responses to stock market crashes. Within the world of the military, some countries stopped supplying health data to the League of Nations around 1940 because they feared that the information could be misused by enemy nations for war planning.

Health, then, could be both as “technical” as communications standards and as “political” as war. By comparing health with other areas of internationalism, we gain a far more nuanced picture of how, when, and why cross-border interactions made reluctant experts into enthusiastic participants or vice versa.

Workshop Report – Writing ‘Outsiders’ into the History of International Public Health

outsiders-blogWorkshop Report – Writing “Outsiders” into the History of International Public Health, Birkbeck 27-28 October 2016

Earlier this term, Birkbeck played host to a two-day symposium examining the history of international public health. Writing “Outsiders” into the History of International Public Health brought together over twenty scholars from the UK, Europe, the US and Canada, setting out to examine what impact factoring in “outsiders” would make to the way historians write the history of international public health. In addition, the workshop sought to ask what close study of “outsiders” and the processes of marginalisation can tell us about the international system of public health – its rules (written and unwritten), its reach, and its commitment to inclusiveness?

cvw7zvrxeaa7zeqThe first panel addressed the theme of ‘giving and taking’ with Jessica Reinisch (Birkbeck) examining the political geography of UNRRA’s donating and receiving countries, noting how the notions of ‘us’ and ‘them’ acted as an important binary for relief work (podcast). Lion Murard (French National Centre for Scientific Research) then focused upon Greek and Eastern European international health during the inter-war period, including a focus on the Americanisation of European public health (podcast). Following this, Yitang Lin,  Thomas David and Davide Rodogno (University of Lausanne and University of Geneva) provided an introductory overview of The Rockefeller Fellows and Fellowship Programmes in Public Health database project, noting that fellows could often be both ‘outsiders’ and ‘insiders’ simultaneously (podcast). All of the papers prompted discussion on the political dimensions of international health, including who was an ‘outsider’ in relation to medical staff within UNRRA and amongst the fellows of the Rockefeller programme (Panel discussion).

cvxwaw3xgaubsu9The second panel examined Soviet Russia during the inter-war years. Susan Gross-Solomon (Toronto) addressed Soviet public health schemes, arguing that Soviet public health was accepted unevenly outside of Russia throughout the whole period and thus Soviet medical professionals can be viewed as suffering from issues of both superiority and inferiority. She suggested the notion of ‘outsider’ or ‘insider’ was therefore perhaps too binary a distinction to make (podcast). Johanna Conterio (Birkbeck) then presented on socialist design in Black Sea resorts, exploring urban planning from a medical and public health perspective. Her paper examined Soviet models of prosperity and the way in which the Soviets presented this case of prosperity from planning in international settings, specifically in relation to the 1958 Congress of the International Architectural Union in Moscow (podcast). Sarah Marks (Birkbeck) followed, using psychiatry and mental health to explore Czechoslovakia’s ‘outsider’ status during the Cold War. She argued that whilst historiographically Czechoslovakia is an outsider, it can be viewed as an insider in many ways and her paper therefore advocated for the necessity of writing medicine and science back into the history of Czechoslovakia in order to understand its role within the broader Soviet sphere (podcast). All three papers prompted discussion on the extent of the performative aspect of ‘insiders’ and ‘outsiders’ as labels in relation to international gatherings and congresses, as well as to what extent the Soviets can be classified as having truly been ‘outsiders’ during this period (Panel discussion).

cvx-j0ww8aaknwwThe third panel of the day centred attention on the history of public health in the so-called ‘outsider’ states of Franco’s Spain, Nazi Germany, and Greece. David Brydan (Birkbeck) addressed Franco Spain’s relationship with the World Health Organisation during the immediate post-WWII period and the country’s isolation on the international stage. The paper noted that it is during this period that Spain can be most clearly viewed as an international outsider. Consequently, the paper examined the means through which Francoist Spain attempted to align itself internationally and its attempts to integrate into mainstream international health networks and organisations (podcast). Paul Weindling (Oxford Brookes) then spoke on Germany as an outsider in international public health under Nazism, addressing the topic of the Nazi vision to create a German-led European public health system and focusing on Nazi initiatives during the Second World War (podcast). Following this, Maria Zarifi (Hellenic Open University) presented on public health in the construction of Greece in the late nineteenth century. Her paper centred around the notion of modernity in relation to medical scientists in Greece and, in turn, how this went hand in hand with the development of the Greek state (podcast). The panel discussion that followed incorporated debate upon the centrality of public health to state building and the role of nationalism in international public health (Panel discussion).

cv3apftwgaambbeOn the second day, the final panel of the workshop addressed inclusion and exclusion in international health networks. Jessica Pearson (Macalester) presented on colonial outsiders in international public health, with specific focus on colonial France and its relations with the WHO. She argued that France’s refusal to allow the WHO to operate in its colonial territories was due to the broader context of the French perceiving the involvement of any international organisation in their African empire as a threat to French colonial sovereignty (podcast). Dora Vargha (Exeter) then spoke on determining who were ‘insiders’ and ‘outsiders’ in the World Health Organisation. Her paper questioned if international health always occurs through international structures. Through examining Eastern European states, she argued that leaving the WHO did not result in isolation and an end to collaborations in the field of international public health (podcast). Following this, Ana Antic (Exeter) presented on the links between socialist Eastern Europe and the decolonising world. Her paper focused in particular upon examining alternative socialist internationalism through the prism of psychiatry and mental health, as evidenced through the case study of a group of Yugoslav psychiatrists in Guinea (podcast). After the three papers, discussion centred upon life beyond the WHO, both for colonial powers and for many socialist states. In addition, debate turned to the importance of distinguishing between global public health and international public health (Panel discussion).

The workshop concluded with a roundtable discussion addressing what difference adding outsiders makes to the way historians write the history of public health and the history of internationalism more broadly. In addition, discussions also examined what happens when we put public health into the history of international organisations and international relations, and vice versa. Similarly, debate revolved around questioning the adequacy of existing standard narratives of international public health and the ways in which historians can instead tell these narratives from below. A podcast of this roundtable discussion is available here.

Tracing the Twentieth Century through Maps

europe_from_space_640The 20th century was a period of extremes, of contrasts and contradictions. It witnessed destructive wars, and yet periods of unprecedented peace. Increasing wealth was joined by higher levels of poverty. There was scientific and technological progress, but also inhumanity and repression. The map was one of the century’s principal objects. Thanks to developments in geography education, cheaper and quicker mapmaking processes, and increasing travel and migration, maps became common, trusted and powerful things in western society. Yet maps were not passive or neutral objects. They were agents of change, presenting only versions of reality, not the reality itself. They were capable of informing, but also misleading. They were tools of control and of protest, and even changed the world.

With these advances and the changing role of maps in mind, on Monday 5th December Dr Jessica Reinisch will deliver a keynote lecture addressing ‘What Matters Most about the Twentieth Century?’ as part of a one day CPD course for secondary school teachers. The course, ‘Tracing the Twentieth Century through Maps‘, is hosted by the Historical Association in partnership with the British Library and is designed to aid those teaching 20th century units at GCSE or A-Level, with the day based around the British Library’s forthcoming exhibition Maps and the 20th Century: Drawing the Line.

The course will comprise of keynotes from Jessica Reinisch and Tom Harper, lead curator of the exhibition, followed by a series of workshops to develop subject knowledge and support best practice teaching. These workshops will feature Ben Walsh, associate vice president of the Historical Association, on the Cold War and Alf Wilkinson, educational consultant and textbook author, on the First World War.

Booking is open now through Eventbrite here. Further information and the full programme for the day is available to consult on the Historical Association’s website here.

Writing ‘Outsiders’ into the History of International Public Health: A Working Symposium

League of NationsHistories 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 Full details of the workshop programme are outlined below.


Introductions 09.30 – 10.00am

Panel 1: Giving and Taking 10.00 – 11.30am

ŸJessica 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

ŸDavid Brydan, Franco Spain as outsider and insider

ŸPaul Weindling, Germany as an outsider in international health under Nazism

ŸMaria Zarifi, Public health and the construction of Greece



Panel 4: Inclusion and Exclusion in International Health Networks 10.30am – 12.00pm

ŸJessica Pearson-Patel, Colonial Politics of Global Public Health

ŸDora Vargha, Insiders and outsiders in the WHO

ŸAna 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?

ŸPatricia Clavin

ŸPeter Jackson

ŸPaul Weindling

ŸPatrick Zylberman