Preliminary Programme

The aim of the presentation is to highlight the impact the transformation of medical research in the past 60 years has had on population based research. Although the rise of biomedicine has been well documented, historians and socials scientists have not yet paid sufficient attention to the multiple influences these innovations have exerted on connected fields, such as public health. This impact goes far beyond the challenge to the epidemiological analysis of disease in terms of ‘lifestyle’ or social aetiology posed by the public success of the ‘constitutional’, and in some ways reductionist, approach favoured by molecular biologists and geneticists. Long before epidemiology ‘went genetic’, the success of biomedicine has forced public health researchers to adapt or risk being marginalized.
The presentation is based on an extensive investigation of the transformations undergone by the different research groups of the French National Institute of Hygiene (renamed National Institute for Health and Medical Research, in 1964) specialised in public health, from the early 1940s to the late 1970s. Although these groups, the “Public Health Sections”, had been central in the early days of the institute, the different aspects of their work were increasingly criticized as archaic. The reliance on work-consuming investigations in the general populations became more and more unfashionable at a time when biologists and clinicians did not need to venture outside their teaching hospitals to gather data; the time-scale of such enquiries (years rather than months) was condemned as unrealistically long; even the monograph series launched by the institute in 1952 as a means to disseminate the complete results of public health studies, once the pride of INSERM, was now seen as distracting researchers from publishing articles in Anglo-American journals. As a result, INSERM’s direction promoted a new kind of medical statistics (in the guise of epidemiology, as well as biostatistics), better adapted to the exigencies of a biomedical research institute. The presentation closes with an analysis of this new, hybrid approach to health and disease, and highlights the influence of a biomedical framework in the definition of research topics, the division of labour within research units, and interactions with laboratory and clinical scientists. (Show less)

Paper is based on archival research in the Archive of Yugoslavia and Archive of Serbia. Of special importance and interest for the topic were these holdings – Ministry of public health, Committee for protection of public health of Yugoslav government, Antifascist women front etc. Paper analyzes difficult health and hygiene situation in Yugoslavia in the first decade after the war. Typhus, malaria, diphtheria, dysentery, syphilis were common illnesses which took thousands and thousands human lives. Difficult health situation was partially the result of the war devastation and destruction, but it was also caused by low hygiene and sanitary situation, lack of basic hygiene habits and primitive customs and believes. In many parts of the country – mostly in Bosnia, southern Serbia, Macedonia, Kosovo and some parts of Croatia (Lika, Banija, Kordun) people lived in the miserable conditions. Houses were made of mud, without windows or with small windows which almost never were opened. The lack of basic dishes, bed linen and clothes, poor personal and house hygiene and existence of many primitive believes and customs (like the one which was “popular” in all rural areas – it was believed that the umbilical cord of the child had to be cut with sickle in order enable the chilled to become a good harvester when the time comes.) were the main reasons because of which Yugoslavia was one of the most backward areas in Europe in 1945 – 1950. The children death rate was one of the highest in the world. Lice infection in some rural areas of Bosnia went up to 100 %. Having faced the difficult health situation, shortage of medical stuff, medicines and hospitals, the communist regime put an effort in order to stabilize epidemic situation and educate population and mainly succeeded, thanks to the programs financed by UNRA and UNICEF. By the end of 50’s, health and hygiene situation was stabilized. (Show less)

This paper will examine the activities of groups that claimed to speak and act for the patient ‘consumer’ in Britain during the 1960s and 1970s. It will consider the interaction between the demands of these groups and changing notions of public health. Was health consumerism, as understood by patient organisations, an individual or collective enterprise? How concerned were patient groups with issues of public, as opposed to individual, health?

During this period a number of bodies were established to represent all patients, regardless of their condition. These organisations included dedicated patient groups such as the Patients’ Association, general consumer groups, like the Consumers’ Association, and quasi-statutory bodies in the form of the Community Health Councils. Within these organisations there appears to have been some confusion as to whether they were representing the patient or all patients, and whether they spoke with one voice or many. A newsletter produced by the Patients’ Association was variously referred to as Patient Voice, Patients’ Voice and Patient’s Voices.

By exploring some of these issues this paper will contribute towards an ongoing discussion about tensions between individual health concerns and those of the wider population, a central element of the recent history of public health. (Show less)

Political and racial persecution under National Socialism forced many in Germany to emigrate. Among these refugees, some were able to obtain asylum in other Western European countries, the United States, and the Soviet Union. After the Second World War, a number of émigrés returned to Germany. Some elected to return to the Soviet-controlled zone of occupation (SBZ) in the hope that there they would be more likely to be able to take part in the reconstruction of a democratic Germany. A few of these returning refugees, along with concentration camp survivors, prisoners of war who had undergone “reeducation” in the Soviet Union, and surviving members of the working class parties, were then appointed by the Soviet Military Administration in Germany to politically influential positions within the German central administrative authority of health .
In this presentation, I consider the larger issue of the appointment of returning refugees to leading health policy positions. In contrast to those who survived National Socialism within the German Reich, the refugees who returned to Germany had experienced other systems of medical care in the countries where they had found asylum. One key point that I wish to consider, therefore, is whether the refugees’ experiences in exile had any effect on models for health care in the SBZ and in the later German Democratic Republic. (Show less)

After the Second World War the German discourse about individual rights of patients who constitute a danger for themselves and the whole community seems to be differing between medical practitioners and Public health officers. Physicians considered themselves to be very concerned about the individual rights of patients (as prescribed in the Hippocratic Oath), while Public Health officers were heavily criticized for having been an active part of the Nazi-state. The crimes of Public health departments were summarized as sacrificing the individual for the sake of the “Volkskörper” – the biological body of a racially defined populace.
Against this background the debate about coping with risky persons who were not only at risk themselves but also dangerous for the community is analysed in Public Health journals compared to disputes in medical journals in Germany and Great Britain. Are there differences in dealing with insubordinate patients in both countries and in both medical groups? And does the character of the debate differ according to the disease (for instance tuberculosis vs. venereal disease)? How is the line of conduct between protection and control defined in the two medical groups? (Show less)