Roberta E. Bivins

Ideology and disease identity: the politics of rickets, 1929–1982

How can we assess the reciprocal impacts of politics and medicine in the contemporary period? Using the example of rickets in twentieth century Britain, I will explore the ways in which a preventable, curable non-infectious disease came to have enormous political significance, first as a symbol of socioeconomic inequality, then as evidence of racial and ethnic health disparities. Between the 1920s and 1980s, clinicians, researchers, health workers, members of Parliament and later Britains growing South Asian ethnic communities repeatedly confronted the British state with evidence of persistent nutritional deficiency among the British poor and British Asians. Drawing on bitter memories of the ‘Hungry Thirties’, postwar rickets—so often described as a ‘Victorian’ disease—became a high-profile sign of what was variously constructed as a failure of the Welfare State; or of the political parties charged with its protection; or of ethnically Asian migrants and their descendants to adapt to British life and norms. Here I will argue that rickets prompted such consternation not because of its severity, the cost of its treatment, or even its prevalence; but because of the ease with which it was politicised. I will explore the ways in which this condition was envisioned, defined and addressed as Britain moved from the postwar consensus to Thatcherism, and as Britains diverse South Asian communities developed from migrant enclaves to settled multigenerational ethnic communities.

Contagious communities : medicine, migration, and the NHS in Post War Britain

A fascinating new study on the connections between migration and the British National Health Service (NHS)

Coming ‘Home’ to (post)Colonial Medicine: Treating Tropical Bodies in Post-War Britain

While investment and popular enthusiasm have fuelled significant growth in the history of medicine since the 1980s, it remains by some metrics well outside of the historical mainstream. Yet developments in the history of medicine could offer traction to historians more generally. Through its close critical attention to power, embodiment and hegemonic institutions and knowledges, the history of medicine also presents a unique perspective from which to interrogate ‘postcolonialism’. Here, post-war British examples demonstrate the potential of a medical and postcolonial lens for historians exploring policy making, immigration or identity. In this period, civil servants, biomedical researchers, policy makers, and publics including migrants actively shaped medical and governmental responses to an apparently novel phenomenon: the mass migration to Britain of its former tropical subjects. Postcolonial analysis uncovers new models of community, and highlights the importance of the late twentieth-century and the post-imperial city as sites of historiographic and theoretical development.

Picturing Race in the British National Health Service, 1948-1988

In 1970, Harold Evans, the respected editor of Britain’s best-selling Sunday broadsheet the Sunday Times from 1967 to 1981, roundly reproached his fellow journalists for their reporting of ‘race’. Writing for the resolutely middle-brow The Listener magazine (published from 1929 to 1991 by the British Broadcasting Corporation [BBC] since 1929 to accompany and amplify the national broadcaster’s educational and cultural mission), Evans asserted that ‘the way race is reported can uniquely affect the reality of the subject itself’. In the matter of race, he observed, the newspapers did far more than fulfil their ‘traditional’ role as a ‘mirror of society’. Instead, ‘stealthily in Britain, the malformed seeds of prejudice have been watered by a rain of false statistics and stories’.1 Evans, famously a supporter of US-style campaigning investigative journalism, applied similar techniques to excoriate his fellow journalists. Focusing closely on the language in which stories about non-white migrants and racialized ethnic minorities were reported, he condemned rhetoric portraying migrants as ‘pouring in’ and Britain as being ‘overrun’.

Weighting for health : management, measurement and self-surveillance in the modern household

Histories of late nineteenth- and early twentieth-century medicine emphasise the rise of professional and scientific authority, and suggest a decline in domestic health initiatives. Exploring the example of weight management in Britain, we argue that domestic agency persisted and that new regimes of measurement and weighing were adapted to personal and familial preferences as they entered the household. Drawing on print sources and objects ranging from prescriptive literature to postcards and ‘personal weighing machines’, the article examines changing practices of self-management as cultural norms initially dictated by ideals of body shape and function gradually incorporated quantified targets. In the twentieth century, the domestic management of health—like the medical management of illness—was increasingly technologised and re-focused on quantitative indicators of ‘normal’ or ‘pathological’ embodiment. We ask: in relation to weight, how did quantification permeate the household, and what did this domestication of bodily surveillance mean to lay users?

The people have no more love left for the Commonwealth: Media, migration and identity in the 1961-2 British smallpox outbreak.

In the last days of 1961, with a Conservative government gingerly guiding highly controversial immigration restrictions through Britains Parliament, another unwanted immigrant to the UK suddenly made its presence felt: smallpox. Media reportage, in both Pakistan and Britain, immediately intertwined legislation and outbreak. This article explores the interplay between these two sets of events, and their mutual impact on public, political, and medical perceptions of and responses to post-colonial immigration and immigrants in Britain.

Compassionate care: not easy, not free, not only nurses

Compassion has historically been defined as an underpinning principle of work conducted by health professionals, especially nurses.1 Numerous definitions of compassionate care exist, incorporating a range of elements. Most include a cognitive element: understanding what is important to the other by exploring their perspective; a volitional element: choosing to act to try and alleviate the other’s disquiet; an affective element: actively imagining what the other is going through; an altruistic element: reacting to the other’s needs selflessly; and a moral element: to not show compassion may compound any pain or distress already being experienced by the other.2 3 Appeals for more compassionate care have become common within international discourses, through initiatives such as Schwartz Rounds established in America, Hearts in Healthcare in New Zealand, and the Asia Pacific Healthcare Hub of Charter for Compassion. In the UK, a policy document called Compassion in Practice outlined 6 ‘Cs’ associated with compassionate care (care, compassion, courage, communication, commitment and competence). It was written in the wake of high profile accounts of negative health services experiences, including the 2013 Francis Report (http://webarchive.nationalarchives.gov.uk/20150407084231/http://www.midstaffspublicinquiry.com/report), which detailed the dehumanising treatment of patients at Mid Staffordshire NHS Trust. Positioned as a solution to neglect and unsafe treatment, contemporary debate around practice and policy often paints compassionate care as an easy, cost-neutral fix for entrenched problems in modern health services. Yet delivering compassionate care is not without costs. First, staff may have to engage in emotionally charged interactions, which can leave them feeling psychologically exhausted and at risk of burnout.4 Furthermore, for health professionals to be able to connect with patients and understand their unique situation, while also addressing fundamental needs (eg, hygiene, feeding) in a non-mechanistic manner, an appropriately resourced workplace is required.5 Nursing, in particular, has been linked to contemporary discussions of …

Immigration, Ethnicity and ‘Public’ Health Policy in Postcolonial Britain

What happens at the end of empire, when decolonisation draws far-flung populations ‘home’ to an environment — political, social and physical — very different from either colonial or imperial expectations? Drawing on British examples, this chapter explores medical and especially public health responses to postcolonial migrants and their ethnically marked descendants in the era of decolonisation and Cold War, responses often generated by professional men and women themselves returning from or building upon careers begun in Britain’s tropical colonies. It focuses on two diseases which came to be closely associated with immigration in the years after the Second World War: tuberculosis (TB) and rickets (in adults, osteomalacia). This pairing facilitates comparisons between medical policies and projects mediated largely by public health actors and interventions, and those shaped principally by the interests and innovations of elite biomedical research. Additionally, it presents the different ways in which infectious and nutritional disorders were addressed and the impact of ‘race’ on perceptions of ‘imported’ illnesses and the migrants affected by them.

Imagining Acupuncture: Images and the Early Westernization of Asian Medical Expertise

While an increasing number of studies have now examined the textual transmission of medical knowledge from one culture to another, less work has been done on the role and impact of medical images and image-making in knowledge transmission and reception. Here, drawing on the example of acupuncture, I assess the ‘translation’ of images, their adaptation in response to the visual norms and medical politics of the receiving culture, and their enduring effects on early responses to Chinese medical expertise and practices in Europe.

Introduction: ‘De Omni Scribili’

This book is a tribute to a historian of rare ability, fertility and generosity: a grammar school boy from working-class London who became Britain’s authority on the histories of the Enlightenment and of madness; a Stakhanovite scholar, teacher and editor who became a media star; a Bohemian of astonishing efficiency who freely gave encouragement and assistance to students and colleagues, and to amateurs and the public at large. It was not hard to find willing contributors to this volume, for many historians grieved at his early death as we also treasure his example and are grateful for his rich gifts. This volume’s authors, like its editors, were Roy’s colleagues, collaborators and students; the collection represents some of his interests and approaches, and it illustrates the impact of his work on the fields which he enlivened. It is, therefore, also an exploration of what it means to be a ‘Porterian’ social historian.