Call for Papers, Space and the Hospital: International Network for the History of Hospitals Conference, Lisbon, 26-28 May 2021

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Hosted by: ‘Hospitalis: Hospital Architecture in Portugal at the Dawn of Modernity’ Research Project and the Hospital Real de Todos os Santos, Lisbon, Portugal

 

Hospital Real de Todos os Santos, Wikimedia Commons


Space, in both its physical and conceptual manifestations, has been a part of how hospitals were designed, built, used, and understood within the wider community. By focusing on space, this conference aims to explore this subject through the lens of its architectural, socio-cultural, medical, economic, charitable, ideological, and public conceptualisations.

This thirteenth INHH conference will explore the relationship between space and hospitals throughout history by examining it through the lens of five themes: (1) ritual, space, and architecture; (2) hospitals as ‘model’ spaces; (3) the impact of medical practice and theory on space; (4) hospitality and social space; (5) sponsorship. Below are more details about how the conference themes will address along with related questions. The themes and questions presented are by no means an exhaustive list; however, we encourage the submission of an abstract that examines any aspects of space and the history of hospitals in innovative ways.

 

Hopital Beaujon, Paris, 1934




Key Themes and Questions to be explored:


1. Ritual, Space, and Architecture
• How has the architectural designs of hospitals shaped their use? How has ritual impacted the built environment? How have these spaces been preserved and how are they presented to modern audiences? How were aesthetic changes integrated over time?
• Examples: architectural design, death care and burials, patient rooms, religious spaces in medical environments, archeological and/or architectural reconstructions, material culture, heritage studies.

2. Hospitals as ‘Model’ Spaces
• How have hospitals, leprosaria, and other health care establishments been conceptualised as ‘model’ institutions, both architecturally and spatially? How were architectural models communicated and circulated? How did colonial ‘models’ inform both hospitals and the surrounding environment? How were these ‘models’ juxtaposed against preexisting institutions and/or practices? Did bad ‘models’ exist, if so, what was the criteria for this categorisation?
• Examples: Using plans from preexisting hospitals; the imposition of a non-indigenous ‘model;’ hospitals in transition (i.e. colonial to postcolonial).

3. The Impact of Medical Theory and Practice on Space
• How did prevailing medical theories influence the built environment? As these theories and practices changed, how were these changes made manifest?
• Examples: colonial medicine and its impact on architecture and space of existing and ‘new’ hospitals; changes in space creating inclusive or exclusive environments; bioarchaeological studies of hospitals and their patients; care versus cure.

4. Hospitality as Social Space
• How has the inclusion or exclusion of groups shaped care and space? How is this reflected in its architecture? How have hospitals been designed to be more welcoming? How were health and social activities balanced in a hospital’s built environment? How does the presence of hospitals and/or leprosaria impact urban planning?
• Examples: segregation within hospitals; concierge services and creating a ‘public face;’ the role of gender and hospitality; hospitality and socio-economic status; psychological responses to space in hospitals.

5. Sponsorship
• How have founders and donors affected the creation and/or development of a hospital? Did their donation change the social or cultural environment? How does this impact the hospital’s reputation?
• Examples: Prioritising wings for specific illness or methods of care; perception of donors as individuals; impact of class and gender.


The Advisory Board of the INHH and the local organising committee wish to invite proposals for 20 minute papers or posters which address the conference theme. Potential contributors are asked to bear in mind that engagement with the theme of space and the hospital will be a key criterion in determining which papers are accepted onto the programme.

Abstracts should be a maximum of 300 words in length, in English and accompanied by a brief biography of no more than 200 words. Proposals should be sent to space.inhh@gmail.com by 30 September 2020. As with previous INHH conferences, it is intended that an edited volume of the conference papers will be published. Submissions are particularly encouraged from researchers who have not previously given a paper at an INHH conference.

Upon provision of full receipts, we hope to be able to support attendance at this conference, particularly for postgraduates and early career researchers. Speakers will be asked to make use of alternative sources of funding where these are available. Any queries may be directed to space.inhh@gmail.com.

 

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Using songs to empower Zambian health volunteers in their battle against CoVid

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Volunteers and mothers discuss handwashing before the distancing measures came in.

For the past two years I have been working with colleagues Professor David Swann of Sheffield Hallam University and Dr James Reid of the School of Education at the University of Huddersfield along with our partner, St John Zambia, to design low cost maternal and child health interventions. Faced with the threats posed by the Covid-19 pandemic, the team are responding by utilising songs to empower volunteers working in local health clinics in resource constrained communities across Zambia. Building on our long term relationship we are working with frontline workers to facilitate the co-production of educational songs on preventing the spread of the virus.

You can see and hear the songs here: https://vimeo.com/405184935

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Building on significant support from the University of Huddersfield, at the beginning of 2020 David Swann, James Reid, Barry Doyle and St John, Zambia, were awarded a grant by the UK Arts and Humanities Research Council to explore the potential of lullabies and songs in reducing adolescent maternal and infant mortality in Zambia. The project developed as an urgent response to President Edgar Lungu’s declaration in 2019 that maternal and prenatal deaths constituted a Public Health emergency in Zambia, with 10 to 15 women per week losing their lives in pregnancy due to preventable, non-communicable causes. However, by early March 2020, before the first cases of Covid-19 in Zambia, we shifted the focus of the project from developing educational messages about maternal and child health (MCH) to key messages about hand washing, social distancing and how to manage antenatal and postnatal care in a time of crisis.

Although evidence from the global north and richer economies indicates that SARS-Cov-2 (the virus that causes the Covid-19 disease) hospitalises and leads to the death of more men than women this does not account for the particular socioeconomic vulnerabilities of women in resource constrained contexts. For them the epidemic could see a general reduction in spending on wider health provision (even maternity and reproductive services), increased caring responsibilities, loss of income, and increased incidences of gender based violence. Significantly, therefore, Covid-19 has the potential to further increase the vulnerabilities of pregnant women and new mothers in Zambia where, in 2017, maternal deaths accounted for 17.2% of all deaths among women in the age group 15-49.

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David and Jim in a workshop, St John Zambia HQ, Lusaka, June 2019

Following a number of discovery workshops with the women volunteers in our partnership, we discovered songs as an appropriate and zero-cost medium for imparting information about MCH care. Our work responds to the recent call by Soumya Swaminathan, Chief Scientist at WHO, to highlight the role and experience of women in designing health and welfare interventions. In doing so, it provides a disruptive alternative to the cyclical pattern of predictable and unsustainable approaches that do not account for the role of women in the frontline of the pandemic. Our interdisciplinary strategy in developing an approach with women for women is accessible and inclusive, especially for the 32% of women in Zambia who are illiterate. Songs offer intrinsic flexibility and the potential for sustained impact as they eliminate the need for public/ private donor investment or printed materials that can often impede the traction of new approaches and their implementation at scale.

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Barry with Morrice (2nd right) and volunteers Danny (1st right) and Davies (2nd left)

Although the worldwide lockdown has stopped us visiting Zambia since the beginning of March, our strong partnership with St John, Zambia and its National Coordinator, Morrice Muteba, and a close relationship with St John volunteers cemented over the past eighteen months, has allowed us to co-produce these songs with urgency, understanding and, hopefully, life-saving effect.

Funding: UKRI, GCRF: Life-Saving Lullabies: Reducing adolescent maternal and neonatal deaths in Zambia. Project reference: AH/T011947/1. https://gtr.ukri.org/projects?ref=AH%2FT011947%2F1

 

Coronavirus prompts a new Emergency Hospital Service

 

The first of the government’s emergency hospitals has opened in London’s Excel Centre. More field hospitals are planned amid significant scaling back of non-coVid hospital admissions. These are major changes to the way our hospitals operate with potentially lasting impact. So what can we learn from similar emergency hospital policy during the Second World War?


With the opening of the Florence Nightingale Emergency Field Hospital in East London, the announcement of many more facilities in the pipeline, non-essential hospital treatments cancelled and deals done to access private beds, CoVid19 is transforming the NHS. But these policies are not new. Many were pursued on a larger scale during the Second World War under the Emergency Hospital Service developed in the years running up to war. The EHS included plans to evacuate large numbers of patients, create thousands of temporary beds, reallocate private provision and make use of existing and new convalescent accommodation.

Why was such extensive intervention deemed necessary? Underpinning the policy was the fear of the bomber. Based on the experience of the destruction of Guernica during the Spanish Civil War, policy makers anticipated up to 1.2 million casualties in the first 60 days of a bombing campaign against British cities. Although Britain was well served with hospital accommodation – there were around 500,000 beds – these were spread across many different types of institution and two separate providers – the ‘voluntary’ acute hospitals and the local authority establishments caring for chronic, infectious and mental health patients.

The Pros and Cons of the EHS

The EHS does offer some potential insight into how the current policies will play out – also of the problems that health officials may encounter.

Cons
The policy rested on an initial phase in which C.140,000 patients were removed from institutions. These were mainly vulnerable: the chronic sick in old workhouse infirmaries, including cancer patients; the elderly and infirm; children with infectious diseases; long term tuberculosis patients; and the mentally ill. These were mostly long stay patients in local authority institutions but many acute beds were also vacated in London. The government agreed to compensate for beds in acute hospitals as these were charitable not state controlled.

But casualties were not as severe as expected. 1. Bombing only began in summer 1940, nine months after the EHS started 2. The military campaign also didn’t start until summer 1940 and was over fairly quickly 3. Bombing casualty numbers, though severe, were much lower than expected and only occurred for a relatively short period 4. Bombing casualties were not evenly spread across the country. As is well known, they were concentrated in London and certain industrial cities. Most places only experienced a few raids.

As a result, many EHS beds remained empty for long periods of time leading to growing waiting lists as ‘normal’ patients went untreated. Acute hospitals were accused of leaving beds empty deliberately to get state grants. Vulnerable patients remained in the community. Yet displaced groups – refugees, evacuees, war workers and sick soldiers – couldn’t get treatment as they were not part of the scheme for war wounded.

Pros
Some services were effectively redistributed – like those in Leeds – and probably worked better as a result. Spare capacity was available when the blitz came and also in 1944-5. Moreover, 80,000 new beds were created in temporary hospital buildings, some on new sites. Resources in some institutions significantly improved, for example isolation hospitals like Seacroft, in Leeds, received operating theatres, X-Ray equipment and pathology laboratories. Much of this temporary accommodation was kept after 1945 and provided the basis for the extra capacity the new NHS needed in its first 15 years when capital projects were restricted.


https://historic-hospitals.com/2017/06/25/stracathro-hospital/


Private beds in acute hospitals entered the system – indeed they probably constituted the largest part of acute hospital beds appropriated. The use of private beds reduced the impact on acute hospitals and secured income for hospitals that they may have been strapped for cash if demand for private treatment had dried up. It was quickly agreed that hospitals would be fully compensated for the loss of their private beds – though it did take some years for the grants to feed through.

Finally, convalescent beds took a lot of the pressure off acute services. In 1939 there were around 50,000 convalescent beds in Britain. Although a number, especially in seaside towns, closed during the war, their numbers were enhanced by further donations during war with many staffed by volunteers from organisations like the Red Cross and St John.


https://www.qaranc.co.uk/voluntary-aid-detachment.php

Lessons
The NHS needs to be wary of squeezing existing capacity too hard and especially of postponing too many non-CoVid procedures. There have already been complaints, especially from cancer patients, that routine treatment has been cancelled indefinitely. If demand for existing hospital beds is less than expected, or it is patchy, this could cause medium term harm to the NHS – as it did to the acute charitable hospital system during and after the Second World War.

Temporary accommodation may not look as good as the conventional hospital but it is a more sustainable response to this crisis. The temporary facilities could allow existing hospitals to carry on with more of their routine work and avoid the possibility of under-utilised capacity causing public anger. Unlike in 1945, however, these won’t need to be kept on after the crisis so there will be no ongoing cost.

Make use of the private sector. Paying for it is not a problem – it was paid for during the Second World War and reflects the fact that costs will be incurred by the owners of facilities. Overall it is better to divert private beds – even at a cost – than to divert mainstream NHS hospitals and their staff.

Finally, we need to make more of the potential for a revival of the convalescent home. The NHS should be looking to free up capacity by moving recovering patients to non-acute facilities staffed by groups like Red Cross and St John volunteers. So seek the loan of large properties – especially if they have been closed because of the crisis. And make use of those suitably qualified volunteers. This approach has the scope to truly emulate the war time experience yet so far it seems to have attracted little attention.

 


The George Woofindin Convalescent Home, Whiteley Woods


*I am very grateful to Dr Eli Anders for providing great information on convalescent homes during the war.

England’s Reaction to CoVid19 Reflects 200 Years of Responses to Public Health Crises

In his press conference on 12 March, flanked by the nation’s leading health scientists, Prime Minister Boris Johnson defied expectations by sticking with a low key approach to containment of the Coronavirus – or CoVid-19 as it is known. Contrary to the policy in many countries in Europe and even the devolved administration in Scotland, that of the UK government is to limit interventions to advice and guidance. Whether or not one is convinced by this, the approach is reminiscent of other English responses to large scale public health crises from nineteenth century cholera to AIDS.

 

 

 Henry Heath, A sketch from the central board of health or the real ass-i-antic cholera!!
Lith 41 Dean St. Soho. HH [1832] Wellcome Library
https://wellcomecollection.org/works/f4573unh

Nineteenth century England was the epitome of the liberal, free trade nation with public rhetoric and policy devoted to individual responsibility and the removal of state barriers in business and private life. But it was also the site of a new urban landscape where thousands of poorly nourished individuals lived cheek-by-jowl in cramped and inadequate accommodation. Into this environment came the novel menace of cholera. When it first arrived in 1832 public authorities had few powers to limit its spread. Although some emergency legislation was introduced it was largely focused on cleaning the streets rather than limiting the interactions of the population. Quarantine may have been an appropriate response to keeping out ‘foreigners’ but not for free born Englishmen.

This was because miasma theory dominated mid nineteenth century public health thinking and influenced cholera management between 1832 and 1866. Miasma – the belief that diseases were caused by bad air rising from accumulated rubbish – proved resilient despite scientific advances because remedies for it were aimed at cleaning up the environment not curtailing the actions of individuals or trade. Moreover, responsibility for keeping the streets free of filth could be placed on householders and communities not the state, saving tax-payers from footing the bill.

West Lane Smallpox Hospital 1898

In the last third of the century policy did change to favour the isolation of those infected, especially with smallpox. Measures included the building of a network of isolation hospitals, stronger powers for local health officials to hospitalise the infected and the growth of a cadre of infectious disease health professionals. Yet even this policy remained focused on managing the individual sufferer rather than containing whole populations. Quarantine and restrictions on mass gatherings were used infrequently and responsibility for making these decisions lay with local health officials.

Friern Hospital, London: a young girl, head and shoulders, with smallpox. Photograph, 1890/1910.

https://wellcomecollection.org/works/qf596hg6

This approach was put to the test in the Influenza Pandemic that swept across the world in 1918. Britain had a highly advanced healthcare system, with health insurance for a substantial number of workers, an extensive general hospital system free to much of the poor, a network of poor law infirmaries providing a general safety net, and a nationwide isolation service. In the preceding years infectious disease protocols had been developed – notification, isolation in a hospital, disinfection and medical inspection of contacts – and local medical officers had considerable power to enforce isolation.

But when the Flu came this infrastructure proved completely inadequate. Victims came down with the disease quickly and many died within four days of catching it. It hit younger adults hardest – the elderly often taking to their beds and recovering while the young tried to carry on. The scale of the pandemic meant health institutions couldn’t cope with the volume of cases. Isolation was impossible at a municipal level and especially not in the home while hospitals were of limited use. The health services had been denuded by the War and the population were weakened by four years of shortages and intense working.

                               

Report on the sanitary condition of the Metropolitan Borough of Hackney for the year 1918, p21-22
https://wellcomelibrary.org/moh/report/b1811670x/20#?m=0&cv=20&c=0&s=0&z=-1.2462%2C0.1087%2C3.2771%2C1.302


So the government reverted to type and adopted an individualised, liberal response. The central state did little beyond ordering that cinemas be aired every three hours. They refused to close schools and left the management of the population to local medical officers. The response of the Medical Officers of Health varied from authority to authority – as shown by the different London boroughs. As with self-isolation today, the key message to emerge from health departments was for ‘the individual to apply such measures to him or herself…what may be termed personal or individual preventive measures’. Some health advice was given, including ‘snuffing’ a permanganate of potash, salt and water mixture two or three times a day. Some boroughs posted health advice around town. That from Hackney looked very like the advice so far released by the UK Government with: warnings that people would die; advice to self-isolate if infected; the need to prevent the spread by coughing or sneezing into a handkerchief; ensuring personal and environmental cleanliness; ventilation of homes and workplaces; warm clothing; plus the reminder that ‘excessive drinking favours the spread of the infection’ – though how was not explained.

At the time of writing the government has just proposed more stringent measures to control the behaviours of the population. But what is clear from the historical record is that the response so far is part of a long English tradition of resistance to dirigiste interventions in public health in favour of a strong emphasis on the promotion of individual responsibility for both personal and public good.

Programme: VIII Abrils de l’Hospital and INHH’s 12th International Conference

Travel and the Hospital: From Pilgrimage to Medical Tourism

24-26th April 2019

Faculty of Geography and History (UB)

Universitat de Barcelona

Ferrer Bassa

Ferrer Bassa (c. 1285 – 1348) Catalan painter and miniaturist.

We are pleased to announce the full programme and registration details for the VIII Abrils de l’Hospital and the INHH’s 12th International Conference on the theme Travel and the Hospital. For more details of the call see our earlier post

The conference will take place at: Faculty of Geography and History (UB), c. Montalegre, 6 Universitat de Barcelona and Amics de l’Art Romànic / Institut d’Estudis Catalans and, Biblioteca de Catalunya, c. Carme, 47

Fees for the conference are:

a).

Partial registration fee: 30€ until the 31st of march of 2019. Starting this same date, the registration fee will be 50€. This registration will grant the right to participate in the conference, take part in the planned tours, the coffee-breaks and two brunches.

b).

Full registration fee: 60€ until the 31st of march of 2019. Starting this same date, the registration fee will be 100€. This registration will grant the right to attend the conference dinner on the 25th of April.

For details of how to register please email abrils.hospital@ub.edu

Master’s students and PhD candidates, as well as doctors who have defended their thesis between 2017-2019 can ask for free registration, provided that they present a paper or a poster. Those who might be eligible should send an e-mail to abrils.hospital@ub.edu before the 15th of February 2019.

Accommodation costs will be assumed in their entirety by the attendees. Since the University of Barcelona does not have an agreement with any of the city’s hotels, we suggest booking early.

FULL PROGRAMME  

Wednesday 24th April

Facultat de Geografia i Història, Universitat de Barcelona, Sala Gran 08:45h. Reception

09:15h. Official inauguration

Ricardo Piqueras, Dean of the Faculty of Geography and History Meritxell Simó, Director of IRCVM

SESSION I. Travel and the Hospital

09:30-11:00 h
Chair: John Henderson (Birkbeck, University of London)

09:30h. Giuliana Albini (Università di Milano): Guarding Bridges, Taking Care of Travellers: Hospital Foundations in Northern and Central Italy (11th-14th centuries).

09:50h. Marina Gazzini (Università di Milano): Hospitals and Travellers in Medieval Lombardy.

10:10h. Sarah Lennard-Brown (Birkbeck, University of London): The Geography of Charity. The Role of Travel in the Foundation and Day to Day Operation of the Late Medieval Hospitals as Compared to Almshouses in the City of London.

10:30h. Discussion

11:00 h. Coffee Break

SESSION II. Pilgrimage and the Hospital

11:30-13:00 h
Chair: Teresa Vinyoles (IRCVM-Universitat de Barcelona)

11:30h. Carole Rawcliffe (University of East Anglia, Norwich, UK): Changing Institutional Responses to Pilgrims and Wayfarers in Medieval England.

11:50h. Antoni Conejo (IRCVM-Universitat de Barcelona): Iconographic Sources for the History of Pilgrimage and Assistance in the Middle Ages

12:10h. Salvatore Marino (IRCVM-Universitat de Barcelona) and Ida Mauro (Universitat de Barcelona): The Hospitality Network for Pilgrims and Foreigners in Renaissance Naples.

12:30h. Discussion

13:00-14:30h. Lunch for all delegates (CCCB Restaurant)

SESSION III. Mobile Hospitals

14:30-16:00h
Chair: Barry Doyle (University of Huddersfield)

14:30h. David Theodore (McGill University): Mobility and the Ideal Modern Hospital.

14:50h. Phuthego Phuthego Molosiwa (University of Bostwana): ‘The Medicine Van’: Social Diseases, Healthcare and Mobile Dispensaries in the Bechuanaland Protectorate, 1930s-1966.

15:10h. Shane Ewen (Leeds Beckett University) and Rebecca Wynter (University of Birmingham): Mobile Hospitals?: The Operation of Civilian Ambulance Services and the Provision of Emergency Medical Care for Burns c.1900-1970’.

15:30h. Discussion

16:00h. Coffee Break

SESSION IV. War and the Hospital

16:30-18:00h
Chair: Joana Balsa (Universidade de Lisboa)

16:30h. Jon Arrizabalaga (IMF-CSIC): Ambulances and Humanitarian Relief to Wounded Combatants: Reach and Limits of Technological Innovation in the Second Carlist War (1872-1876).

16:50h. Mark Butterfield (Leeds Beckett University): Ambulance Train Tourism in the First World War.

17:10h. Discussion

SPECIAL SESSION. Presentation of Scientific Posters

17:30-18:30h
Chair: Antoni Conejo (IRCVM-Universitat de Barcelona)

Pol Bridgewater (IRCVM-Universitat de Barcelona): “Persones miserables de diverses nacions e condicions” (Miserable People of Different Nations and Conditions): The Presence of Foreigners among the Patients of the Hospital of the Holy Cross of Barcelona in the 15th Century and its Significance in the Shaping of a Welfare Landscape.

Isabel Juan Casademont (Universitat de Girona): Construction and Consolidation of an Architectonical Healthcare Model. The Santa Caterina Hospital of Girona (1666-1808).

Mireia Comas Via (IRCVM-Universitat de Barcelona): The Assistance of Foreign Women in Medieval Catalan Hospitals.

Susana María Ramírez Martín (Universidad Complutense de Madrid): Flight Against Smallpox: Experiments Agave and Begonia in Mexico and Madrid in the Late Eighteenth Century.

Jaume Marcé Sánchez (IRCVM-Universitat de Barcelona): The Spread or Influence of Models for Hospitals in the Mediterranean in the Late Middle Ages.

Teresa Vinyoles (IRCVM-Universitat de Barcelona): Foundling Children in the Holy Cross Hospital of Barcelone: 1488-1490.

Joana Balsa (Universidade de Lisboa): The Research Project «Hospitalis – Hospital Architecture in Portugal at the Dawn of Modernity: Identification, Characterization, and Contextualization».

Thursday 25th April
Amics de l’Art Romànic / Institut d’Estudis Catalans, Sala Pere i Joan

Coromines

SESSION V. Travel and the Hospital 2

09:00-10:30 h
Chair: Francesca Español (Universitat de Barcelona-Amics de l’Art Romànic)

09:00h. Esther Diana (Centro di Documentazione per la Storia dell’Assistenza e della Sanità, Firenze): Poor People, Abandoned Children and Pilgrims From the City of Prato’s ‘Misericordia e Dolce’ Hospital, an Example of Symbiosis Between Artistic Representation, Care and Devotion

09:20h. Carmel Ferragud (Institut Interuniversitari López Piñero – Universitat de València): Women in Medieval Hospitals: Sibil·la and the ‘Hospital de Sant Andreu’ in Mallorca.

09:40h. Clara Jáuregui (PhD., History): The Wandering Leper and the Treatment of Leprosy in 14th Century Barcelona.

10:00 h. Discussion

10:30h. Coffee Break

SESSION VI. Heritage, New Technologies and Communities

11:00-13:00h
Chair: Jon Arrizabalaga (IMF-CSIC)

11:00h. Joana Balsa de Pinho (Universiade de Lisboa): The Research Project «Hospitalis»: Study and Valorization of Hospitals as Historic Monuments.

11:20h. Raúl Villagrasa (IH-CSIC): Application of New Technologies and Historical Cartography for the Web Diffusion of the Hospital Network.

11:40h. Ana Mehnert Pascoal, Maria João Neto, and Clara Moura Soares (Universiade de Lisboa): Visits Abroad to Enhance the Portuguese Hospital Network: Administrators, Architects and Doctors Travelling During the 1950s.

12:00h. Rob Ellis (University of Huddersfield): London County Council, Foreign Lunatics and the 1905 Aliens Act.

12:30h. Discussion

13:00-14:30h. Lunch for all delegates (CCCB Restaurant)

VISIT TO THE ANCIENT HOLY CROSS HOSPITAL (NATIONAL LIBRARY OF CATALONIA)
15:00-17:00h (English)
15:30-17:30h (Catalan)

20:00h. Conference Dinner

Friday 26th April
Biblioteca de Catalunya, Sala Caritat

SESSION VII. Missionary

09:00-10:30h
Chair: Barry Doyle (University of Huddersfield)

09:00h. Andrea L. Arrington-Sirois (Indiana State University): Medical Meccas: Missionary Staff and African Patients: At Mission Hospitals in Colonial Southern Africa.

09:20h. Sara Honarmand Ebrahimi (University College Dublin): Caravanserai as an emotional practice: Travellers and the Church Missionary Society (CMS) hospitals in north-west India.

09:40h. Karen McNamara (National University of Singapore). Circuits of Technology and Healing: The Making of a Mission Hospital in South India.

10:00h. Discussion

10:30h. Coffee Break

SESSION VIII. Centres of Excellence and Tourism

11:00-13:00h
Chair: Salvatore Marino (IRCVM-Universitat de Barcelona)

11:00h. Yannis Gonatidis (University of Crete): Foreign Patients in the Municipal Hospital of Hermoupolis (Syros), 1834-1914.

11:20h. Kevin McQueeney (Georgetown University): A “Black Medical Center”: Flint Goodridge Hospital and African American Healthcare in Twentieth Century New Orleans.

11:40h. Yannis Stoyannidis (University of West Antica): From TB Patients’ Travels to Sanatoria Businesses. The Evolution of Medical Tourism.

12:00h. Discussion

12:30-13:00h. Concluding remarks: Antoni Conejo, Barry Doyle, and John Henderson

13:00-15:00h. Free Time for Lunch

VISIT TO THE LIBERTY HOSPITAL OF SANT PAU 15:00-17:00h (English and Catalan)

Organizing Committe: Antoni Conejo (University of Barcelona), John Henderson (Birkbeck, University of London, UK), Barry Doyle (University of Huddersfield, UK), and Joana Balsa de Pinho (University of Lisbon)

Collaboration: Meritxell Simó, Marta Sancho, Salvatore Marino, Pol Bridgewater, Jaume Marcé (University of Barcelona), Núria Altarriba (Biblioteca de Catalunya), Mercè Beltran (Recinte Modernista del Sant Pau), and Francesca Español (Amics de l’Art Romànic, IEC)

Organizers:

screen shot 2019-01-14 at 18.20.01

Collaborators:

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Taking the Maternity Package to Zambia – and the historical lessons that emerged

2018-11-14 11.05.21

Following on from our post about adapting and adopting the baby box, Prof Barry Doyle has been to Lusaka in Zambia to discuss our project and in particular the Chitenge for Change idea being developed by Prof David Swann at Sheffield Hallam. During the visit I met with a range of partners from educational institutions, the Ministry of Health, local health providers and representatives of the charity, St John Zambia. I also spoke to a group of Zambian Medical Students, visited a rural health centre and met up with some leading Zambian historians. And at the end I had time to visit a safari park and spot a giraffe!

giraffe

As a historian of interwar health care I was most struck by the similarities between the current challenges facing maternity care providers in Zambia and those encounters by health professionals between the wars, especially in rural areas.

Most obvious was the lack of money to deliver high quality services. Zambia has recently received significant support from the EU to upgrade their frontline maternity and child welfare services. This mirrors the support given to the countries of central Europe by the Rockefeller Foundation in the 1920s and 30s, especially to develop health centres and train health visitors and community midwives. But huge gaps still remain in Zambia, especially in the countryside. A particular stumbling block to engaging mothers with health centres and antenatal provision in Zambia is the requirement parents face to provide a range of materials for the birth of the child if the baby is delivered in a health centre. Addressing similar problems was at the root of the original Finnish Baby Box scheme – which sought to provide poor mothers in rural areas with a set of minimal requirements for their new born babies. In other European countries between the wars maternity centres also provided some basics. In England, for example, municipal Maternity and Child Welfare Centres distributed layettes to the poorest mothers.

2018-11-14 10.34.07

A key aim of Zambian health policy is to get women to give birth in health centres or hospitals. As in late nineteenth century Britain or inter war central Europe, there is an acute shortage of trained maternity workers and midwives, with many women continuing to make use of village wise women. These traditional birth attendants cause concern for the maternity services both through their limited professional qualifications and the dangers associated with giving birth in remote areas. As with Britain and France in the early twentieth century, there is a big push to train more midwives and to get them into the community – a policy supported by Rockefeller in the 1920s and the EU today – but this is slow and barriers remain to taking up institutional delivery. In addition to the cost, many women live up to 20 kilometres from a health centre and with no access to transport have to walk or be carried – even by wheelbarrow! The centre we visited did have an ambulance stretcher, but this was one vehicle for a substantial area and was used only in extreme emergencies.

2018-11-14 11.00.46

Delivering health education is also constrained by very high levels of illiteracy, especially among women in rural areas. Again, similar issues were encountered in central Europe, especially in the eastern areas of Czechoslovakia and Poland. In these contexts image based health education materials proved particularly important as did taking the message to women in the villages. Interestingly, the recent EU maternity package programme did not include health education as a central feature of the delivery, focusing on raising post natal attendance with the mother and baby pack as an incentive. While in Zambia I made contact with volunteers and staff from St John Zambia who have recently run a Mama na Mwana (Mother and Baby) scheme using volunteers to visit expectant mothers to deliver health education on a face to face basis. The importance of volunteers in this project echoes the extensive network of charitable Infant and Chid Welfare Centres operating in interwar Britain, like the Leeds Baby’s Welcome or the work of the Croix Rouge Francaise in France at the same time.

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A number of other problems were identified, particularly in remote areas. Traditional myths continue to surround childbirth. Health official were cautious about revealing too much about what these were but it is clear they impede their work, especially around early registration of the pregnancy and engagement with the health centre. Health workers in central, and especially south-eastern Europe experienced similar problems into the 1930s with religion, fear of the health system and superstitions all preventing health education and intervention. Gender relations also act as a barrier in some areas with men exerting considerable control over their wives maternity choices. This can be beneficial – we were told of one village where the chief was fining husbands whose wives used the wise women as birth attendants instead of going to the health centre. In general, health professions are seeking to involve husbands in the pregnancy, especially given the cost involved in a health centre birth. This is an area in which the contemporary experience is very different to interwar Europe – I have not come across any historical examples of husbands’ involvement with childbirth or of health professionals expecting or encouraging such involvement. This was very much a post Second World War development in Europe.

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Overall, this was an amazing opportunity. I will continue to work with the contacts I made while in Zambia to develop our initiative – the Chitenge for Change – more of which in the near future. Thanks to the University of Huddersfield GCRF Health Sandpit and to my colleagues in Huddersfield, Sheffield Hallam and especially Christine and Shadrick in Lusaka.

 

 

 

Adapting and Adopting the Finnish Baby Box

 

Screen Shot 2018-10-09 at 07.31.43

For the past nine months Barry Doyle, Director of the Centre for Health Histories, has been involved in an exciting inter-disciplinary project with Dr Jim Reid (PI) from the School of Education, along with colleagues from the School of Art, Design and Architecture at the University of Huddersfield, academics at Sheffield Hallam, Bristol and Tampere (Finland) Universities, the University of Africa (Zambia) and University of Social Sciences and Humanities, Vietnam National University. The key aim of the project is to explore the opportunities to adapt the principle of the Finnish Maternity Package (The Baby Box) for use in two low and middle-income countries (Zambia and Vietnam). A related objective is to develop a historical research project exploring the cultural history of the baby box in Finland. This pilot project has been generously funded by the University of Huddersfield URF Global Challenges Research Fund Sandpit Events.

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The Maternity Package was launched in Finland 80 years ago this year as a key strategy in the nation’s attempts to reduce a stubbornly high infant mortality rate (IMR). Like many of the nations that gained independence in the wake of the First World War, Finland saw social welfare in general, and health policies in particular, as a means to build legitimacy and strengthen national identity. The original maternity package was targeted at the most vulnerable mothers but ten years later was turned into a universal benefit for all women irrespective of income or the number of children they had borne. The box – which is big enough for a baby to sleep in – contains a selection of items designed to provide the parents with the basics for their new baby, including clothing, nappies, feeding aids and other simple essentials. Over the years the contents have changed, from a selection of life saving products to more fashion conscious items that reflect the aspirations of parents. Similarly, the form of the box has been altered, from a functional government ‘archive box’ to a brightly decorated receptacle with a design that changes each year. Although a cash benefit is available, even today around 95% of parents choose the box – though we don’t know if all, or even most, of the contents is used.

 

The maternity package idea is increasingly used across the world. In the UK the Scottish Government commenced a universal baby box scheme on the Finnish model in 2017. It has also been piloted in a number of English localities and another sixty countries have deployed a version of the package – though often the benefit is not universal nor is it necessarily the work of the government. Indeed, in poorer countries it is likely to be charities and other NGOs involved in delivering the service.

 

Our project began with a desk review of current policy and services in Zambia and Vietnam conducted by an intern, Nuala Doyle. This showed that Zambia had one of the highest IMRs in the world, with particular problems in rural areas and among the poorest groups in the cities. Vietnam has made huge strides in reducing IMR but problems remain among ethnic minority groups and especially in the highland areas in the north west of the country. This provided the base information for an initial exploratory workshop in Huddersfield in June 2018 which brought together the core team members (Reid, Doyle, Vahtikari, Swann, Mushibwe and Dinh) with colleagues from Art and Design (Dr Omar Huerta Cardoso), Human and Health Sciences (Dr Serena Bartys) and the Business School (Dr Julia Meaton) to explore how to develop the project. This led to the firming up of three work packages.

 

In package one we will be working with Dr Tanja Vahtikari of the History Faculty of the University of Tampere to develop a project on the cultural and emotional history of the use and meaning of the Baby Box in the Finnish context since the 1940s. This will include background research on Finland’s IMR crisis in the 1930s which ultimately led to the maternity package policy. It will be placed in an international context, exploring other nations’ responses including child welfare centres, health visitors and ‘social nursing’, mother and child feeding policies and the provision of layettes. However, its primary focus will be how people used and have remembered the baby box in Finland. To pursue this we aim to partner with the Finnish Literature Society, an organisation that, to a great extent, is the custodian of the nation’s cultural history and heritage. Through this we hope to uncover the material and emotional history of the boxes. We expect to submit applications for funding for this aspect of the project soon.

zambia-baby-carrier

Zambian Baby Carrier

Our second work package is led by Professor David Swann and aims to adapt the maternity package for use in Zambia. Working with Professor Christine Mushibwe, Vice Chancellor of the University of Africa in Lusaka, we are exploring appropriate ways to deliver assistance to new parents, with a particular focus on very young mothers giving birth while living on the streets of Lusaka. Plans are still in their infancy, but David has been working with his Product Design students to develop prototype ideas that could be used in this context. Barry will be visiting Lusaka in November to discuss plans with Christine and to meet with NGOs, government and academics. More news to follow!

Hmong carrier

A Hmong Baby Carrier

The third package brings together Omar Huerta Cardoso and Linh Dihn to examine potential product designs for use among the highland populations of western Vietnam, the area of the country with the most intractable IMR problems. Jim Reid will be visiting Vietnam in the next few months to discuss prototype designs with state agencies and NGOs along with a range of potential academic partners.

This is a very exciting departure for the Centre for Health Histories. We are really looking forward to developing an interdisciplinary project that could have a significant impact on the life chances of women and children around the world. It also opens up opportunities to extend the international focus of the historical research we undertake into the history of health and healthcare in Finland and, it is hoped, Zambia, both nations with very limited historical healthcare research in English.

 

 

 

 

 

 

Extended Deadline Funded PhD: Visual and Cultural Representations of the St John Ambulance Brigade in the Twentieth Century.

Visual and Cultural Representations of the St John Ambulance Brigade in the Twentieth Century.

AHRC Funded Collaborative Doctoral Award Studentship

University of Huddersfield, Museum of the Order of St John and the Heritage Consortium

 

 

The Heritage Consortium is offering a fully funded AHRC Collaborative Doctoral Award studentship with the Museum of the Order of St John and the University of Huddersfield. Supervised by Professor Barry Doyle (Huddersfield) and Dr Rosemary Wall of the University of Hull, the studentship will combine the support and training offered by the Heritage Consortium, the professional supervision of the curatorial staff of the Museum of the Order of St John in Clerkenwell, London and the academic culture of Huddersfield’s Centre for Health History.

Building on our AHRC funded project Crossing Boundaries: The History of First Aid in Britain and France, 1909-1989 the student will work with Museum staff to make their extensive collection of photographs accessible to a wider public nationally and internationally. In the process they will develop their own archiving, curating and digitization skills.

The academic study will be built around the Museum collections, the aims of the Crossing Boundaries project and the interests of the students. Particular themes that could be developed include:

• St John Ambulance Brigade and St John Ambulance Association in the Second World War,
• the development of the St John Ambulance Brigade ambulance service,
• industry and St John’s industrial heritage,
• and/or using photographs either in heritage organisations or in historical research.

 

 

Candidates should have a good degree and a Masters in relevant disciplines. Please apply using the Heritage Consortium application form available at the webpage below. Please outline any relevant experience and how you will develop a project around one of the themes listed above. Applicants should also submit references and proof of qualifications by the closing date of 24 September 2018 to cdtheritage@hull.ac.uk.

For further information on the Heritage Consortium and application process see
http://www.heritageconsortium.ac.uk/apply/

For more information on the Crossing Boundaries project: https://bmdoyleblog.wordpress.com/2016/03/01/crossing-boundaries-the-history-of-first-aid-in-britain-and-france-1909-1989/

For information on the museum http://museumstjohn.org.uk/

For more information on this opportunity email b.m.doyle@hud.ac.uk
This award is only available to UK students.

       

The History of Emergency Medicine Workshop

The History of Emergency Medicine Workshop
Crossing Boundaries: The History of First Aid in Britain and France, 1909-1989’ project
University of Huddersfield

  

Day One – 27 June 2018
Student Centre Boardroom

12-1.15pm

Welcome and Introductions, Introduction to ‘Crossing Boundaries: The History of First Aid in Britain and France, 1909-1989’ project, and Lunch

1.15pm-3.30pm

Pre-20th century

Lisa Smith, University of Essex
TBC (Early Modern First Aid advice in domestic handbooks)

Sally Frampton, University of Oxford
A Little Knowledge is a Dangerous Thing: The First Aid Movement in Nineteenth-Century Britain

Jennifer Wallis, Queen Mary University of London
“Ha! Ha! I am a b(u)oy again.” Henry Silvester and the life-saving method of self-inflation

3.45-5.15pm

Voluntarism and First Aid in France and Britain

Charles-Antoine Wanecq, Sciences Po
Saving lives, training citizens : the French Red Cross, the State and the control of first aid practices (1940s-1970s)

Stefan Ramsden, University of Hull
St John Ambulance and working-class community

Day Two – 28 June

Oastler 6.09

Project Sessions

9.30-10.30am

Rosemary Wall, University of Hull, and Barry Doyle, University of Huddersfield
First Aid on the Roads

10.45am-12noon

Jonathan Reinarz, University of Birmingham, Rebecca Wynter, University of Birmingham, and Shane Ewen, Leeds Beckett University

‘Burns’

12-1
Lunch

1-2
Student Centre Boardroom
Heritage

Interpreting First Aid Heritage collections at the Museum of the Order of St John and the British Red Cross Museum and Archive

2.15-3.30pm

War

Samiksha Sehrewat, University of Newcastle
Providing medical aid in an emergency: Charitable Organizations, the Mesopotamia Medical Breakdown and colonial governmentality

Susan Grayzel, Utah University
“Chemical Weapons Come Home: Devising Defences for Poison Gas in Interwar Britain and France”

3.30-4.30pm

Closing discussions and reflections on connections between the papers, publication, and the first aid history project and policy relevance over tea and coffee.

   

 

CFP: Travel and the Hospital: from pilgrimage to medical tourism, Barcelona, April 2019

International Network for the History of Hospitals and Institute for Research on Medieval Cultures (IRCVM) of the University of Barcelona

12th Conference of the INHH and VIII Abrils de l’Hospital
24-26 April 2019 University of Barcelona

Ferrer Bassa (c. 1285 – 1348) Catalan painter and miniaturist.

Medical tourism is an increasingly popular feature of health care today. Yet it is not always recognised that, throughout their history, hospitals have attracted patients from afar seeking cures, both spiritual and physical, not available at home. While much work has previously focused on the institution as a fixed place, often closely associated with a specific locality, the hospital’s role as a focus for a wider network of health needs and health consumers has been largely overlooked. This neglected topic will be the focus of our twelfth conference.

From its inception the hospital provided care and cure for pilgrims, either en route to, or on their arrival at, shrines, as well as for patients from beyond the urban centre, some from local areas and others travelling great distances to access treatment. These institutions were also distinguished by their architectural and artistic heritage, being decorated with paintings and sculptures, some of which still survive today and depict pilgrims, the poor and the sick. Although many buildings have disappeared or been transformed over time, others remain that reflect their original size and beauty and are important destinations for tourism.

Over the centuries major man-made crises such as war have prompted the introduction of many forms of mobile hospital. Among them were the first ambulances, the medical units that travelled with troops on campaign, and the sophisticated network of treatment stations developed by the combatants of the First World War, including hospital trains with more patients than a London teaching institution. Hospitals have also featured at the heart of migration stories – with staff moving around empires and across borders to acquire medical training and to assist a growing body of patients, whose access to hospital medicine has been limited by poverty, race, lack of citizenship, or the unavailability of specialist services locally. In many parts of the world, and especially in areas with limited healthcare infrastructure or widely dispersed population, hospitals came to the patients, with a variety of mobile institutions being developed to serve the sick in Africa, Russia, Central Europe and across Asia. These many activities reflect the variety of topics that can be included in our theme of Travel and the Hospital.

We seek abstracts of 300 words in ENGLISH [or Spanish or Catalan with and English translation] pertinent to the conference theme. Papers on any historical period, region or country might focus on, but are not restricted to:

Pilgrimage and the hospital
Migration and hospitals – patients and staff
Perceptions of’ diverse staff and patient populations.
Sites for medical testing (remedies or techniques which are imported)
Global connections, including missionary and transnational organisations
War and campaign medicine
Itinerant healing and healers in rural areas.
Mobile hospitals
Centres of excellence, learning and medical education.
Hospitals as historic monuments; their importance to cities both today and in the past.

The conference languages will be English, Catalan and Spanish. We hope to be able to offer some bursaries for doctoral and early career researchers.

Conference organisers Antoni Conejo (Barcelona), John Henderson (Birkbeck, London, UK) and Barry Doyle (Huddersfield, UK)
Abstracts should be emailed to b.m.doyle@hud.ac.uk OR abrils.hospital@ub.edu by the closing date of Monday 2 July 2018.

https://www.ukri.org/news/uk-research-and-innovation-looks-for-experts-on-equality-diversity-and-inclusion/