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Joris Vandendriessche and Tine Van Osselaer

This chapter offers a varied overview of the historical relation between medicine and religion in Belgium, which was until the 1960s a predominantly Catholic country. Moving beyond a too strong political reading of healthcare debates, in which both fields have been described as opposites (competing with one another or aiming for compromise), this chapter pays attention to intellectual encounters and to the role of religious practices and beliefs in medicine. First, the chapter sketches the evolution of Catholic organisations and institutions, most notably the changing role of religious orders, which in Belgium have held a firm grip on the medical field. It describes evolving Catholic views on ‘care’, along with political conflicts over an expanding welfare state and changing views on the growing role of lay medical personnel. Second, the chapter turns to religious practices, rituals and exceptional phenomena such as miracles, and the medical debates these inspired. From a medical perspective, religion could be a source of health (e.g. ‘moral therapy’ to treat mental illness) or disease (e.g. Christomanie). Third, the chapter goes on to discuss how Catholic doctors and caregivers gave their religious views a place in their professional work and identities. Here the chapter turns to medical ethics and professional codes of conduct, and the ways in which these have been inspired by Catholic thinking. The chapter pays particular attention to questions related to reproductive medicine and the end of life.

in Medical histories of Belgium
Jolien Gijbels and Kaat Wils

This chapter focuses on the ways in which, since the nineteenth century, medicine and medical discourse have legitimised, reinforced or altered gender relations in Belgium. It focuses on three themes: the social division of medical labour, the gendered character of medical knowledge and the role of feminists in claiming and redefining the female body. Addressing the theme of the social division of labour allows us to provide readers with general information about the presence and status of women and men within the main medical structures throughout the period. The chapter presents key social and political debates relevant to the history of medicine, such as discussions on the supposedly limited competences of midwives or women’s access to medical education and the medical profession.

The history of gynaecology enables us to look more closely at the impact of these structures on the treatment of women’s bodies and on discursive practices defining women’s health. Gynaecology emerged at the end of the nineteenth century as a new profession founded on the successes of modern surgery and dedicated to the protection of maternity, femininity and sexual modesty. During the first and in particular the second wave of organised feminism in Belgium, activists involved in political debates about women’s rights had to struggle with stereotypical, often medically legitimised views about women’s moral and physical weaknesses and incapacity to assume various social roles. In women’s political fights centred on themes such as contraception and abortion, feminists developed alternative understandings of women’s bodies, also using medically informed representations.

in Medical histories of Belgium
Tinne Claes and Katrin Pilz

Medicine has become increasingly professionalised and institutionalised in the modern era. Within this narrative of medicalisation, popularisation has been interpreted as a process directed by the traditional protagonists of medical history: physicians and institutions. Although historians have argued that medical knowledge was ultimately democratised throughout the nineteenth and twentieth centuries, they have mostly portrayed the increasingly large numbers of users of medicine as passive consumers of knowledge that was nominally created by professionals. Over the past two decades, however, historians have paid more attention to the circulation of knowledge, arguing that knowledge is constructed by mutual interactions between the scientific and the public domain. In a similar vein, historians have shown that the sharp antagonism between ‘official’ and ‘alternative’ medical beliefs was not a historical reality, but a cultural construct.

This chapter shows the implications of these new theoretical approaches for the Belgian context – in which ‘popular’ and ‘alternative’ views of medicine have not yet been subject to much historical scrutiny. By focusing on visual media through which medical knowledge was communicated and circulated, concrete models displayed in health exhibitions and public health films, this chapter takes a first step to decentralise the history of ‘popularisation’. By drawing attention to the ways in which medicine circulated, we give lay audiences agency in the historical narrative: they transform from passive recipients into active actors and consumers, who have the agency to interpret, choose from and respond to different views of the body, sickness and health.

in Medical histories of Belgium
Dirk Luyten and David Guilardian

This chapter outlines how the organisation of financing of the cost of medicine has evolved since the late eighteenth century. The economic burden of caring and healing has been largely ‘mutualised’ over the past two hundred years. It is no longer individual patients who pay the largest part of medical fees, but society, with – as a consequence of the introduction of a compulsory social security system in 1944 – a key role for the state. However, the state delegated this redistribution to non-profit private health insurance funds – mutual societies – which, since the late nineteenth century, developed into central players in financing of healthcare. However, this narrative does not take into account public welfare at local level in financing the cost of care, nor the middle-class philanthropy and Catholic charity that characterised the field in Belgium as well.

The collectivisation of costs makes the discussion on how to fund the system an ongoing topic in the public space, while also tending to conceal the continued existence of major social differences. At the same time, the medical industry (private hospitals, pharmaceutical companies, etc.) became an important economic factor, both as an employer and as a central player in a knowledge-based economy. These changes had effects on the administration of care, requiring new forms of financial efficiency. As medicine became a business, different norms of management were introduced, which, in turn, were heavily criticised.

in Medical histories of Belgium
Thomas D’haeninck, Jan Vandersmissen, Gita Deneckere, and Christophe Verbruggen

"The medicalisation of society was strongly intertwined with both the overall scientification of society and the rationalisation of dealing with the social question on a pan-European scale. This chapter reassesses the history of Belgian public health by looking at the social activism of physicians and ‘hygienists’ as part of a global field of discourse and practice. In doing so, it nuances the image of the nineteenth-century state as a ‘nightwatchman’, and in particular for the twentieth century, considers the Belgian Congo as an integral component of Belgian health policies.

The chapter consists of four parts that are structured chronologically. The first part starts in the late eighteenth century and focuses on the emergence of scientific medicine and the growing awareness that the study of many diseases could not be separated from the socio-economic context in which they originated. The second part discusses the bacteriological revolution in the 1870s and its impact on public health questions, linking social medicine more closely to applied sciences and preventive healthcare. Social medicine became increasingly entangled with other reformist movements. The third part deals with the further development of social hygiene and the rise of eugenics, national health protection and improvement policies in the interwar period. Finally, the fourth part re-evaluates the period after 1960 when national public health systems were strongly questioned, local community health centres emerged and medical activism went increasingly beyond borders. For each time period, representative players are highlighted, including Adolphe Burggraeve, Victor Desguin, Gustave Dryepondt, Peter Piot and Marleen Temmerman.

in Medical histories of Belgium
Open Access (free)
Renaud Bardez and Pieter Dhondt

Although medical knowledge has been produced in different forms and locations over the past two centuries, the modern university was certainly its primary locus. The medical faculties of leading educational institutions evolved into the central spaces of scientific research ‒ an evolution that in turn had an impact on the medical curriculum. In Belgium, this ‘scientification’ occurred along the ideological dividing lines between Catholics and liberals, between the Flemish- and French-speaking communities, and was influenced by the competition between state and private universities. Its principal driving force was the development of laboratory science. However, this dominant form of scientific medical knowledge was often contested. Engaging in the age-old debate between medicine as a science and an art, nineteenth-century practitioners claimed to have practical knowledge, rooted in everyday observations, that was just as ‘scientific’. Their knowledge originated primarily around the bedside, what contributed to the changing position of the hospital as an additional professional training site.

This chapter presents the development of medical education at the medical schools and later the faculties of medicine in the southern Netherlands/Belgium from the end of the eighteenth century up until today. It focuses on the shifts in the balance between general education, vocational training and scientific schooling, and on the continuous tension between medical specialisation and (the perceived need of offering) a more holistic approach. The process of professionalisation in general followed a similar line of development in Belgium as in most other European countries, yet many specific circumstances also created a unique situation.

in Medical histories of Belgium
Four Conversations with Canadian Communications Officers
Dominique Marshall

As the production, content and display of humanitarian images faced the requirements of digital media, humanitarian organizations struggled to keep equitable visual practices. Media specialists reflect on past and current uses of images in four Canadian agencies: the Canadian Red Cross, the Multicultural Council of Saskatchewan, the World University Service of Canada and IMPACT. Historically, the risk to reproduce the global inequalities they seek to remedy has compelled photographers, filmmakers and publicists in these agencies to develop codes of visual practice. In these conversations, they have shared the insights gained in transforming their work to accompany the rise of new digital technologies and social media. From one agency to the other, the lines of concern and of innovation converge. On the technical side, the officers speak of the advantage of telling personal stories, and of using short videos and infographics. On the organizational side, they have updated ways to develop skills in media production and visual literacy among workers, volunteers, partners and recipients, at all levels of their activity. These interviews further reveal that Communications Officers share with historians a wish to collect, preserve and tell past histories that acknowledge the role of all actors in the humanitarian sphere, as well as an immediate need to manage the abundance of visual documents with respect and method. To face these challenges, the five interviewees rely on democratic traditions of image-making: the trusted relationships, both with the Canadian public and with local peoples abroad, which have always informed the production and the content of visual assets. For this reason, humanitarian publicists might be in a privileged position to intervene in larger and urgent debates over the moral economy of the circulation of digital images in a globalized public space.

Journal of Humanitarian Affairs
Open Access (free)
Lewis Hine’s Photographs of Refugees for the American Red Cross, 1918–20
Sonya de Laat

From June 1918 to April 1919, the American social photographer Lewis Hine made photographs of refugees in Europe. Refugees emerged as an unexpectedly humanitarian subject during World War I. Care for them was part of the American Red Cross’ (ARC) overall war relief activities, which Hine was hired to visually record. In this paper, I present the way in which refugees went from being framed in the ARC’s mass-circulated popular Red Cross Magazine as unique, innocent, idealized war-affected civilians to eventually being visually displaced in a shifting humanitarian landscape. For refugees who were, by 1920, making their way across the ocean to North America, visual displacement from the humanitarian visual sphere was tantamount to territorial displacement. Anxieties and negative rhetoric of the unassimilated alien prevailed, resulting in the temporary ‘closure’ of America’s borders and the ARC’s growing American-centric relief activities. Entwined with anti-Bolshevism, American immigration, and isolationist politics of the early twentieth century, Hine’s photographs and the ARC’s role in contributing to humanitarian photography are an early example of a rise and fall in sympathies towards refugees that would continue throughout the century.

Journal of Humanitarian Affairs
Open Access (free)
Valérie Gorin and Sönke Kunkel

This article introduces you to the general themes and questions of this special issue. We argue that history and visual media have long been central to humanitarian communication, but that the overlaps between history, visual media, and humanitarian communication have seldom been addressed. A focus on those overlaps, we suggest, not only demonstrates that critical historical inquiry has much to offer for professional communication specialists, it also sheds new light on the workings, changes and persistence of humanitarian narratives over the twentieth century.

Journal of Humanitarian Affairs
The Visual Politics and Narratives of Red Cross Museums in Europe and the United States, 1920s to 2010s
Sönke Kunkel

Interpreting Red Cross museums as a visual medium, this essay explores the visual politics of Red Cross museums through the twentieth century. The essay puts particular emphasis on the entanglements between the visual politics and humanitarian narratives of Red Cross museums and identifies three major narratives that museums promoted through the times: a heroic narrative, a narrative of civility, and a volunteer’s narrative. Last, the essay argues that Red Cross museums may offer a fruitful field to encourage more engagement between (public) historians and humanitarian practitioners.

Journal of Humanitarian Affairs