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Open Access (free)
Mass vaccination and the public since the Second World War
Author: Gareth Millward

Vaccinating Britain investigates the relationship between the British public and vaccination policy since 1945. It is the first book to examine British vaccination policy across the post-war period and covers a range of vaccines, providing valuable context and insight for those interested in historical or present-day public health policy debates. Drawing on government documents, newspapers, internet archives and medical texts it shows how the modern vaccination system became established and how the public played a key role in its formation. British parents came to accept vaccination as a safe, effective and cost-efficient preventative measure. But occasional crises showed that faith in the system was tied to contemporary concerns about the medical profession, the power of the state and attitudes to individual vaccines. Thus, at times the British public demanded more comprehensive vaccination coverage from the welfare state; at others they eschewed specific vaccines that they thought were dangerous or unnecessary. Moreover, they did not always act uniformly, with “the public” capable of expressing contradictory demands that were often at odds with official policy. This case study of Britain’s vaccination system provides insight into the relationship between the British public and the welfare state, as well as contributing to the historiography of public health and medicine.

Hajj, cholera and Spanish–Moroccan regeneration, 1890–99
Francisco Javier Martínez

This chapter deals with a rather unknown quarantine institution: the lazaretto of Mogador Island in Morocco. Specifically, the work explores the site’s centrality to the Spanish imperialist project of “regeneration” over of its southern neighbour. In contrast with the “civilisation” schemes deployed by the leading European imperial powers at the end of the nineteenth century, regeneration did not seek to construct a colonial Morocco but a so-called African Spain in more balanced terms with peninsular Spain. This project was to be achieved through the support and direction of ongoing Moroccan initiatives of modernisation, as well as through the training of an elite of “Moors” who were to collaborate with Spanish experts sent to the country, largely based in Tangier. Within this general context, the Mogador Island lazaretto became a key site of regeneration projects. From a sanitary and political point of view, it was meant to define a Spanish-Moroccan space by marking its new borders and also to protect “Moorish” pilgrims against both the ideological and health-related risks associated with the Mecca pilgrimage.

in Mediterranean Quarantines, 1750–1914
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The sanitary control of Muslim pilgrims from the Balkans, 1830–1914
Christian Promitzer

This chapter investigates the use of quarantine as an instrument of social control and as dispositive for the construction and stigmatization of the Muslim ‘other’. The study takes the under-researched case of the Hajj to Mecca from the Balkans, hence focusing on Muslims from Bulgaria and Bosnia-Herzegovina (the latter under Austrian-Hungarian rule as from 1878). Both Bosnian and Bulgarian Muslim pilgrims experienced quarantine on their return from Mecca, yet in unequal measures. Bosnian hajjis were given a more lenient quarantine than their Bulgarian co-religionists by their separate sanitary authorities – with regard to the duration of isolation and the disinfection of their bodies and personal belongings. This was due to the different political and cultural attitudes towards their Muslim minorities by these two Balkan regimes.

in Mediterranean Quarantines, 1750–1914
Quim Bonastra

This chapter provides a thorough investigation of the modes by which the sanitary administration coevolved coherently with and inseparably from the Spanish state’s modern transport-communication and economic-industrial infrastructures throughout the nineteenth century. It also investigates examines how quarantine institutions functioned as sanitary gateways or entry checkpoints at borders, physically marking and consolidating while protecting the national territorial space. The paper traces the ideas underpinning the configuration and development of the sanitary network on Spanish national territory, which occurred unevenly – with the most evolved parts depending on certain strategic ports and on links with the railway transport infrastructure that was still under construction. It also suggests that the gradual relaxation of quarantine in liberal Spain was periodically called into question by economic and political policies that defined the relation between the coastal and inland regions of the country.

in Mediterranean Quarantines, 1750–1914
Malika Ezzahidi

This chapter examines the writings of the renowned late-eighteenth-century Moroccan ambassador Ibn Uthmân Al-Meknassî, the first known traveller from his country to leave an account of European quarantine as experienced during his two diplomatic missions in Spain’s Ceuta (1779) and Malta’s Valletta (1782). It shows that quarantine, on the one hand, acted as a marker of otherness by which Ibn Othman was identified as a Muslim, though this was not a uniform process, owing to the fact that significant differences existed in the degree of alterity experienced in Spain and Malta, and indeed other parts of the Mediterranean. The subjective opinion on quarantine, on the other hand, was also one of the means through which Ibn Uthmân situated himself within Makhzen (Moroccan government) elites at a time when a division between those who declared themselves in favour of European-style modernisation and those who advocated a rejection of European novelties was already visible.

in Mediterranean Quarantines, 1750–1914
John Chircop

This chapter investigates the setting up of a network of lazarettos along the southern and eastern littorals of the Mediterranean during the nineteenth century. The fundamental thesis is that these lazarettos, constructed and frequently directed by Europeans, sustained the expansion of Western colonialism in the region. Starting with an investigation of the workings of the first Sanitary Councils – in North Africa and Ottoman-ruled ports – which preceded the International Sanitary Conferences, the study then goes on to show how maritime quarantine catered for the European powers’ commercial, shipping and imperial interests in the region. By examining the regulations and the actual practices of disinfection adopted in these lazarettos, this chapter also shows how these institutions constructed and/or consolidated stereotypes of the ‘Muslim Arab’ as a ‘threatening contagious body.’

in Mediterranean Quarantines, 1750–1914
Open Access (free)
Rima D. Apple
in Colonial caring
Barbra Mann Wall

This chapter analyses shifting dynamics within medical missionary work in Nigeria, from support for British colonialism to humanitarianism. It explores Irish Catholic missionaries as nurses, midwives and physicians from c.1937-1970, to the end of the Nigerian Civil War in 1970. It uses unpublished documents to disentangle, although not disconnect, modern missionary work from colonialism. Using gender as a category of analysis it focuses on women’s work during the Nigerian civil war compared to men’s activities, and how the media focused on one but not the other. By giving voice to the “silenced” in history it argues that there was a significant Nigerian presence in relief work during the war, differing from most research which focuses only on the work of whites. Significantly, in the 1960s and 1970s, Catholic mission hospitals became sites for shifts in the understanding of mission during periods of violence and upheaval. As Catholic women renegotiated their place in an emerging decolonised world, complex relationships developed among Irish sisters, Nigerian nuns, priests, Nigerian chiefs and international peacekeepers. Whereas in the 1930s and 1940s, Catholic sisters saw Africa as a fertile ground for converts, over time the Catholic mission tradition liberalised to promote humanitarianism.

in Colonial caring
Open Access (free)
A history of colonial and post-colonial nursing
Editors: Helen Sweet and Sue Hawkins

Colonial Caring covers over a century of colonial nursing by nurses from a wide range of countries including: Denmark, Britain, USA, Holland and Italy; with the colonised countries including South Africa, Australia, New Zealand, Ethiopia, Nigeria, India, Indonesia (Dutch East Indies) and the Danish West Indies. It presents unique perspectives from which to interrogate colonialism and post-colonialism including aspects of race, cultural difference and implications of warfare and politics upon nursing. Viewing nursing’s development under colonial and post-colonial rule reveals different faces of a profession that superficially may appear to be consistent and coherent, yet in reality is constantly reinventing itself. Considering such areas as transnational relationships, class, gender, race and politics, this book aims to present current work in progress within the field, to better understand the complex entanglements in nursing’s development as it was imagined and practised in local imperial, colonial and post-colonial contexts. Taking a chronologically-based structure, early chapters examine nursing in situations of conflict in the post-Crimean period from the Indian Rebellion to the Anglo-Boer War. Recruitment, professionalisation of nursing and of military nursing in particular, are therefore considered before moving deeper into the twentieth century reflecting upon later periods of colonialism in which religion and humanitarianism become more central. Drawing from a wide range of sources from official documents to diaries, memoirs and oral sources, and using a variety of methodologies including qualitative and quantitative approaches, the book represents ground-breaking work.

Liesbeth Hesselink

From 1900 Dutch nurses arrived in the East Indies, but their numbers were wholly insufficient to meet the colony’s increased demand for competent nursing staff. Therefore European physicians started training native women as nurses. Initial endeavours were disappointing with problems closely connected to the position young women occupied in native society. Young women from poor families were uneducated, whilst those from middle and upper classes often considered it culturally improper to live outside their parents’ home at marriageable age. The poor reputation of governmental hospitals made them only appropriate as work places for lower-class women and women with dubious reputations. European nurses taught and supervised nursing and provided role models. After qualifying, nurses could spend a further two years studying midwifery which combined hospital and community experience. The nurses and midwives were deployed as intermediaries to spread the ideology of western care among the native population, who nevertheless continued to have an aversion to western medicine. The (student) midwives were distrusted because of their youth and unmarried status. Native women variously rejected or embraced such advice or accommodated it selectively. In the main they remained loyal to the indigenous healers, the dukun bayi.

in Colonial caring