History

This chapter uses the launch of low-fat milk as a case study to argue for the role the food industry played in reconceptualising the public as health consumers. It explores how diets, particularly low-fat diets, became reworked to create a popular understanding that preventive health can be bought on the high street. It demonstrates how government–industry cooperation enabled health education messages to be more effectively transmitted within a consumerist context, part of a rise in voluntary efforts the food industry was making to maintain their influential role within governmental policy-making. It examines what it means to buy health in the 1980s and 1990s and seeks to better understand how this corresponds (or not) to governmental priorities around heart disease prevention. It emphasises how the public was identified as gendered consumers and assesses what this focus means for historical understandings of public health more broadly during this time period.

This chapter introduces the collection by exploring the changing meaning of ‘the public’ and ‘public health’. It suggests that there was no single unitary ‘public’, and ‘public health’ also has multiple meanings. This diversity is echoed in the framing of certain groups, individuals and behaviours as ‘problem publics’. The essays in this collection unpack a range of examples of ‘problem publics’. This introduction summarises the contents of the chapters in the collection, but also highlights a series of key cross-cutting themes. These include the overlapping of ‘problem publics’ with identity categories and certain kinds of behaviour, as well as the geographical location of groups and individuals. The introduction places this in the context of the recent COVID-19 pandemic, which has brought fresh interest in how to deal with ‘problem publics’, but with many old tropes rising to the fore.

Mobilising a queer theoretical framework, by which we mean embracing unhappiness, ephemerality, and instability, this chapter reflects on processes of archiving oral histories as part of the European HIV/AIDS Archive (EHAA). It presents selected challenges and tensions that lie at the heart of remembering, narrating, and archiving the HIV/AIDS epidemic in the broader European region. The EHAA, an online collection of oral history interviews and digitised materials, has been developed to further establish HIV/AIDS history as part of the broader social memory, so as to work through the trauma of mass death and social discrimination and to document innovations, tensions, and inconsistencies in engaging with the epidemic across the region.

Building on a growing interest in archiving histories of HIV activism across Europe and North America, the EHAA project dates back to efforts by the ‘AIDS History into Museums Working Group’ to preserve such histories in Germany. The project was further developed and expanded in two research projects: ‘Disentangling European HIV/AIDS Policies: Activism, Citizenship and Health’ and ‘Don’t Criminalize Passion! The AIDS Crisis and Political Mobilization in the 1980s and early 1990s in Germany’.

Explicitly deviating from an investment in offspring as a route for the transmission of memory, the EHAA joins other queer archival work imagined as sites for handing down queer history. This chapter argues that the EHAA contributes to queer memory work as a necessary revision of public remembrance and current perceptions of the epidemic, and, at the same time, as a source of inspiration for future activism.

As part of the United Kingdom’s response to the escalating HIV/AIDS crisis during the 1980s, special wards and community-based services were established to care for people living with HIV/AIDS (PWHA).  Much of the pioneering and innovative care developed at these centres can be attributed to nurses. However, UK nursing history has hitherto neglected to tell their stories. This chapter rectifies this omission by drawing on a wealth of source material including previously unseen, enlightening, and frequently moving oral histories, as well as archival and news media sources, to explore the actions and perceptions of the UK nurses who cared for PWHA, alongside the reflections of PWHA and their loved ones who received this care.

This chapter reveals how assertive PWHA took control of their own care, often becoming experts on their condition – a phenomenon that challenged ideas of medical paternalism by reclaiming decision-making power in the name of the patient.  We explore questions of ethics and socialisation by analysing how nurses were similarly tasked with deciding what actions were permissible in times of crisis – decisions made along the frequently blurred lines that this crisis drew between private and professional lives. Appreciating the personal draw that HIV/AIDS care had to nurses who identified as queer in particular, and the sense of duty this often evoked, offered a meaningful way of interpreting the research gathered for this chapter.  Last, this makes an important contribution to the documented history of nurses’ experiences and constructions of the care of individuals belonging to stigmatised groups.

In recent years there has been a resurgence of museum exhibitions on the history of HIV/AIDS. While many assumed that there was enough awareness of the historical significance of this new disease to ensure the careful collection and conservation of relevant material, it is increasingly clear that a narrow range of items have been saved. As historians and curators turn to these holdings for analysis and exhibition, they find that archival and museum collections inadequately represent the impact of HIV/AIDS across diverse groups and places.

This chapter considers some of the factors that have shaped museum responses to HIV/AIDS, from the accession of objects to the framing of narratives. It discusses the role of national contexts and pays close attention to the role of Dutch self-image in the framing of HIV/AIDS history there as a story of consensus and success, and the implications of this for museums and exhibitions in the Netherlands. Analysis draws on ongoing discussions with Dutch curators and a workshop with curators from museums across Europe, as well as an exhibition in Amsterdam at the International AIDS Society conference there in July 2018. This chapter highlights some of the issues that have limited museum collections and explores the potential consequences for public history. It argues that the current situation is problematic not only because archives and museum objects fuel inaccurate perceptions of the past about who was as risk and why, but also because these histories feed into responses to HIV/AIDS – and Covid-19 – in the present.

Edinburgh was disproportionately affected by HIV/AIDS in the early 1980–1990s, and women and children were affected in higher numbers there than elsewhere in the UK. Edinburgh’s AIDS crisis also followed a different pattern, with new infections predominantly occurring among IV drug users and heterosexuals. Because of the high rates of HIV infection among women in Edinburgh, the city rapidly became host to numerous charities and organisations scrambling to meet the needs of HIV-affected women and families, aiming to prevent new infections and meet the emotional, medical, housing, and educational needs of those already affected by the virus.

This chapter traces how healthcare workers and HIV-affected women responded in Edinburgh. This was interdisciplinary collaborative AIDS activism born out of the daily fight for resources, information, space, and empathetic treatment for women and their families. This activism can be traced in texts both academic and creative, and was at the very least a backdrop for many women’s experience of HIV and AIDS in Edinburgh in the late twentieth century. To focus the analysis, the creation of the Paediatric AIDS Resource Centre (PARC) in Edinburgh is examined, alongside some of the items the centre published. The need for PARC is demonstrated not just by placing it in its social, political, and historical context, but by recovering the words of HIV-affected women and healthcare workers drawing on its resources, writing these women back into the history they created as subjects rather than objects.

As the AIDS crisis emerged, prisons were quickly identified as possible ‘reservoirs of infection’, where injecting drug use, sex between men, violence, and poor hygiene might all contribute towards the spread of HIV. Some countries moved to introduce punitive or restrictive measures within their prisons, while researchers and international bodies hastened to promote an alternative approach, based on voluntarism, education, and harm reduction. This tried to acknowledge prisoners’ rights and to position prisons as an integral part of the wider community, and by the early 1990s some regions saw innovations such as methadone treatment and needle exchanges established within their prisons.

This chapter reviews and begins to explain the different ways in which countries around Europe responded to HIV/AIDS in their prison systems. The size of a nation’s prison population and the extent of injecting drug use were both important factors in determining national response, as were pre-existing structures of prison healthcare provision and attitudes towards both homosexuality and crime. Responses in prisons were also closely affiliated to responses in the wider community – perhaps to a greater extent than campaigners calling for greater parity were prepared to recognise. It then compares policies and developments in the Republic of Ireland and Switzerland to explore different forms of activism, with different outcomes. Using international evaluations and research from the 1980s and 1990s, national policy documents, and oral histories, this chapter also raises questions about the kind of activism surrounding HIV/AIDS that is remembered.

This contribution brings together the history of psychiatry and the history of disability in Belgium, for the period stretching from the end of the eighteenth century up till the end of the twentieth century. The chapter starts with enumerating several key reasons why such an approach is not only possible, but also valuable and innovative. On the basis of different case studies related to the history of disability and the history of psychiatry, the specificity of Belgian care and medicine is being discussed. Some of the themes being touched upon are the introduction of Belgian psychiatric legislation, the emergence of educational institutes for blind and/or deaf people, the impact of the First World War on representation of otherness and the well-known tradition of family care for psychiatric patients. On the basis of these and other case studies it is, first of all, argued that the Belgian state played an active role in the problematisation of mental and physical differences, but that it actually was private institutions, mainly religious congregations, who managed these populations on a daily basis. Second, the chapter pleads also to take into consideration the agency of the people who were controlled and disciplined; they were not only able to oppose and reinterpret the categories and norms that were imposed on them; they also used these labels to construct new (positive) identities – bringing them into competition with physicians, experts, bureaucrats, etc. By highlighting the variety of different players involved, this chapter illustrates the general theme of this section, ‘Beyond Physicians’.

The epilogue takes stock of the merit and potential of the ‘new narratives’ presented in this volume. As a whole, the volume intends to do two things: empirically, it presents medical histories on Belgium to the Anglophone world while, conceptually, it does so by using the latest methods and perspectives. While ‘traditional’ medical history mainly represented stories about medical science, the medical profession and the state, these new narratives are (also) about patients, alternative healers, clergymen, women and other historical actors.

With its contributors writing after many ‘turns’ (social, cultural, performative, praxeological, material and somatic), the ambition of the present volume is to move beyond science, the profession and the state. Like medicine, medical history is not owned by physicians, but by all of us. While in the past, medical history was written by male, Western physicians, today’s medical history is (also) written by historians, women and non-Westerners, producing multiperspective and multivocal stories. While some may regret this development because of the fragmentation it entails, much is to be gained by including all historical actors. Moving beyond the great doctors, decentring the big picture and provincialising Europe leads to a diversity of narratives – representing the diversity of today’s world.

In an era of transnational and global historiography, reflecting on the national frames of writing medical history remains a necessary endeavour. On the one hand, it helps historians to interrogate the metanarratives they use in writing about the medical past, many of which still focus on interactions between physicians and the state and stem from an older social historiography of medicine. By widening their gaze to a history of (health) care, historians may bring a broader range of actors and influences into the limelight. On the other hand, questioning national frames of writing history also shows the complex stratification of local practices, international circulation of scientific knowledge and national structures. Medical histories of modern Belgium therefore consist above all of a variety of entanglements taking place both in Belgium and beyond.