Global Health Histories FAQs

On 24 April 2018 a Global Health Histories seminar will be held for the first time in York, UK (See - www.york.ac.uk/history/global-health-histories/events/ghh-104-tobacco-control/). This will give a lot of our UK-based followers the first chance to attend one in person. For some it will be their first time engaging with the series. So we’ve put together his quick look at the series’ history and as well as some frequently asked questions.

What are the Global Health Histories Seminars?

The Global Health Histories project (or GHH) was launched back in 2004 to bring together academics, policymakers, public health professionals and members of the public from all over the world to foster useful discussions on topical global health issues, and create opportunities for historians and policy makers to connect with and learn from each other. Over the course of almost a hundred events to date it has provided a framework for academic research to be made available freely to policymakers beyond the conventional academic avenues.

What is their purpose?

The underlying goal of the Global Health Histories project is based on the idea that understanding the history of health, especially during the last 60 years, can help the global public health community respond to present-day challenges. The enduring value to the series is in using different perspectives to tackle issues about how disease has spread, how illness is experienced, and how it is managed across different cultures and time periods.

Which topics have been covered?

Too many to mention all of them here! There have now been over one hundred seminars. Some annual series have focussed on specific areas, such as neglected tropical diseases and the road to universal health coverage, whereas individual seminars have explored topics such as antimicrobial resistance, health communication, healthy ageing and yellow fever. Out next seminar, on 24th April 2018, concerns tobacco control. In many cases you can access recordings via our YouTube channel, www.youtube.com/CGHHYork.

Where are the seminars usually held?

The seminars are usually held at the WHO Regional Office for Europe in Copenhagen, but from time to time seminars are run all over the world. In some cases these events will be broadcast live over the internet, but when this is not possible a recording is usually made and then added to our YouTube channel shortly afterwards.

Who can access these seminars?

Anyone can tune in to the online broadcasts, however please do check beforehand whether or not you will be able to attend in person. The next seminar in York is open to the public: you can register at: www.york.ac.uk/history/global-health-histories/events/ghh-104-tobacco-control/

I won’t be available to log in to the live broadcast but have a question for the panel?

Just email cghh@york.ac.uk. When a seminar is broadcast live you will be informed beforehand seminars are broadcast live so you can also Tweet your question.

Have you just run seminars?

No, we have produced a range of books based on some of the themes and presentations covered in the seminars. They are all free to access online and are multilingual. See www.york.ac.uk/history/global-health-histories/publications-outreach/ for further details.

How do I get more information on upcoming seminars and connected projects?
If you’d like to join the event mailing lists please write us an email at cghh@york.ac.uk. Our website (www.york.ac.uk/history/global-health-histories/) is regularly updated. You can also follow updates via social media, on Facebook (@TheCentreForGlobalHealthHistories) and Twitter (@CGHH_York). For past GHH recordings visit our YouTube channel (www.youtube.com/CGHHYork)

Who runs and funds the project?

The project is a collaboration between the WHO Collaborating Centre for Global Health Histories (which is housed in the Department of History at the University of York) and the WHO Regional Office for Europe. The project is supported by the Wellcome Trust, one of the largest charitable foundations in the world.

Spring 2018 at the Centre for Global Health Histories

It has been a busy start to the year at the Centre for Global Health Histories, with new outputs to celebrate and new colleagues to welcome. We provide a digest below; full particulars on these and all CGHH news and events can be found at www.york.ac.uk/history/global-health-histories/.

New publications

Professor Sanjoy Bhattacharya contributed a chapter ‘Global and local histories of medicine: interpretative challenges and future possibilities’ in A Global History of Medicine edited by Mark Jackson.

Dr Alexander Medcalf’s open access article ‘Between art and information: communicating world health, 1948–70’ was published in the Journal of Global History (Volume 13, Issue 1 (2018), pp. 94-120) and is available to view online via Cambridge Core.

Dr Margaret Jones and Chandani Liyanage’s article, ‘Traditional Medicine and Primary Health Care in Sri Lanka: Policy, Perceptions, and Practice’, was published in the Asian Review of World Histories’ website. This is also an open access article available to all to view.

New team members

Dr Rebecca Wright joined CGHH in January as a Research Fellow in Future Health. Her two-year fellowship was awarded by the Centre of Future Health, an interdisciplinary research centre at the University of York (co-funded with the Wellcome Trust) supporting innovative research on future health challenges. Rebecca’s research will examine the intersections between the histories of energy and health.

Deika Mohamed was awarded the Michael Smith Foreign Study Supplement by the Canadian Social Science and Humanities Research Council (SSHRC) and has joined CGHH as a Visiting Scholar until May 2018. Deika will conduct archival research across Europe while working under the direction of CGHH’s Director Sanjoy Bhattacharya.

New lectures

In January Sanjoy Bhattacharya delivered a lecture ‘History Matters: WHO EMRO and the Worldwide Eradication of Smallpox’ to WHO staff during a visit to the WHO Regional Office for the Eastern Mediterranean. He was subsequently invited to record it for the WHO EMRO YouTube channel and it is now available to view online. The video provides a historical overview of smallpox eradication, and sheds light on various public health, social and political factors which contributed to this landmark global health achievement.

At the end February, Sanjoy also represented CGHH at two events at Nanyang Technological University, Singapore, and a further talk at the Center for Culture-Centred Approach to Research and Evaluation (CARE). The first event, a public lecture on 27th February, re-visited the worldwide eradication of smallpox, exploring the idea of ethically prepared histories as roadmaps for global health. The second event, on 28th February, took the form of a roundtable with Sanjoy, Ivy Yeh, Michael Stanley-Baker, Park Hyung Wook and Fang Xiaoping of Nanyang Technological University tackling the provocative subject ‘Are Medical History and Humanities Useful?’ At the third event at CARE on the 1st March event Sanjoy delivered a public lecture titled "Repositioning the World's Health: Empires, Democracy and the Making of the World Health Organization".

Exploring digitized resources in a better way: workshop at the British Library

PhD Student Arnab Chakraborty reports on a recent British Library workshop

The India Office Medical Archives of the British Library conducted a workshop on its digital resources on 26th January 2018. This was to inform and educate scholars about the digitization project they have been doing with a grant from the Wellcome Trust. The workshop was organised by Dr Antonia Moon, lead curator of post-1858 India Office Records (IOR) and her other colleagues.

The speakers ranged from geographers, software developers to the British Library staff engaged with the digitization process. The participants were mostly those who extensively use the IOR and included senior historians like David Arnold and Mark Harrison among others. There was discussion on newer methods of researching digitized documents and using techniques implemented by organisations such as JISC, using images and maps to explain the medical topography in the IOR and also how visualising metadata can be used for exploratory research work.

The digitization process was started following the sources listed in the ‘health’ segment of the book ‘Science and changing environment in India, 1780-1920: a guide to sources in the India Office Records’ and the present work has covered the Sanitary and Annual Reports until 1910.

The work that the India Office Medical Archives has undertaken is indeed huge and will require plenty more time to be further organised and completed, but during the multiple group discussion sessions that were an integral part of the workshop, critiques and new ideas were exchanged on using visual techniques to explain the historical research in a different way; whereas the participants present also raised concerns about the extent to which we can and should depend on technology to ease the process of research. The workshop concluded with details of collaborative work and funding opportunities provided by the British Library and the Wellcome Trust.

Arnab Chakraborty

Centre for Global Health Histories

University of York

Christian Missions in Global History

This week CGHH PhD student Ben Walker presented a paper at the Institute of Historical Research as part of their seminar series 'Christian Missions in Global History'. Many key figures in the field were in attendance including John Stuart, Deborah Gaitskell, John Manton and David Killingray.

Ben's paper challenged the ways in which postcolonial international health is framed. He argued that in addition to the classic models of East-West conflict, former colonial powers retaining influence and the emergence of the global community, there was another significant framing large absent from the historical literature: that of old colonial power establishing health development in areas which they had never ruled or with which they had almost no relation before since before the 1880s. He argued this using his archive work on the massive growth of West Germany and Dutch Catholic medical missions in Ghana from the late 1950s onwards. This was using his research work from Aachen (Germany) Philadelphia (US), Geneva (Switzerland) and Accra (Ghana). All this was set in the context of long-term growth of medical mission across colonial and post-colonialism in Ghana.

Ben's paper provoked a great deal of discussion and many questions. It also caused debate over the nature of evangelism in medical missions, the larger picture of Catholic expansion and the limits placed on post-war German internationalism. Overall, the paper was received very positively with the leader of the discussion, John Stuart, describing it as 'excellent'.

Leadership for Health for All: Past Perspectives

The World Health Organization (WHO) appointed a new Director General in May 2017, who has since made Universal Health Coverage (UHC) his ‘top priority’. Dr Tedros has recently stated that one of the key ingredients in achieving universal health coverage will be political leadership.

The need for effective leadership in global health is well acknowledged today, even if there is still heated discussion about what constitutes the ‘right’ kind of leadership. Although we may know leadership when we see it, it is more difficult to analyse and define explicitly. Within leadership studies, it is generally accepted that effective leadership constitutes inspiration, creativity and commitment in action. It is, first and foremost, an attitude and not necessarily restricted a rank or position of authority.

The need for inspirational and effective health leadership is by no means a new concern. It was prominent decades earlier in the drive for Heath for All (HFA) by the year 2000, and as part of the primary health care (PHC) model of health care adopted at the International Conference on Primary Health Care held in Alma Ata, Kazakhstan in 1978 (commonly known as the "Alma Ata Declaration"). Indeed, the Alma-Ata conference called for leadership at various levels including professionals and institutions, governments and civil society organizations, as well as communities and grassroots organizations. The ambitious programme held that HFA could only be achieved through concerted and collaborative action.

What challenges to effective HFA leadership did the WHO anticipate? What kind of leadership did it envisage, and what did it end up with? The WHO Iris portal (an online accesspoint to the WHO’s published material since 1948) contains material which enables us to dig deeper into such questions. Whilst this comes with the obvious caveat that Iris contains mainly official records deriving from WHO workshops, conferences and publications, these often comprise very candid assessments of entrenched problems which can be used to help better understand the leadership concerns in the final decades of the twentieth century.

For instance, we find that the WHO only turned seriously to the question of HFA leadership almost a decade after the Alma-Ata conference. The need to develop leadership capacity appeared ever more frequently in WHO reports and regional meetings, and in response in 1985 the Director General instigated the HFA leadership development initiative. A year later the proposed programme budget of WHO 1986-1987 defined six major objectives which included ‘the building up of a critical mass of health-for-all-leaders’.[1]

One of the chief features of the PHC model was close collaboration between communities and health systems, based on mutual decision-making. Community health workers were envisaged as the go between, and whilst this required effective management, it also depended on effective leadership: PHC needed ‘teamwork’, but also ‘team leaders’.[2] 1986’s ‘Leadership for Primary Health Care’ publication (http://apps.who.int/iris/bitstream/10665/37339/1/WHO_PHP_82.pdf) constituted one of the first attempts by the WHO to research the qualities of leaders and the functions of leadership. Highlighting the important role of community health workers and based on twelve case studies, this publication worked with a broad meaning of leadership and was ultimately intended to be used to help countries achieve improved leadership for their PHC programmes (http://apps.who.int/iris/bitstream/10665/37339/1/WHO_PHP_82.pdf).

Between 28-30th October 1987, the WHO’s Director General, Halfdan Mahler, hosted a Director-General's Round Table on ‘Leadership Development for Health for All’ in, Brioni, Yugoslavia. The aim of this workshop was to discuss fundamental questions including: What is leadership? What drives and motivates leader? What are their values?, and, crucially, what issues or gaps are there in HFA leadership, and the future scenario of HFA Leadership? The resulting document, available on WHO Iris (http://apps.who.int/iris/bitstream/10665/60382/1/WHO_HLD_88.1.pdf) contains the frequently frank thoughts of Mahler and his fellow speakers in terms of the challenges facing HFA.

Hot on the heels of this meeting was another ‘round table’, this time gathered together and published in the WHO journal ‘World Health Forum’. Acknowledging the need for leaders to give the HFA movement momentum, in 1988 the World Health Forum asked eleven leaders to discuss leadership characteristics as well as how they approach and tackle their problems (http://apps.who.int/iris/bitstream/10665/49197/1/WHF_1988_9%282%29_p147-174.pdf). Although the avowed aim of such roundtables and discussion groups was to create practical aides and training tools, in each case there is a powerful sense of diversity of opinion, especially when the questioning moved from ‘what is leadership’ to ‘what is HFA leadership’. Whilst there was general agreement regarding importance and qualities, there was no model of leadership.

On Universal Health Coverage day 2017, questions about effective leadership on HFA are once again under the spotlight. It is worth reflecting not just on how far we have come in developing materials and strategies to bolster leadership for health for all, but also to remember that this role is not confined to those in traditionally recognised positions of power. Health for all requires leaders at all levels.

Alexander Medcalf


[1] http://apps.who.int/iris/bitstream/10665/37339/1/WHO_PHP_82.pdf. 3.
[2] http://apps.who.int/iris/bitstream/10665/37339/1/WHO_PHP_82.pdf. 2.

Towards a History of Manufactured Mental Disorders in Post-Socialist China

On the blog today we have a guest post from Harry Wu, giving us background and insights into his Medical History article ‘The Moral Career of ‘Outmates’: Towards a History of Manufactured Mental Disorders in Post-Socialist China’, which appeared in the special issue: ‘Tales from the Asylum. Patient Narratives and the (De)construction of Psychiatry)’ https://doi.org/10.1017/mdh.2015.70

Harry writes: My article deals with an unusual but popular concept regarding the development of modern psychiatry in China. Bei jingshenbing, a Mandarin neologism in referring to ‘manufactured mentally ill’, was a catch phrase appearing in China in the first decade of the 21st Century. The term was coined to describe conditions of involuntary psychiatry treatment or admission due to unjustifiable, and often non-medical reasons.

Since I began to conduct research into the history of psychiatry, I have been particularly interested in the development of the discipline in the Chinese-speaking world. In the monograph that I am currently working on, I look at how theories and methods of social psychiatry have been jointly framed at the World Health Organization (WHO) by scientists, visionary European thinkers, as well as technocrats from the non-western world. However, the project in the WHO did not include People’s Republic of China, since psychiatry was suspended by the Chinese government during the period of the Cultural Revolution.

After coming back to work in Asia, I took the opportunity to take a closer look at the discipline of psychiatry in China in the neglected years. And I found that the story of psychiatry in China during this period cannot be examined under the existing historiographic frameworks, such as the East-West comparison or localisation of the modern western psychiatry. Chinese psychiatry, in fact, evolved in the complex web weaved together in the emerging strands of medical, economic, political, and legal infrastructures during the period of the building of the modern state. In these fields, psychiatry means different and it functions in very different ways for different stakeholders.

The general readers may think that the term is burdened with a heavy political connotation. The negative comments on Chinese psychiatry proliferated, while Human Rights workers began to report on the likely confinement of Falungung practitioners in the 1990s. But my research has found that the misfortune of unjustifiable psychiatric admissions occurred under circumstances when the aforementioned modernization projects failed to evenly mature.

The publication time of this article coincided the implementation of China’s Mental Health Law, which aspired to remove the stigma of mental patients and decrease the situation of human rights violations regarding psychiatric care. I hope that my article can contribute an alternative analytical framework for historians who writes about modern psychiatry in post-socialist China.

Harry Wu

Illness, Healing and the Dynamics of Reciprocal Exchange on the Upper Guinea Coast

On the blog today we have a guest post from Philip Havik which introduces us to his recent Medical History article ‘Hybridising Medicine: Illness, Healing and the Dynamics of Reciprocal Exchange on the Upper Guinea Coast (West Africa)’ https://doi.org/10.1017/mdh.2016.3. Including travel accounts, missionary reports and documents produced by the Portuguese Inquisition, Philip's article shows how forms of medical knowledge shifted and circulated between littoral areas and their hinterland, as well as between the coast, the Atlantic and beyond.

Although currently knowledge of tropical medicine, vaccinations and medical care for ailments generally associated with the tropics such as malaria, yellow fever, sleeping sickness, Chagas disease, dengue fever, cholera, yaws, etc. has greatly advanced, at the time of European expansion in the fifteenth century little was known about them. Without the benefit of modern medical science, travellers were faced with unknown and unseen threats to their health and lives. As the risks of succumbing to tropical fevers became commonly known, the doubtful reputation these regions gained was associated with high morbidity and mortality rates. West Africa, which formed the earliest region of contact as Europeans advanced southwards, was eventually dubbed ‘the white man’s tomb’ in the early 1800s, on account of its fierce tropical climate and disease environment. However, but for rare exceptions, the question of health in pre-or proto-colonial formations has tended to be overshadowed in academic studies by economic and political issues. This despite the key role it played in conditioning strategies towards imperial expansion and settlement.

My article seeks to bring health related considerations back into the equation by focusing on the early period of Euro-African encounters, and fill a number of lacuna by mapping exchanges of knowledge taking place from the fifteenth and to the eighteenth centuries. Centring on the West African Senegambian/Guinea region, which became an important area for slave and commodity exports from the sixteenth century, it shows that European and local African actors and communities were actively involved in the search for remedies that could cure or prevent certain ailments common in the tropics. It confirms the importance attached to the information circulated by and among traders, settlers and missionaries on the one hand, and local communities on the other, on a variety of medical techniques, compounds and cures. Thus, different elements from Galenic medicine, as well as from Oriental medical practice and local African phyto-therapeutical methods came to be used by an increasingly heterogeneous population in coastal areas.

This shows that the social, cultural and economic encounters occurring in this contact zone would lead to a progressive entanglement between different bodies of medical knowledge against the background of a globalising world. Over time, this intense cross-cultural interaction and borrowing would result in a progressive hybridisation of knowledge and practice assembled in the form of ‘cultural kits’ which could be accessed by incoming and local actors, illustrating the fluidity of boundaries. Based upon data extracted from Portuguese, English and French published and archival sources, my article presents evidence of the dissemination and evolution of biophysical and spiritual healing techniques in some coastal locations. These ‘cultural transfers’ based upon a relational approach to health, would operate in a multi-centred fashion in the Senegambia/Guinea region, producing innovative complementary and competing healing narratives and practices.

Philip J. Havik