“Filth is the Arch Enemy of Health”: The Committee on Public Health and Waste Management in New York City

This guest post is by Tina Peabody, 2019 Audrey and William H. Helfand Fellow at the New York Academy of Medicine, and a doctoral candidate in history at the University of Albany, SUNY focusing on the urban environment in the United States. She is currently completing her dissertation entitled “Wretched Refuse: Garbage and the Making of New York City”, a social and economic history of waste management in New York City between the 1880s and 1990s.

The Committee on Public Health at the New York Academy of Medicine is well known for their role in creating the Department of Sanitation in 1929, through the development of the Committee of Twenty on Street and Outdoor Cleanliness. However, the broader Committee’s activism on sanitation has a longer and more complex history. Soon after its formation in 1911, the Committee on Public Health decried the conditions of city streets. They held conferences on sanitation in 1914 and 1915 which included representatives of the Department of Street Cleaning and other municipal departments.[1] While Department of Street Cleaning Commissioner J. T. Fetherston claimed he could not update equipment nor flush streets with water, he nonetheless encouraged the Committee to educate the public about the connections between dirt and disease.[2]  With that in mind, the Committee wrote a report in 1915 which connected the pathogens in street dirt to illness.[3]

Two men hauling garbage into an open refuse truck.

Commitee of Twenty, Dusty Trucks 2

The Committee of Twenty was particularly concerned about open refuse trucks which could spew dust and debris. Images: Committee of Twenty, Committee on Public Health Archives, New York Academy of Medicine, ca. 1930.

In 1928, a subcommittee called The Committee of Twenty was formed, in part because conditions did not improve substantially after the conferences and report.[4]  Among their recommendations, the Committee of Twenty supported the creation of a unified sanitation agency with full control over street cleanliness.[5]  They envisioned themselves as educators for the Department of Sanitation as well as the public, and they researched the latest collection methods and equipment from Europe to recommend improvements.[6] The newly-created Department of Sanitation, however, resisted investing in the recommended equipment, partially due to the expense.[7] Still, the Committee monitored street conditions, and kept photographic evidence of city and private sanitation trucks spewing dust and debris on the streets or other violations of sanitary ordinances.

Commitee of Twenty, Dirty Streets

Picture of overflowing refuse cans from the Committee of Twenty. Image: Committee of Twenty, Committee on Public Health Archives, New York Academy of Medicine, ca. 1930.

The Committee of Twenty also educated the public about outdoor cleanliness and especially the connections between dirt and disease. They issued pamphlets warning that “filth is the arch enemy of health,” and urged them to take personal responsibility for clean streets. “Do not put all the blame on the city administration,” one pamphlet read. “This is your city. A clean city means better health, better business; greater happiness for all; respect for law and order.”[8]  Along with educational literature, they placed litter baskets around the city, and posted signs which reminded New Yorkers of sanitary practices like “curbing” dogs.[9]  They also encouraged public participation in solving sanitary problem in novel ways, such as holding a contest for the best litter basket design in 1930.[10] 

Committee of Twenty, Don't

Educational Pamphlet from the Committee of Twenty. Image: Committee of Twenty, Committee on Public Health Archives, New York Academy of Medicine, ca. 1930.

The Committee was also influential in the citywide cleanup effort in preparation for the 1939 New York World’s Fair. Members of the Committee of Twenty and their allies argued that the Fair was the perfect opportunity for improving street cleanliness. Committee members Bernard Sachs and E. H. L. Corwin wrote that New York City was “the ‘Wonder City of the World,’ beyond a doubt; the ‘cleanest city,’ by no means. But we must make it that.”[11]  In line with the idea, Mayor Fiorello LaGuardia declared April 1939 “dress up paint up” month, and launched a broad beautification effort which included removal of litter, dog waste, and even “beggars, vagrants and peddlers.”[12]  Bernard Sachs was the representative for the Committee of Twenty on the Mayor’s Committee on Property Improvement, which was developed for the cleanliness campaign.

Committee of Twenty, Why Clean Streets 1

Educational pamphlet from the Committee of Twenty. Image: Committee of Twenty, Committee on Public Health Archives, New York Academy of Medicine, ca. 1930.

Committee of Twenty, Why Clean Streets 2

Educational pamphlet from the Committee of Twenty. Image: Committee of Twenty, Committee on Public Health Archives, New York Academy of Medicine, ca. 1930.

In 1950, the Committee on Public Health supported an initiative to introduce alternate side street parking to allow street cleaning unobstructed from parked automobiles, but otherwise was much less active on sanitation issues after the 1939 World’s Fair.[13]  At a meeting with Department of Sanitation Commissioner Andrew Mulrain in 1950, the Committee even debated whether unclean streets actually did cause disease.[14]  One Dr. Lincoln wondered if clean streets were not simply a matter of “public pride.” [15]  Still, the Committee’s early work on outdoor cleanliness would have a lasting legacy, particularly in terms of public education. The Outdoor Cleanliness Association, which was formed shortly after the Committee of Twenty [16], continued their educational work with regular cleanliness drives through the 1950s and 1960s in coordination with the Sanitation and Police departments.

References

 [1] “Minutes of the Meeting of the Public Health, Hospital, and Budget Committee October 26, 1914,” The Public Health Committee of the New York Academy of Medicine Minutes 1914–1915 (New York, NY), 74; “Minutes of the Meeting of the Public Health, Hospital, and Budget Committee Conference on Street Cleaning May 7, 1915,” The Public Health Committee of the New York Academy of Medicine Minutes 1914–1915 (New York, NY), 153–55.

[2] “Minutes of the Meeting of the Public Health, Hospital, and Budget Committee,” November 16, 1914, The Public Health Committee of the New York Academy of Medicine Minutes 1914–1915 (New York, NY), 84–85; “Minutes of the Meeting of the Public Health, Hospital, and Budget Committee Conference on Street Cleaning May 7, 1915,” The Public Health Committee of the New York Academy of Medicine Minutes 1914–1915 (New York, NY), 153-54 .

[3] Committee on Public Health, “Thirty Years in Community Service 1911–1941: A Brief Outline of the Work of the Committee on Public Health Relations of the New York Academy of Medicine” (The New York Academy of Medicine, 1941), 79.

[4] Committee on Public Health, “Thirty Years in Community Service 1911–1941,” 80.

[5] “Minutes of the Meeting of the Executive Committee of the Committee on Public Health Relations,” May 14, 1928, The Public Health Committee of the New York Academy of Medicine Minutes 1927–1928 (New York, NY), 134; Committee on Public Health, “Thirty Years in Community Service 1911–1941: A Brief Outline of the Work of the Committee on Public Health Relations of the New York Academy of Medicine,” 10.

[6] Committee on Public Health, “Thirty Years in Community Service 1911–1941,” 80.

[7] Committee on Public Health, “Memorandum of a Conference between Dr. William Schroeder, Jr., Chairman, Sanitary Commission…..May 19, 1931,” 1–4, Committee on Public Health Archives, Box 4, Folder 50c.

[8] Committee of Twenty on Street and Outdoor Cleanliness, “Why Clean Streets? Because Filth Is the Arch Enemy of Health” (New York Academy of Medicine, n.d.), Special Collections, New York Academy of Medicine Library.

[9] Committee on Public Health, “Thirty Years in Community Service 1911–1941: A Brief Outline of the Work of the Committee on Public Health Relations of the New York Academy of Medicine,” 80.

[10] Committee of Twenty on Street and Outdoor Cleanliness, “Prize Contest for the Design of a Litter Basket For New York City” (New York Academy of Medicine, n.d.), Special Collections, New York Academy of Medicine Library.

[11] Bernard Sachs and E. H. L. Corwin, “Fair Offers Opportunity: City Is Urged to Institute a Program of Outdoor Cleanliness,” New York Times, July 4, 1938.

[12] Marshall Sprague, “Clean City for Fair: Public and Private Groups Hard at Work Dressing Up New York for April, 1939 Mayor Is Enthusiastic Keeping Waters Pure Refurbishing Statues Beautification Drives,” New York Times, September 18, 1938; Elizabeth La Hines, “Drive Is Begun For a Tidy City During the Fair: Outdoor Cleanliness Group to Ask Wide Aid in Fight on Sidewalk Rubbish One Nuisance Abated Aid Through New Equipment Model for Other Cities,” New York Times, April 9, 1939.

[13] Committee on Public Health, “Pioneering in Public Health for Fifty Years” (The New York Academy of Medicine, 1961), 62.

[14]  “Minutes of the Meeting of the Subcommittee on Street Sanitation,” June 21, 1950, The Public Health Committee of the New York Academy of Medicine Minutes 1949–1950 (New York (N.Y.)), 473.

[15]  Ibid.

[16]  George A. Soper, “Attacking the Problem of Litter in New York,” New York Times, November 5, 1933.

 

 

 

 

 

The Medical Journals of U.S.-Occupied Haiti

This guest post is by Matthew Davidson, a doctoral candidate at the University of Miami and the 2019 Paul Klemperer Fellow at the New York Academy of Medicine. His research examines public health in Haiti during the 1915-1934 U.S. occupation.

During the nineteen years of the early twentieth century that the United States occupied Haiti (1915-1934), U.S. officials liked to claim that they had brought modern medical thought to the Caribbean country. Their contention was bunk, but it apparently felt very real when the Haitian physician, Dr. François Dalencour, received a letter from a French colleague asking for copies of any Haitian medical publications. “I was ashamed,” Dalencour later wrote, “of being obliged to tell the truth, to say that there were none. [i] He would have been able to send along reports authored by the occupation medical service, but there was apparently nothing current otherwise. Haiti, Dalencour decided, needed a medical journal.

Soon after, he established one.

LeJournalMedicalHaitien_May1920_1_watermark

The first issue of Le Journal Médical Haïtien (NYAM). 

The occupation, it turns out, was indeed an important period for Haitian medical thought. As was the case in other fields, it provoked a flurry of intellectual production. Consequently, whereas doctors such as Dalencour lamented the lack of Haitian medical publications at the start, by the end the local medical establishment could boast of several. U.S. officials claimed this was a sign of how far medicine in Haiti had “progressed” under their tutelage, but it was truly more the product of Haiti’s own medical tradition. [ii] Meant to advance medical practice and public health policy, the journals provided a forum for Haitian practitioners to debate and discuss all sorts of matters related to health and medicine in the country.

Dalencour’s periodical, Le Journal Médical Haïtien, was arguably the most important of the occupation-era publications. Not only was it the first, founded in May 1920, but it also did the most to open up space for the Haitian medical profession to articulate ideas and positions about their field. With U.S. personnel otherwise completely dominating all aspects of medicine and public health in Haiti, Le Journal Médical Haïtien was the only venue (outside of individual private practices) actually controlled by Haitians. It accordingly brought together “all members of the Haitian Medical Corps, without any distinction”: doctors, pharmacists, dentists and midwives. [iii] In doing so, the journal bridged longstanding divisions within the medical corps and laid the foundation for further independent initiative.

As Le Journal Médical Haïtien facilitated the reorganization of the Haitian medical profession, it also laid bare the lie that the occupation brought medical modernity to the country. After all, it was not because the U.S. introduced “scientific medicine” or any other set of ideas to Haiti that the journal appeared. Rather, it had its genesis in the pre-occupation period. As Dalencour wrote in the first issue, the project was first conceived in 1903. He was still a medical student at the time, so establishing a journal for medical reform was a “somewhat pretentious idea.” [iv] Nonetheless, it was then, well before the Americans landed, that the first steps were taken to establish a “general review of the medical movement in Haiti” (as Le Journal Médical Haïtien was later billed). The principles laid out by Dalencour and his collaborators in 1920 were even the same as those declared in 1903. All that had changed was the name. Dalencour had originally chosen the title Haïti Médicale, but – further reflecting the strength of Haiti’s pre-occupation medical and intellectual traditions – another journal had taken that name in 1910. [v]

The next to emerge was Les Annales de Médecine Haïtienne. Established in 1923 by two young doctors, Drs. N. St. Louis and F. Coicou, Les Annales was associated with a newly reorganized union, le Syndicat des Médecins. Much more oppositional in outlook, the journal was conceived as an “organ for the expansion of medicine in Haiti and for the defense of the interests of the medical corps.” [vi] Explicitly anti-occupation, it actively contested the U.S. health project in Haiti and worked to organize Haitian doctors against it under the auspices of le Syndicat des Médecins. It was not merely a political publication, though, for it also carried articles dedicated to public health education and research in the medical sciences. Over time, such articles became more and more prominent, and as the occupation ended Les Annales de Médecine Haïtienne essentially transitioned to purely scientific journal. U.S. medical sciences, however, continued to be received coolly.

LesAnnalesDeMedecineHaitienne

May-June 1932 issue of Les Annales de Médecine Haïtienne (Schomburg Center, NYPL).

The last of the occupation-era publications was the only one that owed its existence to the occupation health project. The Bulletin de la Société de Médecine d’Haïti, founded with that society in 1927, was the sole journal fostered by U.S. officials, and it was the only one to have U.S. practitioners on its editorial board or to publish articles authored by occupation doctors. The society itself was organized and controlled by the occupation health service, the Service d’Hygiène. Accordingly, most independent doctors (i.e., those not directly employed by the Service d’Hygiène) tended to find the Société “too American” and remained outside of it. [vii] Nonetheless, the Bulletin was more than just an American journal based in Haiti.

BulletinDeLASocieteDeMedecineDHaiti_Jan1927_1_watermark

The first issue of the Bulletin de la Société de Médecine d’Haïti (NYAM).

The Bulletin de la Société de Médecine d’Haïti was an important register for the medical sciences in Haiti. From 1927 until the end of the occupation, it published an impressive array of scholarship, much of it by Haitian practitioners. With an emphasis on medical specialization, it tended to be more concerned with the medical sciences than with public health policy or practice, and it accordingly developed a reputation for being the most scientific of the journals. As a project, however, the Bulletin mostly just brought to fruition ideas and proposals first put forth in the pages of Le Journal Médical Haïtien (or by the 1890 Société de Médecine de Port-au-Prince before that). In form as much as in content, then, the Bulletin was as Haitian as it was American. Consequently, when the American editors shuttered the journal in 1934 with the end of the occupation, the Haitian medical establishment remained committed to the project: it lived on as the Bulletin du Service d’Hygiene et d’Assistance Publique – Medicale et Sanitaire.

BulletinDuServiceDHygieneEtDAssistancePublique_Jun1934_1_watermark

The first issue of the Bulletin du Service d’Hygiene et d’Assistance Publique – Medicale et Sanitaire (NYAM).

Each of these journals have largely been overlooked by historians, despite being incredibly rich sources. With their debates about public health policy, research on various health matters, clinical notes, correspondence between doctors and medical officials, translated articles from abroad, social commentary, and more, they offer significant insight into the state of medical care and the politics of health during the occupation. They would also be of interest to anyone thinking about Haitian social and intellectual history more generally. Few copies of each journal still exist, but they – with the exception of Les Annales – can be found at the New York Academy of Medicine library.

References

[i] Dalencour, François, « En Manière de Programme. » Le Journal Médical Haïtien (Première Année, No. 1, May, 1920; New York Academy of Medicine Library).

[ii] See, for instance, Parsons, Robert P., History of Haitian Medicine (New York: Paul B. Hoeber Inc., 1930).

[iii] Dalencour, François, « En Manière de Programme. » Le Journal Médical Haïtien (Première Année, No. 1, May, 1920; New York Academy of Medicine Library).

[iv] Dalencour, François, « En Manière de Programme. » Le Journal Médical Haïtien (Première Année, No. 1, May, 1920; New York Academy of Medicine Library).

[v] Haïti Médicale was published from 1910-1913, and then was briefly revived again in 1920.

[vi] Les Annales de Médecine Haitienne (9eme Année, No. 3 &4, Mars-Avril 1932; Schomburg Center for Research in Black Culture, New York Public Library).

[vii] Bordes, Ary, Haïti Médecine et Santé Publique sous l’Occupation Américaine, 1915-1934 (Haiti: Imprimerie Deschamps, 1992), 300.

Death, Deformity, Decay: Memento Mori and the Case of the Colloredo Twins

This guest post is by Rach Klein. Rach is an art history Masters Candidate at McGill University whose research focuses on the early modern grotesque, medical illustration, and print. She is a current recipient of a Joseph-Armand Bombardier grant, as well as a Michael Smith Foreign Studies scholarship.

Throughout the last month I have had the privilege of working in the NYAM Library, looking directly at their remarkable collection of broadsheets and rare books.  The opportunity to closely examine the objects and images that I am studying is unparalleled. My research locates a framework for viewing 17th-century non-normative and “freakish” bodies in the memento mori traditions of the previous century. Memento mori, a Latin phrase meaning, “remember you will die,” became shorthand for a host of visual imagery and cultural objects rooted in medieval Christian theory, which permeated the European early modern.  With a specific focus on the culture of spectacle employed by early modern “shows of wonder” and touring freak shows, the research that I have been doing at NYAM combines visual analysis with medical history and disability studies to suggest that integral to the creation of early modern “freaks” is a manipulation of non-normative persons into objects that spark mortuary contemplation. Guiding this research is the case of Italian conjoined/parasitic twins Lazarus Colloredo and Joannes Baptista Colloredo (1617–1646). Their journey, which is remarkably well-documented in both text and image (for example, see Fig. 1), showcases the duality of the so-called “freak body” and its links to mortuary philosophy.

Historia Ænigmatica, de gemellis Genoæ connati

Fig. 1. Mylbourne, R. (Publisher). (1637). Historia Ænigmatica, de gemellis Genoæ connatis, [Engraving]. © The Trustees of the British Museum. Licensed under CC-BY-NC-SA 4.0.

In 1617, Lazarus and Joannes Baptista Colloredo were born into a life of spectacle and uncertainty. Protruding laterally from the breast of Lazarus was his twin brother, Joannes Baptista, whose malformed body lived partially inside him. Unable to speak or move independently, Joannes Baptista was deemed a “parasitic twin”.  As living persons that defy expectations of the “normative,” visual documentation of the Colloredo twins’ spectacular bodies/body provides insight into anxieties about the boundaries between animate/inanimate, normal/abnormal, beauty/ugliness, soul/body, and, ultimately, life/death. Jan Bondeson calls attention to how remarkable their story is, even within the history of conjoined twins. He says:

Conjoined twins are the result of imperfect splitting of a fertilized ovum and the site of conjunction depends on which part of the splitting has not occurred. Lazarus and Joannes Baptista Collerado represent one of the very few convincing cases of viable omphalopagus parasiticus twins (who lived).[1]

The words in parentheses here, “who lived,” iterate the challenges of piecing together a history of marginalized persons such as those who are disabled and deformed, and the gentle surprise provoked by the twins’ survival.

Perhaps the most interesting discovery found throughout my research is the nonlinear timeline in scholarship about these twins due to a misattributed/incorrectly labelled print from Giovanni Battista de’Cavalieri’s series of engravings, Opera nel a quale vie molti Mostri de tute le parti del mondo antichi et Moderni (Monsters from all parts of the ancient and modern world), published in 1585 (Fig. 2). This image, which is reprinted in Fortunio Liceti’s 1634 De Monstrorum Caussis (Fig. 3), is captioned with the twins’ names and place of birth, despite having been created thirty-years prior to their birth. As with many “freakish” bodies, the accuracy of their experience exists separately from its visual history.[2]

Although these contradictions of dates and attributions make reproducing a clean narrative difficult, they reflect a larger theme of teratology: that bodies are detached from persons, and imaginative ideals misaligned from lived experience. The image by de’ Cavalieri was likely a representation of an earlier set of conjoined twins in the 16th century, perhaps based on conjoined twins mentioned by Ambrose Paré in 1530. This image is subsequently reproduced in Liceti’s 1665 edition of his work, now titled De Monstris. Hence, the twins’ image has been collapsed into a narrative that took place well before their birth, and which frames them as simultaneously alive and dead.

 

Liceti_DeMonstrorumCaussis_1634_117_watermark

Fig. 3. Liceti, F. (1634). [Rueffo puer Amiterni natus uno brachio, fed pedibus tribus in hanc effigiem] (p. 117). De monstrorum caussis, natura, et differentiis libri duo … Padua, Italy: Apud Paulum Frambottum.

Worries and uncertainties over death and the body make themselves known in images and stories documenting the “freakish” body. Art that has been traditionally deemed “grotesque,” “macabre,” or more colloquially, simply “disturbing” is part of a symbolic system that expresses metaphysical anxieties about what lurks beneath the surface of the body. I am not attempting to medicalize nor romanticize the history of those who are or have been designated as disabled, deformed, monstrous, and freakish. Rather, my aim is to provide a critical and historical study of how non-normative bodies have been catalogued as a memento mori for its witnesses and used by able-bodied viewers as tools of self-reflection and meditation, a practice that actively erases personhood in favour of objectification.[3]

References

[1] Bondeson, Jan. The Two-headed Boy: And Other Medical Marvels. Ithaca, NY: Cornell University Press, 2000.

[2] Jillings, Karen. “Monstrosity as Spectacle: The Two Inseparable Brothers’ European Tour of the 1630s and 1640s.” Popular Entertainment Studies 2, no. 1 (2011): 54–68.

[3] My work is particularly indebted to the disability, feminist, and race scholarship of Tobin Siebers (Disability Aesthetics), Rana Hogarth (Medicalizing Blackness: Making Racial Difference in the Atlantic World, 1780-1840), and Elizabeth Grosz (Volatile Bodies).

Further Reading

Bates, A. W., Emblematic Monsters: Unnatural Conceptions and Deformed Births in Early Modern Europe. Amsterdam: Rodopi, 2009.

Benedict, Barbara M. Curiosity: A Cultural History of Early Modern Inquiry. Chicago, IL: University of Chicago Press, 2002.

Daston, Lorraine, and Katharine Park. Wonders and the Order of Nature, 1150-1750. New York: Zone Books, 2012.

Thomson, Rosemarie Garland. Freakery: Cultural Spectacles of the Extraordinary Body. New York: New York University Press, 2008.

Remembering the Syphilis Study in Tuskegee

This guest post is by Dr. Susan Reverby, the Marion Butler McLean Professor Emerita in the History of Ideas and Professor Emerita of Women’s and Gender Studies at Wellesley College. This year she is a fellow at the Project on Race and Gender in Science and Medicine at the Hutchins Institute for African and African American Research at Harvard University. Reverby is most recently the author of the multiple prize winning book, Examining Tuskegee: The Infamous Syphilis Study and its Legacy and the historian whose work on immoral U.S. led research in Guatemala in the late 1940s led to a federal apology in 2010. She is currently completing her latest book, The Revolutionary Life of Brother Doc: A 20th Century White Man’s Tale (University of North Carolina Press, 2020).

Conspiracy theories and myths, medical and otherwise, often reflect ways to cope with racism in its multiple nefarious forms.   Many such tales focus on destruction of the black body: from the fears that Church’s chicken, now Popeye’s, put something in their frying that caused Black men to become sterile to the beliefs in South Africa that the HIV virus was spread by false vaccinations funded by the C.I.A. and British intelligence. Did you hear the one about the U.S. government letting hundreds of black men in and around Tuskegee, Alabama with syphilis not get to treatment that went on for four decades between 1932 and 1972?  Or that the government actually gave the men the syphilis and you can see it in the photographs, especially if you cannot differentiate between a blood draw and an injection?

Photograph of Participant in the Tuskegee Syphilis Study

Centers for Disease Control: Venereal Disease Branch. (ca. 1953). Photograph of Participant in the Tuskegee Syphilis Study. Image from https://catalog.archives.gov/id/824612

Only the fact that the government tried to make sure the men who already had late latent syphilis did not get treatment for forty years is true among these tales, and horrendous enough. Now we have to consider the meaning given to this Study over the nearly fifty years since it became widespread public knowledge.

The exposure of the Study came at the end of the modern Civil Rights era and after the medical community was beginning to acknowledge that even the “good guys” did immoral work. Along with the unethical studies at Willowbrook [1] and the Jewish Chronic Disease Hospital [2], the experiment in Tuskegee led to the federal Belmont Report [3] and the modern era of institutional review boards and regulations surrounding informed consent.

Kenan Thompson Hugh Laurie

King, D. R. (Director).  (2006, October 28). Modern Medicine: Hugh Laurie/Beck [Television series episode].  In L. Michaels (Producer), Saturday Night Live. New York, NY: NBC.

For many in the health care community and general public the words “Tuskegee” became symbolic of racism in medical research and care, making its way into popular culture in songs, plays, poems, rap, and cultural imagination.   In 2006, Hugh Laurie (T.V.’s irascible Dr. House) hosted Saturday Night Live and played the wife in a skit with patient Kenan Thompson. When the doctor offers care to Thompson, Laurie and Thompson both look at one another and yell “We know what this is: Tuskegee, Tuskegee, Tuskegee.” Others have done academic studies that prove and disprove that it is the memory of Tuskegee that keeps African American patients from seeking care or participating in research trials.  What we do know is that the subtle, and not so subtle, forms of racism create an aura of distrust that affects the kind of health care African Americans both seek and receive whether they know the details of what happened half a century ago or not.

So can there be another Tuskegee?  If by this question we mean the misrepresentation in informed consent, the danger of scientific hubris, and the misuse of patients of color:  probably in some form. Just as importantly, we need to ask what meaning is given to these experiences once they become public? How can the health care and public health communities create what historian Vanessa Northington Gamble calls “trustworthiness.”  It is the meaning of the study in Tuskegee that needs to be assessed, taught and considered. For it is this meaning that reverberates long after the men caught in its grasp wandered in the medical desert for 40 years, and long after any knowledge of its facts actually fade.

Join Susan Reverby along with moderator Aletha Maybank and Monique Guishard for our panel on February 26th, Could Tuskegee Happen Today?, addressing the history and legacy of the study and why it remains relevant today.

Footnotes

[1] J.D. Howell, R.A.Haywood, “Writing Willowbrook, Reading Willowbrook: The Recounting of a Medical Experiment. In: J. Goodman, A. McElligott and L. Marks, eds. Using Bodies: Humans in the Service of Medical Science in the 20th Century (Baltimore: Johns Hopkins University Press, 2003), pp. 190-213.

[2] Barron H. Lerner, “Sins of Omission—Cancer Research without Informed Consent,” New England Journal of Medicine 351 (2004): 628-630.

[3] Office of the Secretary, The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research, April 18, 1979.

The First Yellow Fever Pandemic: Slavery and Its Consequences

Today’s guest post is by Billy G. Smith, Distinguished Professor in the Department of History, Philosophy, and Religious Studies at Montana State University. He earned his PhD at University of California Los Angeles. His research interests include disease; race, class and slavery; early America, and mapping early America.

Bird flu, SARS, Marburg, Ebola, HIV, West Nile Fever.  One of these diseases, or another, that spread from animals and mosquitoes to humans may soon kill most people on the planet.  More likely, the great majority of us will survive such a world-wide pandemic, and even now we have a heightened awareness that another one may be on the horizon.  This blog focuses on these issues in the past, outlining a virtually unknown voyage of death and disease that transformed the communities and nations bordering the Atlantic Ocean (what historians now refer to as the Atlantic World).  It traces the journey of a sailing ship that inadvertently instigated an epidemiological tragedy, thereby transforming North America, Europe, Africa, and the Caribbean islands.  This ship helped to create the first yellow fever pandemic.

1-Hankey

The Hankey. From “Ship of Death: The Voyage that Changed the Atlantic World.”

In 1792, the Hankey and two other ships carried nearly three hundred idealistic antislavery British radicals to Bolama, an island off the coast of West Africa, where they hoped to establish a colony designed to undermine the Atlantic slave trade by hiring rather than enslaving Africans.  Poor planning and tropical diseases, especially a particularly virulent strain of yellow fever likely contracted from the island’s numerous monkeys (through a mosquito vector), decimated the colonists and turned the enterprise into a tragic farce.

1-Bulama

 From “Ship of Death: The Voyage that Changed the Atlantic World.”

In early 1793, after most colonists had died and survivors had met resistance from the indigenous Bijagos for invading their lands, the Hankey attempted to return to Britain.  Disease-ridden, lacking healthy sailors, and fearing interception by hostile French ships, the colonists caught the trade winds to Grenada.  They and the mosquitoes in the water barrels spread yellow fever in that port and, very soon, throughout the West Indies.  This was only a few months before the British arrived to quell the slave rebellion in St. Domingue (now Haiti).  The British and subsequently the French military had their troops decimated by the disease—one reason why the slave revolution succeeded.  The crushing defeat in the Caribbean helped convince Napoleon to sell the vast Louisiana territory to the United States.  He turned eastward to expand his empire, altering the future of Europe and the Americas.

A few months after the Hankey arrived in the West Indies, commercial and refugee ships carried passengers and mosquitoes infected with yellow fever to Philadelphia, the nation’s capital during the 1790s.  The resulting epidemic killed five thousand people and forced tens of thousands of residents, including George Washington, Thomas Jefferson, and other prominent federal government leaders, to flee for their lives.  The state, city, and federal government all collapsed, leaving it to individual citizens to save the nation’s capital.  Meanwhile, doctors fiercely debated whether “Bulama fever” (as many called it) was a “new” disease or a more virulent strain of yellow fever common in the West Indies.  Physicians like the noted Benjamin Rush fiercely debated the causes of and treatment for the disease.  They mostly bled and purged their patients, at times causing more harm than good because of the rudimentary state of medicine.

Among those who stepped forward to aid people and save the city were members of the newly emerging community of free African Americans. Led by Absalom Jones, Richard Allen, and Anne Saville, black Philadelphians volunteered to nurse the sick and bury the dead—both dangerous undertakings at the time.  Many African Americans and physicians, exposed to yellow-fever infected mosquitoes, made the ultimate sacrifice as both groups died in disproportionately high numbers.  When a newspaper editor subsequently maligned black people for their efforts, Jones and Allen wrote a vigorous response—among the first publications by African Americans in the new nation.

A Refutation_internetarchive

For one of the first times in American history, blacks responded in print; Revd.s Allen and Jones published a pamphlet answering the charges; Courtesy of the Internet Archive.

During the ensuing decade, yellow fever went global, afflicting every port city in the new nation on an annual basis.  Epidemics also occurred in metropolitan areas throughout the Atlantic World, including North and South America, the Caribbean, southern Europe, and Africa.  Among other consequences, this disaster encouraged Americans to fear cities as hubs of death.  The future of the United States, as Thomas Jefferson argued, would be rural areas populated by yeomen farmers rather than the people in teeming metropolises.  The epidemics also helped solidify the decision of leaders of the new nation to move its capital to Washington D.C. and away from the high mortality associated with Philadelphia.

After the Hankey finally limped home to Britain, its crew was taken into service in the Royal Navy; few of them survived long.  More importantly, the image of Africa as the “white man’s graveyard” became even more established in Britain and France, thereby providing a partially protective barrier for Africa from European invasion until the advent of tropical medicine.  The “Bulama fever” plagued the Atlantic World for the next half century, appearing in epidemic form from Spain to Africa to North and South America.  The origins and treatment of the disease drew intense debates as medical treatment became highly politicized, and the incorrect idea that Africans enjoyed immunity to yellow fever became an important part of the scientific justification of racism in the early nineteenth century.

Join Billy Smith along with epidemiologist Michael Levy on October 24 for Sickness and the City for a conversation that uses both science and history to understand the intersection of urban development and the spread of contagions.

References
Billy G. Smith. Ship of Death: The Voyage that Changed the Atlantic World. New Haven, CT: Yale University Press, 2013.

The British National Health Service and the Fight for Universal Health Insurance in the United States

Today’s guest post is by Andrew Seaton, the 2018 Paul Klemperer Fellow in the History of Medicine. Andrew is a History PhD candidate at New York University. His dissertation explains the survival of the British National Health Service since 1948, and its significance at home and abroad. Andrew will be presenting his Fellowship research on Wednesday, April 18, at 4 p.m. in the Hartwell Room. Please email history@nyam.org if you would like to attend. Space is limited.

Americans have often looked to other countries in their debates about extending health insurance. Health reformers in the Progressive Era held up Germany’s sickness insurance as a model to work toward, only to have this turned against them during the First World War.[1] In the postwar period, the British National Health Service (NHS) became a focal point of discussion. President Truman’s attempts to include “national health insurance” within existing Social Security legislation coincided with the establishment of the NHS in 1948. When Truman’s opponents – foremost among them the American Medical Association (AMA) – depicted the NHS as emblematic of the problems with “socialized medicine,” (see image below) progressives rushed to its defense.

Figure1_watermark

Typical representation of the British National Health Service by the American Medical Association. “The Rebellion of British Doctors,” Editor and Publisher, March 6 1948.

The left-wing health economist, Michael M. Davis – whose papers are housed in the New York Academy of Medicine historical collections – stood as a central advocate for the British model. Davis was one of the most important American health campaigners of the mid-twentieth century. He founded organizations such as the Committee for the Nation’s Health (CNH) in 1946 to promote national health insurance, and worked closely with Truman to achieve legislative reform.[2] Cognizant of attacks in the Progressive Era on the German model, the CNH realized that AMA “misinformation” about the British scheme would seriously harm their chances of securing their goal of comprehensive health coverage for all. Responding to this threat, the CNH rebutted AMA communications on the NHS in their own pamphlets (see image below), provided statistics and details about the British health service to newspaper editors, and reprinted favorable media coverage from the U.K.

Figure2_watermark

Committee for the Nation’s Health, “The Truth About Britain’s Medical Program” (March, 1949).[3]

Trans-Atlantic trips undergirded American battles over the NHS. Dozens of opponents and supporters of extending health insurance in the U.S. undertook field studies in Britain to aid in the battle back home. Davis – by this point nearly eighty years old – undertook such a trip in 1959 with his wife, Alice. They not only met with their extensive contacts in the medical profession and British civil service, but also spoke to ordinary people in public parks across the country to find out how they felt about the NHS. The Britons that Michael and Alice Davis met – from hotel maids to university professors – were “practically unanimous” in saying they “wanted the Health Service,” pointing to the end of anxieties about doctors’ bills as the main cause of satisfaction.[4] The following year, Davis presented these findings as a talk to various American community and labor organizations in an attempt to stimulate interest in national health insurance.

Despite these efforts, Davis and other progressives lost their battle with the AMA. Congress struck down Truman-era health bills, the CNH ended its activities in 1956, and trade unions turned towards securing the best deals for their members through private health insurance rather than advancing a federal health program. The reputation of the NHS played an important part in these events; the AMA’s negative vision of the NHS triumphed over that presented by figures like Davis. This underlines the importance of transnational perspectives when thinking about the history of health care in America – and indeed in Britain – alongside the significance of convincing a wider public when attempting to enact structural change. If Davis’s dream of universal medical coverage in the U.S. is ever to be realized, it will rest in part on shaping popular opinion about America’s place in the wider world of health systems.

References:
[1] Beatrix Hoffman, The Wages of Sickness: The Politics of Health Insurance in Progressive America (Chapel Hill: The University of North Carolina Press, 2001), 54-74.
[2] For a biography of Davis, see Alice Taylor Davis, Michael M. Davis: A Tribute (Chicago: Center for Health Administration Studies, 1972).
[3] New York Academy of Medicine, Library of Social and Economic Aspects of Medicine of Michael M. Davis, Box 64, CNH Releases on British N.H.S., “The Truth About Britain’s Medical Program” (March, 1949).
[4] New York Academy of Medicine, Library of Social and Economic Aspects of Medicine of Michael M. Davis, Box 62, Bibliography: England: 2, Michael M. Davis, “My Observations Last Summer of the British National Health Service” (1960).

Saving the Race from Extinction: African Americans and National Negro Health Week

Today’s guest post is written by Paul Braff, a PhD candidate in American History at Temple University whose research focuses on African American history and public health during the twentieth century. On Tuesday, March 6, Paul will give The Iago Galdston Lecture: “Who Needs a Doctor?: The Challenge of National Negro Health Week to the Medical Establishment.” Click HERE to register for this event.

In 1896, Frederick Hoffman, a statistician for the Prudential Insurance Company of America, released his assessment of African American health. His Race Traits and Tendencies of the American Negro recommended against insuring the race and gave an emphatic confirmation of what Charles Darwin and other scientists and doctors had asserted for years: African Americans were going extinct.[1] Within the context of the burgeoning professionalization of the medical field, such a conclusion had the potential to omit African Americans from medical care, especially when combined with the preconceived racial differences of the time.

Joke

A common joke in the early twentieth century.[2]

For Booker T. Washington, this negative view of the future of his race and the idea that blacks could not understand basic health or improve their situation had the potential to undermine all attempts at racial uplift. As he put it, “Without health and until we reduce the high death-rate [of African Americans] it will be impossible for us to have permanent success in business, in property getting, in acquiring education, to show other evidences of progress.”[3] For Washington, health was the building block upon which everything, political rights, economic self-sufficiency, even citizenship, rested.

To fight this white perception of African American health, in 1915 Washington launched a public health campaign, “National Negro Health Week” (NNHW). The Week focused on both public and private displays of health, emphasizing hygiene as well as painting and whitewashing, the latter overt actions to demonstrate that African Americans could achieve “proper,” or white, standards of cleanliness and connect being clean with health improvement. Thus, the Week incorporated Washington’s racial uplift philosophy as NNHW extolled health and cleanliness values to blacks that aligned with those of whites in the hope of decreasing racial differences. This non-clinical definition of health, in which practicing proper hygiene and painting, not physician overseen checkups and vaccinations, made one healthy, allowed African Americans to understand their own health and empowered them to become leaders in their communities. The straightforward and inexpensive activities the Week suggested were easy to duplicate and rally the community behind. The connections made in organizing a Week could then be used for more extensive African American social and political activities. Although he died later that year, the campaign lived on for another 35 years and became part of Washington’s legacy.

Washington

“National Negro Health Week: 17th Annual Observance, Sunday, April 5, to Sunday, April 12, 1931,” USPHS, Washington, D.C., 1931, cover, Folder 2, Box 5, “National Negro Health Week Collection,” Tuskegee University Archives, Tuskegee, AL.

NNHW’s popularity attracted the interest of the U.S. Public Health Service (USPHS), and when the Great Depression made the Week difficult to finance, the USPHS took it over in 1932. With the vast resources of the USPHS behind it, the Week grew into a massive campaign that had millions of participants in thousands of communities participate each year.

Chart

Susan L. Smith, Sick and Tired of Being Sick and Tired: Black Women’s Health Activism in America, 1890-1950 (Philadelphia, PA: University of Pennsylvania, 1995), 70.

However, such participation came with a price as the USPHS worked to redefine the Week’s definition of health. Under the USPHS, physicians were the ultimate arbiters of health and the focus changed from cleanups and whitewashing to vaccination and getting regular checkups from doctors and dentists. With the white medical establishment more centrally enthroned in the Week and the nascent Civil Rights Movement starting to take shape, African Americans called for an end to a Week based upon race.

National Negro Health Week illuminates the important role non-experts can play in defining personal health, and how those definitions can become internalized. Exploring the role of non-experts allows historians to examine the ways in which social constructions of health can be challenged, and the study of NNHW better positions scholars and public health officials to understand how race and health intersect today.

References:
[1] Charles Darwin, The Descent of Man, and Selection in Relation to Sex (London, UK: John Murray, 1871). Reprint. New York, NY: Penguin Books, 2004, 163; Frederick L. Hoffman, Race Traits and Tendencies of the American Negro (New York, NY: The Macmillan Company, 1896), 35; George Frederickson, The Black Image in the White Mind: The Debate on Afro-American Character and Destiny, 1817-1914 (New York, NY: Harper and Row, 1971), 236-237, 252-258.
[2] “An Important Work,” April 12, 1926, in “The Tuskegee Health Collection, 1926,” 853, Tuskegee University Archives, Tuskegee, AL (TA). See also “Negro Health Week Conference,” November 1, 1926, 1, Box 1 Folder 2, “National Negro Health Week Collection,” TA and Edwin R. Embree, “Negro Illness and the Nation’s Health,” Crisis, March 1929, 84, 97.
[3] Booker T. Washington, Gallery Proof, January 15, 1915, 827, “National Negro Health Week,” Reel 713, Booker T. Washington Collection, TA.

Asthma and the Civil Rights Movement

Today’s guest post is written by Ijeoma Kola, a PhD candidate in Sociomedical Sciences at Columbia University Mailman School of Public Health and a former National Science Foundation graduate fellow. Her dissertation examines the history of asthma in urban African Americans in the 20th century, with special attention to medical history, environmental racism, and community activism. On Tuesday, November 14 at 6pm, Ijeoma will give the talk “Unable to Breathe: Race, Asthma, and the Environment in Civil Rights Era New Orleans and New York.” Click HERE to register for this event.

In July 1965, several months after the assassination of Malcolm X and the freedom marches from Selma to Montgomery, the New York Times ran a story about “an emotional epidemic” of asthma sweeping across New York City.[1] Although the writer focused on psychosomatic explanations to link asthma symptoms to the hostility of the Civil Rights Movement, it prompted me to explore the significance of asthma’s emergence as a racial problem during the 1960s.

Asthma Linked to Rights Drive

Osmundsen, John A. “Asthma Linked to Rights Drive.” New York Times. 1965.

Before the 1960s, little was written about asthma in African Americans. For much of the early twentieth century, doctors debated whether black people could have asthma, as they understood the disease to afflict middle and upper-class whites, who were believed to have more civilized lifestyles and delicate constitutions than poor blacks.[2]

However, in the 1960s, several “outbreaks” of asthma made national news headlines. In the fall of 1960, nearly 150 patients from adjoining neighborhoods were treated for asthma at Charity Hospital in New Orleans. One patient, a 73-year-old man, died.[3] After several years of seasonal asthma admission spikes in the same hospital, researchers at Tulane University found that asthma related visits to the emergency room correlated with fire department calls from spontaneous fires at the base of garbage heaps, some five to twenty years old, around the city. Smoke containing silica particles would drift downwind to where the majority of people who visited Charity Hospital, triggering asthma attacks.[4]

Air Pollution and NO Asthma

Lewis, Robert, Murray M. Gilkeson, and Roy O. McCaldin. “Air Pollution and New Orleans Asthma.” Public Health Reports 77, no. 11 (November 1962): 953.

Air Pollution and NO Asthma 2

Lewis, Robert, Murray M. Gilkeson, and Roy O. McCaldin. “Air Pollution and New Orleans Asthma.” Public Health Reports 77, no. 11 (November 1962): 948. with modifications.

At the time, however, the New Orleans asthma epidemic of November 1960 was quickly forgotten, as events over the course of the next few days would quickly turn attention away from asthma to something more urgent. A week after Dennis Knight’s death, on November 14, 1960 – four black 6-year old girls – Leona Tate, Tessie Provost, Gaile Etienne, and Ruby Bridges – began the school integration process at two elementary schools in New Orleans. Violent protests broke out across the city, and only 13 of the usual 1,000 students at the two schools attended on integration day.[5]

In New Orleans in 1960, and in several other American cities with a large concentrated black community over the next decade, asthma appeared to present itself alongside moments of racial tension. Although the New York Times connects these two phenomena with a psychosomatic explanation of emotional distress, I view the relationship differently. Neighborhoods where African Americans lived – often restricted to due to segregation and redlining – were more exposed to both indoor and outdoor particles that triggered asthma symptoms. While struggling to breathe, black people simultaneously fought for the right to live as equals. Rather than think of Civil Rights as a cause of asthma, I see asthma outbreaks in black urban America and subsequent efforts to reduce the asthma disparity as both a symptom and a symbol of the Civil Rights movement.

References:
[1] John A. Osmundsen, “Asthma Linked to Rights Drive: Authorities Note Sharp Rise in Ailment Among Negroes and Puerto Ricans in City CAUSE STILL UNCERTAIN Tensions of Fight for Gains Play at Least Some Role, Many Experts Contend,” New York Times, 1965.
[2] Horace F. Ivins, “Pollen Catarrh-Hay Fever,” in Proceedings of the Fourth Quinquennial Session of the International Homoeopathic Congress, Held at Atlantic City, N.J., U.S.A., June 16 to 22, 1891 (Philadelphia: Sherman & Co., 1891), 732–43.
[3] “Medics Puzzled:: Asthma Epidemic Hits New Orleans; 149 Seized, 1 Dead,” Philadelphia Tribune (1912-2001); Philadelphia, Penn., November 12, 1960, sec. 2.
[4] Robert Lewis, Murray M. Gilkeson, and Roy O. McCaldin, “Air Pollution and New Orleans Asthma,” Public Health Reports 77, no. 11 (November 1962): 947–54.
[5] John G. Warner, “Mob of 5000 Is Hosed By New Orleans Police: Police Hose New Orleans Segregation Rioters,” The Washington Post, Times Herald  (1959-1973); Washington, D.C., November 17, 1960.

Wound Ballistics: The Science of Injury and the Mystery of Exploding Bullets

1018Johnkinder-FBToday’s guest post is written by John Kinder, Associate Professor of History and American Studies at Oklahoma State University. He is the author of Paying with Their Bodies: American War and the Problem of the Disabled Veteran (University of Chicago Press, 2015). On Tuesday, October 17, Kinder will give his talk, “A History of American War in Five Bodies.” To read more about this lecture and to register, go HERE.

On March 11, 1944, an American soldier in the 182d Infantry was digging a foxhole on the island of Bougainville when a Japanese bullet ricocheted and hit him in the ankle. The wound didn’t look that serious. There was almost no blood. Still, it was better to be safe than sorry. Medics bandaged the wound, loaded the soldier onto a litter, and started down the hill to the aid station. He was dead before they reached the bottom.

I recently discovered this story in a volume on wound ballistics published by the US Army Medical Department in the early 1960s. Wound ballistics is the study of the physiological trauma produced by modern projectile weapons. It achieved quasi-scientific status in the late nineteenth century, as military physicians and other self-proclaimed wound experts carried out experiments to measure and ultimately predict what happened when chemically-projected metal collided with living human tissue.

Early on, much of their research involved shooting ammunition into pine boards or the carcasses of  animals to estimate the casualty-causing potential of various armaments. Over time, however, wound ballisticians developed increasingly sophisticated techniques for mapping the body’s vulnerability to different weapons and fine-tuning the production of physiological trauma.

Dog

Microsecond X-ray of the femur of a dog after it has been shot by an 8/32-inch steel ball travelling at 4,000 feet per second. The bone has been shattered despite the fact that it was not actually hit by the steel ball. In order to understand the mechanisms of human injury, World War II-era scientists carried out ballistics experiments on a variety of “model” targets including living dogs, cats, pigs, and horses, as well as blocks of gelatin and tanks of water. 

In the process, they also managed to solve one of the most head-scratching mysteries in nineteenth-century military medicine. The mystery emerged in the mid-century, when growing numbers of observers began to notice a peculiar phenomenon: soldiers were dying from what initially appeared to be relatively minor “through-and-through” wounds. High-velocity bullets seemed to enter and exit the body with only minimal damage. Upon autopsy, however, surgeons discovered extensive internal trauma—pulped tissue, ruptured veins, shattered bones—far outside of the track of the bullet. How was this possible? As early as the 1840s, critics charged that the wounds must be the product of “exploding bullets,” which were subsequently banned by international treaty in 1868. In later years, physicians speculated that the internal explosions were caused by compressed air or heat, but nothing could be proven.

Cat

Microsecond X-ray of a thigh of a cat that has been shot by a 4/32-inch steel ball at an impact velocity of 3,000 feet per second. The dark area is the temporary cavity formed as the ball passes through the muscle tissues. X-rays like this one helped wound ballisticians explain the “explosive effect” that mystified nineteenth-century military physicians. 

By the 1940s, scientists were able to use X-rays and high-speed cameras to solve the mystery once and for all. They discovered that, around 200-400 microseconds after a high-speed bullet strikes a human body, a temporary cavity begins to form around the bullet path. This cavity, which expands and contracts in a fraction of a second, can be more than 20 times the volume of the permanent wound track, resulting in the explosive damage to nearby tissue and bone. And, thanks to the elasticity of human skin, the bullet’s entrance and exit wounds might be nearly closed over by the time the patient reaches medical attention. It was remarkable discovery—not least because it affirmed wound ballisticians’ belief that, when it came to understanding injury, the human eye was no match for a scientist and a machine.

To this day, practitioners of wound ballistics like to justify their work in humanitarian terms. The goal of their research, they often say, is to help military surgeons and body armor manufacturers cut down on unnecessary deaths. All of this is true—to a certain extent. From the very start, however, the field of wound ballistics has played a more ominous role in military history. If wound ballistics is the science of injury, it is also the science of injuring others. Understanding the body’s vulnerabilities has allowed warring nations to develop deadlier antipersonnel weapons: armaments designed to pulverize, poison, burn, shred, emulsify, and eviscerate the bodies of one’s enemies.

No doubt, some readers might be wondering about the soldier at Bougainville, the one who died after a light wound to the ankle. Was he too a victim of the “exploding bullet” phenomenon? As it turns out, his death can be chalked up to a more quotidian threat: human error. Today, we can only speculate about the medics’ actions: perhaps they were in a hurry, or perhaps they were exhausted after a brutal day of fighting, or perhaps—and this is my guess—they were so used to seeing war’s butchery that this soldier’s injury appeared inconsequential by comparison. Whatever the reason, they failed to apply a tourniquet to the wounded man’s leg.

Shortly after the litter party started down the hill, the soldier’s ankle began to hemorrhage. As blood drained from his body, he said that he felt cold. Within minutes, he was dead.

References:
1. International Committee of the Red Cross. Wound Ballistics: an Introduction for Health, Legal, Forensic, Military and Law Enforcement Professionals (film). 2008.
2. Kinder, John. Paying with Their Bodies: American War and the Problem of the Disabled Veteran. Chicago: University of Chicago Press, 2015.
3. Saint Petersburg Declaration of 1868 (full title: Declaration Renouncing the Use, in Time of War, of Explosive Projectiles Under 400 Grammes Weight”). November 29-December 11, 1868.
4. United States Army Medical Department. Wound Ballistics. Washington DC: Office of the Surgeon General, Department of the Army, 1962.

Images:
Dog X-ray: Newton Harvey, J. Howard McMillan, Elmer G. Butler, and William O. Puckett, “Mechanism of Wounding,” in United States Army Medical Department, Wound Ballistics (Washington DC: Office of the Surgeon General, Department of the Army, 1962), 204.
Cat X-ray: Ibid, 176.

More Than Medicine: Social Justice and Feminist Movements for Health

COS-Series-Twitter-R1 Event 1005Today’s guest post is written by Jennifer Nelson, Professor at University of Redlands, specializing in women’s history, the history of feminism in the United States, and medical histories associated with social justice movements. She is the author of More Than Medicine (NYUPress, 2015).

On Thursday, October 5, Nelson will give her talk, “More Than Medicine: Social Justice and Feminist Movements for Health.” To read more about this lecture and to register, go HERE.

I begin my story of social justice and feminist movements for health with the Mound Bayou demonstration clinic—located in the Mississippi Delta. The clinic was founded by medical doctors who had been part of the Medical Committee for Human Rights (MCHR). Most had come to Mississippi to volunteer during the 1964 Freedom Summer, although several others were locals active in the Delta Ministry, a Mississippi based Civil Rights organization.

Dr. H. Jack Geiger and the other founders of the Delta Health Center clinic worked with the Mound Bayou community to prioritize health needs. They quickly discovered that community members needed more than traditional medicine: they demanded food, jobs, and housing—linking these to the promotion of health. The clinic included a cooperative farm that grew vegetables for the community, since most of what was grown in the Delta was for commercial consumption. Click HERE to listen to Dr. Geiger talk about his experiences in Mississippi at the National Library of Medicine exhibit on the Delta Health Center.

Many historians of social movements have emphasized that the women’s liberation movement emerged from the Civil Rights movement. I also pay attention to this connection, but focus on the use of medicine to achieve social justice goals in both the Civil Rights and women’s liberation movements. In both of these contexts, activists expanded the meaning of medicine in the process.

In the 1980s women’s health movement feminists were also grappling with conversations about race and racism. Since the early 1970s, women of color had been demanding that feminists pay more attention to issues raised by women of color. In the 1970s much of the focus was on sterilization abuse. In the 1980s attention shifted to HIV transmission, safer sex, and AIDS. Dazon Dixon Diallo, one of the only women of color working at the Atlanta Feminist Women’s Health Center in the 1980s, focused on developing a program called the Women with AIDS Partnership Project.

Here is a clip from a talk given by Diallo about her organization SisterLove, which she formed when she left the Atlanta FWHC to more directly address HIV/AIDS:

Clip

Dazon Dixon Diallo. (Click image to watch video).

My book also focuses on Loretta Ross, one of the most important founders of the Reproductive Justice Movement, which sought to broaden the feminist discourse around “choice” to address the systemic problems associated with poverty and discrimination that prevented many women of color from simply choosing to have or not have children. Ross’s work connects back to the Civil Rights efforts in Mound Bayou among MCHR activists and local organizers with the Delta Health Center. Ross, by forging a reproductive justice framework, maintained that health promotion for poor women could not rest on medicine alone.

More Than Medicine: Social Justice and Feminist Movements for Health is the third event in the three part event series, Who Controls Women’s Health?: A Century of Struggle. The series examines key battles over women’s ability to control their bodies, health choices, and fertility. It is developed in collaboration with the Museum of the City of New York and supported by a grant from Humanities New York.