Medicine and Public Health in the USSR and the Eastern Bloc 1945-1991 – Conference Report

(Reposted from The Reluctant Internationalists Blog)

Researchers from all over the world, from Australia through Bulgaria came together in Paris for a two-day workshop titled ‘Medicine and Public Health in the USSR and the Eastern Bloc 1945-1991‘ on January 23-24, 2015.  Convened by Grégory Dufaud (l’EHESS, LabEx TEPSIS, France) and Susan Gross Solomon (University of Toronto, Canada), the workshop’s aim was to explore the intersection between Soviet medicine and public health and that of the Socialist Bloc in Eastern Europe after World War II. The papers focused on knowledge circulation, the transfer and local adaptation of public health practices and scientific interaction. Many participants addressed these issues through a comparative perspective, either between the Soviet Union and individual Eastern European countries, East and West or among the members of the Socialist Bloc.

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Setting up the theme of the workshop, Lion Murard (Cermes3, France) gave an overview of the “Story Before the Story” and demonstrated the significance of Eastern European public health practitioners and experiences in shaping international public health in the Interwar era. Alain Blum (l’EHESS, Cercec, France) followed with an analysis of the methods of Soviet demographers and the accessibility of demographic data for contemporary and historical researchers.

Focusing on the emphasis of PREVENTION in Soviet and Eastern European public health policy, Donald Filtzer (University of East London, UK) revealed a fascinating story of factory medicine in the Soviet Union during and after the war. He highlighted how the Soviet health system attempted to counter lost work time due to starvation and illness, the prominence of skin infections due to lack of access to hygiene and the long term consequences of the home front experience on both the health of workers and the organization of medical practice. Chris Burton (University of Lethbridge, Canada) argued that the particular direction of Soviet medicine may have been a result of practical solution and intended as temporary, as much as it was based on ideology. For instance, the synthesis of preventive and clinical work, promoted from the beginning of the Soviet regime, stemmed from an insufficient number of doctors in the Civil War. In her talk titled ‘Personal hygiene and public health care in the Polish countryside after 1945 – confrontation of propaganda and reality’, Ewelina Szpak (Institute of History, Academy of Sciences, Poland) argued that the end of the 1950s and 60s was a time of crucial social changes and attitudes toward hygiene in Poland. This was especially the case in Polish villages that were seen as a bastion of backwardness, and therefore became the focus of an experimental top-down program of village hygienisation. Tricia Starks (University of Arkansas, US) investigated what addiction means and how that meaning affects the image of the addict. Looking at cigarette addiction and alcoholism, she contended that throughought the 20th century, Russian addiction therapies remained rooted in the mind and the will, not the brain and body. Starks’s presentation was guided by the question that if will is based upon Enlightenment concepts of freedom, how is this will in addiction conceptualized in the USSR.

The second large theme explored in the workshop was PRO-NATALISM AND REPRODUCTIVE POLICIES. Paula Michaels (Monash University, Australia) presented a comparative research project jointly conducted with Ema Hresanova (University of West Bohemia, Czech Republic) on Pain and Paternalism in Soviet and Czechoslovak Maternity Care. The paper explored the circulation and adaptation of psycho-prophylaxis in the respective medical and social contexts and demonstrated a heterogeneous pattern of practices that do not map on to the concept of Sovietization. Muriel Blaive (Charles University in Prague, Czech Republic) shifted the temporal focus of the birthing experience to post-communist Czech Republic and placed it in comparison with North American feminist and patient’s rights movements, hospital practices and power structures in maternity care.  Sylwia Kuzma-Markowska (University of Warsaw, Poland) examined contraception and abortion law and practice in postwar Poland as situated between East and West. She showed that Polish legislation followed a Soviet type of abortion culture, and at the same time professional contacts with the West were facilitated by the International Family Planning Organization, which Poland joined as the first Eastern European country in 1959. In the case of Bulgaria, Anelia Kassabova (Sofia University, Bulgaria) pointed out that the legalization of abortion was based on the civil rights of the socialist woman, that is the right to take independent decisions on the matter of motherhood according to her own conscience. The gradual tightening of the law towards prohibition did not reduce the number of total abortions significantly, but raised the proportions of medically justified ones – with the lack of access to contraceptive technologies, abortion remained the main method of family planning.

The second day brought the workshops focus to clinical trials, treatment and international collaboration in public health and medicine. Grégory Dufaud’s paper analyzed the ways in which Soviet psychiatrists reconsidered psychiatry and its therapeutic ambitions in the context of the competition between clinical and experimental models after World War II. In her paper, Galina Orlova (The Russian Presidential Academy of National Economy and Public Administration) looked at the discursive practices and shifts of nuclear physicists on the subject of the health risks of radiation.  Pascal Grosse (Charité, Germany) presented a paper on clinical trials conducted in East Germany by Western pharmaceutical companies in the 1970s and 80s. Grosse argued that the trials were part of the GDR’s trade with the West, in this case the expertise of clinical staff and the bodies of patients were the commodity provided by the state in exchange for hard currency. The clinical trials were situated in a complex network of state bureaucracies and became sites of power struggles among their different factions. Jessica Reinisch (Birkbeck, University of London, UK) focused on the interactions of local German policymakers and their Soviet counterparts in the Soviet Occupation Zone after World War II. She argued that the public health policies heralded by the Soviet military and public health experts found fertile ground in Germany, since its core ideas were considered to be inherently German by the local experts. Finally, Dora Vargha (Birkbeck, University of London, UK) gave an overview of Sabin vaccination trials conducted in Eastern Europe and investigated how ideas about socialist public health and Cold War politics in general propelled the region to a prominent place in polio prevention and eradication.

In her concluding comments, Susan Gross Solomon called to attention the importance of the prewar legacy in public health and medicine and to examine what was carried forward to the postwar era and by whom, what was resisted or scrubbed, and who debated what was to be kept. She invited the researchers of Soviet and Eastern European health and medicine to investigate the assumptions that influence research through archival research and in order to critically approach the concept of Sovietisation and to see what the dynamics was in acceptance, pseudo-acceptance, adaptation, resistance, etc. of Soviet ideas. Solomon also pointed out that many papers addressed collaboration and interaction between East and West, the existence and intensity of which seemed to depend on the scientific field, the presence of intermediators, the number of players and changed over time, e.g. intensified as the Iron Curtain wore out and became more porous.