A Forgotten Episode of International Health

In this month’s post on UCD Centre for the History of Medicine in Ireland‘s blog, Dr Dora Vargha, University of Exeter, uncovers the neglected role of the Socialist Bloc and Eastern Europe in the history international public health. Dora argues that rectifying this omission is essential to capture a complete picture of international and global public health in the crucial era following the postwar settlement. 

The Establishment of the World Health Organization

The establishment of the World Health Organization is no doubt a crucial and fundamental moment in the history of international (and global) public health. The leadership, ideas and early decades in the unfolding Cold War can be assembled through biographies of Director-Generals, the Organizations own chronicle of its first decades and through histories of malaria eradication. However, certain equally important aspects of the early years of the WHO, like the sudden exit of the Soviet Union and Eastern Europe shortly after the establishment of the organization merit little more than a mention in these histories.

The Socialist Bloc and the Missing History of the WHO

This omission from the historiography is not entirely surprising. The Socialist Bloc, and Eastern Europe in general has been, until recently, missing from international health narratives on the whole, despite foundational Eastern European figures in its history such as Andrija Stampar, key member of the League of Nations Health Organization (LNHO) and president of the First World Health Assembly, and Ludwik Rajchman, director of the LNHO and founder of UNICEF. Often seen as a politically homogeneous area under complete Soviet control in the postwar era, Eastern European countries have not been considered to have agency in international health during the Cold War.
But the history of international and global health has a lot to gain by including the Socialist Bloc in the picture. This unexplored history points to questions whether international health always happens within organizational structures of international agencies and through philanthropic entities such as the Rockefeller Foundation; what the stakes were in this Cold War divide in the formative years of the WHO; and the extent to which we can talk about a unified response within the Socialist Bloc to diplomatic and public health challenges in their time outside of the organization.

Continue reading the original blog post here.

European Healthcare before Welfare States

The Centre for Health Histories at the University of Huddersfield has received an award by the University research Fund for a project designed to enhance the international research and profile of the Centre. The project will include a focused pilot project to collect data on health care systems in Poland, Hungary and Czechoslovakia to build knowledge in an area with little published research in either local languages or English. The Centre will also appoint of 3 visiting professors on short term placements in Huddersfield to develop projects, co-write for international journals and prepare funding bids.

The aim of the focused pilot project is to identify a primary source base to explore how hospital provision was established, managed and funded in the successor states of East Central Europe (Poland, Czechoslovakia and Hungary) created in 1918. It will examine these developments from a ground up approach to explore the practical process of building health care provision at a local level. It will seek to locate suitable source material to undertake local case studies of hospital services.

The project will use international comparison across three countries and will open up opportunities to examine healthcare in diverse economic, social and political situations. It will draw on Doyle’s comparative work on Anglo-French hospital services which utilised urban case studies to assess the day-to-day operation of healthcare before welfare states. Healthcare provision in the three nations chosen for this project Poland, Czechoslovakia and Hungary has received limited attention from historians. Much of the English language work has focused on the activities of the Rockefeller Foundation, between 1918-25, while studies of early national health policy have concentrated on links between eugenics and local services. Local studies of provision remain rare.

The team will conduct literature reviews, archival scoping and the collection of some pilot data with the help of research assistants with high-level competence in Czech, Polish and Hungarian respectively. After an initial period reviewing literature and identifying appropriate collections, the RAs will spend up to two months in their respective countries exploring archival sources, undertaking initial data collection and meeting with potential collaborators and project partners. The research visit will include a period in the capital identifying national records, print sources and medical journals and some time in a provincial centre scoping local archival material such as hospital records, local authority material, newspapers. In the final two months they will write up reports to include assessment of the scope and quality of archival material, the problems and possibilities offered by the source base and the initial pilot data collected. This material will be presented in a plenary workshop involving ten-fifteen academics interested in interwar health care provision in a European context. There will also be a co-authored article on the findings of the project for submission to a major medical history journal.

The goal of the project is to make a significant contribution to the history of health care provision by opening up local records in East-Central Europe for researchers and by placing hospital development in these countries in a Europe wide context. In particular, they will view these developments from the ground up examining the practical process of building health care provision at a local level. Integrating East Central Europe into the history of European hospitals will challenge existing paradigms based on the relatively wealthy, urban and politically stable states of western Europe that currently dominate the historiography and offer an opportunity to explore the role of health care in national identity formation.

Find out more about the Centre and the project here.

 

CFP: After the End of Disease

London, May 26-27, 2016

Public and academic discussions on the end of diseases are abundant in the midst of recent epidemic crises. Faltering vaccination rates have seen old diseases, like measles and whooping cough resurface to epidemic proportions in the Global North. Several global epidemic crises, such as the swine flu and ebola, have prompted international organizations, local governments, pharmaceutical companies, research institutions and individuals to respond in manifold ways with the aim of controlling and eventually ending epidemic diseases. Ending diseases for good have been the goal of several eradication campaigns over the 20th century and are the focus of global projects such as the polio eradication initiative, spearheaded by the a public-private partnership including the WHO, the CDC, UNICEF, the Rotary and the Bill and Melinda Gates Foundation.

In his now classic article ‘What is an epidemic?’, Charles Rosenberg pointed out that epidemics as social phenomena work with a particular dramaturgic form of increasing tension, crisis and eventual closure. Scholarly analysis, historical or contemporary, has tended to follow this narrative, focusing on prevention, outbreaks, epidemic crises, upheaval, and the end of disease. What happens after the end is more often than not left to epilogues, or addressed only in relation to a new, emerging disease on the cusp of crisis. Yet, diseases are often imprinted on the bodies of survivors, societies and cultures. Epidemics may change economic structures, social interaction, shape practices of international intervention and attitudes towards healthcare. In some cases, the proclaimed end of a disease leaves individuals or whole societies and states without resources previously guaranteed by the perceived epidemic threat. In others, the action of looking back after the end creates space for making moral judgements on individuals, societies, governments and international organizations.

This conference brings together historians of medicine and global public health, anthropologists and sociologists with policy makers to think past the conventional narrative curve of epidemics and disease in general. Proposals that address one or several of the following questions are particularly welcome:

  • How do states, societies and international organizations prepare for the end of a disease? Do they prepare at all?
  • What happens to the disease itself after the end?
  • What are the lasting consequences of epidemic diseases that linger on after the end?
  • What happens when a disease makes a comeback?
  • Who and when decides if a disease is over? Where and for whom do diseases end and who is excluded/forgotten?
  • How does the action of determining the “end” of an epidemic (e.g. ebola, polio, etc.) affect those involved: those who fear, those who prepare, those who cure, those who survive?
  • What happens if the end of a disease fails to arrive?

Deadline to submit abstracts up to 300 words is December 1, 2015.

Please send abstracts and any queries to d.vargha@bbk.ac.uk

Contact details:

Dora Vargha

Postdoctoral Research Associate
Department of History, Classics and Archeology
Birkbeck, University of London

Call for Abstracts for AAHM panel Socialism and Health: a Global Exchange of Ideas and Practices

We invite submissions for abstracts to join the panel titled Socialism and Health: Socialism and Health: a Global Exchange of Ideas and Practices for the upcoming meeting of the American Association for the History of Medicine (AAHM) to be held in Minneapolis, April 29-May 1, 2016. The aim of this panel is to track how ideas of public health, a cornerstone in how socialist states had defined themselves, circulated among socialist countries and welfare states, which practices and concepts were adopted as opposed to others, and how local solutions fed back to the overall idea of health in national contexts. In sum, we ask to what extent can we talk about a distinctly socialist public health? As Cuba’s role in the Ebola epidemic, British debates on the structure of the NHS or rhetoric on American healthcare reform suggest, these are pressing questions even today. Confirmed panelists Miriam Gross (University of Oklahoma) will be addressing Chinese, while Dora Vargha (Birkbeck College, University of London) will be analysing Hungarian perspectives in the 1950s.

Please submit an abstract of no longer than 350 words, along with name, title and institutional affiliation to Dora Vargha at d.vargha@bbk.ac.uk by September 25. Feel free to contact with any questions and queries.

CFP: Cultures of Harm in Institutions of Care: Historical & Contemporary Perspectives

This two-day interdisciplinary conference will explore the shifting political, socio-economic, cultural and medical influences that have formed and perpetuated cultures of harm from the eighteenth century to the present day. We are particularly interested in the production of harmful practices – physical, sexual and psychological violence directed by one person or group against another – in therapeutic and caring environments, worldwide. These might include hospitals and infirmaries, psychiatric facilities, religious institutions, care homes, children’s homes and educational establishments, as well as infirmaries and medical spaces in prisons and correctional institutions, military barracks, camps and workhouses.

Please submit an abstract of up to 300 words together with a brief outline of your academic affiliation to trauma@mail.bbk.ac.uk by 20 September 2015.

Full details can be found at www.bbk.ac.uk/trauma/events

Psychiatry in Communist Europe – out today!

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CEEHM Network fellow editors Sarah Marks and Mat Savelli have put together a wonderful and groundbreaking volume in the Mental Health in Historical Perspectives series of Palgrave. This is the first book to address the history of psychiatry under Communism in Central and Eastern Europe, from the Soviet Union to East Germany. It brings together new research addressing understandings of mental health and disorder, treatments and therapies, and the interplay between politics, ideology and psychiatry. It challenges assumptions about the extent of political control, exploring beyond the instances of punitive abuse of psychiatry, and recognizing the international exchanges which informed the development of research and practice in the region.

More details and full review to follow. Until then, sign up to get your copy hot off the presses at the publisher or Amazon!

‘The Perils of Peace: The Public Health Crisis in Occupied Germany’ is now Open Access

Jessica Reinisch’s The Perils of Peace has just been published as an Open Access monograph. You can download the full pdf from the OUP catalogue for free, here: http://ukcatalogue.oup.com/product/9780199660797.do

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In The Perils of Peace Jessica Reinisch considers how the four occupiers – Britain, France, the Soviet Union, and the United States – attempted to keep their own troops and the ex-enemy population alive. While the war was still being fought, German public health was a secondary consideration for them: an unaffordable and undeserved luxury. But once fighting ceased and the occupation began, it rapidly turned into an urgent priority. Public health was then recognized as an indispensable component of creating order, keeping the population governable, and facilitating the reconstruction of German society.

But they faced a number of problems in the process. Which Germans could be trusted to work with the occupiers and how were they to be identified? Who could be tolerated because of a lack of alternatives? How, if at all, could former Nazis be reformed and reintegrated into German society? What was the purpose of the occupation in the first place?

This is the first carefully researched comparison of the four occupation zones which looks at the occupation through the prism of public health, an essential service fundamentally shaped by political and economic criteria, and which in turn was to determine the success or failure of the occupation.

Call for Papers: The history of health and disease in Central and Eastern Europe since 1945

 Institute of National Remembrance and Institute of History of the Polish Academy of Sciences invite you to participate in the international conference “The history of health and disease in Central and Eastern Europe since 1945”, which will take place in Warsaw, 14-15 October 2015.

The material destruction, difficult sanitary conditions, poverty, as well as infectious disease epidemics collecting a heavy toll are important phenomena, often overlooked in the historiography, describing the post-war reality of Eastern Europe.

A new political order, introduced in this part of the continent, also covers the issue of health care. Some of the basic questions to be discussed during the scheduled conference are: to what extent, however, was the theme of universal, free access to health care put into practice in the second half of the twentieth century, what problems were encountered while implementing the reforms of the health care system by the end of the 80s, and how they were perceived by ordinary people.

The history of health and disease constitutes a relatively new field of historical research and it focuses, inter alia, on issues such as health policy of the state (the idea of public health), living conditions, and public health awareness. Issues related to health and disease refer to the particularly delicate sphere between the private and the public life. Therefore, research on the historical circumstances refers to a number of significant problems both in the field of social policy as well as within the scope of everyday life and mentality.

How in the postwar period (but also before the war) the concepts of health, disease, cleanliness, and dirt were defined in the culturally diverse European societies, and to what extent they have undergone transformations in the second half of the twentieth century; what influenced the directions and pace / dynamics of cultural as well as awareness and mental changes, – these are additional questions and problems we would like to focus in the discussions planned.

Other issues to be discussed during the conference include:

  • Health policy of communist states
  • Sanitation and quality of life
  • Awareness and health education
  • The health status of the citizens of the people’s democracy countries
  • The health care institutions and their activities in practice
  • Excluded groups? War invalids, mentally ill, the disabled
  • Aging of the population
  • The phenomena of medicalization
  • Transformation of civilization and health issues
  • Occupational diseases, occupational medicine and OHS in socialist factories
  • Problems of in-patient and out-patient health care
  • Adaptation practices and health habits
  • The social position of doctors and medical / hospital staff
  • Patient and the total institution
  • Health – a public or a private sphere
  • Non-medical treatment

We are also open to other suggestions regarding the discussion of problems of the post-war history of health and disease in Eastern Europe. We invite both historians and cultural theorists, sociologists, anthropologists, and all researchers dealing in their work with issues falling within the framework of the planned program of the conference.

The conference will be held in Polish and English (with simultaneous translation). The organizers will cover the authors’ of the papers costs of stay (accommodation, meals) and the travel expenses will be reimbursed.

Please send the applications form to the address: european.healthhistory@gmail.com

The deadline is 30 April 2015.

Please enclose the abstract of the paper (up to 300 words in Polish or English), a short CV of the author and a fragment of one of the previous publications (articles). The organizing committee will make the selection and notify authors by the end of May 2015. We plan to publish the conference papers.

The Cold War legacies of vaccination

Reposted from the original blog post on The Reluctant Internationalists:

Academic life, as I have learned, makes you painfully aware of the many different regimes of immunization across the globe. Moving between fellowships and jobs, our first son got his vaccines in four different countries – that means four distinct healthcare systems, vaccination schedules, payment structures and vaccination records in three different languages. I think it is safe to say that he has become a reluctant internationalist in his own way. As for us, parents, we pretty much did what we usually do in our working life. We spent hours after each vaccination appointment to analyze the microcosm of public health systems: the doctor-patient encounter. We have been fascinated by the carefully crafted pro-vaccination speech prepared by our American paediatrician, the kind, but firm approach of the German doctors, the inescapable abundance of posters and leaflets on vaccination in the British surgery, and the lack of any kind of publicity and a matter-of-fact discourse in the district paediatrician office in Hungary.

This personal experience has also made me particularly interested in the way childhood immunisation is conceptualised and the points when it is contested or even seems to break down, such as the current ‘anti-vaxx’ controversy prompted by the Disneyland measles outbreak. As I am currently finishing a chapter on debates surrounding the Salk vaccine in Eastern Europe in the 1950s, I started thinking about how communist public health officials would have made sense of debates like this.

An excellent analysis by Jennifer Reich, published in Gender& Society has brought up an important point that would surely have sparked the interest of the communist vaccinators. In this study Reich is speaking to a debate that, in broad brushstrokes, posits crazy and irresponsible people (mainly women) against rational and responsible parents, physicians and public health experts. Reich is arguing that the ‘anti-vaxxers’ are far from being ‘crazy’: in fact, they base their decision on time-consuming research and their choice reflects their social and economic privilege. Not only is this analysis important in understanding current American anti-vaccination movements and their consequences, it also makes clear that behind this potential public health crisis is the primary role of the patient-consumer and an interpretation of personalised medicine. According to Reich’s study, mothers who decided not to vaccinate their children were unconvinced by arguments that they should be participating in public health and expressed that their responsibility was to their own children, not others’. This is along the lines of what popular satirical outlets, such as The Onion have picked up on.

Responsibility for health was exactly the thing in the crux of Cold War attitudes towards public health. Eastern European party dignitaries and public health officials were always happy to boast that countries like Czechoslovakia and Hungary triumphed over polio years before the West and about a decade before the United States did. Their Western colleagues acknowledged the feat, and explained this with totalitarian state organisation – effective epidemic management tends to be authoritarian. The Eastern Europeans had a different explanation, however: the socialist model of organising public health, where prevention is seen as key to the health of the population, healthcare is available to all, vaccines are free, and the paternal state takes responsibility over children’s health. They pointed to the ‘backwardness’ of America for sacrificing the health of children to selfish and market-driven agendas.

Article detailing the Sabin vaccine campaign of December, 1959. Népszava, December 12, 1959. p. 1

With the end of the Cold War, we could dismiss this as a moderately interesting episode in history, but, as most things in the Cold War, such sentiments, experiences and ideologies have long-term effects. Traces of the Iron Curtain linger in vaccination coverage: measles, for instance, tends to appear in Western Europe much more than in the East. In 2011 of all measles cases in Europe, over 83% was reported from Western Europe, while Central and Eastern Europe accounted for less than 14% of them. According to data from 2013 by the WHO, inPoland, Slovakia, the Czech Republic, and Hungary the vaccine coverage for measles has been 98-99%, while in the US it is 91%, UK (after a dip to 81% in 2004) rising to 95%, France 89%.

Vaccine coverage of course is a marker of superiority only in Cold War rhetoric. It does not reveal much about the quality of healthcare, access to it, or the overall health of a population. Coverage rates can also quickly change due to political unrest and/or economic problems, like in Ukraine, where vaccination has hit critically low rates in the past decade. However, when comparing politically and economically stable countries in the Global North, this difference between East and West does reveal Cold War legacies and attitudes towards the responsibilities of citizens. In much of Eastern Europe, the state expects physicians and parents to comply with vaccination policies without much debate or contestation, and parents expect the state to provide free vaccine and to guarantee its safety. The ‘social’ in medicine is very much still present and high vaccination rates are still a point of pride for Eastern European governments.

Vaccine resistance is also not a phenomenon. Since there had been vaccines, there has been resistance to it – revealing a wide variety of reasons, usually connected with a much larger issues regarding power relations, distrust, religious integrity, etc. In some societies, like Britain, vaccine resistance has a long history, since the introduction of Jenner’s vaccine.But resistance to vaccines is not even something particularly Western, even if we limit our view to the Global North, although it is slightly more difficult to spot on the Eastern side of the Iron Curtain in the Cold War era. Archival sources give a glimpse of resistance to the Salk vaccine in Hungary, which had to do mostly with opinions that the state was not fulfilling its public health provider role adequately, either by following the ‘wrong’ method of injection, or supplying vaccine lacking in quality and quantity.

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There are, of course, new aspects of today’s vaccine resistance in the Global North. Parents have easy access to information online and can establish ties with each other over social media. These ties and the flow of information does not stop at borders, making vaccine resisters at once national agents – in that they respond to a particularly local set of problems of state, public health and culture – and internationalists who participate in shared networks across the globe. Over 25 years after the fall of the Berlin wall, the wind of change might finally reach public health organisation and vaccination in Eastern Europe. In Hungary, where vaccination is compulsory and free, the voice of vaccine critics seems to be growing steadily, drawing mostly on social media, supported by arguments based on translations from English language materials. With a healthcare system that perpetually seems to be on the verge of breakdown – another Cold War legacy -, questions of responsibility for health keep bubbling up to the surface. But for now, the legacy of a previous century is imprinted on my child’s body, who has moved with ease back and forth between East and West, unknowingly becoming a vaccine cosmopolitan.

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.