Hospitals in Times of Crisis

Hospitals in Times of Crisis

German Society for the History of Hospitals; International Network for the History of Hospitals; University of Warsaw
Fand statt
Vom - Bis
18.05.2023 - 20.05.2023
Lea Münch, Institut für Geschichte der Medizin und Ethik in der Medizin, Charité Universitätsmedizin Berlin

The conference was jointly organized by the German Society for the History of Hospitals (DGKG), the International Network for the History of Hospitals (INHH) and the Faculty of History of the University of Warsaw. The cooperation in this constellation is a novelty and made it possible to approach the history of the hospital in a chronologically and geographically broad spectrum and by means of diverse methodological approaches. The focus was on the question of the hospital in times of crisis. The concept of crisis was covered across different eras in its various fields of meaning. These ranged from the original, ancient meaning as a decision or turning point in the course of an illness to the broad transfer to a personal or socio-political level in the modern sense. In the opening address of the conference, FRITZ DROSS (Erlangen-Nürnberg) traced this change in meaning by way of introduction. He emphasized the understanding of crisis as the moment in the course of a disease when no longer doctors but nature decides the outcome. It contrasts with the decision of a society to respond to various crisis phenomena with the institution of the hospital. MICHAL KOPCZYNSKI (Warsaw) highlighted the related pressure of expectations to which hospitals are exposed, especially in times of crisis. A historical perspective could also sharpen the view for current problems and better health care. BARRY DOYLE (Huddersfield) situated the conference in the current efforts to give hospital history a stronger international orientation and to network it.

The first panel addressed political crises and hospitals. YANNIS GONATIDIS (Crete) presented the multiple crises of the hospital in Hermoupolis, which had to respond to enormous demographic challenges in the 19th century. The rudimentary hospital evolved from a drop-in centre for refugees as a result of rapid population growth to a central care facility. SHRAVASTI PATHAK (Burdwan) spoke about the role of the Bengali medical profession in the Campbell Hospital and Medical School in Bengal, established by the British colonial power to care for the local population. Although Western medicine had found a "new home" in the colony, it also contributed to the "Indian National Movement". AXEL HÜNTELMANN (Berlin) analyzed the causes that led to a general crisis based on a state-intended audit report of the Charité hospital in 1921. He described the effects of the First World War on patients and doctors and placed the structural change in the context of economization processes in hospitals.

The second panel covered the topics of war, epidemics and psychiatric hospitals. OLGA GAIDAI (Mykolaew/Warsaw), in cooperation with TADEUSZ SROGOSZ (Częstochowa) shed light on logistical organizational problems of the military hospitals during the Napoleonic Russian campaign "Polish War" (1806-1807). In a very short time, a network of permanent hospitals and mobile lazarets was created behind the front to care for wounded soldiers. IVA MILOVAN DELIĆ (Pula) and KATARINA KEBER (Ljubljana) conducted a comparative study of the roles of the Pula Provincial Hospital and Ljubljana Provincial Hospital in the treatment of the Spanish flu in 1918/19. The results regarding the course and mortality are in line with previous knowledge in Europe. They highlighted the importance of constant care in contemporary medical discourse, which both institutions were only able to provide to a limited extent. CLAIRE DELIGNY (Paris) analyzed the contemporary, divergent interpretations of the rising number of mental patients at three psychiatric institutions in Britain at the end of the 19th century. This institutional crisis combined with a deeper cultural-social crisis: views on the nature of mental illness and its institutional treatment evolved towards a deterministic approach. KELLY ADAMSON (Dublin) explored the use of three somatic therapies – deep sleep, insulin coma and electroconvulsive therapy – in the years 1939-1950, analyzing the impact of these therapies on the daily lives of patients and doctors against the backdrop of resource scarcity during the Second World War.

The afternoon offered space for a guided tour of the campus of Warsaw University, which was founded in 1816 on the edge of the old town and whose oldest buildings date back to the 17th century. The tour included a visit to the old university library (Dawna Bibliotheka Uniwersytecka) and the representative Kazimierz Palace (Pałac Kazimierowski). This was followed by the general meeting of the German Society for the History of Hospitals, which was open to interested parties.

A special highlight was the half-day excursion to the Tworki Hospital in the rural periphery of Warsaw, which has been one of the most important psychiatric institutions in Poland since its foundation and is currently undergoing structural change and extensive restoration. After a welcome by the director of the pavilion-style institution, built in 1891, a lecture by the psychiatrist and former director MARIA PAŁUBA (Tworki) followed, introducing the history of the institution. Psychiatrist AGATA SZULC looked at the historical development of psychiatry in the Polish health system. A patient-centred perspective in both contributions would have been desirable, as would a more in-depth look at the Second World War and the Soviet era. The architect PIOTR GERBER (Wrocław), who is currently involved in the historically careful renovation of the complex, spoke about the manifold challenges that currently arise in the value-preserving restoration of the extensive institution.

The following panel focused on the Second World War. KATRIN SIPPEL (Vienna) examined three hospitals in Lisbon, which was a transit point or final destination for up to 80,000 mostly Jewish refugees during the Second World War. Using short biographies of patients, she showed the importance of the hospitals, which represented an important place of refuge for many through cultural and linguistic ties. CHRISTOPH BREZINKA (Innsbruck) contextualized the relocation and reorganization of the obstetrics department of the University of Innsbruck to a hotel in rural Seefeld. He reported on an extensive oral history project with those born there, which provides a counter-pool to the otherwise meagre source material. LEA MÜNCH (Berlin) addressed the relationship between occupiers and occupied on the basis of the medical staff of the medical clinics of the “Reichsuniversität” of Strasbourg, which were part of a structural change in annexed Alsace. A socio-demographic analysis of the clinic's patient files focused on forced laborers as patients.

The fifth panel addressed hospitals in Africa, (post-)colonialism and decolonization. FLAVIUS MOKAKE (St Louis) examined the role of ghettoized leprosy settlements in the fight against leprosy in colonial and post-colonial Cameroon. The focus was on the tense isolation and custody policies as well as the patients' perspective. ADESOJI ADEDIPE (Kansas) analyzed health care in Lagos (Nigeria) and Durban (South Africa) during epidemics from a comparative perspective. She characterized hospitals as "tools of empire" and as institutions of "othering". KATHLEEN VONGSATHORN (Edwardsville) outlined the history of the Kalango Hospital in Northern Uganda from its foundation by Catholic missionaries to the crisis in the military conflict with Tanzania. She emphasized the self-image of the local community, which sees the hospital as a community project.

The sixth panel dealt with local and global contexts. BARRY DOYLE (Huddersfield) spoke about the development of health care in West African states under the colonial rule of the United Kingdom and France in comparison. The two great European powers, which proceeded differently with regard to their colonial hospital and health care systems, nevertheless faced similar tasks with the independence movements in the 1960s, which Doyle interpreted as both a crisis and an opportunity. ELISABETH BISHOP (San Marcos, Texas) illuminated the interactions of the Algerian national liberation movement with Poland in the 1950s at the level of health care, which led to diplomatic cooperation. This resulted in diverse support for Algerian medical students.

The last panel was dedicated to the post-war period. MEGAN BRIEN (Dublin) spoke about the construction of the Irish tuberculosis sanatorium Ballyowen. She analyzed from an architectural and discourse-analytical perspective the subsequent transformation into a psychiatric hospital, which took place in response to an infrastructural crisis. SEAN LUCEY (Cork) presented the far-reaching reform of the Northern Ireland health and hospital system that started in the slipstream of the "Troubles" in 1972. The changed power relations made it possible to overcome traditional resistance. AISHA MASHINGAUTA (Stellenbosch) spoke about the development of health care in Zimbabwe, which was supported by the Catholic mission during the colonial period. State hospitals opened after independence lost importance due to economic crises, so that mission hospitals are currently in the foreground again.

In his concluding remarks, Fritz Dross focused on the question of the relationship between hospitals and power, which, in view of the research on non-European, colonial and post-colonial hospitals, is also worth posing again for European hospital history. The power relations resulting from economic structures became clear in view of the financing of hospitals and health care, which are and were often the starting point for crisis developments. He pointed to the sometimes divergent or even opposing interests of political forces such as state or colonial, religious and civil society actors, which shaped the objectives and self-image of hospitals and changed the institution itself. In addition, hospitals were in a dynamic process of interaction and adaptation with the socio-political framework conditions: They had to adapt to quantitative and qualitative changes in the population to be cared for, to be mobile in the literal sense in wartime conflicts, etc. The conference brought together contributions on hospitals from over 200 years in four continents. This global perspective, which included seven papers on non-European hospitals and the medical care practised there, has not been achieved before in the history of hospitals. It offered an outlook on the history of the hospital as a central place of global health care. Overall, the conference was convincing due to its varied program with excursion, which offered young researchers in particular the opportunity to present and exchange information on research projects. A publication of the contributions is planned.

Conference overview:

Chair: Barry Doyle

Yannis Gonatidis (Grete): The Multiple Crises of the Municipal Hospital of Hermoupolis (Syros) during the 19th Century

Shravasti Pathak (Burdwan, West Bengal): Campbell Medical Institution in Nineteenth Century Bengal (online)

Axel Hüntelmann (Berlin): Charité at Crisis. The Charité Hospital in Berlin in Financial and Political Turmoil Between 1914 and 1935

Chair: Fritz Dross

Olga Gaidai (Mykolaew, Ukraine / Warsaw), Tadeusz Srogosz (Częstochowa): The Organisation of Hospitals during the Polish War of 1806-1807

Iva Milovan Delić (Pula), Katarina Keber (Ljubljana): Hospitals as a Place of Survival. Treatment of the Spanish flu 1918/19 in Pula Provincial Hospital and Ljubljana Provincial Hospital (online)

Claire Deligny (Paris-Nanterre): Asylums in Crisis? The Lancashire Asylums and the Perceived Increase of Insanity in Late 19th-Century (c. 1870s-1914)

Kelly Adamson (Dublin): 'He Wants to Go Horne': the Use of Deep Sleep, Insulin Coma (ICT) and Electro-Convulsive (ECT) Therapies in Irish District Mental Hospitals, 1939-1950


Maria Paluba: History of the Tworki Hospital: an Outline

Agata Szulc: Psychiatry in Poland - Transition from Asylum to Community Model

Piotr Gerber (Wrodaw): Modernization of Historical Hospital Buildings

Session 4: WORLD WAR II
Chair: Axel Hüntelmann

Katrin Sippel (Vienna): Hospitals in Lisbon - a haven for refugees from National Socialism during WW II?

Christoph Brezinka (Innsbruck): Relocation of Obstetric Departments from Cities to the Countryside in Wartime Germany 1941-1945

Lea Münch (Berlin): Clinic Operations and Patient Care under Occupation Conditions. The Medical Clinics of the "Reichsuniversität" Strasbourg in Annexed Alsace (1940-44)

Chair: Jane Stevens Crawshah

Flavius Mokake (St. Louis): "Voices Yet Unheard." Controlled Spaces, Custodial Care and Diseasehood in Ghettoized Leprosy Settlements in Cameroon, 1950s-1970s (online)

Adesoji Adedipe (Kansas): Facilities of Alterity in Africa? Hospitals and the Provision of Medical services during epidemics, Lagos Nigeria and Durban South Africa in comparative perspective (online)

Kathleen Vongsathorn (Edwardsville): "We built the hospital": Community Ownership and Overcoming Crisis at Kalongo Hospital in Northern Uganda

Chair: Kathleen Vongsathorn

Sadie Levy Gale (Cardiff): "The Mother Hospital of the Empire": Imperial Visions of Healthcare in St Bartholomew's Hospital Fundraising Appeals (cancelled)

Barry Doyle (Huddersfield): West African Hospitals and the Crisis of Decolonisation

Elisabeth Bishop (San Marcos, Texas): Hospitals as Sites of Blackmail

Chair: Mathias Schmidt

Megan Brien (Dublin): Ballyowen a hospital formed, reformed and transformed in response to crises

Sean Lucey (Cork): Reform in a Time of Crisis: The Northern Ireland Troubles and Reorganisation of Hospital and Health Services

Aisha Mashingauta (Stellenbosch): Mission Hospitals and public health in Zimbabwe 1980-2017: Case of the Manicaland Province (online)

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