Report by Tamara Scheer (Ludwig Boltzmann Institute for Social Science History/Institute for East European History/University of Vienna)

Thinking about Health and Welfare in (Eastern) Europe and Beyond

July 1-3, 2015 at Birkbeck College, University of London

Co-organised by the German Research Foundation Network ‘Social Welfare and Health Care in Eastern and Southeastern Europe during the Long 20th Century’ (Regensburg University, Germany) and ‘The Reluctant Internationalists’ (Birkbeck, University of London)

Our joint network meeting aimed to discuss the current research of our members, with a special emphasis on sources related to health and welfare. Although the geographical focus was on Eastern, South Eastern and Central Europe, most of the 19 papers drew attention to global transfers and networks by discussing a period stretching from the 19th century up to recent contemporary history. The workshop included two key notes, one by Paul Lerner on “War Trauma and the Historiography of Psychiatry”, the other by Marius Turda on “Health and Social Welfare in Southeastern-and Eastern Europe: A Troubled Relationship”.

The Regional and Transnational Character of Health and Welfare

All papers drew attention to the importance of the state and region in which the research topics are placed but at the same time pointed to the impact of global trends and the inter- and transnational character of debates and ideas. Marius Turda emphasized: “A regional focus is by is nature comparative, while at the same time placing emphasis on trans-national and global interconnections, a regional approach encourages us to historize different aspects of the pasts and revisit existing paradigms and chronologies.” He added that even dealing with a certain state is always somehow comparative as states consist of different parts shaped by nature, different historical background, social structures as well as ethnicity and religion. Therefore it was of importance if an illness or a social issue appeared only in some regions and affected only parts of the population or was a widespread phenomenon.

Throughout the 19th century until the 20th century a growing internationalization and mutual influence was also inherent in all papers discussed. Sometimes going international was state driven but sometimes it was driven by private associations or personal (academic) relationships. Maria Zarifi highlighted for Greece the knowledge transfer with Germany between 1870s up to 1945. Germany was codified as being modern. More and more people studied abroad and brought ideas back to their home countries. David Bryan described the example of establishing a health insurance system in Franco Spain. Commissions were sent to Europe (he emphasized Slovakia, Romania, and links with Nazi Germany and  fascist Italy). Germany was seens as the home of social insurance. Ana Antic presented “cold war exchange”. The countries behind the iron curtain were influenced by changes in  child education in Europe and the United States. In Yugoslavia state efforts were not only directed against traditional patriochal structures but also against Sovjet Russia.

After the First World War Polish scientists from Austria-Hungary and Russia settled in Warsaw. Different cultures merged aiming to create a “Polish health” which met political interests to build up a Polish nation, as Katrin Steffen argued. Dora Vargha pointed to the virologist Albert Sabin’s international network skills, which influenced his career positively. Nevertheless, although ideas were transferred to another country and discussed they needed a certain starting point where they fitted into state policy to become reality. Even when a state closed ist borders for foreign ideas transfer took place. Johanna Conterio shows that in Soviet Russia, journals from Germany and the UK dealing with natural healing were available in institute libraries. Fanny Le Bonhomme described psychatry in the GDR. Even in the 1960s, the director of the Charité came from the West and was not a party member. She also pointed to the fact that the sources show that discussions in the GDR did not differ much from contemporary discussions in France.

The Variety of Agents involved in Health and Social Welfare           

All papers draw attention to the importance of the specific actor or agent who or which dealt with questions of health and social welfare. An agent doesn’t necessarily have to be a certain person but can also mean institutions or even objects.

Jessica Reinisch showed through the example of UNRRA relief work how individuals shaped humanitarian work in the field. She started by explaining how field workers were recruited and how their personal and political interests influenced their work. She also asked which role the receiving countries played. This additional focus on the state’s interest was also part of Friederike Kind-Kovacs paper on the example of post World War I Hungary, when international relief was gained for malnourished children. Andre Thiemann questioned the role of personality in assessments of a family’s social status and therefore their need for help among Serbian social workers.

Francesca Piana works on Dr. Ruth Azniv Parmelee, who came to central Turkey with the Hoover organisation and was there when the Armenian genocide took place. Women’s work was in the margins, and Parmelee was critized for her lack of own experience with children as she was single. In Jessica Reinisch’s case the motivation for women to apply as UNRRA relief workers was a great chance for women to be professionally engaged in a foreign country, in contrast to their career chances in their own country. War often implied the opportunity for women to engage in official positions (doctors and nurses). On the other hand Paul Lerner stated that war was not necessarily a motor for severe changes in the way of thinking as in his case World War I did not really change (academic) conceptions in German psychiatry

Under the zeitgeist keyword of “modernism” new international and national institutions popped up throughout the late 19th century. Johanna Conterio showed that in a short period of time in the 1930s eleven institutes for natural healing were founded in the Soviet Union. Whole new groups of agents were created. On the example of Russian railway workers Angelika Strobl showed that they became a “railway population” inside the Russian empire. The railway company  started a process of statistification as an overall health care had become necessary to guarantee the physical condition of specialized professionals. Modernization therefore was characterized by efforts to bring health and welfare efforts to the masses, including mass injections aimed to regulate and control the people’s bodies. Through exhibitions, posters and booklets, the state expected the enlightenment of the massess. Justyna Turkowska presented exhibitions in Poznań (today in Western Poland) where the contact zone of Russia and Germany created an additional kind of racial propaganda. Poles were mentioned in a way that they more tended to alcohol abuse in contrary to Germans.

When health and welfare measures were discussed by states and scientists this always implied that certain groups were left out. This marginalization played an important role, regardless of whether these people were part of an ethnic minority or a distinct group apart from the majority. Eszter Varsa pointed to the selective nature of pronatalism. Hungary legalized abortion already in the 1950s. Physicians argued that abortion would harm the Hungarian nation, as only the wrong women would make use of it, that is, upper class women, rather than Roma. Educating the population was not only directed to adults but also to children. Ana Antic described in the example of Yugoslavia in the 1960s that children were seen as key figures for the long-term transformation of society. They would later become the agents for the Yugoslav version of socialism.  Indira Durakovic focused on the role of marginalization in late 19th century Serbian public health. The newly independent state aimed to have a healthy population not only to have wealthy tax payers but also to marginalize all groups which did not meet the aim of an ethnic, homogenous society, such as female prostitutes and homosexual men.

In Sara Bernasconi’s case the “agent” had been the midwives’ cases in Bosnia-Herzegovina. The so called kofer was interpreted as a symbol for modernization and state’s control by the Austro-Hungarian occupation administration in Bosnia-Herzegovina and therefore as an imperial tool. On the other hand it supported the professionalization of a woman’s job and it had an afterlife as it was used even after the dissolution of the Habsburg monarchy.

Critical Assessment of Health and Social Welfare Terminology and Visualization

Friederike Kind-Kovacs argued for tracing the “origin of terminology”. When were terms first used and in which context, but by taking into account that even in the same time people or state’s used them differently. Heike Karge argued for a normalization of several terms such as  “East” and “Balkans” which were often used by contemporaries to draw a distinctive line between themselves (modern) and the others (backward). She showed through the example of post World War II Yugoslavia that these parts of Europe went congruent to discourses in the so called West. Socialism meant something different in Yugoslavia than in Romania. A distinction should also be made between early and late socialism. Esther Wahlen compared measures directed to alcoholics in Romania and Chechoslovakia. She  described the change from early socialist interpretation about the reasons for alcoholism (poverty) to the late socialism where it was seen as the problem of an indivuum. The term modernization played a key role. All actors – regardless of the country – understood the 19th century as a period of modernism. But we have to ask what this term meant for whom and when and why the usage ended after 1945? In the 20th century modernization was enriched by nationalist prospects of a healthy nation.

Another periodization was connected to science. The period until the First World War was called by scientists as a “nervous era“ (Paul Lerner). In the late 19th century until 1945, as Maria Zarifi argued, among Greek officials modernization implied an effort to step away from any Ottoman tradition, by tracing back to ancient times, and to Europeanize. Modernization was synonomous with Westernization.

Also terms related to health and welfare have to be taken critically into question such as “backward”, “poor”, “educated”, “ill,” “healthy,” or even “failure”. Failure of a relief mission, as Jessica Reinisch argued, is always declared by individuals, often linked to political changes.

Health and Welfare are usually not only written words in political or scientific papers but often materialized in exhibitions or pictures. Pictures of childrens‘ coffins were used for public exhibitions (Turkowska) or to gain international attention on malnourished children (Kind-Kovacs).  Dora Vargha presented a post card where a child was dressed up as a syringe or a picture where children thanked Albert Sabin for rescuing them from polio. The late 19th century was also a time of increasing publishing of educational booklets for the masses and public lectures. Indira Durakovic pointed to booklets which aimed to fight venereal diseases. In the case of the Austro-Hungarian army these booklets were printed in the languages of all nationalities living in the monarchy with the same content (Tamara Scheer).


For this workshop researchers gathered who are only on the first sight dealing with different topics. What quickly became obvious was to what extent to which we are all challenged by the same questions. One is that even when states close their borders, agents of health and welfare, ideas and debates are crossing borders. A mutual influence was even traceable for restricted countries such as Soviet Russia and the GDR. In each case we have to ask to what extent the regional (not state) social and cultural situation influenced ideas and debates. The other challenge is how to use terms such as Western, Eastern, Europeanization or modern. For each case researchers have to ask if and how these terms were used by historical actors, in different languages and countries, in the same period. The importance of tracing ideas and debates back to single personalities was also highlighted. Often actors brought in personal interests and prejudices, which influenced the outcomes of their activities. The theme of engaging the masses or directing health and welfare measures toward the masses also appeared repeatedly in our discussions. This engagement shaped thinking about health and welfare in Europe in the 19th century up to contemporary history.