Foolish Remedies: Plague doctors

A few months ago, we asked for your best tips for curing a cold on Twitter. The answers were brilliantly illustrated by our very own Rob Bidder as part of our Curious Conversations. April Fools’ Day kicked off our Foolish Remedies series as Muriel Bailly explores other unusual cures for illnesses inspired by Henry Wellcome’s collection.

For this week’s final post we will leave the Medicine Man gallery to explore the wonders of the Wellcome Library. In yesterday’s blog I mentioned that Goa stones were used, among other things, to cure the plague. Oddly enough, this was not the most desperate attempt.

Europe faced a long and deadly episode of plague in the 14th century called the Black Death and plague itself was still found in Europe until the 19th century. The pandemic originated in China and spread to Europe along the Silk Road, reducing the world’s population from 450 million to 350 million. The disease spread extremely rapidly leaving even the most reputable doctors and physicians clueless as to the causes of this new killing machine. As a result, many made the decision to flee, making room for less experienced doctors and opportunists.

A physician wearing a 17th century plague preventive costume.

Speculations were made on the potential causes of the plague and amongst the most popular was the theory of miasma. This theory advocates that diseases such as cholera and Black Death were caused by “bad” or “polluted” air. In the 17th century, the French physician Charles de Lorme, who was a personal physician of many members of the Medici family in Italy and to the French royal court, created the iconic plague doctor outfit to protect himself from catching the disease when visiting his wealthy, infected patients. The costume is made of a wax-coated canvas outer garment and wax-coated leather pants as well as gloves, boots and hat.

The most iconic part of the costume is no doubt the leather mask with its curved beak and fitted glass domes. The beak was intended to hold the fragrance supposed to protect against the “plague air”. Favourite scents were lavender, camphor, mint, cloves and almost anything else with a nice, strong smell. Charles de Lorme was soon imitated in the rest of Europe by doctors in the infested cities although many plague physicians lacked any medical training. Plague doctors also practiced bloodletting to “rebalance the humors” (discussed in a previous post). The costume is described in a 17th century poem:

As may be seen on picture here,
In Rome the doctors do appear,
When to their patients they are called,
In places by the plague appalled,
Their hats and cloaks, of fashion new,
Are made of oilcloth, dark of hue,
Their caps with glasses are designed,
Their bills with antidotes all lined,
That foulsome air may do no harm,
Nor cause the doctor man alarm,
The staff in hand must serve to show
Their noble trade where’er they go 

Although de Lorme died at the honourable age of 96, his costume did very little to protect other physicians and prevent the spread of the disease. The Plague was not entirely eradicated from the European soil until the 19th century.

Muriel is a Visitor Experience Assistant at Wellcome Collection.

Foolish Remedies: Goa stone

A few months ago, we asked for your best tips for curing a cold on Twitter. The answers were brilliantly illustrated by our very own Rob Bidder as part of our Curious Conversations. April Fools’ Day kicked off our Foolish Remedies series as Muriel Bailly explores other unusual cures for illnesses inspired by Henry Wellcome’s collection.

Throughout human history, poisoning has been a method of murder, suicide and execution. The long list of people who met their end at the hands of poison includes the Greek philosopher Socrates, the Queen of Egypt Cleopatra and a variety of Roman emperors. Even today, poisoning remains a threat for royalty, political figures and military leaders.

Oval Goa stone, 1601-1800.

Goa stones, such as the one usually on display in our Medicine Man gallery, were for centuries considered the only cure for poisoning. Goa stones are named after their place of origin, Goa in India. They are the artificially manufactured versions of bezoar stones: a mixture of gallstones and hairs found in the stomach of deer, sheep and antelopes. Many of us may first have heard of bezoars from Professor Snape lecturing in Harry Potter’s first year Potions class:

“A bezoar is a stone taken from the stomach of a goat and it will save you from most poisons.“

The original bezoars did indeed come from the stomach of goats found in the mountains of Western Persia and were introduced to Europe from the Middle East sometime during the 11th century. They remained popular there as medicinal remedies until the 18th century. The term bezoar comes from either the Persian “pahnzehr” or the Arabic “badzehr,” both of which mean “counter-poison” or antidote.

Supplies were limited, however, so in the 17th century a group of Jesuit monks in the Portuguese colony of Goa began producing man-made bezoars from a paste which included exotic ingredients such as narwhal tusk, amethyst, ruby, emerald, coral and pearl. The method of administration consisted of scraping a little bit of the surface of the bezoar or Goa stone into water or wine and drinking the mixture. The monks truly believed that the manufactured bezoars would have the same properties as the real ones and, therefore, save lives.

At a time prior to modern science and medicine most people had absolute faith in the medicinal properties of the stones. Wealthy clients were prepared to spend huge amounts of money for the remedy purported to cure almost everything from poisoning to plague and depression. England started importing Goa stones in the late 17th and early 18th centuries for a very high price.

The exquisitely carved case for an artificially manufactured Goa stone.

On top of their (literally) incredible medical properties, Goa stones were also very beautiful and refined objects. Containers for the stone were often made of stone and exquisitely decorated with Mughal trellis designs including creatures such as unicorns, griffins, dromedaries, monkeys, stags and lions with human heads. They soon became a status symbol as well as, or maybe rather than, a medicine.

Muriel is a Visitor Experience Assistant at Wellcome Collection.

Foolish Remedies: Bloodletting

A few months ago, we asked for your best tips for curing a cold on Twitter. The answers were brilliantly illustrated by our very own Rob Bidder as part of our Curious Conversations. April Fools’ Day kicks off our Foolish Remedies series as Muriel Bailly explores other unusual cures for illnesses inspired by Henry Wellcome’s collection.

People have always been fascinated by illness and disease, whether out of self-interest, general curiosity or morbid preoccupation. It’s interesting to look at how people in the past dealt with various afflictions and how effective (or not) they were. Looking back, some make more sense than others and then there are those that really make you wonder…

The first object from the collection to illustrate this is the scarificator and bleeding bowl. They are used for bloodletting and can usually be seen in our Medicine Man gallery. Bloodletting is the practice of making a small incision in someone’s veins to let the excess of blood out (not arteries: the patient would bleed do death within seconds).

An English Scarificator with six lancets.

Can someone have “excess” blood? If you believe in the theory of the four humours, or humorism, then yes. Ancient Greeks and Romans mapped their understanding of human health and the body on their understanding of the universe. For them the harmony in the universe was maintained by the right balance of the four elements (air, water, fire and earth) and the four seasons (hot, dry, cold and wet). Similarly, good health was ensured by the right balance of the four humours, or body fluids, within our body: blood, phlegm, black bile and yellow bile.

In the 2nd century AD, when Galen discovered that arteries carried blood, as opposed to air (as it was believed until then), there developed a need to “purge” the excess of blood previously not accounted for. From that moment, the practice became very popular and remained so until the 19th century.

During the 1800s, the practice of bloodletting was extremely fashionable in Europe, particularly in the UK, where people in good health were bled as regularly as they went to the market. It was considered a preventive action to boost your health, not dissimilar to drinking fresh orange juice or a yogurt type drink every morning today.

Another popular method of bloodletting was to use leeches. By 1830 France imported about 40 million leeches every year for medical purposes and in 1840 England imported 6 million leeches from France alone for the same purpose. The practice lost favour in the 19th century when doctors and researchers started questioning what the actual beneficial effects of bloodletting were. However, other inefficient and harmful treatments were still available, such as potions and tonics.

Pharmacy leech jar.

Today, bloodletting (or phlebotomy) is still practiced to cure specific illnesses such as haemochromatosis (iron overload) and polycythemia (high blood volume).

Muriel is a Visitor Experience Assistant at Wellcome Collection.

Putting the art into “tart”: Live Twitter Q&A

One of the most exciting #MuseumWeek themes is #AskTheCurator. Stephen Lowther, the Wellcome Library’s Ephemera curator, will be joining us for a live Twitter Q&A Friday 28 March to answer questions about the Library’s notorious collection of ‘tart cards’ – those naughty calling cards found in telephone boxes. Submit questions in advance below or join us on Twitter on Friday 12.00-13.00 GMT to ask your questions live.  Here’s a bit of background about the collection from Stephen to get you started.

Among the various collections in the Wellcome Library, the printed medical ephemera collection aims to complement the more academic and mainstream collections of books, journals, archives, prints and paintings. By ‘ephemera’ we mean anything published as a standalone single sheet, whether informative, educational, functional or advertising.

We have many works on sex, gender, sexually transmitted diseases, AIDS, sexuality, sexual problems and sexual psychology. In 1991, the Wellcome Library (on the Euston Road) was in the middle of London’s sex trade (King’s Cross, Baker Street, Mayfair) and local telephone boxes housed an ever-changing selection of photocopied, coloured cards advertising prostitutes’ services. It made sense that we preserve some of these for posterity, building up a chronological document telling the story of what was being offered and who was offering it, as well as the evolving design and reproduction of the cards themselves. The ephemera collection now houses about 4,500 cards (from 1991 to the present day) in 20 box files.

A selection of the cards from the collection.

Design changed from borrowed, photocopied and hand-drawn images with dry transfer Letraset type through to the full colour, digitally produced cards that appear today. The first colour ones we have appeared as one-offs in 1992, with colour becoming standard by late 1996. Black on day-glo card was popular in 1993. Desktop publishing arrived in the 1990s and photocopying moved to print in about 1994. Nipples in photographs were blocked out by coloured stars (so as not to offend public decency, one assumes) until 2012, when the first nipples began to appear.

Trends are quite apparent. For instance: transsexual prostitutes appear from about 1999; and ethnic-minority prostitution increases (possibly reflecting trafficking of young women, which became much more common after about 1999, although Asian and black women were apparent from the start of our collection). There are students (paying their way through college?), and teams of two or three young women advertising “lesbian” sex (2007). Interestingly only four men feature in the collection (West End Luke, Naughty Jason, Man-to-Man Dave and Man-to-Man Grant), around 1994, the men preferring to advertise in the back of the weekly gay free press at the time.

A selection of the cards from the collection.

Staple services included ordinary sex (“Roses are red, violets are blue, St. Valentine’s coming and so may you” – February 1992), oral sex (Miss Deep Throat), electrocution (“Get a BUZZ at Madame Electrique’s”), ‘schoolgirls’ (“Naughty schoolgirls want some fun, dress me up and spank my bum”), spanking, whipping (“No school dinners here, only lashings of discipline CORRECTLY GIVEN”), domination (“human doormat required” and the Venus Man Trap), bondage, cross-dressing (“Femininity found”), “rubber rumpus with Madame Sin” and Naughty Sammy Nipples.

The landline numbers advertised were cut off and replaced with others (and others…), but the mobile phone crept in and is now standard on all cards. The business is also shifting online as phone boxes become less commonplace. Cards advertising websites (e.g. “girlsinthebox.com”) appeared about in 2009.

One of the hand-drawn varieties of card.

The cards have become part of London’s colourful social landscape. Tourists take photographs of them (as well as taking a few cards as souvenirs), children have actively collected them and swapped them in the playgrounds (like Pokemon cards, only you didn’t pay for these). Westminster Council has passed laws outlawing them and despite officials going round removing them on a daily basis the cards still appear with relentless regularity.

A full history can be found in Caroline Archer’s successful book ‘Tart Cards’ (West New York, NJ: Mark Batty, 2003).

Any questions? Join us on Twitter on Friday 12.00-13.00 GMT to ask your questions live or leave a comment below.

Stephen Lowther is an Assistant Librarian (Cataloguing) and Ephemera curator at the Wellcome Library. To see the full collection, just join the library. Check out the Wellcome Library blog for more articles about the resources and information available.

Around the world in 80 days: Filming Art and Global Health – Part 1

Over the course of four months, Barry Gibb visited our major overseas programmes in Africa and Asia to make a film about Wellcome Collection’s Art and Global Health project. In the first of his journal entries from the trip, Barry discusses how the project came about and how a filmmaker plans a shoot spanning 6 countries.

In the latter half of 2012, I was asked to take part in something extraordinary.

Art in Global Health sees six sets of artists selected to take up residency in each of the Trust’s major research centres across the world. Danielle Olsen, curator of this ambitious venture, was looking for ways to somehow record their progress, their artistic process as they immersed themselves in the research centres, the science and scientists.

We discussed various possibilities, several of which she had already initiated, such as blogging, audio or video diaries. Then she mentioned the possibility of making a film, a globe-trotting visual delight, filled with art, science and exotic locations – a fantastic way to reveal the artists, the scope of what they were trying to achieve and the cultural nuances of each location. What I wasn’t quite prepared for was the moment Danielle casually asked, ‘So, will you do it?’. How could I refuse?

Of course, it’s never that simple. Working in any large organisation, on a project of this scale, you quickly discover there are layers of protocol and bureaucracy. This was, potentially, a massive additional undertaking alongside my usual work, involving visiting six different countries and six different institutions around the world: Kenya, Malawi, South Africa, Vietnam, Thailand and Germany. I’d be out of the office for weeks.

Soundtracking the past

Bermondsey Borough Council’s innovative interwar public health work is on display in our ‘Here Comes Good Health’ exhibition. But what do these films look like to young people today? Alexander Green joined the Cuming Museum’s Youth Panel as they set out to create a new soundtrack to one of Bermondsey’s silent films.

One Friday lunchtime during February half-term I found myself anxiously waiting with Wellcome Trust colleagues from the Youth Programme and Wellcome Library in Walworth town hall, Southwark. In collaboration with the Cuming Museum, we had organised an open workshop for young people to come along and create a new soundtrack for one of the Wellcome Library’s newly acquired and digitised health education films made by Bermondsey Borough Council. We were confident that a few of the regular members of the Cuming Museum’s Youth Panel would give up a day of their holidays, but were still unsure exactly how the day was going to come together.

The Bermondsey films were produced in the 1920s and 1930s by Bermondsey Borough Council’s Public Health Department. Shown to thousands of people across the borough for over 15 years, the films aimed to educate the public about the importance of health and hygiene and encourage uptake of medical services and treatments. Here Comes Good Health!, a display about the health education efforts of the borough is currently running in Wellcome Collection until 3 June 2012.

We began the day by investigating the context in which the Bermondsey films were produced. Reading through original sources, including leaflets and newspaper clippings provided by Southwark Local History Library, we developed a bleak view of conditions in Bermondsey at the time. One report spoke of an “all-night war with rats”, while others described terrible conditions of overcrowding with multiple families sharing the same room. We then watched the film Some Activities Of Bermondsey Borough Council and discussed the council’s work to try to improve health; how new medical facilities were developed for the people and how the borough’s Medical Officer of Health, Dr D M Connan, saw education as central to the improvement of  health.

While watching the films we talked about how they can seem quite distant from our lives today. Not only do they present a very different vision of urban life to the one we are familiar with, but the modes and conventions of representation in the films distance us. To a modern audience the pacing seems slow, the intertitles remain on the screen for a long time and – obviously for this period in film history – there is no colour or sound. Watching the films in a silent darkened room can often be quite a sombre experience. However, these films were never originally shown in silence; the film programme was introduced by a member of the Public Health Department and while the film was rolling the audience was free to ask questions, converse or interject. Contemporary reports even describe children making up tunes  to accompany the intertitles! The films were also presented in informal settings, not just in school halls and cinemas. Projected on the back of the touring cinemotor vans they were shown all across the borough, from courtyards and street corners to playgrounds. In the late 1930s soundtracks were created for some of the Bermondsey films using a specially purchased gramophone recorder; however, these have now been lost.

With this in mind, the Youth Panel decided they would create a similarly lively atmosphere in their soundtrack. They devised a concept around showing the film to a contemporary group of students, questioning and reacting in the same way schoolchildren might have done when the films were originally shown. The film we were working with was Where There’s Life There’s Soap. Aimed at a younger audience, the film combines comic moments, such as a man with a boil bigger than a chicken egg, with shots of animals from London Zoo washing to illustrate the importance of personal hygiene and cleanliness. In their soundtrack the Youth Panel worked to bring out these comic elements and recapture some of the lively atmosphere that would have characterised the film’s reception.

Throughout the day the Youth Panel members displayed an amazing level of energy, focus and engagement. Even with this level of commitment, it was still an ambitious project to complete in a day. The original film had a running time of 18 minutes but we felt that was too long for our purposes. We created a special short, cut-down version of the film which had a running time of around 5 minutes, while still retaining much of the comedy of the original. Despite this, after checking the time while recording, we only had 45 minutes to go with a third of the scenes left to cover! Fortunately, thanks to a brilliant final effort, and a last-minute deadline extension, we managed to wrap up just in time, having produced an interesting and engaging soundtrack that the Youth Panel members can be justifiably proud of.

The Youth Panel members were Toyin Ayedun, Rose Stephens, Tejiri Cousin, Karen Serwaya Gyebi-Ababio and Fitzroy Ugorji.

Elvie Thompson runs the Cuming Museum’s Youth Panel; they meet at the museum on alternate Saturdays. Aimed at young people based in Southwark and aged 13 to 19 years, anyone who is interested in meeting new people and learning new skills should get in touch on 020 7525 2332.

Stanley Green is a graduate trainee at the Wellcome Trust. Here Comes Good Health is on display at Wellcome Collection until 3 June.

Here Comes Good Health: Health and Clothing

Here Comes Good Health! is a new exhibit at Wellcome Collection about the health propaganda films made by Bermondsey Borough Council in the 1920s and 1930s. In their attempt to create healthy lives for Bermondsey’s residents, the borough’s health department touched on subjects well beyond germs and medicine. Patricia Dark looks at a film that’s all about what you wear.

The Wellcome Films YouTube page describes Health and Clothing (1928), one of the Bermondsey Borough Council public health films, as ‘mildly diverting’; at first glance, from more than 80 years’ distance, it seems a generous description. It opens with shots of kittens and of a baby in the arms of a district nurse: as the caption notes, animal babies are born dressed and human babies are born naked. Ponderous demonstrations of Tudor and Victorian women’s fashions follow, then a hapless toddler boy is stripped – twice – so his summer and winter clothes can be weighed and compared. Later scenes point out the properties of healthful clothing: light, warm, absorbent, loose, easily washed, non-flammable, and weatherproof. Sheep being shorn reinforce the point that wool is the fibre of choice. Finally, the film extols the virtues of modern fashion: healthy, cheap, and easy to make at home.

It leaves modern viewers with more questions than answers. Why is Health and Clothing so overwhelmingly feminine? What does clothing have to do with health? Why would the public health department advocate fashion? The answer lies in the background to the films: Bermondsey itself, and the conditions in which many viewers lived. Clothing and cleanliness, like almost all aspects of household life, was a feminine concern. Even for women who worked outside the home, keeping a clean, tidy, respectable house was a priority. The film’s particular stress on light, simple, easy-to-care-for clothing – especially for small children – would resonate with its audience.

Bermondsey’s housing stock conspired against the borough’s housewives, even years after Health and Clothing was released: much of it was wretchedly overcrowded and appallingly unsanitary. A Daily Express reporter found a family of seven living in one room eight feet square in 1924: a passage two and a half feet wide provided space to dry washing. Howard Marshall of the Daily Telegraph visited Cherry Gardens Pier in 1933: he found 4 families – 18 people in total – living in five rooms, with one tap between them. In 1939, the News Chronicle reported that Wolesey Buildings provided a single sink for 4 families – up to 30 people – that provided each family’s cooking, bathing, and washing water. Wolesey Buildings did have a communal washhouse, but it was derelict. Housewives there, as elsewhere in the borough, either did laundry in their tiny, overcrowded flats or spent more money to send it out to a laundry.

In these conditions, as the Daily Express put it, “[c]leanliness [was] utterly impossible; decency [was] utterly damned”. Dirty clothing irritated skin and provided perfect breeding grounds for parasites like body lice, which transmitted deadly diseases like typhus. But it was also demoralising – a tangible sign of the all-too-often futile struggle of the “honest…ambitious, God-fearing” people of Bermondsey against misery and despair. For the reformers of the Bermondsey Borough Council, clothing was a symbol: of the decent conditions everyone deserved to live in, and of the dignity and decency of the working class.

Snide stereotypes and cheap jibes were simply wrong – given the opportunity, the residents of Bermondsey took as much pride in their surroundings as more prosperous Londoners, and worked harder to beautify their homes and themselves. In 1930, an Evening Standard article called Bermondsey “[t]he most optimistic place in London”; alongside the riot of flowers in windowboxes and front gardens, the reporter singled out the “factory girls…” who “wore their trim little coats and their close-fitting frocks with what the modistes call ‘an air’.” Peter Ritchie Calder of the Daily Herald visited the Vauban estate – once one of the worst slum areas in the borough – in 1934. His report fairly glows with cleanliness – a young mother wearing a “spick-and span overall” hanging out “spotless” laundry on the drying-green, an elderly lady’s white lace curtains – and the power of pride, belonging, and the “moral pressure” of respectability.

Health and Clothing, then, is more than a mildly diverting film, or even a didactic one. At its heart, it is a celebration of the modern: modern dress, modern ideas, and a modern Bermondsey that its residents can be proud of.

Dr Patricia Dark is Local History Library and Archives Manager at the Local History Library, Southwark Culture.

The Bermondsey Borough Council films have been recently digitally remastered with material preserved by the British Film Institute and form part of Here Comes Good Health!, an exhibit running at Wellcome Collection from 22 February to 3 June 2012 together with other health educational materials. The films and photographs in the display have been supplied courtesy of Southwark Local History Library and Archive. For more details contact Southwark Local History Library and Archive, 211 Borough High Street, London, SE1 1JA. T: 020 7525 0232 E: local.history.library@southwark.gov.uk.

Find out more about the Wellcome Library’s Moving Image and Sound Collection by searching our digitised film, video and audio or visiting the Wellcome Film YouTube channel.

Here Comes Good Health!

Today sees the opening of Here Comes Good Health, a new exhibit at Wellcome Collection about the health propaganda films made by Bermondsey Borough Council in the 1920s and 1930s. Above, you can watch one of the films on display: Some Activities of Bermondsey Borough Council (1931). Angela Saward tells us more about the work of a pioneering London council.

This film was made as a comprehensive cinematic catalogue of the public health and social welfare efforts of the London borough of Bermondsey, situated to the South East of the city. Selected films were back-projected from the rear of a cinemotor van (in the first instance a converted disinfection van) as well as other public locations such as schools, clubs and other institutions. The cinemotor appears at the end of the film. Evidence suggests that their reception was at times rowdy: the vans were gaily painted and children would cheer at each slide.

The catchy intertitles encouraged audience participation; Where there’s life, there’s soap (1933) was written in poetic doggerel and was all about the benefits of good versus bad personal hygiene. According to the annual Ministry of Health report for Bermondsey of 1937, the films held by the borough had an audience of 42 464 people that year (the 1931 census put the total population at 111 000 inhabitants). The same films were shown repeatedly and became a familiar fixture to many local people.

Health propaganda in terms of education and general awareness was considered to be key in moderating bad and promoting good health. It could be a matter of choosing life over death and people needed to actively engage with the available health prevention measures.

Evidence from an intertitle in the film suggests that the death rate reduced from 21 people per 1000 to 13 within a 30 year period. In fact, after 1911, the trend in England & Wales was for a reduction in mortality rates overall Mortality rates in 2001 were very similar to those of the 1930s even taking account of boundary changes (Bermondsey is now part of Southwark), and population numbers dropping after the Second World War.

It’s hard to pinpoint exactly which initiative had the greatest impact between 1920 and 1939, the hey-day of Bermondsey’s civic activity as there was such a panoply of universal free services available to the local population. At a time when universal healthcare was exceptional, Bermondsey offered the hard-working population engaged in its dockyards and factories  maternity welfare, dental surgeries, a solarium (artificial sunlight treatment), a tuberculosis dispensary and a foot clinic. These are all shown in session in the film. Other amenities such as regular refuse collection are presented as well as an electricity showroom which extolled the virtues of ‘clean’ energy with the demonstration of vacuum cleaners and electric cookers available for hire.

This genre of film-making is explored in greater depth by Elizabeth Lebas in her book which surveys municipal film, Forgotten Futures: British Municipal Cinema 1920-1980. There is a chapter devoted to Bermondsey, “When Every Street Became a Cinema”. Lebas describes  the  prevailing ideology as “missionary as well as socialist”; the Public Health Department was staffed by social visionaries and also very ‘hands-on’ men and women. Indeed, rather than hire a professional, commercial organisation to script and shoot, resident radiographer, Mr C. F. Lumley took the role of cameraman in a number of films. (A compilation of films of a more amateur nature attributed to him shows important events of 1937 and 1938.)

The films were, at least originally, silent and have been edited together using simple, no frills editing. Illustrative scenes are intercut with explanatory intertitles in between. The intertitles are onscreen for a long time; perhaps to encourage debate and discussion but also, perhaps due to lower literacy levels of the time.

The films have been recently digitally remastered with material preserved by the British Film Institute. The films form part of the plethora of health educational materials across a selection of media; illuminated ‘propaganda tables’, electric signs flashing warnings, leaflets and pamphlets all used in the service of the Public Health Department of the borough. A selection of these, together with the four films highlighted in this series, will be running at Wellcome Collection from 22 February to 3 June 2012.

Angela Saward is Curator, Moving Image & Sound, Wellcome Film

The films and photographs in the display have been supplied courtesy of Southwark Local History Library and Archive. For more details contact Southwark Local History Library and Archive, 211 Borough High Street, London, SE1 1JA. T: 020 7525 0232 E: local.history.library@southwark.gov.uk

You can learn about the Wellcome Film project on the Wellcome Library website . If you would like to make use of this archive footage in your own projects, please visit the Wellcome Library catalogue to download the original files, which are distributed under a Creative Commons Attribution-Non-Commercial 2.0 UK: England & Wales licence.

Solutions for a sick city

Solutions for a sick city?

London played a very important role in the history of hot air ballooning, but when we gather at Wellcome Collection for a balloon debate, it’s not to extol or denigrate the virtues of this early form of human flight. Rather, we take an important problem, invite four speakers to each put the case for one solution or priority, and then allow the audience to vote them out, one by one, of an imaginary balloon which is losing height, leaving one victor at last.

Last week, the issue was public health priorities for London. During the week, on this very blog, each speaker had been given a chance to make their point, On Thursday night, the four came together, chaired by the BBC’s Home Editor, Mark Easton, to put their case to a live audience. Each speaker was given just ten minutes to get the facts and their argument across.

Round one

In the first round, Paul Farmer, chief executive of Mind, supported the case for putting mental health first, an invisible but widespread problem that underlies other health issues. Over 30 per cent of London residents have experienced mental disorders, 19 per cent have had suicidal thoughts and 11 per cent have attempted suicide. More time is lost at work through mental health issues than through musculoskeletal disorders. Worse, 90 per cent of people with mental health problems have encountered stigma and discrimination at work and in society at large. Mental health needs to be at the centre of a virtuous circle of changing attitudes, Paul argued.

Bobbie Jacobson argued for taking on child poverty. We all were children once, and 56 per cent of London’s children today are prevented from living a full participative life due to poverty. Even the richest London borough is without pockets of abject poverty. Any map of health problems is a map structured by an underlying map of poverty. Merely raising awareness of the problem without suggesting a solution is pointless, argued Bobbie. Her solution is the London Living Wage, a London-specific minimum wage of £7.85/hour, which takes into account the higher cost of living in London. There are half a million businesses in London, and all of them need to pay the London living wage.

Ajit Lalvani made the case for tackling tuberculosis, a medieval scourge that many might be surprised to find on the agenda. TB was the only threat presented to the audience that is an infectious disease. We might think of ourselves as beyond the age of cholera, but SARS, also a respiratory disease, caused 2 million deaths among 9m cases worldwide in its recent outbreak. London is the only western European capital with rising rates of TB, which is acquiring drug resistance and can kill in as little as 16 days. Latent TB, which can show no symptoms, is a silent killer – the full scale of which is unknown.

Finally, Alan Maryon-Davis proposed childhood obesity as London’s biggest health challenge. At current rates, by 2025, half the male population of London will be clinically obese. Overweight children are not only subject to teasing and low achievement at school, but massively increase their risk of ill-health from heart disease, diabetes and cancer, reducing their life expectancy by the same amount as smoking. In order to avoid a generation of children dying younger than their parents, we need to promote both healthy physical activity and better awareness of healthy cooking. Southwark, for example takes local kids to Borough market to learn about fresh food.

Such groundbreaking activity cut no ice with the audience. They raised their green cards and voted Alan out of the balloon. The remaining three speakers were then given four minutes each to develop and expand their position.

Round two

Ajit then outlined a course of action to fight TB: an outreach programme of mobile chest x-ray units to target the poor and homeless, who are most at risk. Improved tests on sputum can detect latent TB at much improved rates. These new diagnostic tools are already at risk from cuts and have to be saved.

Bobbie argued that Paul’s proposal offered no strategy for dealing with mental health, and that previous efforts to fight TB had been successful primarily because they housed and fed the homeless. She admitted that the London Living Wage couldn’t solve the problem of workless poverty, but rather would kick-start a bigger fight.

Paul argued that there were indeed concrete solutions for mental health. Mind’s Time to change campaign tackled stigma, working with teachers who are at the sharp end of fighting discrimination, and achieved improvements in public attitudes with very little public money. He questioned whether poverty was really a public health issue at all.

The final round

Mercilessly, the audience raised their cards, and voted Ajit and TB out of the balloon, leaving mental health and child poverty in the final face off. Bobbie read from an Evening Standard article by David Cohen, which describes burying the children of London’s poor in unmarked communal graves. Paul offered his respect for the fight against child poverty, but argued that ultimately it wasn’t a public health issue; the opportunity to make London a happier, and therefore, healthier place was unmisssable.

Before the audience got their chance to put questions directly to the remaining panellists, Alan and Ajit were asked who they would vote for: both plumped for mental health.

From the floor, Paul and Bobbie were asked what measurable improvements they could offer against their challenge. Bobbie answered with a reduction of a third in child poverty; Paul suggested a 10% shift in attitudes towards mental health. Another questioner wondered to what extent solution for London could be a blueprint for other cities. Paul answered that in fact much of Mind’s campaigning has been inspired by a similar effort in New Zealand; Bobbie suggested that we could, in fact, look to other countries like Cuba, where equality and healthcare are taken much more seriously. The question of whether small businesses could afford the London Living Wage was also raised; Bobbie answered that, as with elsewhere in the world, it was possible.

The audience was asked to choose one final time, between the state of poverty and the state of mind. Your humble blogger, who can now reveal that he was voting for Bobbie and child poverty down the line, had suspected throughout that it would come down to these two, and felt sure child poverty had an unanswerable case.

It did not, and the audience ultimately decided that mental health was London’s number one public health priority.

If you’re inspired by the audience’s decision, why not get involved with Mind, and start changing attitudes? If you disagree, the comments thread below is open for your thoughts. On this blog  we’ve enjoyed playing host to an interesting and vital debate, but now it’s over to you.

Sick City: Mental health

 

Mental health. Wellcome Images

 

Tonight, Wellcome Collection presents Sick City, a balloon debate in which the audience decides public health priorities for London. Four speakers each propose a problem which they think demands our resources and attention. This week on the Wellcome Collection blog, we present a brief introduction to each speaker’s priority. Join the debate using the comments below, or come to the event to help make the decision.

Paul Farmer will put the case for mental health as London’s most urgent health challenge.

Quite simply, mental health is the greatest public health issue facing London, yet it is one of the most ignored.

The facts are clear:

• One in four Londoners experience mental health problems;
• The World Health Organisation identifies depression as a growing mental health issue, becoming the biggest issue by 2020;
• 90% of people who have a mental health problem experience stigma and discrimination as a result;
• The recession has had a major impact on our mental health, with a steep increase in the prescription of antidepressants.

We need to act on this quickly. It does not have to be like this.

What can we do:

• Public education campaigns to tackle stigma and discrimination are already having an impact, but more needs to be done;
• We can and should treat our mental health in the same way as we treat our physical health – with preventative approaches;
• Timely access to effective services, such as talking treatments, provides effective help and further destigmatises mental issues.

Paul Farmer has been Chief Executive of Mind, the leading mental health charity working in England and Wales since May 2006. He was a co-author of Realising Ambitions, an independent review for the Department for Work and Pensions  (DWP). He is a member of the Improving Access to Psychological Therapies (IAPT) Programme Board, Care Quality Commission (CQC) Mental Health Board and Chair of the Disability Charities Consortium. He is also a member of the Centre for Social Justice Mental Health Inquiry.Before becoming Chief Executive of Mind, Paul was Director of Public Affairs for Rethink and was Chair of the Mental Health Alliance from 2001-06.