Good Health as the First Line of Defence
Weidenfeld & Nicolson
Fighting Fit charts the development of the British government’s public health measures during the Second World War. Its well-researched and highly informative chapters are cleverly divided according to the different parts of the body, while following a largely chronological structure.
This study begins in 1939 with the threat to Atlantic convoys, dealing with issues of diet and rationing (‘The stomach for war’). It ends in 1947 when Regulation 33B, which had been introduced in 1942 to help control the spread of venereal disease, was repealed just as the National Health Service Act was about to come into effect (‘Black spots on pink bits’). Dawes argues that, to keep Britain ‘fighting fit’ for the war effort, the government not only mobilised women and men of working age in its various services, but also co-opted the entire civilian population, including housewives and children, as a means of keeping up morale while maintaining or even improving the health of the nation. As a result, a significant ‘gift economy’ developed, for instance around the need to supply and run the blood transfusion service, which extended across the Atlantic when, in 1941, as a diplomatic gesture of good will before the US entered the war, the American Red Cross collected blood from donors in New York hospitals for the ‘Blood for Britain’ project. Women’s institutes and associations also played their part. For example, the Silver Thimble Fund of the Women of India, a charitable organisation created in the First World War and with chapters throughout the Empire, donated money for a plasma drying plant and for ambulances, including two air ambulances aptly christened ‘Women of Britain’ and ‘Women of Empire’.
Schoolchildren were mobilised for a variety of purposes. After supplies of imported Japanese agar (a gel used for bacteriological testing and for making vaccines, pills and ointments) had been interrupted once the war had spread to the East, alternative sources of agar had to be found and harvested among the local species of seaweed (‘Immune defences’). As the most useful grew along the western and north-western coasts of the British Isles, between 1943 and 1945 young volunteers gathered tens of thousands of pounds of seaweed, which they sold to pharmaceutical firms and other organisations. Meanwhile – it later transpired – German pathological labs remained well stocked with Japanese agar thanks to the Reich being able to continue to import it secretly via submarine.
There was a darker side to the mobilisation of the British population, however, and that was the use of conscientious objectors in experimental treatments practised during the Second World War, from insecticides for de-lousing the infested hair of members of the women’s service branches, to research on scabies and scurvy. This sometimes involved inflicting unnecessary pain and suffering on volunteers, much like the research carried out by German medical doctors tried in Nuremberg after the war.
Fighting Fit reveals both unfamiliar and well-known facts. Some of these are disturbing, others comical, all conveyed with gusto by Dawes. Churchill’s eloquent speeches and stirring prose are a thread that runs throughout the book, as he saw the strategic importance of maintaining and improving the nation’s health. Thus, it is not surprising that the NHS inherited important elements of wartime organisation: a co-ordinated hospital service, a national pathology service and an integrated blood-banking system.
Unfortunately, some of the key lessons of the war were not learnt, or were promptly forgotten in its aftermath, in particular that to be effective public health should also consider community, diet, social class, mental health, preventative medicine and health in the workplace. These lost lessons were partly due to the medical profession, who resisted the intrusion of government into medical practice, but also to the growing belief that emerged from the very same war that most problems could be solved by biomedical science and high-tech fixes.
Viviane Quirke is Senior Lecturer in Modern History and History of Medicine at Oxford Brookes University.