War, colonialism and medicine

War, colonialism and medicine


Leo van Bergen is a medical historian who has spent his career chronicling the history of health and humanitarianism in warfare.


In 2009 Van Bergen was awarded the J.A. Verdoorn-prize for his work, and his upcoming book A Cap of Horror will feature a collection of poems  written on the First World War by nurses and carers.


For more of his books, articles and columns, visit www.leovanbergen.nl , or view his ResearchGate profile here


Hello, and welcome to ResearchPod. In this episode, we cover the work of Leo van Bergen in chronicling the history of health and humanitarianism in warfare.

A mass of human wreckage, drifting in

Borne on a blood-red tide,

Some never more to brave the stormy sea

Laid reverently aside,

And some with love restored to sail again

For regions far and wide.

In her poem ‘The Military Hospital’ nurse-poet Vera Brittain poignantly grasped the dilemma of medical wartime care: the wounded were healed only to see them off to fight again, or: to kill or be killed. This is at the heart of what Dutch medical historian Leo van Bergen investigates: medical work in contexts of power inequality, contexts of power versus powerlessness, contexts such as war or colonialism. Or, medically speaking: care given by colonial doctors to colonised patients or by officer-doctors to soldier-patients. He is a researcher at the Leiden University Medical Centre and co-editor of the Taylor & Francis-journal Medicine, Conflict and Survival, (formerly: War and Medicine) a journal publishing on the health aspects of violence and human rights in a broad sense.

Van Bergen began as a historian of war and peace, but his interest was mainly reserved for what damage war did to the bodies and minds of those engaged in it. At the end of the nineteen eighties this automatically led to an interest in what aid was given, humanitarian and military. The medical historian was born, starting his career in 1994 with a PhD on the Dutch Red Cross. A great number of books and articles on the history of the relationship between war and medicine and colonialism and medicine would follow. In 2009 Van Bergen was awarded the J.A. Verdoorn-price for his work on war and medicine.

Whatever your position on war is, it certainly is good for medicine. And whatever you may think of colonialism in Western colonies medically speaking a damned fine job was done. These are two commonly heard statements Van Bergen disputes. He points out that medical care is not in itself ‘a good thing’; a ‘humanitarian thing’. This depends on the reasons behind the aid given; the goal aid is aiming to achieve.

In his PhD Van Bergen showed that the Dutch Red Cross was in fact more a military than humanitarian organisation. Brought to life by King William III, it from the beginning was a conservative organisation, filled with nobility and military men, obedient to the Dutch government and aimed more at keeping up fighting strength than taking care of wounded soldiers regardless of their nationality. The so-called peace-work started at the beginning of the twentieth century because it had dawned upon the board that without it the organisation would never be able to fulfil its task in wartime: giving medical aid to their own, national army and fleet. Especially the chapter on the Second World War – showing that it had taken part in the Nazi-prescribed anti-Jewish blood transfusion measures and proudly equipped an everything but neutral ambulance for the SS-Eastern front volunteers – gained a lot of attention. It was followed by a book on the Dutch Indies Red Cross, adding colonial power structures to the already problematic and overwhelming situation of trying to save lives in a situation directed at taking lives.

His most famous book – a history of the First World War concentrating on the suffering, the diseases, the wounds, the dying and the medical care given to the soldiers on both sides of the Western Front – first appeared in the Netherlands in 1999. Ten years later an English translation followed entitled: Before My Helpless Sight, a sentence from Wilfred Owen’s famous poem Dulce et Decorum, in which he made short work of the old saying that it was sweet and honourable to die for the Fatherland. Because of this book he was invited to write the chapters on ‘military medicine’ of both the Cambridge University History of the First World War, and the Online Encyclopaedia of the First World War of the Freie Universität in Berlin.

As already mentioned, one of the recurring themes in books on wartime aid is the goodness of it for medicine. Because of experiments, inventions, training, more and more soldiers were spared and after the war this would be of great benefit to sick and wounded civilians. Van Bergen doubts this very much. Circumstances differ, goals differ, means differ, illnesses and wounds themselves differ too much in war and peacetime for war medicine to really have an impact on medicine in general. It is likely to be the other way around. Speaking of the First World War, wartime medics applied what they had learned only adjusted to the new situation. Furthermore: if there had been any benefit, this applied to branches of medicine benefitting warfare such as surgery and psychiatry. Other branches, branches focused on civilians, and especially women, children, the elderly, had a hard time. Thirdly: any benefit was a mere by-product of the real goal: keeping up fighting strength and morale. In his article in the Palgrave Handbook for the History of Surgery, ‘Surgery and War’, he not only states that the phrase was a myth created after 1918 by doctors trying to make medical sense of their work during the previous war, but also that the phrase should in fact be turned around twice: medicine is beneficial for war, peace is beneficial for medicine.

In his work on the Dutch Indies Red Cross in general and on the humanitarian and military medical aid during the war of decolonisation in particular, he makes clear that the aid delivered was military to the corps, not only the aid given by the military health service, but by the Red Cross as well. For instance: during the war in Aceh [[pronounced A! Chey]]

from (1870-1910) aid was completely adapted to the needs of the Dutch forces (and within those forces the Dutch or Indo-European soldiers were given cigars and the indigenous soldiers tobacco with straws). During the war of decolonisation (1946-1949), the military doctors gave preference to their military oath sending soldiers to battle although they knew they actually were anything but fit enough to engage in such an operation. They knew that if they gave preference to their Hippocratic oath, the war would soon be lost because of a lack of fighting strength.

Furthermore: when men committed atrocities it was said that the war was to blame and especially atrocities committed by the other side, while war was never to blame for the abundance of neurotics, deserters, objectors; in those cases fingers pointed at ‘character weakness’. Medicine – be it humanitarian or militarily, the line between them was vague at best – was declared to be the ‘carrot’ in a carrot and stick strategy. Apart from never being enough – even the aid to Dutch soldiers was grossly inadequate – lending aid to sick and starving indigenous inhabitants was not a medical goal in itself, but a means to a goal: trying to get the population back on the Dutch side. As a Red Cross-manager said, not noticing the discrepancy: ‘Giving aid is a humanitarian and national task’. In general: medical aid had maintained or even strengthened the colonial system. Medical aid was not in the first place given out of humanitarian reasons but was an instrument for strengthening or repairing colonial relations.

Van Bergen is now working on a book called A Cap of Horror – after a line in a verse of Mary Borden – containing 50 poems of 17 different First World War-nurses and carers; hence the opening lines written by Vera Brittain. It contains poems – translated by him into Dutch and the original English ones – praising the work done but also poems at least hinting at the downsides of it all: repairing men because there is a war to be won. Poems outlining the impact the enormous amount on violence had on the nurses. Poems problematising the fact that this violence was executed by men while the healing was done by women, resulting in severe gender-issues. These men were also brothers, friends, lovers. And they died. Longing and loss are therefore two other characteristics. And where there is loss and longing there is nostalgia: during the war for better times before, and after the war for the war itself, for these were years in which for the first time women had had the idea they had really made a difference. However, without the violence that defines war, there would have been no nursing, no nostalgia, no loss. It therefore is fitting to end with a poem on violence. It is called ‘Battlefield’ and is written by Lilian Helen Bowes Lyon, a niece of the wife of King George VI.

Men in their prime,

Boys venerably young.

With all-unfaded brows, died here upon a time;

So heavy a wrong—

How may this black world right who trod them into slime?

Still must pour milder suns,

Splintering the stained glass window of a wood,

Be darkly seen through these men’s blood

And midnight mutter in her sleep with guns.

To read more of the books, articles of columns of Leo van Bergen, visit his website, Leovanbergen.nl . Thanks for listening, and stay subscribed to ResearchPod for all the latest science. See you again soon.

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