Marie Clark Nelson, institutionen för studier av samhällsutveckling och kultur (ISAK), Linköpings universitet

Projektet har hittills resulterat i ett antal presentationer vid svenska och vid internationella konferenser som är redovisade under publikationer. En uppsats skall publiceras i en antologi under våren 2006. Omvandlingen av konferensbidrag till publicerbara artiklar har försenats av en stor operation som orsakade en tre månadslång sjukskrivning och allt detta innebar. Det finns tre olika saker som skall bli klar de närmaste månaderna: 1) tre tidsskriftsartiklar som är under bearbetning (på engelska); 2) bokmanuset som beskrivs nedan; samt 3) två artiklar på svenska.

Beskrivning av boken och dess innehåll:

Meeting Disease in the Modern World: Sweden and the International Struggle against Disease in the Late Nineteenth and Early Twentieth Century (preliminär titel)

Part I. Out in the World
Chapter 1 - Diseases Respect No Borders - Introducing the Problem
Chapter 2 - Sweden and the Sanitary Conferences
Chapter 3 - Other Conferences
Chapter 4 - Summer courses and study trips

Part II. Development of Policy
Chapter 5 - The Public Health Act of 1874
Chapter 6 - The Revision Debate
Chapter 7 - The Public Health Act of 1919
Chapter 8 - Legislation on Epidemics

Part III. A Small Country in a Big World - Conclusions
Chapter 9 - Disease, Diplomacy and Policy


Synopsis:

The first four chapters (Part I) deal with defining the problem studied, and discussing Sweden's participation on the international medical scene in the late nineteenth and early twentieth centuries, whereas the second part (Part II) discusses the development of health policy within Sweden. Studies of public health and disease have often neglected the interplay between the diplomatic game at the international level and the development of health policies within an individual nation. Part III presents the conclusions of the study.

Part I. Out in the World

Chapter 1 - Diseases Respect No Borders - Introducing the Problem
The first chapter traces the relevant literature in the field, defines the problem and discusses the points of departure for the study.

Chapter 2 - Sweden and the Sanitary Conferences
In the mid-nineteenth century the countries of western Europe and the Ottoman Empire banded together to attempt to deal with the threats of various infectious diseases through extended meetings, which came to be referred to as the Sanitary Conferences. Focus initially was on plague and cholera that were the most important diseases of that period, at least for the initiators. While emphasis was first on the Mediterranean world and the Near East, the participants soon expanded to include most European nations as well as the Americas. Sweden first joined the assembly by taking an unassuming role in the 1866 conference in Istanbul. These conferences were both diplomatic and scientific to their nature, and the delegates were expected to represent these two worlds. Thus health policy was not merely a scientific matter, but even part of the political sphere. The second chapter deals with the sanitary conferences per se and the role that Sweden played in these gatherings.


Chapter 3 - Other Conferences
The third chapter deals with other conferences that Sweden participated in during this age of gigantic gatherings made possible by new methods of travel and communication. Sometimes these were medical conferences, or they might also deal with statistics, military medicine, the "abnormal" or other fields. Although most participants were medical professionals, this was not always the case. The exchange of ideas and knowledge was important in the rapidly changing Europe that was emerging into the modern world.

Chapter 4 - Summer courses and study trips
Another dimension that was extraordinarily important for the medical profession for their maintenace of an international status and their introduction into the new, "modern" medicine (e.g., bacteriology, hygienics and psychiatry) was participation in summer courses and the undertaking of extended study trips abroad, which is treated in Chapter Four. Often (though not always) financed by the state, these trips were primarily taken to the German-speaking world. They were significant not only for spreading knowledge, but also for intitiating and keeping contacts with the continent. It is sometimes possible to see the direct adoption of ideas in Sweden, while at other times adaptations have clearly been made to Swedish conditions.

Part II. Development of Policy

Chapter 5 - The Public Health Act of 1874
Chapter Five deals with the development of the Public Health Act of 1874 in relation to conditions within the country and outside influences. The passing of this act took over ten years, and the discussions and controversies involved had roots in the major social debates of the day, both within Sweden and beyond the country's boundaries.

Chapter 6 - The Revision Debate
When after ten years, an accounting was taken of the degree to which the country's towns and cities had actually observed the letter of the law, it became obvious that revision was necessary. Early voices calling for revision became stronger as the century was drawing to a close (Chapter 6). The earlier concentration on the towns and cities had caused a reaction and a plea for a change of focus to the countryside. The changing nature of health problems, and the incorpration and application of new knowledge were also essential. The discontent led to the appointment of a national investigative committee that delivered its report in 1915.

Chapter 7 - The Public Health Act of 1919
Chapter Seven with the implications of the legislation that resulted from this report. A detailed approach to health became evident. The once omniscient, omnipresent law that was to cover all aspects of heath had now been revised and, above all, specified and limited. Not only was there specialized legislation to deal with specific problems (e.g. work environments, child labor, etc.), the focus was changed to purely domestic problems and strict limits were put on its field of action. This particularization of problems continued far into the twentith century.

Chapter 8 - Legislation on Epidemics
This section ends with a discussion of the development of the specific disease legislation, because of its prominent role on the international scene and in the Swedish mortality pattern in the late nineteenth century. The changing ways in which Sweden dealt with epidemics did not reflect the actual mortality patterns within the country.

Part III. A Small Country in a Big World - Conclusions

Chapter 9 - Disease, Diplomacy and Policy
Part Three ties the two parts of the study together and discusses the ways in which Sweden interacted in the international health work at the end of the nineteenth and the beginning of the twentith centuries. This chapter deals not only with how Swedish policy was informed by its international role. It also discusses the ways in which small nations act and react under the pressure of their interaction in the outside world.