Medical Humanities Award 2020: Learning from the past – Polio and vaccinations

In this new mini-series, we meet each of the winners of the AHRC Wellcome Trust Medical Humanities Awards 2020 as they share their winning projects. In our third post, we hear from Dr Dora Vargha, winner of the Best International Research Award, and Senior Lecturer in Medical Humanities at the University of Exeter. The AHRC Wellcome Trust Medical Humanities Awards 2020 celebrates the best of arts and humanities research that seeks to understand and transform the quality of life, health and wellbeing of the population.

I was thrilled to receive the Medical Humanities Award 2020 for Best International Research for Polio Across the Iron Curtain. This project has been long years in the making, on a road with many twists and turns, which led me to unexpected places, including this pandemic year.

I grew up with polio, and it has always been part of my life: my father contracted it in 1954 at the age of three. However, I never considered it as a possible object of research until I was in graduate school at Rutgers University. I was traveling home for Christmas, so I was thinking about my family and also about the task ahead of me to find a topic on the 1950s for a research seminar, and suddenly things fell into place. Images of muscular steel workers on communist propaganda posters, in tension with pictures of children in leg braces popped up in my mind, epidemic uncertainties and revolutions, vaccines and the iron curtain running across Europe. It was a kind of Eureka moment, I wanted to jump up and down and shout to the world ‘I’ve got it!’.  

To place something that had, until then, seemed like a natural part of my life under critical investigation opened new ways of thinking about disability, childhood, vaccinations and international collaboration in an era fraught with geopolitical tension. It led me to long years of research in an area that, at the time, had virtually no secondary literature, and not much previous research to build on. This meant more hours (days, weeks, years) in more archives, collections and libraries than I had ever anticipated, but it also forced me to approach my subject with creativity and to bring together fields that had not been in conversation previously. Finally, as someone working on an area that is often considered to be peripheral, I was always pushed to think about broader contributions that my research might have. This pandemic year it has become clear that historical research in general, and the story of polio in particular, has a lot to offer for thinking about current challenges.

Untangling the threads of the development and use of several polio vaccines during the Cold War, it highlighted that vaccines as objects are inseparable from vaccinations, and cannot be considered or understood as mere objects. They are complex technologies, which are embedded in social, political and cultural contexts, and most of all, are technologies of trust. This research also revealed that the politics of vaccination and research don’t always map onto political conflicts, and challenge the ways we think about geopolitical divides. For instance, the vaccine used currently in the global polio eradication programme was developed in an international collaboration between American and Eastern European (mainly Soviet) scientists. However, a more general mistrust in Soviet trial results, and the particularities of socialist healthcare systems led to the vaccine being wide-spread in the socialist world first. Thus, countries like Czechoslovakia and Cuba became polio-free years ahead of Western states.

Front cover of Dora Vargha’s book, Polio Across the Iron Curtain: Hungary’s Cold War with an Epidemic (Cambridge University Press, 2018)

While I was conducting interviews for this research, it struck me that there is a tension between regarding polio as a past disease in most of the world and with a definite endpoint in eradication efforts, and between the hundreds of thousands of people living with polio around the world, whose lives have been impacted by the way polio changed in perception, or how it has disappeared from medical training and practice. This tension brought me to think more thoroughly about the temporalities of epidemics, and what happens after an epidemic ends. This is not merely a historical question: how we think about epidemic narratives and endings has an impact on how we engage with a disease, what decisions we might make, and who and what might be left out of those decisions.

Time is the bread and butter of historians, who have the luxury of analysing fast-moving and complex crisis situations, such as epidemics, in retrospect. I had years to unravel the ways in which polio played out in families, hospitals, governments and international relations, and to explore the convoluted way people, technologies, knowledge and pathogens moved across them. This kind of analysis highlights questions, exposes underlying problems, and places into focus actors that might not be immediately apparent in an epidemic situation. Furthermore, historical thinking throws light on important trajectories that are crucial to understand – and tackle – public health issues, including disparities, vaccine uptake, political tensions in epidemic management, etc.

The importance of thinking about the past as part of an effort to plan for the future has been increasingly recognised by public health practitioners and policy-makers. This year, I contributed to the pandemic planning efforts of the World Health Organization’s Western Pacific Regional Office as part of a historical think tank, where I had the privilege to work with and co-author a report with fantastic fellow historians titled ‘History as Partner in Public Health’. These kind of collaborations, reaching across academia and public health demonstrate the role medical humanities can – and should – play in connecting local, national and global practices to provide analysis and better inform decisions and processes that impact all of our health.

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