Hans Pols, Claudia Michele Thompson and John Harley Warner have edited an impressive volume on the history of medical education in modern Southeast Asia. They argue for the multiple meanings and practices of medical education in the region through the works of eleven contributors in the volume who draw richly from classical medical texts, archival documents, newsletters, interviews, newspapers and field observations. This pluralistic construction of educational facilities and training of medical personnel was mediated by shared problems of language, migration and sovereignty. The volume illustrates the arduous and sometimes controversial efforts made by medical personnel in overcoming economic scarcity and transnational opposition to develop public health and medical schools in Southeast Asia. These physicians, healers and nurses often sought to repurpose colonial medicine for their post-independence needs, as well as invent new forms of traditional medicine that drew on Western and indigenous concepts of rituals and healings. This review highlights several outstanding chapters that critically unpack the interactions between global influences and indigenous practices in shaping Southeast Asian medical education. In Chapter 2, Rosemary Wall and Anne Marie Rafferty reveal the tension between British colonial nursing education and the Rockefeller Foundation sponsored American-style nursing in British Malaya. They argue that the latter provided an attractive alternative vision of class equality, resource abundance and medical expertise to nurses and physicians in the colony. Mitchitake Aso contends in Chapter 5 that the Vietnamese Communist Party did not especially repress medical educators, despite their French education and openness to traditional medicine, because the physicians worked with the party-state to advance common military aims. Vivek Neelakantan reveals in Chapter 6 that Indonesian universities faced constant challenges in recruiting qualified teachers and students even as they switched from a Dutch-style medical education to an American-style education system backed by the China Medical Board and the Rockefeller Foundation in the post-Independence period. In Chapter 7, Jenna Grant reveals how the representations of biomedical modernism in a Cambodian journal, Revue, showed the promises and perils of a Khmer−Soviet Friendship hospital in the 1960s. Finally, Junko Iida argues in Chapter 10 that faculty members of the Siriraj Medical School were central to constructing the notion of Traditional Thai Medicine in the twentieth century. They sought to elevate and propagate the medical properties of Traditional Thai Massage, which became de-medicalised by masseurs catering to foreign tourists from the 1980s onwards. Scholars in the volume highlight clearly the ways in which indigenous people, physicians and nurses challenged the practices and legacies of colonial and Cold War medicine. For example, Liesbeth Hesselink analyses in Chapter 1 how Javanese women selectively rejected, embraced or accommodated ideas of birthing and mothering propagated by Dutch nurses (pp. 60–1). Scholars also convincingly show that not all colonial and Western medicine was the same, given the presence of multiple colonial powers in the region. Even within the same colony, Wall and Rafferty argue that there were different schools of Western medicine. Finally, the volume illustrates how the history of medicine challenges binary approaches towards colonialism in Southeast Asia. The desire of newly independent Southeast Asian leaders and their collaborators to build a viable nation, to fight wars, to heal the sick and to invent new medical traditions did not mean that physicians and nurses had to actively work with or against the legacies of colonialism. For example, Kathryn Sweet illustrates in Chapter 4 how successive regimes in twentieth-century Laos often forget, and fail to build on, the efforts of previous administrations in developing medical education, resulting in the unsustainability of such endeavours. This volume provokes a productive discussion on how the broader global context of colonial and Cold War politics shaped medical education. The volume also has the potential to provide a more comprehensive background of how domestic politics shaped the outcomes of medical education. Non-specialists in Southeast Asian history might find it useful to understand how the authoritarian New Order regime in Indonesia, the racialised politics of British colonialism in Malaya, the longstanding Vietnam War, the rise of the royal family in Thailand, and the emergence of the brutal Pol Pot regime in Cambodia moulded the decisions of medical educators in the region. Aso’s chapter shows the potential of adopting such an approach by examining how Vietnamese medical educators grappled with domestic politics and the changing international pressures from China, France and the Soviet Union in shaping their medical practices and ideologies. Pols, Thompson and Warner provide a clear introductory overview of the significance of the volume by drawing richly on the literature on Asian and colonial medicine. However, many of the individual contributors could draw more from their detailed case studies to develop new epistemological concepts and frameworks of medical knowledge and specialisation that may be of interest to a wider audience. They could consult two similar edited volumes; one by Andrew Cunningham and Bridie Andrews and another by Andrew Cunningham and Perry Williams.1 Many contributors in those volumes actively utilised their case studies to critique longstanding assumptions as well as develop alternative conceptual terms and analysis of biomedicine around the world. Jenna Grant’s chapter in the current volume demonstrates the potential of this approach. Grant elegantly characterises the emergence of a ‘Cambodian pathology’ in Cold War Cambodia as underpinned by the ‘enactment’ in Revue of ‘a practice of biomedical knowledge production and circulation within collaborative, politically charged, and economically constrained context’ (p. 221). Adopting such an approach across the board would encourage contributors to better highlight how the response to colonialism and empire in Southeast Asia inscribed the permanence of flexibility, adaption and flows in Southeast Asian medical education. These efforts might eschew the inevitability of institutional professionalisation and medical specialisation which is taken for granted in the discussions of histories of medical education elsewhere around the world. In sum, students interested in Southeast Asian medicine will find the vivid historical details of individual case studies and the careful attention paid to the interaction between global forces and indigenous medical actors in this volume helpful for their research. Historians of medicine and the empire would find the engaging narratives on the success and failures of medical educators, as well as the broader analysis of the practices and legacies of colonialism on medicine in this volume useful and inspirational. Footnotes 1 Andrew Cunningham and Bridie Andrews (eds), Western Medicine As Contested Knowledge (Manchester: Manchester University Press, 1997); Andrew Cunningham and Perry Williams (eds), The Laboratory Revolution in Medicine (Cambridge: Cambridge University Press, 2002). © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for the Social History of Medicine.
Social History of Medicine – Oxford University Press
Published: Feb 7, 2018
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