History of Medicine in Southeast Asia. Singapore: NUS Press; The University of Chicago Press [distributor], 2018. ix, 370 pp. (Graphs, figures, B&W photos.) US$34.00, paper. ISBN 978-981-4722-05-6.
In Translating the Body the editors bring together 11 essays, which, together with their own wide-ranging overview, add materially to our understanding of disease and health across Southeast Asia and present fresh insights and invigorating analysis that merit further consideration for this region and beyond. Although each essay focusses on a single country and so limits the opportunity to explore common trends and mutual influences, collectively the contributors span Southeast Asia from Malaysia and Indonesia to the Philippines and Vietnam. In covering the period from high imperialism almost to the present, they usefully connect colonial strategies and shortcomings to postcolonial nation-building, international aid, and Cold War politics. The essays explore two interrelated themes—how modern Western scientific medicine was (or failed to be) “translated” into vernacular knowledge, and how, through what is broadly identified as “education,” indigenous populations were trained as doctors and nurses, or the wider public was persuaded (or not) to accept new medical concepts and practices or came to adopt and reinterpret them in the light of local traditions and political needs. Pivotal to both these issues were the “medical go-betweens,” the locally recruited men and women who were required to negotiate between very different ways of understanding (and languages for expressing) health, disease, and the clinical body. Three of the opening essays focus on women. Liesbeth Hesselink considers the career of the Dutchwoman Nel Stokvis-Cohen Stuart, who sought to enlist Indonesian women to become nurses and midwives—only to confront the social obstacles and pedagogic difficulties involved in recruiting, training, and retaining suitable candidates, especially through a language (Malay) which was “neither for them nor for us our native tongue” (45). Rosemary Wall and Anne Marie Rafferty address the question of nursing in British Malaya and, in a theme of conflicting or divergent “models” to which several other contributors relate, discuss the tension between the British practice of nursing and the North American public health scheme promoted by the Rockefeller Foundation. They remind us of how, far from being monolithic, “the West” represented not just different political powers but also very different approaches to health and education. Kathryn Sweet examines women’s health care in Laos, connecting the limited impact of recent programs to the now largely ignored history of earlier, colonial-era failures. Moving from sick people to unhealthy animals, Annick Guénel explores French veterinary science in colonial Indochina and the (largely frustrated) attempt to improve the quality of livestock and curb cattle diseases. As well as illustrating a diversity of externally generated reformist ambitions, all four of these opening chapters tend to present the issue in terms of a Western scientific agenda and “civilizing mission” running up against indigenous opposition and local ignorance: in this sense, they do not move far away from the terms of engagement set by the colonialists themselves. A later chapter by Francis A. Gealogo briefly returns to a theme of resistance by examining responses to the 1918 influenza pandemic in the Philippines in which the occupying Americans saw an opportunity to propagate their public health ideas while the Filipino population instead regarded the American occupiers as part of their suffering and affliction.
A second set of chapters, propelling the reader into postcolonial times, substantially complicates the issues of health and education. In Michitake Aso’s account of Vietnam’s “socialist medicine” between 1945 and 1954, new models of health care, inspired by Soviet Russia and Communist China, supplanted those of the colonial French and encouraged the formation of a cadre of people-oriented, battle-hardened doctors: in this essay, perhaps more than any other, the dual problem of linguistic translation and political transition becomes most conspicuously evident. In related fashion, Vivek Neelakantan’s discussion of medical education in 1950s Jakarta and Surabaya highlights the problems posed for a newly-independent nation at the height of the Cold War when faced with conflicting Dutch and American educational expectations and the tasking of Indonesian students and their teachers with having to negotiate between competing political, medical, and pedagogic regimes. Jenna Grant provides further insight into the medical politics of the Cold War and non-alignment era by examining a Cambodian-Soviet medical journal of the 1960s and the attempt to develop a “Cambodian pathology” to fit the aspirational needs and material circumstances of the new Cambodian nation. Inverting some of the earlier discussion, Laurence Monnais then reflects on the conundrum of “medical education ‘from below,’” in which the Vietnamese appeared at first to reject French medicine and the corporeal interventions of colonial public health, but then began by the 1920s and 1930s, through a combination of self-medication and medical pluralism, to adopt and popularize a new regime of “therapeutic citizenship.” The volume closes with two essays on Thai traditional medicine: the first by Junko Iida on the emergence (or “invention”) of a local medical tradition, drawing as much on the provocations and appetites of the West as on pre-existing practices and texts; the second by C. Pierce Salguero on a contemporary ritual in which practitioners of Thai medicine honour their teachers and thereby express their identification with an indigenous medical lineage.
Inevitably, for such a wide-ranging and varied collection, the contributors engage to different degrees with themes of education and translation. Some essays are more imaginative, ambitious, and extensively researched than others, but all benefit from the skillful elaboration of overarching themes and historiographical context in the editors’ introduction. It is regrettable that closer attention is not given to the actual process of translation—how authority and authenticity are established, how words, texts, and clinical terms are borrowed, reworked, or rejected, in order to make one medical culture intelligible to another. And, in placing so much emphasis upon “go-betweens,” it is a pity we do not hear more from the intermediaries themselves. But overall Translating the Body makes a significant contribution to medical history, opens up a rich regional prospectus, and demonstrates the value of nuanced local studies.
David Arnold
University of Warwick, Warwick