This chapter takes as its central theme the relative absence of HIV/AIDS in
the 1980s and 1990s in Wales, together with the social, cultural, and
political consequences. Described as a ‘phoney war’ by a leading public
health consultant, the non-appearance of the HIV/AIDS crisis across Wales
fostered a struggle between medical practitioners, campaigners, and
administrators under pressure to implement spending cuts. The result, in
many parts of Wales, was relative complacency. This chapter is the
first sustained historical analysis of the public response to the HIV/AIDS
crisis in the Welsh context. It draws on both epidemiological and wider
English and Welsh-medium evidence, including epidemiological and
sociological research, local health authority records, educational
materials, and, notably, the call logs of the helpline FRIEND, which had
been founded in the 1970s. Three main themes emerge: the distinctive
work of the medical community and public health education; the reactions of
the general public and politicians, which were not always as hostile as the
conservatives assumed; and the internal anxieties and reflections of gay men
captured in telephone logs and interviews. Finally, the chapter also locates
the public response to HIV/AIDS in a shifting political context. Rather than
a ‘phoney war’, this was a complex and changing series of responses to a
developing situation. This, far more than hostility, ignorance, or absence,
should serve as the framework for studying social and cultural reactions to
HIV/AIDS in Wales.
Edinburgh was disproportionately affected by HIV/AIDS in the early
1980–1990s, and women and children were affected in higher numbers there
than elsewhere in the UK. Edinburgh’s AIDS crisis also followed a different
pattern, with new infections predominantly occurring among IV drug users and
heterosexuals. Because of the high rates of HIV infection among women in
Edinburgh, the city rapidly became host to numerous charities and
organisations scrambling to meet the needs of HIV-affected women and
families, aiming to prevent new infections and meet the emotional, medical,
housing, and educational needs of those already affected by the
virus. This chapter traces how healthcare workers and HIV-affected women
responded in Edinburgh. This was interdisciplinary collaborative AIDS
activism born out of the daily fight for resources, information, space, and
empathetic treatment for women and their families. This activism can be
traced in texts both academic and creative, and was at the very least a
backdrop for many women’s experience of HIV and AIDS in Edinburgh in the
late twentieth century. To focus the analysis, the creation of the
Paediatric AIDS Resource Centre (PARC) in Edinburgh is examined, alongside
some of the items the centre published. The need for PARC is demonstrated
not just by placing it in its social, political, and historical context, but
by recovering the words of HIV-affected women and healthcare workers drawing
on its resources, writing these women back into the history they created as
subjects rather than objects.
As the AIDS crisis emerged, prisons were quickly identified as possible
‘reservoirs of infection’, where injecting drug use, sex between men,
violence, and poor hygiene might all contribute towards the spread of HIV.
Some countries moved to introduce punitive or restrictive measures within
their prisons, while researchers and international bodies hastened to
promote an alternative approach, based on voluntarism, education, and harm
reduction. This tried to acknowledge prisoners’ rights and to position
prisons as an integral part of the wider community, and by the early 1990s
some regions saw innovations such as methadone treatment and needle
exchanges established within their prisons. This chapter reviews and
begins to explain the different ways in which countries around Europe
responded to HIV/AIDS in their prison systems. The size of a nation’s prison
population and the extent of injecting drug use were both important factors
in determining national response, as were pre-existing structures of prison
healthcare provision and attitudes towards both homosexuality and crime.
Responses in prisons were also closely affiliated to responses in the wider
community – perhaps to a greater extent than campaigners calling for greater
parity were prepared to recognise. It then compares policies and
developments in the Republic of Ireland and Switzerland to explore different
forms of activism, with different outcomes. Using international evaluations
and research from the 1980s and 1990s, national policy documents, and oral
histories, this chapter also raises questions about the kind of activism
surrounding HIV/AIDS that is remembered.
Activism, politics, and medicine in Norway, 1983–90
Anne Kveim Lie
In the early years of the Norwegian HIV/AIDS epidemic, three main groups were
affected: gay and bisexual men, drug users, and people with haemophilia.
However, another group played a dominant role in the political, medical, and
public discourse: sex workers. This chapter analyses the early political and
medical responses to the epidemic, particularly the position of sex workers,
the limits of inclusion in the ‘Norwegian model’, and the impact of the
epidemic on sex worker activism. Using media sources, public and
private archives, and oral interviews with sex workers, activists, social
workers, and civil servants, this chapter explores how different
representations of 'the prostitute' were constructed and
mobilised. From the mid-1980s, doctors, public health researchers, and the
media constructed sex workers as a potential reservoir for HIV infection.
Gay activists were gradually recognised as 'experts' by
authorities and medical professionals, while it was much more difficult for
sex workers to make their voices heard. This had historical reasons because
prostitution was generally recognised as a social problem on different
levels of society: by politicians, by the police, by social workers, by
feminist groups, and in the media. This chapter examines the remarkable
story of a creative group of people in the health authorities who approached
sex workers as experts, hiring two women for outreach HIV prevention work.
The sex workers reported back to the authorities, who thus had first-hand
knowledge about a community which otherwise was hard to reach. This outreach
work spurred sex worker activism and led to the establishment of the first
Norwegian sex worker activist organisation (PION) in 1990. However, the
Norwegian story shows how much more difficult it has been for sex workers to
get a seat at the table in political decisions than other marginalised
As the whole book is organised thematically, the conclusion offers to span the evolution of the discourse on spas throughout the long eighteenth century, reprocessing the various notions addressed in the book within a stricter chronological frame. Three main topics are discussed in relation to the evolution of spas and spa towns throughout the century: medicalisation, commercialisation and cosmopolitanism.
‘From bog to jug: a risky remedy?’ explores the multiple representations of the dangers of the water cure. It challenges the idea that mineral waters were yet another cure-all in the quack pharmacopoeia of the eighteenth-century commercialised and competitive medical world. Relying on recent scholarship in the history of medicine, I contextualise the contemporary accusations against water doctors in eighteenth-century medicine, and I address the question of spa promotion, rooted in the relationship between commerce and medicine at the heart of the development of spa towns. In a second section, ‘waters as pharmakon’, I turn to the descriptions of water treatment as a corrosive and potentially dangerous remedy. Waters, doctors argued, were not to be taken lightly, and could have dramatic consequences on the patient’s life if their intake was not properly monitored by medical prescription. This discourse aimed at fighting the practices of self-prescription, especially the habits of the local people of drinking purging waters at smaller wells. The last section, ‘Brine, mud and dung’, focuses on the waters themselves and their literal murkiness: some drinking wells produced cloudy waters with stinking smells, and their origins could be traced in the muddy ponds of nearby swamps. Contemporary descriptions of baths and bathing facilities could be revolting. Many a watering place was satirised as a house of office, and the results of constant purging were exposed to the reader in rich scatological imagery.
The introduction provides a useful synthesis of the development of British spas in the long eighteenth century. It is both a preliminary reading to the chapters and a pedagogical overview of the phenomenon. It provides a map of spas in the eighteenth century specifically designed with cartographies, based on an original survey. It aims to give the reader a set of categories so they may navigate the book with a clear idea of the size and scale of spas, the various types of mineral waters and the methods of treatment, as well as an account of the chemical analyses performed. This introduction takes stock of the multiple primary sources under study, their genre and their popularity, as well as the methods implemented to interpret them. It clearly sets out the purpose of the book and gives a synthetical review of previous and current scholarship on the topic.
In the medical world of eighteenth-century Britain, doctors, caregivers and relief-seeking patients considered mineral waters a valuable treatment alongside drugs and other forms of therapy. Although the pre-eminence of Bath cannot be denied, this book offers to widen the scope of the culture of water-taking and examines the great variety of watering places, spas and wells in eighteenth-century British medicine and literature. It offers to veer away from a glamorous image of Georgian Bath refinement and elegant sociability to give a more ambivalent and diverse description of watering places in the long eighteenth century. The book starts by reasserting the centrality of sickness in spa culture, and goes on to examine the dangers of mineral water treatment. The notion of ‘murky waters’ constitutes a closely followed thread in the five chapters that evolve in concentric circles, from sick bodies to financial structures. The idea of ‘murkiness’ is an invitation to consider the material and metaphorical aspect of mineral waters, and disassociate them from ideas of cleanliness, transparency, well-being and refinement that twenty-first-century readers spontaneously associate with spas. At the crossroads between medical history, literary studies and cultural studies, this study delves into a great variety of primary sources, probing into the academic medical discourse on the mineral components of British wells, as well as the multiple forms of literature associated with spas (miscellanies, libels and lampoons, songs, travel narratives, periodicals and novels) to examine the representation of spas in eighteenth-century British culture.
‘Pump room politics and the murky past of spas’ takes a look at the political impact of spa societies of temporary visitors, who gathered for a season before returning to their homes bearing new ideas and new information. It starts by examining the politics of gossip, a recurrent theme in spa literature, made no less dangerous by its gender bias and its ramifications into cultures of power. In a second section, ‘Healing the nation’, the chapter addresses the national issues at stake in the spa towns, and the political role of master of ceremonies and the colonial dynamics at work in British spa towns. Finally, the chapter dwells on the religious heritage of healing waters in the eighteenth century by tracing the resurgence of Catholicism in the culture of British spas, and the ways in which this was negotiated in the discourse of medical doctors, visitors and literary authors. Relying on the work of A. Walsham on the reformation of holy waters, their disappearance and their modes of persistence in early modern culture, this chapter investigates the eighteenth-century sites of Roman Catholicism in which mineral waters kept some of their original holiness. Spas such as St Winifred’s in Wales and St Chad’s in London were clearly remembered as holy wells, and the rituals associated with them were not forgotten by contemporary authors.
‘Pumping and pouring: watering places and the money business’ looks at the representation of investment, speculation and the circulation of money at private and public levels. The first section focuses on the discourse on gambling in watering places. Before casinos existed, games rooms were open and gambling was one of the attractions of spas available to the sick and bored – games like pharo, quadrille and hazzard were at the heart of many a cautionary poem. The metaphor of gambling extended to the ambitious investors in the development of spas. Their hubris was exposed in narratives of failure or corruption such as Austen’s unfinished Sanditon. Further examples of urban speculation are exposed in a second section. At the other end of the spectrum, lack of money was a lurking phenomenon in spa literature. In the major spas, medical doctors published propositions for monitoring the poor, regulating and financing their access to the baths or the wells. In medium-sized spas, the discrepancy between advertising tracts and the scarcity of lodgings was often acute. In all cases, social promiscuity was an object of constant worry, and fortune-hunting was represented as a favourite sport.