Medicine and Conflict, c.1945-c.1980: The United Kingdom and the 'Savage Wars of Peace'

Lead Research Organisation: University of Oxford
Department Name: History Faculty

Abstract

At the end of the Second World War, health and medicine were at the forefront of thinking about the creation of a new society. Service personnel and civilians had benefited from a high level of medical care and campaigns for disease prevention, and blood transfusion epitomized a shared commitment to the public good. The creation of the National Health Service in 1948 consolidated these ideas, which also found expression internationally in the creation of the World Health Organization and the United Nation's charter on Human Rights. The right to health was now listed alongside more familiar rights such as freedom from torture and freedom of expression.

The eruption of war on the Korean peninsula in 1950 challenged many of these ideals and served as a reminder of the devastating impact of war on civilians as well as troops. The same was true of bitterly fought campaigns in Europe's remaining colonies, in which the struggle for independence often took the form of an ideological battle between communism and capitalism. In all these campaigns, medicine played a vital role, not only in protecting the health of combatants but also in attempts to capture hearts and minds. From the Malayan campaign onward, medical, dental and veterinary care was used extensively in counter-insurgency operations. The health of prisoners of war and those who remained in combat became highly politicized, as did some aspects of the medical relief campaigns launched by combatants and the United Nations to aid civilians.

This project examines the contested domains of health and medicine from the Korean War (1950-53) to the aftermath of the Dhofar Rebellion 1975. Its focus is primarily on the medical services of the British armed forces and Britain's contribution to medical relief through the United Nations, the Red Cross and other agencies. However, Britain's role is put into a broader context, which allows us to compare medical aspects of the UK's involvement in relation to that of other combatant nations, as well as to examine the impact of war upon civilians. In addition to Korea, the project will study the role of health and medicine in a number of post-1945 conflicts involving British forces, e.g. the Malayan Emergency (1948-60), Borneo (1962-66), Aden (1963-67) and Oman (1962-75). These campaigns posed major challenges to the armed forces, which had to operate in difficult environments, often with high casualties from disease and psychiatric conditions. Despite the advent of helicopter evacuation, removing casualties from the battlefield often proved difficult because of heavy fighting, poor weather or difficult terrain. New methods of disease prevention and forward treatment needed to be devised to cope with these situations. The project will evaluate the effectiveness of these methods, some of which remain highly relevant to conflict today. The extensive and largely unused archives relating to the medical aspects of these campaigns can also be read alongside memoirs, diaries, letters and newspapers to provide insight into how they were experienced by service personnel, and how they were perceived by the public in the UK and other countries.

The project will reveal a dimension of post-1945 campaigns that remains largely unknown. In addition, it will assist the UK's armed forces in a reappraisal of their medical capabilities, making use of the PI's long-standing relationship with the Defence Medical Services and other branches of UK forces and collaboration of the former Surgeon-General, who is still actively involved in medical aspects of defence policy. Our project partner, the Museum of Military Medicine, which is shortly to move to new premises in Cardiff dockland, will allow us to engage the public with findings from the project, while the Military History Institute in Seoul will do likewise in South Korea.

Planned Impact

The UK's armed forces are acutely aware that their medical capabilities need to be reviewed in the face of new military threats, including so-called 'Grey Zone' conflicts. Historical analysis is vital in order to assess the nature of these threats and in proposing measures to mitigate them. However, the medical aspects of post-1945 conflicts - which are the most relevant to understanding the current situation - are poorly understood. In view of this, UK Defence Medical Services (DMS) and other branches of the armed forces have agreed to lend their full support to this project, which is intended as the first stage in a systematic review of the medical aspects of UK defence since the Second World War.

Historical work undertaken as part of this project will feed directly into operational and strategic planning and will be used to engage the general public in the UK and relevant overseas locations. These pathways include:

1. lectures to medical professionals, e.g. Association of Service Physicians;
2. staff rides and battlefield study tours (all branches of the armed services);
3. articles in relevant journals, e.g. British Army Research or papers uploaded on Defence Gateway sharepoint;
4. briefing papers to bodies such as the Development Concepts and Doctrine Centre (the MOD's 'think tank');
5. briefing papers for various branches of the armed forces, e.g. UK Special Forces;
6. shorter briefs (in print and in person) to individuals and units;
7. exhibitions in the Museum of Military Medicine;
8. exhibitions in the War Memorial, Seoul.

In his capacity as a historian and Army (Reserve) officer, the PI is already centrally involved in re-thinking UK medical capabilities, operationally and strategically. As former Surgeon-General of the UK armed forces, Co-I 2 (Bricknell) will also play a crucial role in facilitating the translation of findings from this project into formats likely to be of use in military contexts. We have also enlisted support from other serving and retired officers who will form an advisory board. These include Major-General Alan Hawley (former Director of the Army Medical Services; currently Colonel Commandant, Army Medical Service), the Commander of 236 City of London Field Hospital, the Chair of the Defence Transfusion Committee and a senior intelligence officer. The PI and both Co-Is also have contacts with the defence medical services of other countries (e.g. South Korea, Japan, Singapore, Myanmar, USA, Australia) who will serve as advisers, contributors and conduits through which we can engage constructively on medical matters with strategically important nations.

As a trustee of the Museum of Military Medicine since 2007, the PI has been actively involved in engaging the wider public. The museum is currently planning to move to purpose-built accommodation at Cardiff docks, with backing from the Welsh Government, the City Council and assistance from £2 million of Libor funding (see https://www.bbc.co.uk/news/uk-wales-50249739). The new museum is projected to open in 2022 and the project will help shape permanent and special exhibitions (physical and virtual), as well as other forms of public engagement ranging from lectures to events involving veterans of post-1945 conflicts. The latter will probably be assisted by a grant from the Royal Army Medical Corps, funding 2 posts at Oxford to conduct oral histories of former personnel. This distinct project will assist the research element of the AHRC project and facilitate engagement. It is hoped that the RAF and Royal Navy will become involved in the museum and engagement work in due course. The other major outlet for public engagement will be through the Institute for Military History in Seoul, South Korea, which is attached to the War Memorial. This a major tourist destination in Seoul and an exhibition there is likely to have a major impact. Co-I 1 is Director of the Institute, which exercises control over the museum inside the Memorial

Publications

10 25 50
 
Description British Army 
Organisation British Armed Forces
Country United Kingdom 
Sector Public 
PI Contribution Members of the project team made contributions which pointed out the relevance of historical examples from this project to current and possible future scenarios of interest to the armed forces.
Collaborator Contribution The armed forces provided a pathway through which research undertaken in the project was able to have impact beyond the academic world and general public engagement. We will have the first opportunity to provide a substantial impact on policy shortly after this submission.
Impact Precise outputs/outcomes cannot be elaborated at present due to the need for confidentiality.
Start Year 2021
 
Description Collaboration with Kyung-Hee University Medical Humanities/Medical History 
Organisation Kyung Hee University Medical Center
Country Korea, Republic of 
Sector Hospitals 
PI Contribution Owing to the fact that our original collaborator in Korea (Dr Lee, former Director of the Institute for Military History) unexpectedly left his post soon after the project began, we sought new Korean partners, one of whom is Professor Park Yunjae of Kyung Hee University. This collaboration has allowed a wider network of scholars (based at Kyung Hee) to contribute to the project and for our project team to assist them in their research by providing guidance on sources, research themes/questions. Several scholars will accompany Prof Park when he visits the UK (this has been delayed because of Covid-19) and they also benefitted from interaction with UK project members during a visit to Korea which took place in September 2022, which included a conference, seminar and other activities.
Collaborator Contribution In his position as an official collaborator, Prof Park is helping to steer and coordinate research and engagement activities in Korea. His university will support joint events (e.g. conferences) financially and in kind when scholars from the UK visit later this year. Prof and members of his team will contribute to and co-edit two special editions of the journal, Korean Journal of Medical History. These volumes will take the place of the single edited volume planned for this conference. The final papers are due at the end of April 2023. Through Prof S.V. Yim at the Kyung- Hee Medical School, we will also have access to important historical archives relating to war and medicine, as well as contacts in the military medical services.
Impact As indicated above, the outputs from the first of the planned conferences (delayed from Year 1 to Year 2 because of Covid-19), will consist of 2 special editions of a journal. These will consist of 11 papers plus an introduction. The concluding paper, by Prof Martin Bricknell of KCL, former UK Surgeon-General, will wrap up the volume. The papers are primarily historical but the introduction and Prof Bricknell's paper also draw heavily on other disciplines (e.g. War Studies) and are aimed at a military medical readership in addition to a primarily historical one.
Start Year 2021
 
Description Collaboration with Sciences Po, Aix en Provence 
Organisation Aix-Marseille University
Country France 
Sector Academic/University 
PI Contribution Prof Harrison and Dr Kim spoke at a workshop aimed at French military medical officers (see below) and will collaborate with scholars based at Science Po Aix in further work on the history of military medicine related to and beyond this project, e.g. medicine in counter-insurgency operations, medicine in special operations. Prof Harrison will work as a visiting scholar at Aix in September 2023, during which time he will assist local researchers and engage sections of the French armed forces.
Collaborator Contribution This collaboration resulted in the invitation of two members of the project team (Harrison and Kim) to Paris, in 2022, to participate in a workshop on medicine in S E Asian conflicts (see Engagement) and will result in further collaboration in two conferences in Oxford in July and November 2023, which will be hosted at the Maison Francais, Oxford.
Impact No impact yet, beyond contribution to the conference in Vincennes in 2022 (see Engagement).
Start Year 2022
 
Description Yonsei University Institute of Medical History 
Organisation Yonsei University
Country Korea, Republic of 
Sector Academic/University 
PI Contribution This collaboration began after our initial plan to collaborate with the Institute of Military History at the National War Memorial in Korea fell through, due to the sudden departure of its Director. We are collaborating with the Institute of Medical History at Yonsei in order to coordinate research that will culminate in a series of conferences, workshops and project publications. As part of this collaboration, the project team from Oxford and KCL visited Korea in September 2022 and will visit again in 2023, when the conference will be hosted by Yonsei (probably December). UK-based researchers will convene conferences and workshops for the Korean scholars in Oxford (July 2023 and November 2024), as well as assisting their research while they are in the UK.
Collaborator Contribution Dr Youngsoo Kim (one of our two lead Korean collaborators) and the Yonsei Institute's Director, Prof Inseok Yeo will both contribute to two special editions of the Korean Journal of Medical History on medicine and health in the Korean War, which will be published later in 2023. In addition, the Yonsei Institute will host the second of the two conferences in Korea and a special exhibition on medicine in the Korean War at Yonsei University's medical museum and contribute to the conference volume following the next two Oxford conferences.
Impact No outputs as yet. First publications (2 special journal editions) expected late 2023.
Start Year 2021
 
Description 'Cholera epidemics and border control in Japan and Korea under US military occupation', The Kansai Branch of the Japanese Society for Demography (13 March, 2022) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Postgraduate students
Results and Impact In this presentation, one of the project's key researchers (Dr Jeong-Ran Kim, Oxford) examined the cholera epidemics in 1946 in Japan and liberated Korea south of the 38th degree of latitude. She focused on how the Supreme Command for the Allied Powers (SCAP) handled a situation in which many cholera patients and carriers of cholera bacilli were found among Korean illegal entrants to Japan. Sanitary screening and border controls between liberated Korea and Japan organised by the SCAP were intended to erase Japan's imperial past and contribute to the rebuilding of a US-led geopolitical order in East Asia.

The talk was attended by around 40 people, most of whom were historians and demographers, but also some people from other disciplines such as medicine and public health. The audience included many postgraduate students as well as academic staff. After the talk, there were many questions and great interest was expressed in the project and in parallels between Korea and Japan under military occupation at the same time. Two participants subsequently contacted Dr Kim expressing their intention to work in conjunction with our project and to attend events hosted in Korea. Medical practitioners expressed surprise over the situation that obtained in Korea and Japan in the period after the Second World War and were able to draw parallels with some contemporary issues.
Year(s) Of Engagement Activity 2021
 
Description 'The Army, Health and War' - National Army Museum 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Postgraduate students
Results and Impact This workshop was delivered by Professor Martin Bricknell, drawing on his experience as former Surgeon-General of UK forces and historical examples, including those highlighted by the current project.
Year(s) Of Engagement Activity 2022
 
Description Lecture to Abingdon and District National Trust Association on 'The Medical Aspects of Post-1945 Conflicts'. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact The talk focused predominantly on surgery and casualty evacuation in the Korean War, with some reference to the Malayan Emergency. Issues covered included the types of war wound sustained; the difficulties of evacuation in the Korean environment; collaboration and tensions involved in medical support in coalition warfare; surgical procedure and evacuation (e.g. the advent of helicopter evacuation); and lessons for future wars. There was interest in the relevance of the war to recent, current and possible future conflict situations and many questions of a factual nature concerning the conflicts discussed in the lecture. Many people in the audience knew little about the Korean War or medicine at the time and those that did commented that they had learned much and had some of their images of medicine (taken from the popular TV series 'MASH') altered.
Year(s) Of Engagement Activity 2022
URL https://www.abingdon.gov.uk/event/prof-mark-harrison-the-medical-aspects-of-post-1945-conflicts
 
Description Medical intelligence - European Network 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Prof Harrison was invited to speak as the leading expert at a conference convened by the European Expert Network on Terrorism Issues in Milan, at the Catholic University of the Sacred Heart, on 26 January 2023. His contribution covered all aspects of medical intelligence, including military, drawing on analysis done in the course of this project. The conference was attended by medical officers from the Italian armed forces, as well as a variety of European counter-terrorism and counter-insurgency experts. On the strength of this, Prof Harrison was invited to become a member of the network and is currently working on a paper on medical intelligence which will serve as a strategic document to develop this on a European basis.
Year(s) Of Engagement Activity 2023
 
Description Presentations to French military medical services 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Prof Harrison and Dr Kim gave presentations at a workshop on medicine and conflict in S E Asia (Violences de guerre et pertes militaires en Asie du Sud-Est, 20 October, 2022), aimed primarily at French military medical officers. Dr Kim's paper examined blood supply in combat situations and Prof Harrison's the uses of medicine in the Malayan Emergency.

The conference was held at the French military base and historical centre at Vincennes, Paris.


The aim of the lectures was to use history to show the uses of medicine in counter-insurgency operations, including practical challenges and ethical dilemmas.
Year(s) Of Engagement Activity 2022