The Ebola epidemic makes his latest book highly topical: historian Malte Thießen has published a social and cultural history anthology on the history of epidemics in modern and postmodern times. In this interview, he talks about linking the fight against epidemics to current fears, health policy as a gain in national prestige and missed lessons from history.
QUESTION: Mr Thießen, in the volume "Infected Europe", scientists from various disciplines shed light on the history of epidemics in the 20th century - from the fear of syphilis at the beginning of the century and the Spanish flu in 1918/19 to "new epidemics" such as SARS or Ebola. How would you summarise the social significance of epidemics?
THIESSEN: Dealing with epidemics allows us to measure the structure of societies and their areas of tension. Epidemics show where things are on fire in a society, where things are at their worst, where there is a rattling in the gears, so to speak. This makes them a seismograph of the social. From a historical point of view, epidemics are a wonderful case study for social tensions, whereby we must always remember that we are dealing with life-threatening, existential issues.
QUESTION: The book fills a major research gap. Can you explain why contemporary historians have tended to neglect the epidemics of the 20th century until now?
THIESSEN: Epidemics up to the 17th and 18th centuries are a major topic in historical studies, but at the latest when looking at the 20th century, many have not had them on their radar until now. However, when you realise that the Spanish flu of 1918/19, even at a conservative estimate of 25 million deaths, claimed significantly more victims than the First World War, the far smaller amount of historical research and literature is remarkable. I explain this gap, this blind spot, to a certain extent with modernisation itself. That epidemics don't really fit into this modernity, into the idea of rational planning of societies and health conditions.
QUESTION: You say that epidemics don't fit into our idea of modernity. Is it a misconception to think that this can be controlled and brought under control?
THIESSEN: Epidemics are always an issue, especially in Western Europe and the USA, on the part of the state and in the public press, when they are controllable. For example, polio or tuberculosis suddenly played a major role when vaccines were invented. The fight against the epidemic then offers opportunities to raise the profile of one's social system and catalogue of health measures - which stands in the way of cross-border measures. You can even play on fears and concerns a little, because on the one hand you can show that the state is doing something, that we have the epidemic under control, and secondly, of course, as an appeal for participation in vaccinations and other health measures.
QUESTION: The fight against the epidemic helps to legitimise the state or the healthcare system?
THIESSEN: That's right. What's more, epidemics become an issue when they fit in well with public perception patterns. Take AIDS, for example - in the 1980s, it fits into the upheaval of sexual liberalisation and the associated sense of threat. Aids is an example of how such epidemic phenomena have to fit in with current patterns of interpretation, with current fears. Against this backdrop, AIDS suddenly becomes an outlet for negotiating fundamental norms. You notice that as soon as epidemics fit into a current pattern of perception, they have the potential to be scandalised.
QUESTION: To what extent does this fit in with the reporting on the current Ebola epidemic?
THIESSEN: It fits in quite well in that respect. Ebola has been on our minds for almost half a year, but is only now suddenly becoming a major topic when we can use it to address the problems of globalisation. Suddenly the disease is very close, we see connections to global networking, migration,... all the classic topics that are already causing anxiety in society or at least leading to self-problematisation. Ebola can be linked to this and suddenly becomes an issue. Conversely, plague or smallpox, for example, play less of a role due to secularisation in the 19th and 20th centuries, after they were very religiously charged in the Middle Ages until the early modern period.
QUESTION: You mentioned that disease control still reflects the state's performance today. To what extent are healthcare systems now equipped to deal with such a global phenomenon as an epidemic?
THIESSEN: It has been a long process from the founding of the World Health Organisation in 1948 to the present day for stakeholders to think beyond national borders and understand health as a global phenomenon. The history of epidemics shows this very impressively, as the question of national prestige always plays a role. During the Cold War, for example, when the GDR and West Germany held their smallpox and dysentery deaths against each other. De-nationalisation in the fight against epidemics has come a long way, partly due to the fact that the national health system was charged with the potential to gain prestige. Ebola also shows that the initiatives in the fight against the epidemic are initially national.
QUESTION: Surely we could have learnt more from history?
THIESSEN: The fact that there is an international forum does not automatically mean that international cooperation will suddenly work perfectly. Closer integration? To some extent, the opposite is the case. The fact that there is an international exchange instead of clear compartmentalisation means that we suddenly have international comparability. And this is actually fuelling competition, competition for the healthiest society, which in some cases is leading to a lot of friction within the WHO - and to the fact that international co-operation on such international phenomena is getting off to a slow start, to put it mildly.
QUESTION: The new volume on the history of epidemics also describes how epidemics are being outsourced to a certain extent and understood as someone else's problem. Does this also apply to Ebola? Is the rather relaxed reporting by Western media - and the lack of a vaccine - due to the fact that Ebola is seen as "someone else's problem" as long as it is predominantly raging in Africa?
THIESSEN: I think that is changing. It will be interesting to observe this in the near future. This so-called "othering" - that societies deal with a phenomenon but externalise it as a problem of others - is not yet something that fuels fear, but something more abstract. And I believe that it really does tip over at the moment - and this is also evident with Ebola - when there are also deaths in Europe. When Ebola killed people in Spain, the attention threshold suddenly went up. As soon as it's really on the ground, and is specifically linked to images that feed into our lives, then it becomes a problem and leads to a completely different thematisation of the epidemic.
Interview: Deike Stolz