At The Movies: An Account of ‘Health on Screen’
'Never again will a single story be told as if it is the only one.'
- John Berger, G
The screen comes to life. The words ‘Foot and Mouth, directed by Lindsay Anderson’ flash across a sea of monochrome. It is 1955. A decade has passed since the end of the Second World War, and Britain is on the path to recovery. Yet, this path is marred by outbreaks of disease. This is a story of one such outbreak—of foot and mouth disease, which spreads among livestock. The screen shows a farm. One of the cows in the barn doesn’t seem too well. Two farmers inspect the cow, unaware that it is carrying Foot and Mouth disease. They do not think much of the cow’s symptoms and load the animal onto a truck which is headed for the local market. To us in the audience, this act of loading the animal on the truck is the last moment of peace. The script is painfully clear, written on the wall. As the truck totters down the open road, we know what is really being carried. Pathogens. Infection. Contagion. Chaos. And soon enough, chaos ensues. The only way to stop the disease now is to trace the routes and networks through which that cow travelled and cull all animals it affected. The culling begins. The sight of sickened animals is juxtaposed by gunshots. The face of the farmers who sold the infected animal flashes on the screen. If only they had acted differently, the voiceover now says, then we could have avoided this.
By ‘this’, the camera shows scenes of loss and destruction—the carcasses of livestock, the killing of animals to avoid spread, the huge economic losses. There have already been two outbreaks of this disease in the last five years, and the disease has devastated European neighbours too. A map shows the disease entering the UK from the outside—Europe—a sight reminiscent of war invasions. The message is clear. There is an insidious enemy in our midst, who must be driven out or arrested—it is the pathogen, invisible to the naked eye, but whose effects can be seen through and on the carrier (either infected or asymptomatic). But there is another enemy—ignorance— and the voiceover, clean, crisp and precise, stresses this: diseases are dangerous, but they spread not only through the will of the nonhuman microbe, but also through the faulty and ignorant practices of the public. The government springs to action. It coordinates research into the disease, providing aid, and helping information on how to properly disinfect farmland and the public themselves. But the core responsibility is on the individual. It was an individual mistake, after all, that opened this Pandora’s Box of contagion. Look, the voice seems to say, look what happened because two farmers in a single farm, somewhere in the country, made a seemingly small mistake. Look how it costs us, the public, the community, the nation. And now, as the film draws to a close, there is another subtler message: in representing retrospectively, those of us watching the film are made to feel that the whole outbreak was preventable. If only that one farm had acted differently, responsibly, public health could have been upheld.
As a historian of disease, the prospect of sitting in a room full of public health professionals and academics and watching movies is the stuff of dreams. And that’s what it felt like, attending Health on Screen. Health on Screen: The Public and the Global workshop, organised through a collaboration between Medical Humanities (TORCH, Oxford) and the British Film Institute (BFI), brought specialists and students, working on different aspects of public health, in conversation with one another, through screenings and discussions on four short public health films ranging from the 1930s to 2023.
The event began with a screening of ‘Tropical Hookworm’ (1936), a film which, set in Africa and funded by missionary zeal, sought to educate the local community about the disease. This education included, mainly, a discussion on the aetiology of the disease, as well as preventive methods such as the development and use of sandals made from old tyres and hides. The second film, ‘Foot and Mouth’ (1955), discussed at length at the beginning of this article, elicited a lively discussion on not only the intended audience of this film (Who was it meant for? Where would it be screened?), but also the ethics of large-scale culling of suspected infected animals. Discussed almost seventy years after its production, it was interesting to see the ways in which present debates on animal ethics, Euroscepticism, and the portrayal of violence on screen were discussed. In contrast, the third film, ‘New Ways’ (1978), developed and produced by the Ealing and Hammersmith Council, served as an informative guide for South Asians moving to the UK. Produced during a period of increased immigration and rising cardiovascular disease among this demographic, the film stressed on the changes in dietary and sartorial practices that needed to be adopted by a South Asian immigrant if they were to be ‘integrated’ into this new society. It also highlighted the importance of the National Health Service (NHS) while also stressing the individual immigrant’s responsibility of maintaining the health of their family. There was also a presentation by Tolulope Osayomi (AfOx Visiting Fellow), which focussed on the history of public health campaigns in Nigeria, showing the shifts and continuities in the ideology, language and nature of such campaigns as the country faced different (often concurrent) outbreaks of disease.
Finally, the film and project ‘Infecting Minds: The Past, Present and Future of Vaccine Hesitancy’ (2023), developed through a collaboration between academics at the University of Oxford, the Crick Institute, and AHRI (Africa Health Research Institute), investigated the question of vaccine hesitancy, focussing on the ways in which the issue was imagined, understood, and debated by young people, particularly school children. The focus groups included school students in Oxford (UK) and in Durban and Somkhele (South Africa). In contrast to the instructive and didactic nature of the first three films, Infecting Minds showcased another way of approaching public health, done through the interactive dialogue between the “public” (in this case, school students in two different national contexts) and public health experts. We laughed. We cringed. We were moved, shocked, and amused by the way in which the past came to life, on screen, in front of our eyes in that room. But the past was not the only voice in that room. As ‘Infecting Minds’ came to a close, there seemed to be another voice; like the proverbial bird that escaped last from Pandora’s Box, hope was sitting on our windowsill.
By the end of the four films, we had travelled almost ninety years in time. Where did that leave us? We had moved between continents, across time and space, from colonial Africa to postwar Britain, from Ealing of the 1970s, to Nigeria, and then to Oxford, Durban and Somkhele in 2022-23. What had changed? What had not? How close and distant were we, sitting in St. Anne’s College in Oxford in 2024, from those watching the film on hookworms in 1930? How far had we moved, in effect, from the historically suggested paternalistic voice of public health films?
Looking at the nature of official public health messaging and media even in the present, one cannot deny that traces of this old inheritance remain. Now, as then, health and disease, quite often in the public sphere, are seen as opposites, and the relationship between them portrayed as one of war—the microbe or the pathogen, like a criminal, is on the loose, and must be curtailed, contained, trapped and, perhaps even repurposed. The public in this discourse are rendered soldier-like: “the fate of everyone else rests on you” they are told, or “you can help in this war against the disease!” And yet, public health is not a war against a disease and ignorance, or not only a war against disease and ignorance. It is also, like everything else, a story. And, like every story, it is also one that is made, narrated, heard, listened to and re-made, over and over again.
Be it hookworm in colonial Africa, foot and mouth disease in post-war Britain, dietary and vitamin deficiencies in immigrant populations, or debates about vaccination, public health is as much about facts as about the imagination. Juxtaposing and contrasting ‘Tropical Hookworm’ with ‘Infecting Minds’ showed us, very clearly, that, over time, those who speak for public health have increased and changed dramatically. While it is important to acknowledge the complex histories of public health and cinema, a history mired to a large extent in power and the state, it is important to consider the way in the stakeholders have grown and changed. There are more stories, more storytellers, more ways of imagining, of understanding the public, of understanding heath, and understanding public health. Contrasting, however, does not mean merely suggesting that public health films have radically altered. The didactic nature of the medium persists—as it should, for didacticism is an important component of the form itself—, but there is a shift towards a dialogism which leaves room for greater cooperation.
Towards the end of the event, the panellists of 'Infecting Minds', argued that one of the main aims of their project was to bring different people together to facilitate a more robust, multidisciplinary conversation on questions of public health. It was also mentioned that through the discussions that they had had in the schools, they had learnt a lot of new things about the issue themselves, and thus, the “public” had been brought in as an important discussant in the discussion on public health. Yet, agreement and cooperation were not the only issues at play. One of the most important things for me was the range of disagreement and debate among the different professionals at the event, a range which was countered at the same time by the underlying agreement on cooperation. And these disagreements were almost always based on disciplinary difference. The range of questions and answers demonstrated this. Each one of us had come from our own academic backgrounds, and our questions and concerns were, on the surface, different. But every conversation, every panel seemed to end, refreshingly, on moments of agreement. The recognition of agreement does not mean succumbing to a utopian idea of equality or symmetric cooperation.
Inequalities between narratives, between stories of public health exist. But the very recognition of difference, and the attempt to bring different voices in conversation with one another seems necessary, especially at a moment when polarity and dissonance seem to drive so much of public discourse. John Berger, in his novel G, wrote that never again will a single story be told as if it is the only one. Berger was advocating for a kind of polyphony, a recognition of otherness, a plurality. And perhaps this is how plurality begins: in a room full of differences, recognising what separates them and looking for what brings them together.
Utsa Bose is a DPhil candidate in History at the University of Oxford, researching the sociocultural and medical history of plague in Calcutta, 1890-1920.
