Curative Powers: Medicine and Empire in Stalin's Central Asia (review)

Given a nearly total absence of historical studies of Soviet medicine during the Stalin years, this book could have been a welcome introduction to a subject that fascinated, inspired, and puzzled generations of contemporary medical practitioners around the globe. Curative Powers is based on a wealth of documents from local and central Soviet archives that have never before been scrutinized by scholars, and it introduces extensive new data on Soviet medical policies and practices in one of the least-studied regions of the USSR. The book's six chapters explore medical discourse, propaganda campaigns, institution-building, training and field experiences of personnel, and particular policies toward two population subgroups: women and nomads. Paula Michaels's work builds upon fashionable trends in the history of medicine and Soviet history: the analysis of medicine as an instrument of imperial domination, and the study of the USSR as a particular kind of imperial power. Her line of reasoning is quite simple: the USSR was an empire, and hence its medical policies and practices in its "colonies" were similar to those of other European empires. Alas, for a historian of medicine, the book falls short of the promise of its title.

To begin with, Curative Powers is not about Soviet Central Asia, but only about Kazakhstan—admittedly territorially the biggest, but at the time not the most economically, demographically, or politically important of its five republics. One might dismiss this "innocent" deception as a naive attempt to widen the prospective market for the book, if it did not have important implications for the treatment of the book's subject. Michaels's frequent use of such terms as "Central Asians" and "non-Russians" instead of "Kazakhs" reinforces the simplistic scheme of opposing, monolithic entities—metropolis vs. colonies, biomedicine vs. ethnomedicine, the state vs. the people, center vs. periphery, Russians vs. non-Russians—that informs much (if not all) of the book's explanatory armamentarium. With Kazakhstan as a case study, this work seeks to illuminate "how the Communist regime's deployment of biomedicine and biomedical cadres served as a mechanism to entrench Soviet power" (p. 3)—reflecting the author's apparent belief that this process differed little, if at all, from one locale to another.

Even more disappointing is that Michaels has much more to say about "powers" than "cures" and about "empire" than "medicine." It seems that medicine is almost incidental to her study: a ten-page section on "Kazakh ethnomedical practices" is sketchy at best, and the actual therapeutic practices of "Soviet biomedicine" receive almost no attention beyond a single field: protection (okhrana—peculiarly translated by Michaels as "defense") of maternity and childhood. There is no attempt to describe Kazakhstan's epidemiologic profile: the prevalence of particular endemic, chronic, nutritional, occupational, and epidemic diseases; the morbidity and mortality patterns of particular illnesses; and the distribution of various ailments throughout the vast expanses of Kazakhstan territories. There is no discussion of the plague, trachoma, tuberculosis, or smallpox, not to mention a host of endemic illnesses such as various helminthoses, malaria, and cholera, which plagued the region. Likewise, although a whole chapter deals with "medical propaganda," very little is said about the actual medical content of this "biomedical drive": the illnesses targeted, the preventive and therapeutic measures advocated, or the behavioral patterns promoted. One can easily imagine replacing "medicine" with education, the arts, sports, the military, science, industry, or any other social institution in the book's analysis of "the transformative power of Communist rule" (p. 3) without much loss to its basic argument.

The conspicuous absence of disease in a book that purports to tell the history of medicine in a particular region reflects the dangers inherent in the forcing of a preconceived theoretical framework onto new material. The emphasis on "parallelisms," "analogies," and "similarities" between Soviet and other European empires completely obscures a number of fundamental...