Prevention and Cure: The London School of Hygiene and Tropical Medicine, a Twentieth-Century Quest for Global Public Health (review)

The London School of Hygiene and Tropical Medicine has had a long and colorful history. It grew from the Seaman's Hospital Society, which in 1821 converted the old gunship H.M.S. Grampus into a hospital ship and moored it at Greenwich. In 1870 the hospital came ashore to become, in 1890, the Albert Dock Branch Hospital; in 1899, it was expanded to become the London School of Tropical Medicine. After World War I the school moved upstream to London, where it was housed in the refurbished Endsleigh Palace Hotel (now the site of the University College Students' Union). Finally, in 1929, after ten years of negotiation with the Rockefeller Foundation, the school was moved into a new building at its present site on Keppel Street, adjacent to University College and the Senate House, to become the London School of Hygiene and Tropical Medicine. This story has been told many times before, but this book, for the first time, takes the story beyond 1929 to the present day.

The authors rightfully skim over the early years and basically begin their story with chapter 3, "Transition 1919-29: From Tropical Medicine to Global Public Health," in which they argue that the school changed from a concern with tropical medicine to "public health on a wider global scale" (p. 65). In subsequent chapters, to substantiate this point of view, they deal first with the nontropical divisions of the school before finally, in chapter 10, addressing tropical medicine. However, while I do not deny that the post-1919 school differed from the early school of tropical medicine, I am not convinced that tropical medicine took quite the backseat that they imply. First, the old school did not really become the new school of hygiene; rather, when the Rockefellers agreed to endow a new school of hygiene close to the School of Tropical Medicine which would be "imperial in scope," Manson realized with alarm that it would become a threat to his own school. He therefore proposed that the School of Tropical Medicine should be housed in a wing of the new school, and thus, in 1924, the new school was renamed the LSHTM. By the mid-1930s, more than 1,000 medical graduates had received the Diploma in Tropical Medicine, compared to fewer than 150 who received the Diploma in Public Health. Furthermore, after World War II, large numbers of African students flooded into the school to take classes in tropical medicine.

Unfortunately, the book is a rather disorganized in-house document in which the authors separately narrate the history of each of its major divisions and do so in a way that indicates that the school's faculty, past and present, are the principal audience. The bewildering series of organizational changes, for example, are never explained for an outside reader and are always ascribed to internal changes within the various disciplines. The school's history seems to have taken place in a political vacuum: no mention is made of either British or Imperial history. The impact of World War II is mentioned only briefly, the postwar collapse of Empire not at all. Neither is there mention of Mrs. Thatcher, despite the fact that major organizational changes coincided with her government (while I was there, cafeteria gossip, admittedly not a solid source of historical evidence, abounded with scuttlebutt of how the school negotiated its way around her). Why are we never told how such an institution, so clearly linked to Empire, survived?

The problems are compounded by an utterly useless index. Gordon Smith, for example, dean from 1971 to 1989 and the one responsible for the most dramatic organizational changes, receives a single index citation, whereas...