It’s Cervical Cancer Prevention Week, so Louise
has been looking again at Edinburgh’s history of advocacy
and care reflected in our collections:
By their very nature, many archives tend to represent an ‘institutional’
view of the past, since it’s the history and accountability of organisations
(such as the National Health Service) that these archives are set up to
represent in the first place. For example, we have many, many records about
patients in the form of various registers, ledgers and case histories, but these
reflect hospitals’ aims in treating people and sending them out well again – case
histories are taken down by a doctor or clerk (not always verbatim), clinical
opinions are given on care and progress and the patient’s outcome assessed.
First-hand patient experiences, reactions and feelings are almost always filtered
through the clinical needs of the record and the voice of the physician – at least
in our older holdings. Luckily, we have a number of more modern collections
that reset this balance, conveying the direct experiences of those being cared
for – one of these being our Cervical Smear and Women’s Health collection (GD31).
As a result of publicised (and avoidable) deaths from
cervical cancer in the early 1980s, Lothian Health Board’s existing cervical
screening services were in extremely high demand – particularly since women
were not invited to attend regular screenings. In 1985, laboratory facilities
had a backlog of 10,000 un-read slides and froze the screening programme to
catch up. In response to public concern about this, Edinburgh District Local
Health Council and Edinburgh District Council Women’s Committee organised a
public meeting, and the ‘Cervical Smear Campaign’ was formed.
The campaign petitioned Lothian Health Board to lift all screening
restrictions and to demand a fully comprehensive service in Lothian and
Scotland, including regular tests with organised call-backs and treatment for
abnormal smears. Public support for the petition was massive in Lothian, Fife
and the Borders, with nearly 18,000 signatures. In May 1988, Lothian Health
Board introduced three-yearly screening for women aged 20 and over, a
computerised recall system, and automatic notification of all test results to
women themselves in addition to their doctors.
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| Cervical Smear Campaign video, 1987 (GD31/4/3) |
The campaign became national as the decade went on. In
November 1987, a second petition was launched, demanding a full screening
service across Scotland. Campaign members also gave talks to hundreds of women
across the region and produced information leaflets and a video in the absence
of any other health education material, raising awareness and changing
attitudes towards cervical cancer within the general public, the NHS and the
media.
My favourite items in the Cervical Smear Campaign part of
the collection are undoubtedly these publicity materials – they show a real
grass-roots approach, giving straightforward and non-intimidating information
about women’s health:
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| Cervical Smears and Women's Health leaflet, Cervical Smear Campaign, 1986 (GD31/3/1/1) |
Importantly, this key information was made accessible for
those whose first language was not English:
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| The same leaflet in Chinese (left) and Bengali (right) - GD31/3/1/2 |
As well as information generated by the Cervical Smear
Campaign, there’s also local and national information and discussion on testing
and attitudes to cervical cancer - for example, this Lothian Health Board 1988
leaflet, which echoes the imagery used in the earlier Cervical Smear Campaign:
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| Lothian Health Board leaflet, 1988 (GD31/3/7/1) |
Debates around women’s
health and morality, still very much on the agenda today, are also reflected in this collected
literature. On the back page of a 1985 publication from the London-based Women’s
Health Information Centre (GD31/6/1), the moral assumptions involved in
abnormal smear results and cervical cancer diagnoses are explored. Since the virus that leads to cervical cancer is spread through sexual contact, the article reported women ‘already
distressed by a diagnosis of cancer… additionally humiliated by insensitive
questions about the number of sexual partners they have had.’ The author
describes women being ascribed responsibility for the sexual promiscuity of any
potential partners and being urged to keep themselves morally and physically pure
to remain cancer-free. In contrast, despite the increasing incidence in young
women in the 1980s, the article points out that cervical cancer ‘remains predominantly
a disease of poverty and old age’ – since working class women without a
bathroom at home and wives of men working in ‘dusty’ occupations (like mining,
working with machine tools and with certain chemicals) were especially
vulnerable. Regular testing, social change, health education and better environmental
working and living conditions – rather than cementing stigma and fear – were then,
as now, seen as the most effective health promotion.
If you’d like to know more about our collections around
women’s health in Edinburgh and the Lothians, get in touch.
