Located within the corridors of Lewisham Shopping Centre, the Migration Museum commemorates the critical role migration has played in British society. Its latest exhibition explores the intersection of migration and the National Health Service (NHS), a cornerstone of British identity and solidarity. This touring showcase, born amidst the challenges of the COVID-19 pandemic, is a crucial reminder of this essential yet often overlooked connection. At its inception, it took the form of a comprehensive digital exhibition, which was also displayed on Piccadilly Circus’ LED screens. In 2023, the Migration Museum translated it into a physical touring exhibition, which launched in Leicester last summer to coincide with the 75th anniversary of the NHS. After a showing in Leeds, the exhibition – entitled ‘Heart of the Nation: Migration and the Making of the NHS’ – is now on at the Migration Museum in Lewisham until the end of July.
Mapping migrants’ journeys to the heart of the NHS
The exhibition reflects on the genesis of the NHS, a beacon of hope forged in the aftermath of World War II. The creation of the NHS in 1948 marked a pivotal moment in healthcare accessibility, opening doors for everyone regardless of their financial standing. Prior to the NHS’ founding, the healthcare system had already been reliant on workers from abroad. From Irish and Eastern European immigrants to Jewish refugees fleeing the horrors of Nazism, the NHS owes much of its early success to the dedication and resilience of these individuals. Among the notable figures highlighted in the exhibition is Sir Ludwig Guttmann, who, after escaping the Nazis, revolutionised spinal injury treatment and subsequently founded the Paralympic Games; it is worth reflecting on this significant contribution, particularly given the upcoming games in Paris this summer. The information is presented in an engaging and interactive manner, with testimonies displayed on clipboards that visitors can hold and read. The topics covered range from Lotte Fuchs’ arrival from Czechoslovakia in 1938 to Dr. Muhayman Jamil’s arrival from Iraq in the 1980s. This approach successfully fosters personal connections among stories and testimonies that span decades and continents.
The exhibition also effectively highlights how migration patterns were intricately tied to the remnants of the British Empire. Following the war, demand for medical professions from abroad was created by an exodus of nearly 4,000 British-trained doctors, with Commonwealth nations such as Australia, Canada, and New Zealand becoming popular destinations due to the ease of transferring British qualifications. Meanwhile, the 1948 British Nationality Act facilitated the arrival of medical migrants from Britain’s former colonies, shaping the NHS workforce in its formative years. The exhibition explores the active recruitment of medical personnel from South Asia and the Caribbean, situating this migration within the legacy of the Empire. Many of the new arrivals were familiar with the British education system due to their upbringing, with Leila Philips, who arrived from Guyana in 1951, remarking that “I knew Britain before I went there”.
Overcoming medical racism
There is a longstanding historical relationship between medicine and imperialism, highlighted in the exhibition by examining how the NHS emerged against this backdrop. During the 1830s, the British established medical colleges and schools in places like India, with Kolkata’s Medical College and Hospital founded in 1835 by Lord William Bentinck. These institutions, built through imperialist structures, provided training for healthcare workers from around the world before the NHS’s inception. This trend persisted even after countries gained independence, further illustrating the deep-rooted connections between British healthcare and global medical practices.
Prior to this, health and disease were sites of constructing otherness. The world of the tropics was conceived of as alien to Europeans in the 18th and 19th centuries. Literature on colonial disease after 1750, by writers such as James Lind, viewed the tropics as hostile environments. Tropical medicine emerged in the 1890s with parasitology, bacteriology, and the work of Patrick Manson and Ronald Ross, arguing that the nature of tropical climates and their temperatures produced diseases, and that travel to these climes was injurious to Europeans accustomed to temperate zones. Disease was understood in humoral and geographical terms, with Lind describing Egypt as unhealthy because of “noisome vapour” in his publication, “An Essay on Diseases Incidental to Europeans in Hot Climates” (1768).
Space and climate were also seen as producing national and racial characteristics. Tropical medicine continued to be part of a Western discourse of racial otherness, justifying imperialism and guiding the social relationships between white rulers and indigenous subjects in the colonial world. Tropical medicine was positioned as constructive, addressing the major obstacle of disease to British imperial administration, and thus worthy of investment. The political power of scientists was advertised through medical publications that hailed colonial medical discoveries, while altruistic narratives were conveyed through literature, obscuring the economic motives for the field’s development. Thus, the unequal treatment of non-white NHS staff reflects a broader historical paradigm of imperialism and racial othering, with its after-effects manifesting domestically within this institution.
Heart of the Nation courageously confronts the enduring legacy of racism within the NHS, shedding light on the hostilities faced by healthcare workers of colour whose competence was unjustly questioned by patients and colleagues alike. Many testimonies spoke of how their qualifications from abroad were not recognised, thus requiring staff to undergo gruelling extra training. Afterwards, there still remained difficulties in progressing in the medical field due to assumptions made about their abilities. The 1960s and 1970s saw offensive comments written about immigrant doctors in the British Medical Journal, with the popular press thereafter circulating offensive cartoons. This treatment occurred against a backdrop of a plethora of inequality wrought on non-white arrivals nationwide, ranging from housing discrimination to the rise of the National Front. Through powerful testimonies and personal anecdotes, visitors are confronted with the harsh realities of systemic discrimination that continue to plague the healthcare system. The continued prevalence of health disparities among communities of colour in the UK underscores the importance of examining the history of racism in the NHS.
Yet, amidst the shadows of adversity, the exhibition also celebrates the resilience and spirit of solidarity that define migrant communities, whether the healthcare workers were from Nigeria, Spain or the Philippines. The exhibition makes a careful effort to foreground the spectrum of lived experiences. The lives of new nurses living in nurse homes are relayed through testimonies, pictures and remembrances. Reading their tales of frequenting familiar locations such as Brixton and Hammersmith unveiled to me a new layer of the past, and a different appreciation for the spaces and the legacies contained therein. Chris Porsz’ photographs from a Peterborough hospital in the 1980s offers visitors intimate glimpses of the lives of porters and kitchen staff, imbued with warmth and authenticity. Speaking of his photography, Porsz wrote: “My mother was a Holocaust survivor so knew exactly what hatred leads to and my images are a tribute to that generation and the sacrifices they have made for us in our NHS.” Through props such as Notting Hill carnival headdresses made by Allyson Williams MBE, to personal anecdotes recounting memories of dances and communion, migrant healthcare workers are shown to have forged bonds of camaraderie and support, overcoming barriers with unwavering determination while continuing to excel in their provision of healthcare.
Given the significance of health as a site for constructing national identities, this exhibition is a crucial intervention. Today, one in six NHS workers has a non-British nationality, and a disproportionate number lost their lives working on the frontlines of the COVID-19 pandemic. The Migration Museum’s NHS exhibition stands as a testament to the power of collective memory and solidarity. Its message is urgent; a challenge to confront the deep-rooted inequalities pervading our healthcare system, and an intimate introduction into the people who are foundational to its maintenance.
Written by Nadia Awad
‘Heart of the Nation’ is currently exhibiting at Lewisham Shopping Centre until Saturday July 27th 2024. If you’d like to explore another story of a migrant founder of the NHS, you can read our two-part biography of Thora Silverthorne, who came to Oxford in the 1930s, volunteered in the Spanish Civil War and helped to set up the National Nurses Association. You can also book on our regular History of Medicine tour, which tackles contentious developments in medical research and practice down the centuries.
