Care in the Past: Archaeological and Interdisciplinary Perspectives edited By Lindsay Powell, William Southwell-Wright, and Rebecca Gowland (Oxbow Books, 2017).
This volume showcases research that neatly synthesises not only how past communities may have provided care, but also why this caring impetus could have arisen. Born from a one-day conference held at Durham University (“Care in the Past: Archaeological and Interdisciplinary Dialogues”), and a session within the Theoretical Archaeology Group (TAG) Meeting, University of Liverpool (“Disability and Archaeology: Critical Perspectives and Inclusive Practices”), this collection of papers provides an important platform for the presentation of research from both emerging and established academics.
Care is defined within this volume, broadly, as ‘the provision of what is necessary in order to maintain another person’s state of health and welfare’ (p. 1). The cover image beautifully depicts a concerned family drawn together to care for a sick child, the dark oppressive atmosphere highlighting the perils of raising a family during the turn of the nineteenth century, when even the most commonplace of diseases came with a high risk. While this image is perhaps more aligned with our concepts of compassionate care today, a more skeptical view has often existed regarding care in the past — assuming a more distanced approached to poor health at a time when mortality was so high. So which viewpoint is more accurate when considering care within past communities across historical periods in time? Did perceptions fluctuate according to the requirements of age, and through the passage of time? How did our ancestors interact as a community/family to support each other in times of infirmity? Did they provide care? How, and to whom? Was it out of compassion, or obligation? Many of these questions are founded deeply in emotion and societal structures, making it often difficult to access evidence of care in the past. As such, this book endeavours to cover a vast variety of topics within one volume, from a range of academic disciplines, all connected by the primary aim to explore changing perceptions of care throughout history, and the life course.
The book is structured according to three sections. The first, Care and the Life Course, explores how care giving may have changed or been influenced by differing health risks combined with social perceptions as an individual aged, with contributions from Mary Lewis (exploring evidence for the treatment of disabled children within the archaeological record), Ellen Kendall (providing a timely critique regarding our tendency to overlook inter-family variation on infant feeding practices within palaeodietary studies), Heidi Dawson (examining care of children in Late Medieval England), and Rebecca Gowland (confronting the consequences of lack of care of the elderly in Roman Britain).
The second theme, Care, Impairment and Disability, reflects on the varieties of care that may have existed in the past, with contributions from Nick Thorpe (challenging past perceptions of compassion and care within Palaeolithic societies), David Doat (supporting the need to include evolutionary biological perspectives when considering caregiving behaviours in the past), Shawn Phillips (presenting the consequences of institutionalised care for individuals with physical or mental disability in a nineteenth century asylum), and Marlo Willows (combining osteological and isotopic analyses to explore pilgrimage and healing traditions at the Isle of May, Scotland, during the Medieval period).
Lastly, Care and Non-Human Animals considers the involvement of non-human animals in both the provision of care with Gary King discussing the variety of uses for insects within medicinal care, and also the receipt of care with Richard Thomas discussing the evidence for human-provided treatment of pathology within the zooarchaeological record.
Remarkably, this volume has not only achieved its aims in providing a comprehensive tour in care through time, place, age, and taxa, its inclusion of the chapters by Nick Thorpe and David Doat have also reopened discussion regarding the formerly contentious issue of accessing evidence of caring and compassionate behaviours in past communities. In fact, nearly half of the chapters identify the “Index of Care,” previously constructed by Tilley and Cameron (2014), as a promising novel approach of identifying evidence of care within archaeological case studies. This thorough methodology has the potential to reinvigorate studies of care in the past within archaeological research, and also promotes the practice of taking an interdisciplinary approach to this topic. For these reasons, a quote from the preface provided by Professor Charlotte Roberts is particularly apt – this volume is set to ‘become essential reading for those working in this field.’
This volume offers food for thought for those working within the interdisciplinary field of the medical humanities. Access to health and care is fundamental within any functioning society. Members of a community will inevitably fall ill, or experience injuries, and this will not only affect their relation to society, but also how the community in turn will interact with them. Chapters by Rebecca Gowland and Shawn Philips, for instance, highlight the implications of absence of care in both the domestic and institutionalised setting. Lack of care can lead to a rapid decline in overall health and wellbeing, and from the perspective of a publicly available and accessible healthcare system, it can often be difficult to fathom a world where access to health care is not a simply a case of where and when – but if and how. However, those living within developing countries continue to face challenges in accessing health care services today (Peters et al. 2008:161), and even social inequality within countries can lead to poorer health outcomes for lower income families (Wilkinson and Pickett 2010). Thus, health inequity can lead to a perpetuation of the cycle of poverty as delays in treatment can lead to loss of income and escalating health care costs (Peters et al. 2008:161). In light of the UK’s status as one of the most unequal societies in the world (Wilkinson and Pickett 2010), alongside an uncertain future for its National Health Service (NHS), volumes such as Care in the Past emphasise the pertinence of understanding how communities in the past overcame, or succumbed to challenges in quality and availability of health care.
Reviewed by Sophie Newman recently completed a PhD in Bioarchaeology at Durham University, focusing on the impact of industrialisation on child health in eighteenth and nineteenth century England. Her research interests include the influence of social status and vitamin D deficiency on growth and development, and overall population health. She has co-authored a paper on the influence of social status and child care practices on child health in eighteenth and nineteenth century England in the International Journal of Osteoarchaeology in 2016. She currently works as a Contract Osteoarchaeologist for York Osteoarchaeology.
Correspondence to Sophie Newman.
Works cited:
Peters, David H., Anu Garg, Gerry Bloom, Damian G. Walker, William R. Brieger, and M. Hafizur Rahman. 2008. Poverty and Access to Health Care in Developing Countries. Annals of the New York Academy of Sciences, 1136: 161-171.
Tilley, Lorna, and Tony Cameron. 2014. Introducing the Index of Care: a web-based application supporting archaeological research into health-related care. International Journal of Paleopathology, 6: 5-9.
Wellcome Library no. 16897i. Concerned parents trying to coax a sick child to take some liquid while a dog waits patiently. Watercolour by W.H. Margetson,1901. http://catalogue.wellcomelibrary.org/record=b1174783 (Accessed March 3, 2017)
Wilkinson, Richard, and Kate Pickett. 2010. The Spirit Level. Why Equality is Better for Everyone. London: Penguin Books Ltd.