'To map out the "venereal wilderness"' : a history of venereal diseases and public health in New Zealand, 1920-1980

Abstract

This thesis traces the public health debate about venereal disease in New Zealand from 1920, when the first venereal disease clinics were established, to 1980 before the first AIDS/HIV cases emerged. Studies of venereal disease in New Zealand have concentrated on issues of morality and on the political and social debates; this thesis focuses on treatment procedures and Health Department campaigns. The thesis explores the role of doctors in relation to venereal disease. While advancements in drug therapy benefited patients, medical authority was undermined by demanding and defaulting patients, inadequate medical education, and a low status of the profession. The medical profession developed epidemiological studies and defined 'at risk' groups in post-war decades. Despite claims to be 'scientific', the assessments were informed by stereotypes which had changed little over time. The thesis evaluates the scope of preventative health campaigns. Defined as a public health issue by the 1920s, venereal disease was seen as an individual responsibility by the 1960s. During this time the use of legislation declined, and education and contact tracing increased. The control of infection was limited owing to financial and administrative problems, defaulters and opposition from doctors. Those deemed most at risk were not reached by government educational campaigns, leaving much to the work of welfare groups and individual doctors. The health campaigns targeted groups like Maori and servicemen. The historiography has tended to overlook Maori, and, when military campaigns are discussed, to focus on females. This thesis attempts to redress the balance. Maori had, at least until the 1950s, different treatment experiences from non-Maori patients, although this did not necessarily imply discrimination. The military did attempt to control servicemen, though each Service had different experiences. This thesis stresses the complexity of the gender issue. There was a change from blaming females for infection in the early twentieth century to increasingly pointing to male responsibility. Despite these changes, even with the concept of individual risk pattern by the 1960s, and the understanding that men could be asymptomatic carriers, women were persistently seen as the 'reservoir'. A gender bias persisted.