Histories of sickle cell anaemia in postcolonial Britain, 1948-1997

This thesis examines the interactions between post-war immigration, the welfare state and ideas of belonging and citizenship in Britain, focusing on the hereditary blood condition sickle cell anaemia (SCA). By following SCA through five different spheres – those living with the illness, doctors and nurses ‘on the ground’ in the National Health Service’s hospitals and surgeries, medical researchers at the cutting edge of molecular biology, patient advocacy groups and policymakers in Whitehall – this thesis reconstructs an architecture of state power and political protest, and traces changing ideas of British citizenship and ‘race’ across the post-war period. Using oral histories, archival research and data analysis, this thesis is in the format of cross-section of the institutions and communities who encountered the condition across a sixty-year period. Drawing on a range of sources, including government papers, medical journals, laboratory casebooks, memoirs and oral histories, this thesis is both a case study in the shifting power of patients and patient groups within the NHS, and of the impact of protest, advocacy and Black British political action in reconfiguring notions of citizenship and shaping the priorities of the British state. Recent historiography has uncovered the influence of decolonization and Commonwealth migration upon the emergent British welfare state in this period, and this thesis draws connections between anthropology, colonial medicine and the experiences of Black British people in the clinics and wards of the National Health Service. It illustrates how Black healthcare professionals shaped the NHS and challenged institutional racism through often unpaid or unstable work. The project speaks to a rich historiography dealing with agency in the relationship between non-white communities in Britain and the British state, in terms of how racism is constituted in public life, how institutional racism operates and is challenged, and how ethnocentric definitions of citizenship are contested or reinforced. This thesis makes the case that the experiences of people with SCA have been tied to the position of Black British voices within the NHS and in the British political system, and the example of SCA is a compelling historic case for diversity in these institutions