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- All Subjects: Immunization
- Creators: Chen, Angela
- Creators: Malotky, Braeden M
The nineteenth-century invention of smallpox vaccination in Great Britain has been well studied for its significance in the history of medicine as well as the ways in which it exposes Victorian anxieties regarding British nationalism, rural and urban class struggles, the behaviors of women, and animal contamination. Yet inoculation against smallpox by variolation, vaccination’s predecessor and a well-established Chinese medical technique that was spread from east to west to Great Britain, remains largely understudied in modern scholarly literature. In the early 1700s, Lady Mary Wortley Montagu, credited with bringing smallpox variolation to Great Britain, wrote first about the practice in the Turkish city of Adrianople and describes variolation as a “useful invention,” yet laments that, unlike the Turkish women who variolate only those in their “small neighborhoods,” British doctors would be able to “destroy this [disease] swiftly” worldwide should they adopt variolation. Examined through the lens of Edward Said’s Orientalism, techno-Orientalism, and medical Orientalism and contextualized by a comparison to British attitudes toward nineteenth century vaccination, eighteenth century smallpox variolation’s introduction to Britain from the non-British “Orient” represents an instance of reversed Orientalism, in which a technologically deficient British “Occident” must “Orientalize” itself to import the superior medical technology of variolation into Britain. In a scramble to retain technological superiority over the Chinese Orient, Britain manufactures a sense of total difference between an imagined British version of variolation and a real, non-British version of variolation. This imagination of total difference is maintained through characterizations of the non-British variolation as ancient, unsafe, and practiced by illegitimate practitioners, while the imagined British variolation is characterized as safe, heroic, and practiced by legitimate British medical doctors. The Occident’s instance of medical technological inferiority brought about by the importation of variolation from the Orient, which I propose represents an eighteenth-century instance of what I call medical techno-Orientalism, represents an expression of British anxiety over a medical technologically superior Orient—anxieties which express themselves as retaliatory attacks on the Orient and variolation as it is practiced in the Orient—and as an expression of British desire to maintain medical technological superiority over the Orient.
Method: Twenty families with children 10 years and older were recruited to participate in a 3-week equine assisted learning program at a therapeutic riding center in Phoenix, Arizona. Sessions included groundwork activities with horses used to promote life skills using experiential learning theory. The study design included a mixed-method quasi-experimental one-group pretest posttest design using the following mental health instruments: Devereaux Student Strengths Assessment, Brief Family Assessment Measure (3 dimensions), and Family Satisfaction Scale to measure child social-emotional competence, family function, and family satisfaction, respectively. Acceptability was determined using a Likert-type questionnaire with open-ended questions to gain a qualitative thematic perspective of the experience.
Results: Preliminary pretest and posttest comparisons were statistically significant for improvements in family satisfaction (p = 0.001, M = -5.84, SD = 5.63), all three domains of family function (General Scale: p = 0.005, M = 6.84, SD = 9.20; Self-Rating Scale: p = 0.050, M = 6.53, SD = 12.89; and Dyadic Relationship Scale: p = 0.028, M = 3.47, SD = 7.18), and child social-emotional competence (p = 0.015, M = -4.05, SD 5.95). Effect sizes were moderate to large (d > 0.5) for all but one instrument (Self-Rating Scale), suggesting a considerable magnitude of change over the three-week period. The intervention was highly accepted among both children and adults. Themes of proximity, self-discovery, and regard for others emerged during evaluation of qualitative findings. Longitudinal comparisons of baseline and 3-month follow-up remain in-progress, a topic available for future discussion.
Discussion: Results help to validate equine assisted learning as a valuable tool in the promotion of child social-emotional intelligence strengthened in part by the promotion of family function and family satisfaction. For mental health professionals, these results serve as a reminder of the alternatives that are available, as well as the importance of partnerships within the community. For therapeutic riding centers, these results help equine professionals validate their programs and gain a foothold within the scientific community. Additionally, they invite future riding centers to follow course in incorporating evidence into their programs and examining new directions for growth within the mental health community.