HHH column: Oral history as a necessity and a solution in the digital world by Arjan Nuijten

The HHH column is a monthly blog in which History, Health & Healing members share their thoughts on research, current affairs, or anything to do with medical history. Each edition is written by a different member – in due time, we hope to offer everybody a chance to publish a contributionThis month, the floor is for Arjan Nuijten, lecturer in modern history at the University of Amsterdam. During the pandemic, Arjan worked as a researcher for the GGD, the Municipal Health Service, in the Utrecht region. In this column, he explains how the storage of digital data and the use of digital tools in health organisations does not necessarily mean that their activities will be well-recorded. Historians and health organisations still need “traditional” methods, such as oral history, to understand and preserve past work in healthcare.

Oral history as a necessity and a solution in the digital world

Arjan Nuijten

The field of (medical) history is grasped by trends in digital development, just like the world around us. New methods and programs stimulate our thinking on writing about the past: from programs within the CLARIAH Digital Humanities toolbox that find new connections between different source material, to the implementation of artificial intelligence to complement our writing. For the historian or researcher that prefers older methods of research and writing, these developments can be daunting. Luckily, methods such as oral history are not only withstanding the test of time but can help us find the needle in the ever-growing digital haystack.

During the first few years of the Covid pandemic, I had the opportunity to work as a researcher for the GGD (Gemeentelijke Gezondheidsdienst, Municipal Health Service) Regio Utrecht. The GGDrU is the largest regional public health service of the Netherlands, which was tasked to trace and prevent the spread of Covid, enact prevention measures and ensure widespread availability of vaccines in the province of Utrecht at the outbreak of the pandemic.[1] The efforts of the GGDrU, and the Covid pandemic on the whole, were deemed important enough to call for the enactment of an archival hotspot: all activities of the organization related to the Covid pandemic had to be registered, collected, archived and safeguarded for future historical research, to a larger extent than they normally would have to under the Archive Law.[2] This means that a wealth of data on these first Covid years was collected. Yet, although the GGDrU made ample use of digital tools to collect this data, the research process for future historians will not necessarily be easier, as the data and visualizations produced by the organization were imperfectly stored and used.

At the outbreak of the pandemic, a special Covid division was created within the GGDrU. Within this Covid division, our research & information team collected all kinds of raw data on the daily activities of the division, such as the number of vaccine shots handed out at a specific vaccination location. This data was collected in a central database and plotted and visualized in graphs with tools such as PowerBI. More than once, however, our team found out that the managers who were supposed to base their decisions on these visualizations kept their own Excel sheets with often incomplete data. In fact, even though the data in the central database offered precious information, the organization did not necessarily use it to make important decisions. More importantly, to be able to handle this data, a historian would first have to gain knowledge on the use of PowerBI and MySQL. To make matters worse, it is unsure if the visualizations produced from the dataset by the team will still be available in the future, since they were hosted in the cloud of PowerBI and not necessarily saved offline.

An image generated by an AI representing an archive full of computers.

This brings me to a point about information management, which, at first sight, seems to be easier with digital tools at hand, but requires more planning than organizations think about. The office work in the GGDrU Corona division was highly digitalized. Employees of the different teams shared their work in Sharepoint and held meetings over Teams, next to specific epidemic registration tools such as HP Zone. The list of tools used and integrated with each other goes on and on. This digital office had its upsides such as being able to work from home – especially handy during a pandemic. On the other hand, we had a few archival employees who tried to get a grasp on how the division was structured and what kind of files should be saved for the future. Here, the flexibility of Sharepoint created an obstacle rather than a solution. Hierarchies of folders and files were changed over time as there was no general structure from the outset and employees changed folders as they saw fit. The digital files never had a permanent location on Sharepoint, but neither were they ever ‘finished’, as you can even revert document files back to earlier versions. It was therefore unclear what versions were permanent versions and what files were still being worked on. This is a dream for the data completionist of the future, who can trace back steps within a Word document. But for the archival employees in the present, the flexibility is a nightmare since it is never clear which documents are vital or final versions. An actual paper trail of finished reports would give a clearer insight on the workings of the organization.

For the future historian who wants to take a deep dive into the data of a regional public health service, the digital footprints of the GGD are a godsend. But if one wants to track how decisions were made within this organization, what went wrong behind the scenes and which challenges were overcome, the solution in this maze of unorganized data is oral history, rather than digital history. The hotspot employees fell back on interviewing the different teams of the organization to find out what tasks their team actually performed and what kind of files needed to be safeguarded for the future. Our own research team made use of interviews to improve the organization in matters such as the accessibility of vaccination for undocumented people in the region. And after two years of pandemic the organization itself decided to draw up the different stories of its employees rather than diving into its own pile of digital documents. The future belongs to oral history rather than to searching through the ever-growing digital database.

[1] See: https://ggdru.nl/

[2] ‘Wat is precies een hotspot?’, https://www.informatiehuishouding.nl/medewerkers/vraag-en-antwoord/wat-is-precies-een-hotspot-en-wat-moet-ik-daarover-weten (27-01-2023).