MUSE in Focus:
Contextualizing Pandemic

While the eradication of smallpox has long been documented, not many know the Chinese roots of this historic achievement. In this revelatory study, Mary Augusta Brazelton examines the PRC’s public health campaigns of the 1950s to explain just how China managed to inoculate almost six hundred million people against this and other deadly diseases. Mass Vaccination tells the story of the people, materials, and systems that built these campaigns, exposing how, by improving the nation’s health, the Chinese Communist Party quickly asserted itself in the daily lives of all citizens. This crusade had deep roots in the Republic of China during the Second Sino-Japanese War, when researchers in China’s southwest struggled to immunize as many people as possible, both in urban and rural areas. But its legacy was profound, providing a means for the state to develop new forms of control and of engagement. Brazelton considers the implications of vaccination policies for national governance, from rural health care to Cold War-era programs of medical diplomacy. By embedding Chinese medical history within international currents, she highlights how and why China became an exemplar of primary health care at a crucial moment in global health policy.

Did you know that many of the greatest and most colourful Ottoman statesmen and literary figures from the 15th to the early 20th century considered plague as a grave threat to their empire? And did you know that many Ottomans applauded the establishment of a quarantine against the disease in 1838 as a tool to resist British and French political and commercial penetration? Or that later Ottoman sanitation effort to prevent urban outbreaks would help engender the Arab revolt against the empire in 1916? Birsen Bulmus explores these facts in an engaging study of Ottoman plague treatise writers throughout their almost 600-year struggle with this epidemic disease. Along the way, she addresses the political, economic and social consequences of the methods they used to combat it.

Few diseases have provoked as many wild moralistic leaps or stringent attempts to measure, classify, and define risk and treatment standards as AIDS. In Politics in the Corridor of Dying, Jennifer Chan documents the emergence of a diverse range of community-based, nongovernmental, and civil society groups engaged in patient-focused AIDS advocacy worldwide. She also critically evaluates the evolving role of these groups in challenging authoritative global health governance schemes put in place by what she describes as overcontrolling or sanctimonious governments, scientists, religious figures, journalists, educators, and corporations. Drawing on more than 100 interviews conducted across eighteen countries, the book covers a broad spectrum of contemporary sociopolitical issues in AIDS activism, including the criminalization of HIV transmission, the fight against “big pharma,” and the politics of the President’s Emergency Plan for AIDS Relief. Chan argues that AIDS activism disrupts four contemporary regimes of power—scientific monopoly, market fundamentalism, governance statism, and community control—by elevating alternative knowledge production and human rights. This multidisciplinary book is aimed at students and scholars of public health, sociology, and political science, as well as health practitioners and activists. Politics in the Corridor of Dying makes specific policy recommendations for the future while revealing how AIDS activism around the world has achieved much more than increased funding, better treatment, and more open clinical trial access: by forcing controlling entities to democratize, activists have changed the balance of power for the better and helped advance permanent social change.

The fields of global health and international relations are increasingly concerned with the responsibilities of nations to respond to disease outbreaks in a way that safeguards their neighbors as well as the broader international community. In Containing Contagion, Sara E. Davies focuses on one of the world’s most pivotal (and riskiest) regions in the field of global health—Southeast Asia, which in recent years has responded to a wave of emerging and endemic infectious disease outbreaks ranging from Nipah, SARS, and avian flu to dengue and Japanese encephalitis. Between 2005 and 2010, Davies explains, Southeast Asian states, despite having vastly different health system capacities and political systems, repeatedly committed to pursue a collective approach to the communication of outbreaks. Davies draws on newly gathered data and extensive field interviews to explore how these states implemented the revised International Health Regulations (IHR) through the deliberate alignment of political interests and regional cooperation. Examining why these Southeast Asian states adopted a collective approach, Davies also describes the complications that ensued and traces the consequences of this approach. The first book to explore what problems exist in the relationship between international relations and health, Containing Contagion frames contrasting views of global health agency within the current crises that are facing global health. Providing an immediate, contemporary example of a region networking its response to disease outbreak events, this insightful book will appeal to global health governance scholars, students, and practitioners.

The 2013–2015 outbreak of the Ebola virus disease (EVD) was a public health disaster: 28,575 infections and 11,313 deaths (as of October 2015), devastating the countries of Guinea, Liberia, and Sierra Leone; a slow and mismanaged international response; and sensationalistic media coverage, seized upon by politicians to justify wrongheaded policy. And yet there were also promising developments that may improve future responses to infectious disease epidemics: the UN Security Council’s first involvement in a public health event; a series of promising clinical treatments and vaccines for EVD; and recognition of the need for a global public health system to deal with epidemics that cross national borders. This volume offers a range of perspectives on these and other lessons learned, with essays on the science, politics, and ethics of the Ebola outbreak. The contributors discuss topics including the virology and management of EVD in both rich and poor nations; the spread of the disease (with an essay by a leader of Médecins Sans Frontières); racist perceptions of West Africa; mainstream and social media responses to Ebola; and the ethical issue of whether to run clinical trials of experimental treatments during an outbreak. Contributors: Christian L. Althaus, Daniel G. Bausch, Adia Benton, Michael J. Connor, Jr., Kim Yi Dionne, Nicholas G. Evans, Morenike Oluwatoyin Folayan, Stephen Goldstein, Bridget Haire, Patricia C. Henwood, Kelly Hills, Cyril Ibe, Marjorie Kruvand, Lisa M. Lee, Maimuna S. Majumder, Alexandra L. Phelan, Annette Rid, Cristine Russell, Lara Schwarz, Laura Seay, Michael Selgelid, Tara C. Smith, Armand Sprecher.

Mirko D. Grmek (1924-2000) is one of the most significant figures in the history of medicine, and has long been considered a pioneer of the field. The singular trajectory that took Grmek from Yugoslavia to the academic culture of post-war France placed him at the crossroads of different intellectual trends and made him an influential figure during the second half of the twentieth century. Yet, scholars have rarely attempted to articulate his distinctive vision of the history of science and medicine with all its tensions, contradictions, and ambiguities. This volume brings together and publishes for the first time in English a range of Grmek’s writings, providing a portrait of his entire career as a historian of science and an engaged intellectual figure. Pathological Realities pieces together Grmek’s scholarship that reveals the interconnections of diseases, societies, and medical theories. Straddling the sciences and the humanities, Grmek crafted significant new concepts and methods to engage with contemporary social problems such as wars, genocides and pandemics. Uniting some major strands of his published work that are still dispersed or simply unknown, this volume covers the deep epistemological changes in historical conceptions of disease as well as major advances within the life sciences and their historiography. Opening with a classic essay – “Preliminaries for a Historical Study of Diseases,” this volume introduces Grmek’s notions of “pathocenosis” and “emerging infections,” illustrating them with historical and contemporary cases. Pathological Realities also showcases Grmek’s pioneering approach to the history of science and medicine using laboratory notebooks as well as his original work on biological thought and the role of ideologies and myths in the history of science. The essays assembled here reveal Grmek’s significant influence and continued relevance for current research in the history of medicine and biology, medical humanities, science studies, and the philosophy of science.

Holmberg, Christine, and J. Hillis Miller. Manchester University Press, 2017. https://muse.jhu.edu/book/64072 Mass vaccination campaigns are political projects that presume to protect individuals, communities, and societies. Like other pervasive expressions of state power - taxing, policing, conscripting - mass vaccination arouses anxiety in some people but sentiments of civic duty and shared solidarity in others. This collection of essays gives a comparative overview of vaccination at different times, in widely different places and under different types of political regime. Core themes in the chapters include immunisation as an element of state formation; citizens’ articulation of seeing (or not seeing) their needs incorporated into public health practice; allegations that donors of development aid have too much influence on third-world health policies; and an ideological shift that regards vaccines more as profitable commodities than as essential tools of public health. A novel lens through which to view changes in concepts of “society” and “nation” over time.

In An Epidemic of Rumors, Jon D. Lee examines the human response to epidemics through the lens of the 2003 SARS epidemic. Societies usually respond to the eruption of disease by constructing stories, jokes, conspiracy theories, legends, and rumors, but these narratives are often more damaging than the diseases they reference. The information disseminated through them is often inaccurate, incorporating xenophobic explanations of the disease’s origins and questionable medical information about potential cures and treatment. Folklore studies brings important and useful perspectives to understanding cultural responses to the outbreak of disease. Through this etiological study Lee shows the similarities between the narratives of the SARS outbreak and the narratives of other contemporary disease outbreaks like AIDS and the H1N1 virus. His analysis suggests that these disease narratives do not spring up with new outbreaks or diseases but are in continuous circulation and are recycled opportunistically. Lee also explores whether this predictability of vernacular disease narratives presents the opportunity to create counter-narratives released systematically from the government or medical science to stymie the negative effects of the fearful rumors that so often inflame humanity. With potential for practical application to public health and health policy, An Epidemic of Rumors will be of interest to students and scholars of health, medicine, and folklore.

News footage of disease in Africa is a familiar sight. Yet these outbreaks are often presented out of context, with no reference to the conditions that have triggered them. MISTRA’s new book, Epidemics and the Health of African Nations, aims to redress that. Researchers and practitioners from within the continent explore why Africa is so vulnerable to disease, and show how this vulnerability is closely linked to political and economic factors. They demonstrate how these same factors determine the way epidemics are treated. Authors extract lessons from case studies in different parts of Africa; challenge conventional frameworks about disease to argue for a ‘syndemics’ approach that takes into account the interrelationship between disease and political and socio-economic contexts; explore challenges of Africa’s future. They argue that a well-functioning health system is at the core of a country’s capacity to counter an epidemic. This volume brings African experts together to probe possible solutions to the continent’s heavy burden of disease. The insights offered will be helpful in devising policy for the control of disease and the combatting of epidemics in Africa.

Empires of Panic is the first book to explore how panics have been historically produced, defined, and managed across different colonial, imperial, and post-imperial settings—from early nineteenth-century East Asia to twenty-first-century America. Contributors consider panic in relation to colonial anxieties, rumors, indigenous resistance, and crises, particularly in relation to epidemic disease. How did Western government agencies, policymakers, planners, and other authorities understand, deal with, and neutralize panics? What role did evolving technologies of communication play in the amplification of local panics into global events? Engaging with these questions, the book challenges conventional histories to show how intensifying processes of intelligence gathering did not consolidate empire, but rather served to produce critical uncertainties—the uneven terrain of imperial panic.

"Charting the relays of rumor and knowledge that stoke colonial fears of disease, disorder, and disaster, Empires of Panic offers timely and cautionary insight into how viscerally epidemics inflame imperial anxieties, and how words and their communication over new technologies accelerate panic, rally government intervention, and unsettle and entrench the exercise of global power. Relevant a century ago and even more so today." — Nayan Shah, University of Southern California; author of Contagious Divides: Epidemics and Race in San Francisco’s Chinatown.

"Empires generated anxiety as much as ambition. This fine study focuses on anxieties generated by disease. It is the first book of its kind to track shifting forms of panic through different geopolitical regimes and imperial formations over the course of two centuries. Working across medical and imperial histories, it is a major contribution to both." — Andrew S. Thompson, University of Exeter; author of Empire and Globalisation: Networks of People, Goods and Capital in the British World, c. 1850–1914 (with Gary B. Magee).

Health, Hygiene and Eugenics in Southeastern Europe to 1945. Central European University Press, 2011. https://muse.jhu.edu/book/16015 This volume is a collection of chapters that deal with issues of health, hygiene and eugenics in Southeastern Europe to 1945, specifically, in Bosnia-Herzegovina, Bulgaria, Croatia, Greece and Romania. Its major concern is to examine the transfer of medical ideas to society via local, national and international agencies and to show in how far developments in public health, preventive medicine, social hygiene, welfare, gender relations and eugenics followed a regional pattern. This volume provides insights into a region that has to date been marginal to scholarship of the social history of medicine.

Few illness narratives have been published about the 1918–1919 influenza pandemic. This essay links this silence to representational problems posed by mass trauma that happened before response to the Holocaust began our present era of attention to the narrative testimonies of suffering. In a pandemic, the collective replaces the individual as protagonist, and the health of the public takes precedence over the particular and subjective. History turns to statistics. Beginning with Katherine Anne Porter’s Pale Horse, Pale Rider, her novella about her experience during the pandemic, and speculating on the entanglement of Virginia Woolf’s accounts of influenza with Porter’s strategies for recounting her sickness, the essay then examines two 2006 novels—Thomas Mullen’s The Last Town on Earth, and Myla Goldberg’s Wickett’s Remedy—to show how narrative representations of the 1918 flu grapple with recounting the experience of sickness, a struggle repeatedly troped as waking from and remembering a nightmarish sleep. The value of these fictional accounts lies less in their historical accuracy than in the attention they draw to the representational demands that pandemic disease makes as it threatens to overwhelm the narrative medium.

Few illness narratives have been published about the 1918–1919 influenza pandemic. This essay links this silence to representational problems posed by mass trauma that happened before response to the Holocaust began our present era of attention to the narrative testimonies of suffering. In a pandemic, the collective replaces the individual as protagonist, and the health of the public takes precedence over the particular and subjective. History turns to statistics. Beginning with Katherine Anne Porter’s Pale Horse, Pale Rider, her novella about her experience during the pandemic, and speculating on the entanglement of Virginia Woolf’s accounts of influenza with Porter’s strategies for recounting her sickness, the essay then examines two 2006 novels—Thomas Mullen’s The Last Town on Earth, and Myla Goldberg’s Wickett’s Remedy—to show how narrative representations of the 1918 flu grapple with recounting the experience of sickness, a struggle repeatedly troped as waking from and remembering a nightmarish sleep. The value of these fictional accounts lies less in their historical accuracy than in the attention they draw to the representational demands that pandemic disease makes as it threatens to overwhelm the narrative medium.

The emergence of global history has been one of the more notable features of academic history over the past three decades. Although historians of disease were among the pioneers of one of its earlier incarnations—world history—the recent “global turn” has made relatively little impact on histories of health, disease, and medicine. Most continue to be framed by familiar entities such as the colony or nation-state or are confined to particular medical “traditions.” This article aims to show what can be gained from taking a broader perspective. Its purpose is not to replace other ways of seeing or to write a new “grand narrative” but to show how transnational and transimperial approaches are vital to understanding some of the key issues with which historians of health, disease, and medicine are concerned. Moving on from an analysis of earlier periods of integration, the article offers some reflections on our own era of globalization and on the emerging field of global health.

The one-hundredth anniversary of the influenza pandemic offers scholars, teachers, and students an opportunity to explore the history of Pennsylvania’s epidemic experience through easily accessible local records. This brief historiography of Pennsylvania-related source material aims to encourage new research and facilitate a more detailed analysis of the epidemic in the Commonwealth.

The present article challenges the popular perceptions that historians, documentarians, and policy advisors espouse with respect to the role that Philadelphia’s director of public health, Dr. Wilmer Krusen, played during the city’s uniquely catastrophic outbreak of influenza during the pandemic of 1918–22. The article analyzes the autumn 1918 outbreak and suggests that the portrayal of Krusen as a public health amateur or bumbling incompetent by various authors and multimedia documentaries is misleading. Furthermore, as the threat of epidemics by respiratory viruses—for instance, HPAI H5N1, H1N1, SARS, MERS, and Nipah— appears to increase, public health officials and policymakers may look to history in their own efforts to fashion responses to future urban outbreaks. Historians must take care to avoid incorrect conclusions concerning the failures of Philadelphia’s response to the great influenza epidemic if they wish to make competent suggestions for combating future outbreaks.

This paper deals with a particular aspect of a wider work-in-progress centring on epidemics and economics in Mediterranean Africa. The analysis of the maritime aspects of this phenomenon is preceded by a discussion of three key and interlinked factors, i.e. the weight of epidemic outbreaks in maritime intercourse; western prejudice about the fatalist attitude of Muslim peoples in the face of epidemics; and the response of the Muslim authorities as regards health matters. It subsequently considers briefly the matter of compliance with and violation of quarantine regulations and the complaints and negotiations involving captains, consuls and local maritime authorities from the eighteenth century to the middle of the nineteenth century. It studies four complementary aspects: the decisions of governors and the extent of local administrators’ applications of these; the observation and violation of quarantine measures; lazarettos and quarantine conditions; and, finally, the rationalization of the system during the latter part of the period under consideration which paved the way for more extensive reforms under the colonial administration.

The outbreak of bubonic plague in Kumasi from March 1924 until March 1925 killed 145 people and contributed to significant social and political changes in the city. In this article, I reconstruct the events that surrounded the epidemic, particularly British officials’ responses and efforts to end it, to argue that the epidemic grew out of Kumasi’s integration into the British Empire and capitalist system and therefore must be examined within the context of global histories of disease, empire, and capitalism. I show that while British officials saved lives and ended the epidemic with relatively few deaths, they also exploited the medical crisis to remake Kumasi politically, socially, and spatially as a colonial city governed largely around issues of trade, sanitation, and public health.