by Jessica Wells
In February, the 2nd U.S. Circuit Court of Appeals in New York heard arguments in a case against the state of Connecticut, which is accused of illegally quarantining a group of travelers from West Africa who were suspected of carrying Ebola, despite a lack of symptoms. In recent years, heightened U.S. fears over Ebola and Zika have caused Americans across the political spectrum to call for tightened borders in the form of quarantines, travel bans, and increased restrictions on immigration from affected regions of the world. Unfortunately, these actions—undertaken in the interest of the public health—can be the opposite of helpful, resulting in less medical help and fewer supplies reaching stricken communities. Fear of disease often leads to the scapegoating of already stigmatized populations, particularly during periods of economic or political turmoil.
In addition to the recent outbreaks of disease that have already reached U.S. shores, yellow fever epidemics have been on the rise in recent decades as a result of the removal of mass-vaccination campaigns and the defunding of mosquito control initiatives as a function of decolonization. Further, ecological and economic changes have contributed to the growth of cities in Africa and South America. Public health officials have watched with alarm as recent yellow fever epidemics in these regions have depleted world reserves of the yellow fever vaccine. As I write this review, Brazil is currently undergoing a yellow fever epidemic which has already killed seventy people. Last year, the body count reached over 200.
Sugar plantations in the Americas helped to create and perpetuate the urban cycle of yellow fever
While many historians have studied the colonial implications of the medically-theorized relationship between tropical diseases, climate, and racialized bodies, Urmi Engineer Willoughby adds a new dimension to this familiar tale: the vital importance of sugar cane cultivation to the epidemiological history of yellow fever. Willoughby convincingly argues that the development of sugar plantations in the Americas helped to create and perpetuate the urban cycle of yellow fever. In building sugar plantations, humans unwittingly created new environments that were well-suited to mosquito-breeding. The deforestation required to clear the land removed natural predators; sugar cultivation provided numerous casks of clean water where larvae could thrive; sugar sap provided a convenient food source to sustain mosquito populations; and blood meals were plentiful when it came time to breed. Further, the growth of the sugar economy helped facilitate yellow fever’s spread across the globe in the holds of ships carrying sugar and slaves, resulting in endemic zones surrounding port cities.
Enslavers, merchants, and consumers created a massive system of exchange that altered the environment, initiating the conditions under which yellow fever could flourish.
By focusing on the development of large-scale sugar cultivation as a catalyst for urban yellow fever, Willoughby is able to demonstrate why epidemics of the disease were first documented in American sugar-producing regions and only much later in Africa. Epidemic yellow fever coincided with the height of African slavery, which rose to meet the labor demands of Atlantic producers. Ecological, demographic, and economic changes were thus required in both places to pull yellow fever out of its jungle home, away from its original primate food source, and into a new environment of human development, migration, and global capitalism.
According to Willoughby, “the first documented outbreak of yellow fever in New Orleans” coincided exactly with the initiation of “an era of large-scale sugar production in the region” (44). Many of the first epidemics likewise coincided with “early land and water management projects that facilitated the spread of yellow fever, particularly swamp drainage and canal construction” (45). Migration from the Caribbean following the Haitian Revolution, and from the United States following the Louisiana Purchase, fed both sugar cane cultivation and yellow fever epidemics.
Alongside her analysis of the ecological changes necessary for yellow fever to spread in the southern United States, Willoughby examines how changing race relations influenced people’s reaction to the disease. She documents the rise and fall in popularity of the prevailing belief that African slaves and their descendants were racially immune to yellow fever. She also points to the complicity of much of the historical profession in continuing to support the belief that people of African descent have at least some genetic resistance to yellow fever.
Willoughby touches on the fact that statistical data of yellow fever morbidity and mortality were flawed by the preconceived expectation of racial difference. She brings to light much anecdotal evidence to show that the African American community in the South suffered significantly from yellow fever and briefly discusses the impetus many white Southerners had to ignore this fact—a topic that I cover extensively in my own work. The evidence for a genetically-predetermined differential mortality and morbidity found in statistical data compiled by physicians can be attributed to both the general invisibility of black mortality in historical records and the lack of medical care available to African Americans (slave and free) during epidemics.
For historians, this implies that the primary sources that we use as evidence cannot be trusted to be a true representation of what happened in the past, even if they come to us in the form of sound, scientific, statistical data which has been accepted as accurate by generations of our predecessors. On a broad level, these concerns challenge the historical profession to question long-held assumptions based on this type of data and to remind ourselves that quantitative data is just as likely to be filtered through the human experience and worldview of those collecting it as qualitative descriptions of events found in a diary or newspaper. Likewise, historians—and others in the academy—must recognize how our own scholarship reinforces these popular beliefs in medical and scientific ideas that promote the social construction of race and racial difference.
Quantitative data is just as likely to be filtered through the human experience and worldview of those collecting it as qualitative descriptions of events found in a diary or newspaper.
Willoughby is extremely successful at elucidating the complex relationship between ecological changes, economic development, and the dependence on African slaves. Willoughby recognizes “a global pattern in attitudes toward race in the emergent field of professional medicine,” in the 19th century, suggesting a network of communication between physicians who shared medical and anatomical ideas that contributed to growing scientific theories of racial difference. This intellectual climate, she argues, paralleled changing views of race in New Orleans and corresponded to growing U.S. imperial aims during the period of westward expansion. Willoughby concludes with a discussion of the military-medical complex of state-sanctioned, coercive public health campaigns—as well as the U.S. corporations who funded them—as vital components in the eventual eradication of yellow fever in sites deemed necessary to U.S. military and economic imperial interests.
The contemporary academy acts as a similar network of official knowledge that can either reproduce or challenge popular knowledge. It can likewise either assist or resist political, economic, or cultural imperialism and exploitation. Non-governmental, economic, and state organizations beyond the academy have equally vital roles to play in contemporary scientific and medical initiatives around the world. There is a long history of scientific and medical initiatives—even those originally envisioned as broadly humanitarian in nature—acting as tools that guarantee regional military or corporate hegemony. Scholars must be cautious not to inadvertently reproduce the structures of oppression that we study and critique.
Willoughby’s book is extremely well-timed. Her analysis of the reciprocal relationship between humans and disease-causing agents—in this case, the A. aegypti mosquito vector—brings to mind other, more recent examples of human actions creating niches wherein microbial life can thrive. The abundant use of antibiotics and other “wonder drugs,” for example, has led to strains of resistant microbes. Willoughby’s epilogue describes a similar overreliance on pesticides and larvicides which create resistance in mosquito populations. She also raises the provocative concern over the eventual “ill effects of global disease control policies.”
Scholars must be cautious not to inadvertently reproduce the structures of oppression that we study and critique.
But Willoughby’s work also challenges contemporaries to think about far broader changes that humans make in their environment and of their potential long-term consequences. The global migration of goods and people, as well as technological innovations such as airplanes and massive container ships, play an even greater role in spreading disease-producing agents into these ripe environments than they did for yellow fever in previous centuries. What new avenues of global capitalism will ultimately lead to more devastating epidemics in future?
Likewise, with our current political climate, which feeds on racist, nativist rhetoric, an epidemic tied to immigration would have devastating consequences in the United States, or any of the countries currently undergoing waves of pro-nationalist protest. The racialization of immigrant bodies and the still-prevalent belief that African Americans are immune to yellow fever would likely lead to fear and discrimination of stigmatized populations within the U.S. should yellow fever ever return to it shores. And while yellow fever has not reached epidemic proportions in the United States for more than one hundred years, a number of disease-causing organisms would find the current ecological, economic, and racial environment in the United States perfectly suitable to their propagation.
 Mariola Espinosa’s excellent essay, “The Question of Racial Immunity to Yellow Fever in History and Historiography,” is the best summary of the scientific and historiographic arguments against the commonly-held belief that Africans and their descendants are resistant to yellow fever.
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