Bioinsecurities: Disease Interventions, Empire, and the Government of Species
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Bioinsecurities: Disease Interventions, Empire, and the Government of Species
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| ISBN-13: | 9780822374671 |
|---|---|
| Publisher: | Duke University Press |
| Publication date: | 03/31/2016 |
| Series: | ANIMA |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 288 |
| File size: | 7 MB |
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Bioinsecurities
Disease Interventions, Empire, and the Government of Species
By Neel Ahuja
Duke University Press
Copyright © 2016 Duke University PressAll rights reserved.
ISBN: 978-0-8223-7467-1
CHAPTER 1
"An Atmosphere of Leprosy"
Hansen's Disease, the Dependent Body, and the Transoceanic Politics of Hawaiian Annexation
The Hawaiians are a very affable, agreeable, and lovable people just as much so as any other on earth; but in contact with disease, all their desirable traits are seriously discounted by their lack of care, because they endanger all of us "by failing to obey the most simple rules of health, necessary for their own salvation and self-preservation." It is a most pitiable condition, evident to the most unobserving, "that an atmosphere of leprosy clings to and surrounds the unfortunate Hawaiian." Why? Because he fails to realize the danger that menaces him, apart even from the extreme receptivity of his system to the bacillus of leprosy, a condition lacking in other races domiciled in Hawai'i nei: this being an indisputable fact, then he (the Hawaiian) is the weak link in our chain of national health defense.
— ALFRED A. MOURITZ, The Path of the Destroyer: A History of Leprosy in the Hawaiian Islands, 1916
Physician Alfred A. Mouritz, who had served for four years as the resident doctor at the Kalawao Hansen's disease settlement on the Hawaiian island of Moloka'i beginning in 1884, published a history of the disease's impact on Hawai'i in 1916. Although the first page of Mouritz's book glosses English translations of the Bible, which in 2 Kings suggests that a skin disease "clings" to the general Naaman and his descendants, Mouritz declares, "Leprosy as a hereditary condition is of doubtful proof." Mycobacterium leprae, at the time called Bacillus leprae, was discovered as the cause of what we today call Hansen's disease in 1873. Still, well into the twentieth century, its mode of transmission, its divergence in severity, and individuals' seemingly random immunity to it made the persistence of leprosy a mystery. How, then, could Mouritz declare that "an atmosphere of leprosy clings to and surrounds the unfortunate Hawaiian"? The answer is a "receptivity" to bacteria that was both physical and moral, an irrational lack of self-care compounded by biological vulnerability. This explanation of how an infectious disease defines a racial "atmosphere" — an affective intensity that defines a group's relation to others in space — is compounded by the main epidemiological finding of the study. The book describes a series of increasingly macabre and unethical experiments Mouritz conducted on patients and at least one kokua (helper or care worker) at the Moloka'i settlement: testing the ability of flies and mosquitoes to contract Hansen's from his patients; holding communal meals and taking samples of patients' chewed or touched food for the presence of bacteria; conducting gynecological exams for sexual transmission; attempting to infect healthy residents or reinfect ill ones; even exhuming the grave of a former patient to extract bacilli from the corpse. Mouritz comes to a conclusion that ends with the title of his study: "The main entry of the Bacillus Leprae into the system of Man is through the mouth and digestive tract, and this is 'the path of the destroyer.'"
The oral opening to the alimentary canal presented an abyss of uncertain connection. Writing at a moment when increasing public knowledge of germ theories of disease advertised the body's physical interface with microscopic bacterial species, Mouritz draws the risk of disease transmission and immunological vulnerability into a racial typology that dominated US medical, journalistic, and literary representations of indigenous Hawaiians. Associating Hawaiians with unsanitary transfer of feces, saliva, and dirt carrying unwanted bacterial species, Mouritz's experimental conclusion regarding an oral pathway for Hansen's disease confirms Parama Roy's assessment that "colonial politics often spoke in an indisputably visceral tongue: its experiments, engagements, and traumas were experienced in the mouth, belly, olfactory organs, and nerve endings, so that the stomach served as a kind of somatic political unconscious." As Hansen's disease literally damages the nerve endings in its advanced stages, Roy's phrasing is particularly apt for capturing Mouritz's triangulation of immune, digestive, and nervous entanglements with microbes. Mouritz trains the settler's fear of disease upon a Hawaiian subject who lacks the proper compass for navigating the environment, the nervous disgust that modern hygiene attaches to putrid smells, the exchange of bodily fluids and wastes, and other transfer points of interspecies contact. In a sense, this absence of affect indicated that even prior to infection, the Hawaiian was always already "anaesthetic," a diagnostic term used in Mouritz's day to describe cases of Hansen's that affected the nerves' proper capacity for feeling.
Like many other tropical medical experts and colonial travelers writing on Hansen's disease at the turn of the twentieth century, Mouritz combined modern tropes of filth, contagion, and animality with a tragic sense of the biblical antiquity of the disease. In asserting the spiritual taint that clings to the colonized and the curse of their inevitable physical isolation once afflicted, such writings actually contributed to a new and intense practice of spatial quarantine of Hansen's disease in an era of colonial tropical medicine. Against the presumption that the isolation of Hansen's disease patients was an unchanging historical practice of abjection, in the late nineteenth century the disease became an intense preoccupation of British and US tropical-medical experts crossing South Africa, India, the Pacific Islands, California, and Louisiana, despite the fact that it is only moderately contagious and slow to progress in the body.
This chapter suggests that sensational representations of native Hawaiian (Kanaka Maoli) susceptibility to the Hansen's disease bacterium, such as Mouritz's, channeled racial fears of colonial movements of labor, commodities, and settlement into an emergent government of species reliant on segregation of the ill. The technique of racial engulfment through quarantine in turn advertised the inevitable biological and political dependency of Hawaiians on the settler institutions of the US occupation. Documenting how such public fears and hopes were conjoined in literary, photographic, and epidemiological depictions of the Hansen's disease settlements on the island of Moloka'i, I suggest that this logic of dread life invoked persistent contrasts between living and dead, primitive and modern, human and animal, and dependent and independent bodies. The interspecies transitions of disease — and Hansen's disease was, again and again, represented as a terror-inducing transition state — were narratively and visually organized through the unveiling of the purported animalization of individuals' skin, faces, and extremities. Within the resulting imperialist discourse on "the Hawaiian leper," Hansen's patients were not simply excluded from the law, but engulfed by state practices of quarantine and medical uplift in which they were progressively distanced from an ideal of American liberal individualism. If this meant the increasing use of the state's health policing powers, it also occasioned public battles over treatment and connected Hansen's patients in struggles crossing expanding borders of colonial control.
Observing the resulting patient activisms for expanded forms of medical and legal citizenship, I conclude that the case of Hansen's disease quarantine requires a reevaluation of necropolitical theories suggesting that the medical camp and the practice of human vivisection become privileged sites for the articulation of the state's power to kill. Instead, the spatial form of Hansen's disease quarantine reveals the potential for liberal reform to capture and mobilize life, to govern both the biological entanglements of species and the affective entanglements of state and subject. The stories of activists including Kalauiko'olau and Olivia Breitha who challenged the Hansen's disease segregation policy demonstrate these conjunctions of politics of life and death as Hansen's disease incorporated Hawaiians and settlers into the architectures of public health in its golden era at the turn of the twentieth century.
Racializing Risk: Asia-Pacific Geographies of Hansen's Disease
At the turn of the twentieth century, one word dominated discussions of Hawaiian annexation in the journalism of the continental United States: leprosy. A wide variety of press reports, literary texts, and medical and governmental debates concerning Hawai'i in the annexation years constructed the bacterial infection as a central problem in the relationship between the islands and mainland. While annual cases of the disease in Hawai'i were at any given time several hundred higher in number than the total for the continental United States during this period, Hansen's disease was by no means geographically confined to one territory of Euro-American settlement. In fact, in Louisiana and the north central states of the United States, the disease had long been endemic (at times associated with Scandinavian immigrants), yet occasioned little popular representation or major public efforts at containment until the debates over Hawai'i produced a national policy of isolation. What accounted for this difference?
Beginning in the 1870s, industrial expansion and its unequal concentration of wealth in corporate monopolies allowed US capitalists to emerge for the first time as a financial rival to Britain. Seeking expanded investment westward in the Pacific at the moment of the closing of the frontier, the United States funneled hoarded capital into territorial expansion led by filibustering capitalists. This expansion involved taking over land in the Pacific and the Caribbean, with the broader goal of the enforced opening of Chinese and Japanese markets to US trade. While fears of imperial overstretch and the dangers of expanding contact permeated public discourses on expanding territorial settlement and trade in both the Pacific and the Caribbean during the 1890s, Hansen's disease offered a ready trope of empire's racial contagion that could be transmuted into attempts to control personal and environmental space in an era of shifting borders. The risky touch of the so-called leper suggested the endangerment of able-bodied whiteness in the face of expanding networks of transoceanic trade and sovereignty. The body of the Hansen's patient was represented using the figures of beasts and zombies haunting the settler-colonial project.
The first known cases of Hansen's disease appeared in Hawai'i in the 1830s, presumably brought by increasing US and European shipping activity. Despite the fact that Hansen's disease impacted fewer individuals than other diseases such as tuberculosis and spread relatively slowly, it was publicly attributed to the supposed social and sexual impurity of the Hawaiians, and thus could be disavowed as an agent of the colonial genocide perpetrated against indigenous peoples of the Pacific. Under an 1865 law of the Hawaiian Republic, signed by King Lot Kamehameha under pressure from US and European advisors at the Hawaiian Board of Health, persons diagnosed with leprosy were denied rights to property, movement, marriage, and legal standing. They were segregated in state hospitals and, eventually, in the Kalawao and Kalaupapa Hansen's disease settlements on the island of Moloka'i. Although some of their rights were later restored following public protest, institutionalized quarantine rapidly medicalized the disease and brought heightened surveillance. In the first three decades of the policy, those quarantined were almost exclusively native Hawaiians. In addition to subjecting Hawaiian "leprosy suspects" to enforced police screenings for skin lesions and other symptoms, those infected were criminalized and termed alternately and ambiguously in early Board of Health documents as "prisoners" and "patients." The disease, commonly known in Hawaiian as ma'i Pake ("the Chinese sickness," associated with indentured plantation laborers), would now also be known as ma'i hookawale, or "the separating sickness." Those diagnosed with leprosy were sent to a small section of the island of Moloka'i bounded on one side by the sea and on three sides by steep cliffs. Prior to the establishment of Kalawao, the first settlement, this site was inhabited by small numbers of farmers from the adjacent valleys.
As segregation numbers grew to 3 percent of native Hawaiians (some 8,000 Hawaiians were eventually interned), pressure from the public, religious organizations, and settlement residents ensured that the government and religious groups would administer medical care, provide supplies and shelter, closely monitor patients, and develop social, cultural, and police institutions. After charges of harsh arrest tactics and wrongful detention, the Hawaiian Board of Health eventually introduced procedural rights through which defendants could challenge a leprosy diagnosis — but not the actual authority to detain. In contrast to the image of the helpless leper that continues to influence historiography of the settlements, much of the initiative behind organization and improvements in care was taken on by residents themselves, who organized a church, established informal administration, spoke out privately and publicly against the abuses of some superintendents and other administrators (including the famed Catholic missionary Father Damien), and even protested US annexation of Hawai'i. Patients remained, however, subject to police power to possess property, restrict movement, and chemically sanitize both their bodies and any items they attempted to send out of the settlements through the mail. Although the segregation order in theory applied to any individual diagnosed with the disease, reports indicate that whites benefited from racial profiling, racially unequal enforcement, and the settler government's policy of allowing nonnatives to return to their home countries for treatment. The vast majority of those interned at Moloka'i were Kanaka Maoli. One individual who was arrested along with his daughter for transport to Moloka'i described the segregation practice as a blatant form of state racism: "These actions are like Sweeping away the Brownskinned people."
Following the 1893 US-backed corporate coup against the Hawaiian monarchy and the official 1898 US annexation, Moloka'i settlement residents did not obtain significantly expanded rights; despite the institutionalization of social services by missionaries, public health boards maintained strong policing powers, and annexation debates strengthened the regime of carceral quarantine. In 1904, the US District Court in Hawai'i declined a legal petition for habeas corpus, which would have restored the legal rights of interned Hansen's disease patient Mikala Kaipu. This was the main legal challenge to the application of the Jacobson v. Massachusetts precedent (which upheld enforced quarantine and vaccination) to patients segregated on Moloka'i. During the appeal to the Supreme Court, Kaipu died and the case was vacated. The court never explicitly discussed the detention of people diagnosed with Hansen's disease, but subsequent legal cases such as that of Typhoid Mary in New York confirmed state authority to detain individuals on public health grounds. Meanwhile, the United States opened a Hansen's disease hospital in the Philippines immediately after the 1898 takeover there. And as federal law restricted "transportation of lepers in interstate traffic" and health boards in San Francisco, New York, and Louisiana mandated segregation, US health officials began floating the idea of making Moloka'i the national leprosarium.
It is no surprise then that many Hawaiians were skeptical of representations of themselves as diseased or contagious. Pennie Moblo details the various ways in which Moloka'i residents protested their stereotyped association with disease and sought forms of patient control. Like other indigenous Pacific peoples, Hawaiians were subjected to both settler occupation and exposure to epidemics as twin elements of a genocidal strategy to colonize land beginning in the early decades of the nineteenth century. Yet this awareness of disease as an effect of settlement and trade forces was not acknowledged by the US press, which highlighted the seemingly inevitable demise of the native Hawaiian due to incomplete development and biological and cultural weakness. The Hawaiian was often rendered as a sentimental and biologically vulnerable victim of a disease brought by other racialized groups whose excessive bodies endangered the islander. Susceptibility of the native Hawaiian to leprosy was often contrasted to the contagion of migrant Chinese entering the Hawaiian plantation; in the words of author Charles Warren Stoddard, "It is ... understood that the seed of the dreadful malady came from Asia, and came in the person of an ill-fated foreigner." Hansen's disease was often associated with Chinese Americans in the late nineteenth century and used to justify port quarantines as well as the exclusion, segregation, and repression of Chinese immigrants.
(Continues...)
Excerpted from Bioinsecurities by Neel Ahuja. Copyright © 2016 Duke University Press. Excerpted by permission of Duke University Press.
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Table of Contents
Preface: Empire in Life viiAcknowledgments xvii
Introduction. Dread Life: Disease Interventions and the Intimacies of Empire 1
1. "An Atmosphere of Leprosy": Hansen's Disease, the Dependent Body, and the Transoceanic Politics of Hawaiian Annexation 29
2. Medicalized States of War: Venereal Disease and the Risks of Occupation in Wartime Panamá 71
3. Domesticating Immunity: The Polio Scare, Cold War Mobility, and the Vivisected Primate 101
4. Staging Smallpox: Reanimating Variola in the Iraq War 133
5. Refugee Medicine, HIV, and a "Humanitarian Camp" at Guantánamo 169
Epilogue. Species War and the Planetary Horizon of Security 195
Notes 207
Bibliography 231
Index 249
What People are Saying About This
"Bioinsecurities unravels the twentieth-century U.S. obsession with disease control, health security, and racialized suspicions. Adeptly harnessing law, fiction, film, and medical research, Neel Ahuja brilliantly tracks how militarized interventions and medical solutions to contain Hansen's disease, smallpox, polio, and AIDS intensified interspecies entanglements between humans, animals, bacteria, and viruses. Ahuja boldly redirects studies of biocitizenship and empire toward a fresh approach to the political as a lively and viscous zone of embodied connection and affective friction."
"Bioinsecurities unsettles human life in its most primal manifestations. Using 'dread life' to describe the racializing process that converts fear of infectious disease into hopeful embrace of the life-preserving and life-making possibilities of technology, Neel Ahuja documents a planetary poetics that channels living forces into the relations of governance. Bioinsecurities is impressive for the scope of its vision and its meticulous attention to detail and nuance. In its careful articulation of the thoroughness of imperial world-making, it offers the possibility of and inspiration for change."