Eras Journal – Sendziuk, P: Review of “Imperial Hygiene: A Critical History of Colonialism, Nationalism and Public Health”, Alison Bashford
Alison Bashford, Imperial Hygiene: A Critical History of Colonialism, Nationalism and Public Health,
Palgrave Macmillan, Basingstoke, 2004
Isbn: 1 4039 0488 X
In Australia from the late nineteenth century, ‘hygiene’ came to be a personal and political mission. It was, as Alison Bashford notes, “a noun [that] spawned ever-more adjectives which connected the bodily and the personal to larger government projects: sex hygiene, domestic hygiene, social hygiene, national hygiene, moral hygiene, tropical hygiene, maternal hygiene, racial hygiene, international hygiene and more” (pp.4-5). This missionary zeal was manifest in vaccination campaigns to control infectious disease, the granting of coercive powers to public health authorities, and the sometimes forced detention in sanatoria and quarantine stations of individuals suspected of ‘carrying’ diseases such as smallpox, tuberculosis and leprosy. Such measures contributed to the decline in morbidity and mortality, and created what was deemed, by many, as desirable order, cleanliness and safety. However, because men and women of different socio-economic status and colour were targeted and treated differently by public health authorities, these practices also reproduced and perpetuated prejudicial notions about race, class and gender. By identifying and isolating those who were considered to be ‘unfit’, ‘dangerous’ and likely to transmit disease (the Chinese, foreigners and the ‘ungovernable’ poor and homeless, for example), discourse about hygiene effectively produced identities of inclusion and exclusion – of belonging and citizenship, and of Otherness. As such, according to Bashford, “the enclosures, boundaries and borders which were the objects and means of public health” (p.1) functioned as vital aspects of colonial, national and racial administration.
The author’s argument is perhaps best illustrated in her discussion of the Sydney smallpox epidemic of 1881, in which 41 people died, 163 people were recorded as infected, and many times this number were implicated as possible ‘carriers’ and isolated in their homes or the Quarantine Station. Those detained in the Quarantine Station were first spatially divided into two zones separated by a high barrier: ‘Hospital Ground’ (for the infected), and ‘Healthy Ground’ (for those who remained well, but were suspected of ‘carrying’ disease). Healthy Ground was further demarcated into buildings for white married and single men and women, and for white people of different classes (a divide that was soon enforced by a high paling fence that separated poor and working people from their more affluent neighbours). Within Hospital Ground there was a three-way distinction: the ordinary ward pavilions, rooms for private paying patients, and two ward pavilions for ‘Dark Races’. Even this arrangement was deemed inadequate when eight Chinese men were forcibly admitted to Quarantine in July 1881. Despite having no symptoms of infection, they were not integrated into Healthy Ground but instead housed in specially constructed tents. A constable was given the task of ensuring that they did not mix with the ‘healthy’ people or escape. As Bashford contends, “by virtue of their race, and irrespective of their diagnosis as ‘clean’, these Chinese men were already pathologised, already seen to be diseased and to require separation…to be ‘clean’ and ‘Chinese’ was all but impossible in the dominant racial discourse of colonial Australia”. (p.49)
While powerfully propelling her thesis, this chapter is not without its problems, which are symptomatic of those that diminish the overall usefulness of the book. The Sydney epidemic is not placed in the context of other smallpox threats and it remains unclear as to whether other state authorities would have responded the same way, or if New South Wales authorities were likely to respond differently twenty or thirty years later. While claiming to be a history of public health and governance in Australia between the 1850s and World War Two, three states – Western Australia, South Australia and Tasmania – barely rate a mention despite the fact that they differed significantly in their approach to disease control (the control of tuberculosis provides the obvious example).
This is not to say that the book is limited in scope. Bashford leaps from efforts to control smallpox, tuberculosis and leprosy, to anxieties about maritime quarantine, immigration and social hygiene (eugenics) in successive chapters. My preference would be for a more sustained discussion of fewer topics, or a longer book, but others will appreciate her wide-ranging investigation.
Imperial Hygiene might disappoint those seeking a social history of these disease epidemics and social anxieties. In the smallpox chapter, for instance, Bashford states that “both the infected people contained in the Quarantine Station and those contained there as guards and doctors, were subject to the surveillance and limitation of movement, contact and activity characteristic of a prison, as well as an intensely close medical surveillance”. (p.53) But we learn nothing more about the latter. What role did doctors, policemen, cooks and gardeners play in the Quarantine Station? What was their experience of surveillance and control? How did they end up there – is theirs a story of class, race and ‘criminality’ as well? With this said,Imperial Hygiene is an important contribution to a growing literature that examines the link between public health and colonialism (works by Meghan Vaughan, David Arnold, Mark Harrison and Michael Worboys come to mind), and medicine and nationalism.