3. Quarantine and the International Sanitary Conferences

Question 1

What is the historical significance of quarantine? 6

Answer 1

1. medical screening - greater role of medicine and drs in international policies and boundaries
2. international diplomacy - needs understanding among nations about the factors that lead to epidemics
3. reflected economic, social and cultural factors involved in infectious disease eg. by banning certain products from trade
4. important role in regulations that govern movement of foreign people and goods across borders, therefore represents level of state intervention over citizens and outsiders
5. connected with development of restrictive immigration polices and protection/control of trade
6. used effectively in international relations and a way of protecting sovereignty of the state, both in and out of political boundaries

Question 2

How/when did quarantine become important?3

Answer 2

1. mid 19thC, global migration begins
2. quarantine becomes very important
3. quarantine is a reflection of migration and disease

Question 3

give the early history of quarantine and trade routes. 7

Answer 3

1. earliest by italian merhcants in mediterranean during the black death
2. intended to stop plague spreading to western europe by land and sea routes
3. in medieval era, mediterranean was centre of world, where east and west trade met
4. very rich port cities, received most of profit for asian goods
5. spanish trade opens to atlantic trade
6. in 1498, mediterranean trade declines as cargo taken directly to india via boat around cape of africa
7. affects italian and arab trade

Question 4

Describe the global spread of cholera. 4

Answer 4

1. 1816-1823 - east asia and india affected
2. 1826-37 - europe, uk, north and east africa
3. 1842-1862 - becomes global. more of africa and much of north, some of south africa
4. 1865-1975 - declines in americas, africa and europe but still global

Question 5

give the history of modern quarantine. 5

Answer 5

1. by mid-19thc, repeated european cholera pandemics highlighted need for quarantine in europe
2. france proposed an 1834 meeting to discuss international standardisation of quarantine
3. france held the contagiontist position - britain didn’t participate
4. 1851 - first international sanitary conference in paris
5. 10 conferences 1851-1900, compromise reached in 1893 over min and max holding times

Question 6

Why was it difficult to reach a quarantine agreement? 6

Answer 6

1. contagion vs anticontagionism divided opinion on importance of quarantine vs local conditions
2. there was international disagreement
3. quarantine had different political/economic factors to consider in each state
4. quarantine causes goods to perish and reduces prices
5. cholera was coming from Bengal, a british colony, so could damage british trade - good for france
6. the debate became critical at the 1885 rome conference

Question 7

Explain the importance of the suez canal and the events of 1885. 9

Answer 7

1. Suez canal dug by french in 1869
2. allowed ships to reach asia without travelling around cape, could go through egypt
3. the british opposed - wanted a railway line
4. there were a lot of french in egypt by 1882, but british found success there and took over, incl. control of canal
5. by 1880s, 80% suez canal ships british
6. mediterranean becomes important again and europe arab relations very important
7. discovery of cholera vibrio by robert koch in 1883 in egypt
8. 1883 cholera outbreak at suez canal - british blamed for bringing it from asia
9. quarantine enforced here

Question 8

Who was willian hunter? 4

Answer 8

1. british surgeon-general
2. gives to egypt and publishes cholera report in 1883
3. said cholera due to bad summer of miasma
4. claimed not connected to bengal cholera

Question 9

What work did robert koch do on cholera? 3

Answer 9

1. in 1883, identifies cholera pathogen in dead
2. leaves to find patients in calcutta, india
3. dooes not find patients but finds vibrio in water tank and concludes bacilli travelled

Question 10

What was the argument surrounding germ theory, contagionism and anticontagionism, and quarantine? 5

Answer 10

1. In 1884, koch gave a lecture to the German Imperial Board of Health and said cholera traveled from Indian ports eg, calcutta and bombay, to the red sea, through the suez and to europe
2. suggested cholera could reach egypt in 11 days, italy in 16 days and sough of france in 18 days
3. he argued that main carriers were crowded british coolie ships carrying indian labourers to work in west indies via suez canal
4. some believed cholera bacilli/germ theory an attempt to stop suez trade
5. contagion vs non-contagion became a qustion of health vs trade

Question 11

what happened at the international sanitary conference of venice in 1892? 7

Answer 11

1. some agreements reached
2. all ships passing through suez classified as to whether there was a cholera case on board
3. debate on how long quarantine should be
4. all hajj pilgrim ships to mecca from india were quarantined at al tur for several days - conditions were very bad
5. separate strain of cholera developed in al tur quarantine station
6. those traders etc. with no cholera could pass through
7. those with suspected cholera were inspected by dr and a disinfecting machine brought on board

Question 12

what happened at the 1903 international sanitary conference? 5

Answer 12

1. 11th international sanitary conference, initiated by italians, held in paris
2. unified earlier conferences in light of scientific knowledge (1892, 94, 97)
3. resulted in international sanitary convention of 1903, which was ratified by most participating states in 1907
4. first convention to introduce international conformity against cholera and plague
5. superseded by conventions of maritime traffic of 1912 and 1926, 1926 modified in 1938, 44.

Question 13

How did quarantine pander to and reinforce the fear of the other? 6

Answer 13

1. quarantine received a lot of popular support in europe as it kept ‘the others’ away, yet mostly directed against ordinary people
2. european sanitary commissions saw islam as the obstacle against the european sanitary movement - assumed cholera arrived with hajj pilgrims
3. brutal detentions, obstacles etc. were placed in pilgrim’s way - most important was lazaret at al tur in sinai peninsula
4. kept there for 15-20 days with limited water supply
5. anyone suspected of cholera was kept for 3-4 months in extreme heat and cold
6. continued into 20thc - in 1933, became more lenient and pilgrims vaccinated

Question 14

What was the significance of the international sanitary conferences? 7

Answer 14

1. highlighted how issues of infections and diseases were related to imperial economy, diplomacy and politics
2. highlighted cultural and political differences within europe and between europe and asia
3. realisation that spread of disease can’t be halted without international cooperation
4. differences in ideas about contagion and quarantine
5. some thought quarantine progressive and the only way to stop spread of disease based on science
6. supporters of free trade movement and free movement of goods and people found it to be regressive
7. international sanitary conferences led to international health organisations

Question 15

How did the international sanitary conferences approach asia? 5

Answer 15

1. conferences eurocentric in nature and constitution, which viewed asia or the orient as backward, filthy and disease ridden
2. fear of asia/east as new routes and communication brought it closer
3. start of european dominance in international health, and view that asian systems should be replaced with european medical care
4. europe and usa portrayed as healthy and progressive, invaded by asian disease
5. particularly visible in australia where quarantine became very important to protect from asian people and disease

Question 16

the unification of the globe by disease? the international sanitary conferences on cholera 1851-94. v. huber, 2006.

What was the international science surrounding quarantine at the time? 3

Answer 16

1. these conferences reflected increased international cooperation as science collided with politics, as transport links were making the world smaller
2. international meetings became standard
3. scientists more important in international relations as numbers grew and meetings became frequent

Question 17

the unification of the globe by disease? the international sanitary conferences on cholera 1851-94. v. huber, 2006.

Describe the international sanitary conferences. 12

Answer 17

1. early conferences showed the dawn of internationalism, as time was taken up with the organisation of procedures
2. mixed/unclear approaches at prevention pointed to the underlying scientific debate
3. conference united europe against illness of asia, revealing eurocentric views
4. 2nd conference - no scientists but still no results
5. europe was wary of ottoman empire, disagreed with them in votes
6. 3rd - deepening divide between east and west. east were against emergency plan of desert quarantine for pilgrims to mecca- unrealistic for the weak
7. 4th - shorter, took new scientific information into account. no final law - concerns about internationalism
8. 5th conference - science became united as koch had done his bacillus thing. political rivalries prevented british cooperation
9. 6th conference - new science eg. telegram and disinfectants allowed better measures - there were few long quarantines due to this. suez canal ships carrying diseases were recorded but that’s all
10. 7th conference - checks and disinfection implemented at land borders and rivers. prejudices abounded
11. 8th conference - back to mecca pilgrim prejudice and quarantine. same applied to those entering america
12. overall, conferences became more prepared for, precise and predictable

Question 18

the unification of the globe by disease? the international sanitary conferences on cholera 1851-94. v. huber, 2006.

What were the overall themes of the international sanitary conferences? 3

Answer 18

1. the conferences attempted to implement a standardised, european system in europe and other colonies for travelers to adhere to
2. certain groups eg. mecca pilgrims blamed
3. eastern europe and suez canal used as protection points

Question 19

Maglen, 2002.

what was quarantine like in the 19th century? 6

Answer 19

1. quarantine interfered with british empire’s trade and only worked for contagious diseases - anti-contagionism was quite strong in britain in mid-19thC
2. despite dr mclean’s insistence on contagionism being false, 1825 quarantine act was passed to fit in with europe for plague and yellow fever
3. despite with quarantine measures, cholera epidemic in 1831-2 created more doubt in quarantine
4. britain had to comply with some basic quarantine measures due to sanitary conferences but developed other methods eg. sanitary conditions that interfered less with free trade
5. cholera infected ships in harbor weren’t covered by cholera act without a general order against cholera, and there was no clear guidance on who’s responsibility the boat was.
6. 1869- urban sanitary districts became responsible for ports

Question 20

Maglen, 2002.

describe the establishment of the port sanitary authorities. 7

Answer 20

1. post 1872 public health act, varying committees overseeing port sanitary conditions were replaced with port sanitary authorities and port medical officers of health, responsible for standard procedures
2. those suffering non-specified diseases went to isolation hospitals, alongside existing quarantine laws
3. healthy from infected ships were free to go and observed by other sanitary authorities
4. having sanitary and quarantine authorities, along with unclear law, meant non-quarantinable diseases would slip through as quarantine inspection was undergone first by port medical officers of health, and crew didn’t have to mention other diseases
5. also time consuming, which hindered free trade
6. quarantine was used by the british, just for plague/yellow fever and cholera under general order, while the branched ‘English system’ was also used
7. argued quarantine could spread disease to healthy on the ship - continued 20+ years after port sanitary authorities

Question 21

M. harrison, 2006.

Describe the history of quarantine. 10

Answer 21

1. 17thC quarantine was popular in europe due to plague success
2. 18thC - drs and traders began to question it
3. some believed weather caused disease eg.plague
4. not always effective and could be evaded eg fake bills of health
5. some believed commercial rivals gave false bills of health
6. some believed it was the state’s duty to protect itself
7. quarantine in europe often used for commercial interests rather than health - maksing
8. inconsistent regulations across mediterranean
9. quarantine was attacked via contagionism - even those who agreed emphasised other factors
10. napoleonic wars - armies suffered dieases - quarentine reformed. seemed non-contagious

Question 22

M. Harrison. 2006.

How was an international sanitary system approached?

Answer 22

1. after french wars, trade began to recover
2. quarantine abandoned reluctantly and still used often in countries near source of outbreak
3. cholera quarantine debate didn’t open until 1830s, as stations developed to deal with plague and not obvious cholera would be a threat
4. Dupeyron, sec to supreme council of health in france, thought plague connected to commerce as commercial areas suffered and radiation showed contagious
5. wanted a less oppressive, more systematic quarantine system
6. in early 1800s, less use of quarantine as a political/economic weapon, but countries more likely to identify this use
7. quarantine relaxation at suez was supported by britain, germany, austria and italy

Question 23

What defined the origin of the modern quarantine system: the threat of disease or imperial trade? essay question

Answer 23

1. threat of disease obviously impacted, without it there would be no quarantine in the first place
2. some people and countries eg france wanted to implement quarantine as they had a contagious point of view
3. koch’s work (Egypt to india) showed that it could spread between countries and this threat could not be ignored
4. despite importance of suez trade, measures were taken
5. threat of disease -common to all nations- overcame trade fears that were only of concern to some nations, in the making of the sanitary convention of 1903
6. Huber, 2006, argues that early conferences showed an inconsistent approach towards solutions and this pointed to underlying scientific debate ie. how dangerous threat was if contagious
7. imperial trade delayed implementation of quarantine, as it reduced trade and britian didn’t like this
8. some were against quarantine because it caused goods to perish and and priced to drop
9. lots of british trade from bengal that would be affected
10. many found quarentine regressive as it undermined the free trade movement
11. Maglen, 2002, said british people were opposed to own 60 day quarantine as it cost the empire trade
12. also said britain had to comply with some basic quarantine requirements (19thc), but preferred other ways that interfered less with free trade, so more difficult to reach international decisions
13. port-sanitary authorities developed post 1872 to enforce some quarantine measures, but still disliked
14. end Maglen in the 18thc, distrust of quarantine as some believed commercial rivals gave fake bills of health - harrison, 2006
15. harrison, 2006 - quarantine often used for commercial/political interests
16. relaxation at suez - supported by german, austrian, italian and british authorities
17. while the implementation of quarantine at all was a product of disease, the arguments surrounding imperial trade contributed to the slow course of action and lack of initial agreement
18. also influenced by contagion vs anticontagion