The history of medicine,
particularly that of quarantines was something I have enjoyed researching in
the past; I had never thought I would be experiencing lockdowns or quarantines in
my lifetime, but it was never impossible. Now you cannot go anywhere in the
world without hearing about this controversial topic (although, perhaps not as
much as masks – and I refuse to be baited by anybody who argues against the
usage of them), and although I’m nervous about what is happening and what is to
come, the historian side of me cannot help but feel interested in how this will
be presented in the future – because I’m still thinking about Hamilton my
head keeps singing ‘History Has its Eyes on You’, and the statement should be
taken to heart by governments all over the world, especially during this
crisis. We learn history so that we can avoid mistakes others have made in the
past, and the history of quarantines from a ‘history from below’ approach would
have been incredibly useful for governments to consider.
The earliest
quarantine – that we know of – was created by Italian merchants in the 14th
century following the Black Death, and since then quarantines have held
incredible significance in combatting disease, in the narrative of disease, and
in government influence over its own people as well as those across nations. Quarantine
has always caused controversy and continues to do so, but it is effective in preventing
the spread of disease; it was used to defend against the SARS outbreak in 2003,
for example. Quarantine as a method is not the only thing that should be employed,
and of course on its own cannot combat disease, but it can be used immediately
on the frontline; the method is particularly useful when not enough is known
about the disease to deploy much other defence against it. The method also has
controversy however in its use as a political tool, and as we see in the race
for a vaccine, especially in the UK and the US, countries want to use such methods
to be the first to win against the disease they face.
A ‘history from
below’ approach shows that there is a lack of faith in the usefulness of
quarantines also because of the negligence of staff and governments. The
quarantine station at Tor to prevent the spread of cholera is a particularly
prevalent example of inefficiency. Although the station was adopted to prevent
the spread of cholera during the pilgrimage, it was there a new strain of the
disease, eponymously named El Tor, developed due to a lack of standardisation
of all quarantine stations, poor equipment and inadequate for the pilgrims
within; the strain was found present on dead pilgrims inside the station, and
it soon caused four outbreaks in Indonesia between 1937 to 1958 resulting in
high death rates.
We have moved
on now to have more resources and perhaps less negligent staff, but even now
there are issues: quarantines at some airports are carried out more efficiently
than others, while travel companies see a quarantine as a deterrent for
potential customers, pressuring governments to only ask people arriving to
quarantine themselves at home. The issues here are clear, relying on people who
have their own lives that might be significantly disrupted if they forced themselves
to stay inside for two weeks or more. Plus, it is up to them to understand how to
effectively quarantine themselves off from the world, meaning some might act
more leniently than others. While many are for the use of quarantines, because
of the protection they can offer against the spread of disease, governments and
public health authorities need to consider the effects of the method on individuals.
Different
individuals have different needs: someone who might be all for quarantining themselves
after travelling abroad may find themselves unable because they have to go into
work and they are not being paid for any time they take off, despite the fact
that it is in the interests of public health. Those who go on holidays might
find a quarantine for two weeks frustrating if that is all or most of their
holiday, and if they then return to a country where they must quarantine again,
it will undoubtedly cause issues.
Quarantines
also face issues with oppression and racism by the staff inside. Public health
officials, doctors, and scientists might find themselves with more power and
influence during pandemics – some might feel undermined – and inside quarantines,
this can also be the case. In the past, people relied on quarantine staff for
many things, including meals; in one quarantine station, Russian Jews were
almost starved by staff because they were refused kosher meals. During cholera
outbreaks, Indian pilgrims faced discrimination by some officers who described
them as “cholera personified”.[1]
Even now, there is discrimination against certain groups outside quarantine because
of the spread of coronavirus. Countries have blocked tourists and travellers
from certain countries from even entering, or request that they quarantine,
while letting others in; these decisions are based on the disease, but in many
areas are heavily influenced by political and economical factors, which could
cause frustrations not only with travellers, but between governments.
To employ such methods
as quarantine to prevent the spread of disease is interesting, but the impact
of these needs to be fully understood to be able to gain any real benefit from
them. As with many things, ignore the history, ignore the people, then you only
make the same mistakes made many times before.
[1] Nawab K. B. A. M. A. Rahim, Safir-e-Harmain Sharifain wa Jikr-e-Madina
Munwarah (Matba Shaukatul Islam, 1914) vol.1, p.84 in S. Mishra Pilgrimage, Politics, and Pestilence: The
Haj from the Indian Subcontinent, 1860-1920 (Oxford: Oxford University
Press, 2011), p.92.
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