Farewell to the God of Plague is the first archive-based, grassroots examination of the campaign to eliminate schistosomiasis (snail fever, a parasitic waterborne disease) during the People's Republic. It is also the first monograph since the 1970s to evaluate the Maoist primary health care model, celebrated globally as an effective model for dealing with endemic disease in poor, rural areas. Miriam Gross argues that the official claim made by Chinese leaders—that the campaign gained widespread popular support and mobilized people to patriotically participate in prevention efforts—does not hold weight. The campaign constantly met grassroots resistance, especially in efforts to alter local environments, hygiene, and sanitation habits. Using previously unavailable archival sources, primarily from three locales—urban Shanghai (campaign headquarters), suburban Qingpu (青浦; snail-infested national test site located in nearby Jiangsu, incorporated into Shanghai in 1958), and rural Yujiang County (余江县; national model site located in Jiangxi)—and supplementary data on nonmodel areas in Jiangxi and Jiangsu, Gross contends that it was treatment activities rather than prevention efforts that eventually succeeded, and that this success only came in the early Cultural Revolution period. She argues that the ultimate efficacy of the campaign depended upon a new kind of "grassroots science" that legitimated the new regime and provided the foundation for what she calls "scientific consolidation" (3), a "new mechanism of state power" that facilitated party control in rural areas "without the need for an intact bureaucracy or the use of overwhelming force" (3).
The book is divided into four parts. The first is a chronological overview that traces how Mao's unwavering support for the campaign—epitomized by his penning of a 1958 poem whose title this book borrows—provided the leverage necessary for continual government support despite initial failings. The remainder of the book is structured thematically and focuses on how the campaign played out at the grassroots. Part 2, "The Campaign Nobody Wanted," covers the structural and economic reasons for rural resistance (primarily in the 1950s), while part 3, "The Three Arms of the Campaign," discusses education, prevention, and treatment efforts. The last section covers non-health-related benefits of the campaign: its role in the scientific legitimation of the party in the 1950s and in scientific consolidation in the late 1960s and 1970s.
Early campaign efforts to eliminate snail fever failed for a variety of reasons. Efforts to educate locals using scientific rationale failed to successfully connect pathogens to disease, making prevention activities seem irrelevant to most. Prevention and treatment activities, such as building public latrines, managing night soil, cleaning up water sources, and testing stool samples, were often perceived by locals as unnecessarily intrusive. They actively resisted participation by refusing to submit stool samples, comply with state control over night soil, or support infrastructure projects that disrupted fengshui. Yet the real [End Page E-24] problem was not intrusion into daily bodily functions, but rather disruption of production activities. The party attempted to manage the cross-departmental campaign through a new decentralized structure based on "leadership small groups" (LSGs) that functioned outside of official health departments at national, provincial, county, and township levels. But leaders of snail fever LSGs often simultaneously held other positions and deemed their time and resources better spent on production activities, which benefitted both their careers and local constituents and were always given higher priority than health campaign work. Campaign activities were never successful when they competed with production for attention or resources. Prevention activities involving water sources, for example, only gained traction if they also meant better irrigation and more arable land. Treatment frequently conflicted with production by removing laborers—and their potential for work points—from the field. Convincing locals that treatment was necessary could also be difficult when the majority of people were asymptomatic for long periods of time. And because health campaigns were largely unfunded, treatment often came at private cost. In fact, obtaining stool samples sometimes only worked when local leaders withheld work points until individuals complied.
Gross argues that the campaign was...