- Plague and Fire: Battling Black Death and the 1900 Burning of Honolulu's Chinatown
On April 1, 2003, in an attempt to halt the spread of SARS (Severe Acute Respiratory Syndrome), the Department of Health in Hong Kong ordered the evacuation to holiday camps of residents in Block E of the apartment complex Amoy Gardens, where a cluster of SARS cases had occurred. In late April and early May, the Department of Health in Beijing quarantined some four hundred students in a Beijing university after SARS cases appeared there. In both instances, the respective governments adopted quite drastic measures to deal with a public health crisis when little was known about the disease or its cause. But these actions, taken in the context of intense domestic and international pressure to control the epidemic, followed essentially the guidelines of prompt isolation of patients and potential contacts and management based on strict procedures of infection control advocated by public health authorities, scientists, and physicians around the world, who were still trying to identify the causative virus. These and other measures introduced at that time remind us of the difficulties faced by authorities in "making public health policy in times of crisis on the basis of limited medical knowledge" (pp. 5-6), as in the case of the outbreak of bubonic plague in Honolulu in December 1899. Of course, different factors also came into play in the Hawaiian story, which climaxed in the burning of Honolulu's Chinatown, but the central issue—one that James Mohr examines in this book—remains similar: how the formulation and implementation of public health policies are shaped not only by current scientific knowledge but also by political, social, economic, and cultural factors that oftentimes complicate the attempts to resolve the problem.
Indeed, as Mohr's careful and thoughtful reconstruction of the events in late 1899 and early 1900 demonstrates, public health policies were not made in a vacuum. Five years earlier, the Republic of Hawaii had been proclaimed by annexationists, who were pushing for the formal takeover of the Hawaiian Islands by the United States; they, including the three physicians in the Board of Health in charge of dealing with the crisis, were worried that a prolonged epidemic would jeopardize Hawaii's chances for full territorial status. Economic concerns also added to the sense of urgency. Fear of a possible collapse of Hawaii's economy if widespread death among Asian plantation workers took place or if Hawaii's international trade were not restored prompted the white business community to demand immediate action, however arbitrary, as long as that would bring an end to the epidemic. Such political and economic calculations certainly influenced the [End Page 206] behavior of, and the course of action taken by, decision makers during that rather unsettled time.
And in the center of the crisis were the residents of Chinatown, which was deemed the worst slum of the city. The outbreak of plague in this generally unhealthy area reinforced the cultural biases of Honolulu's whites, who shared the opinion that the Asian races were more susceptible to the disease, and who associated the presence of plague with filth and chaos and to "'diseased' social and political ways of life" (p. 56). Not surprisingly, many people, especially white medical professionals and those representing white commercial interests clamored for the preemptive burning of the entire area when initial attempts at targeted burning failed to contain the epidemic. The question of who was responsible for the unsanitary conditions in Chinatown, however, remained unanswered—was it the largely wealthy white landlords, who failed to improve the existing building structures; the government, which was derelict in the enforcement of building and sanitary codes; or the residents, who somehow lived in "filth and chaos"? But the way that displaced residents of Chinatown were marched off to detention camps under military guard like prisoners of war seemed to imply that the victims themselves were indeed at fault.
The epidemic, in...