Epidemic Invasions: Yellow Fever and the Limits of Cuban Independence, 1878-1930 by Mariola Espinosa (review)

Viruses respect no borders, but all efforts at disease control take place within a political context. Mariola Espinosa, a history professor at Yale, studies the role of disease and public health in the history of Latin America and the Caribbean. In this very readable book, Espinosa demonstrates how trade, epidemics, and quarantine interacted within a complicated international relationship. Her principal argument in this book is that disease control projects and public health policies tell us a great deal about competing interests.

At the turn of the nineteenth century, yellow fever was rampant in the Caribbean. To alleviate this epidemic, which threatened US trade activities, Washington moved to intervene in Cuba's war of independence. When the sanitary measures for yellow fever control urged by the United States are examined, it becomes clear, says Espinosa, that political and economic concerns were paramount.

Espinosa approaches this topic from a macrohistorical perspective, gradually narrowing her focus from public health to colonial disease control and then to yellow fever and the Cuba-US relationship—that is the substance of chapter 1. Chapter 2 narrates the destruction of trade between the American South and Cuba by yellow fever. The next chapter describes efforts by American health authorities after the occupation of Cuba: all attempts to stem yellow fever achieved limited success.

In this book are many black-and-white photographs showing street sweepers, cleaning brigades, and others mobilized to improve Cuban sanitation. The author also uses graphs to convey the mortality rate in Havana during the relevant periods, shoring up the argument that the occupiers were not particularly concerned about the general health of Cubans. Because of the American obsession with yellow fever and trade, many contagious diseases, such as tuberculosis and malaria, received scant attention, and efforts to fight them were poorly funded.

In spite of tremendous efforts, the yellow fever epidemic was not slowed until the role of the mosquito in its transmission was established by the efforts of Henry Rose Carter, Jesse W. Lazear, and Carlos J. Finlay. From that time, yellow fever was vulnerable to sanitary controls. As chapter 5 shows, a range of tools deployed by the occupier, including sanitary policies laid out in the Platt Amendment, eradicated yellow fever in Cuba—while at the same time influencing the Cuban constitution. Indeed, America's informal imperialism closely resembled that exercised elsewhere in this period by European powers.

In chapter 6, Espinosa presents the rebellion of Cuban intellectuals against the stereotype of the "dirty Cuban." This included campaigns against US newspapers and professional journals and a struggle to reclaim the credit owed Finlay for his pioneering research. In her conclusion, Espinosa argues that public health and the control of yellow fever were realized in the context of Cuban-American relations, an area where the United States made sure that its interests were fully protected.

Furthermore, Espinosa used Frantz Fanon's ideas on colonization to explain the American project in Cuba. The ruler can legitimate his power only by providing benefits to the ruled. Obviously, in the Cuban case, the occupiers did not convince their subjects that eradication of yellow fever was a reasonable reward for tolerating the persistence of colonization.

Taiwan (N 23.1 E 121.5) and Cuba (N 23.13W 82.36) share geographic traits, agricultural customs, and a colonial history. What sorts of contagious diseases broke out in Taiwan in the nineteenth century? In Pesuto to kindai Chugokuペストと近代 中国 (2000), Iijima Wataru 飯島涉 described a plague that spread from Hong Kong to Taiwan at the beginning of the period of Japanese colonization. The Japanese authorities tried many of the same policies that the United States imposed in Cuba, including the construction of hospitals and sewage lines and the establishment of a special sanitary police force tasked with controlling epidemics. In Taiwan, a system of community responsibility known in Chinese as baojia 保甲 was introduced by the Japanese to augment sanitary control. This all led...