Contagion and the Politics of Prevention

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The natives bazaar in Abadan 1940's Credit: Corbis
The natives bazaar in Abadan 1940’s
Credit: Corbis

 

Author: Kaveh Ehsani, Leiden University 
[ From “The social history of labor in the Iranian oil industry : the built environment and the making of the industrial working class (1908-1941)” ]

The question of contagious diseases and their root causes became a central preoccupation of urban life in 19th century European and colonial cities caught in the midst of the largest wave of urbanization in history. The related processes of industrialization, the accelerating marketization of economic life, and of modern nation state building were among the major causes of this geographic revolution[10]. The population of capital cities like London and Paris grew fivefold during the 19th century as waves of destitute rural migrants were forced off the land and moved to cities in search of a living. Colonial metropolises such as Calcutta or Bombay grew as fast. The more lucky would find work in industrial wage labor, domestic service, or the remaining crafts, guilds, in menial tasks in the growing municipal services, otherwise they found themselves in poor houses or pushed into the underclass[11]. In this new urban geography, inhabited by different social classes during an era of revolutionary political and economic change, contagious diseases became increasingly associated with the foremost fears and concerns that preoccupied the middle class imagineries. As a result, contagious diseases were linked, explicitly or subconsciously, either with delinquencies, especially criminality, prostitution and theft; or with poverty; and subversive political radicalism[12]. The cure for these ills became in large part associated with notions of proper sanitation, the application of science to improve the social condition, and the role of professional experts and of state institutions to regulate social affairs.
Comparatively, the urban condition of Abadan in the 1920s was not dissimilar to large sections of Paris, London, Chicago, New York, or Calcutta, of the mid to late 19th century to WWI, where destitute migrants uprooted from the countryside or their homeland were eking out an existence amidst poverty and disease[13]. It is important to analyze the mentalities and the politics of prevention that emerged out of this history in order to be able to frame the dynamics of urban change in Abadan in the 1920s. The severe cholera crises of 1832 and 1849 in Paris book-ended the upheavals of the 1848 revolution, and linked the notions of contagions with criminality and class conflict as specifically urban pathologies[14]. The notion of a “sick city, perpetually agitated by disturbances, revolts, riots, and revolutions” took the appearance of commonsense in exponentially growing metropolises where social classes had to cohabit in close proximity[15]. It is worth quoting Evans’ summary of how contagion, poverty, and radical politics came to be associated within the social imaginary of mid 19th century, because it is a sentiment that still survives in various ways and colors attitudes and perceptions to various degrees in class divided societies. “Cholera undermined bourgeois optimism by revealing the existence in great towns and cities of 19th century Europe of whole areas of misery and degradation. Virtually all commentators were agreed from the start that cholera affected the poor more than the well off or the rich, and the widespread middle class view that the poor only had themselves to blame was hardly calculated to mollify the apprehensions of the poor. Early writers on the disease constantly reiterated the bourgeois belief that drunkards, layabouts, vagabonds, and the idle “undeserving poor” were those most affected, and echoes of this view continued to surface right up to the end of the century. In this way confidence in bourgeois society as the epitome of progress and civilization was precariously maintained by ascribing the ravages of the disease to the uncivilized nature of the poverty stricken masses. By contrast, the poor could easily interpret the relative immunity of the bourgeoisie as evidence of exploitation, injustice, and even a desire on the part of the rich to reduce the burden of poverty by killing off its main victims”[16].
Cholera was the most feared disease of the 19th century, carried to Europe from colonial India via ever faster and larger merchant ships, through newly manmade and shorter routes like the Suez Canal and the expanding railways system. It spread in port cities and industrial towns with poor water sanitation and dreadful general hygiene and living conditions[17]. In other words, the increasing potency of contagious epidemics in the 19th century was directly linked to, and inseparable from, the twin processes of the consolidation of industrial capitalism and the global spread of colonialism. In European capitals and ports as well as in the colonies the dispossession of agrarian populations was driving them to towns. At the same time, the mineral extraction and export of raw materials from the colonies was processed through a global network of port cities, linked to the rural hinterlands through improved networks of land transportation through railroads, canals, and roads[18]. In the 19th century colonial cities acted more as warehouses for the export of extracted raw materials, in the 20th century this changed, and they became factories for the partial processing of these goods, with Abadan as a typical example[19].
This urbanization of deracinated populations, interconnected globally by demands of capital and colonialism, was fertile ground for deadly epidemics. The situation created a conjuncture between sewers, criminality, poverty, and social conflict. It led to the emergence of “a politics of prevention” in the second half of the 19th century where professional experts began to take a more prominent role in social affairs in an attempt to address the crisis on behalf of the entire population[20]. As the “sanitary idea” took hold of imaginaries through systematic scientific, parliamentary, and journalistic investigations by social reformers such as Edwin Chadwick, Henry Mayhew, or John Snow[21], a new consensus gradually emerged as to the causes of the spread of epidemics; but the means of its prevention remained highly divisive. John Snow’s statistical investigation and mapping of London drinking wells in 1854 had proved that contaminated water and not miasma was the cause of cholera, but the appropriate policies for combating epidemics remained a highly divisive terrain. Decades of scientific research, the compilation of statistical reports, and numerous commissions of experts followed this discovery without much being done in practical terms. The main bone of contention remained how to finance and build a sanitary urban infrastructure and to institutionalize universal public health measures to deal with the dangers of contagion in vast cities and among fast growing populations. For utilitarian liberals, such as Chadwick, who had been at the forefront of pushing through parliamentary legislation such as the 1848 Public Health Act, this created a fundamental philosophical dilemma. True to their free market ideology liberals wanted private companies that already owned the distributions rights to improve the water supply, however there were few incentives for private entrepreneurs to invest in costly urban infrastructure for the poor[22]. Eventually, the accumulation of statistical and cartographic knowledge about contagious diseases, and the failure of a private sector solution to the pressing need for sanitary urban infrastructure contributed to paving the way for new perspectives on ‘society’, the appropriate role of the government, and poverty and inequality. Sociology, as the new “science of society”, differentiated the intimate face to face bonds of ‘community’ from the more abstract rules and institutions holding together ‘society’, bonded within national borders, and conceptualized as an organic body[23]. The poor and the sick were as much part of this social body as the aristocracy and the middle classes. The afflictions of contagious diseases among the poor and the working classes, if untreated, eventually would infect the entire social body that had been amassed in congested cities, and therefore could not be ignored. This new conceptualization of society as a collective organism gave impetus to notions of ‘trusteeship’, and of the responsibility of ‘men’ of science and professions to discover, plan, design, and implement reformist sanitary and municipal policies on behalf of universal social welfare and progress, disregarding the resistance of narrow and particularistic communal interests[24].
In France, the quantifiable data proving that poor urban areas were worse affected, combined with the knowledge that epidemics moved geographically across national as well as social boundaries and spread through contaminated water, allowed a link to be established between epidemics and “the age old accumulation of poverty”. The medical knowledge of cholera, in other words, made urban social inequality incontrovertibly visible, and turned it into a social problem affecting all[25]. The size and rate of population growth during rapid social change, as well as issues previously thought to be purely economic – such as the price of bread, the rates of unemployment, the quality, availability and costs of housing, and the causes of hunger — now became recognized as critical and quantifiable factors in controlling and preventing the spread of deadly epidemics[26]. As a result, poverty came to be framed increasingly as a social ill affecting all, rather than an indication of innate inferiority or personal and cultural failure.
By the late 19th century a political shift was on the way to make preventive public health measures — such as food security, sewage treatment, the provision of safe potable water, vaccination, etc. — compulsory upon everyone, including the poor and destitute, through legislation and direct government intervention. This paved the way for legitimizing the direct intervention of states into a widening range of compulsory public health measures, such as food regulations and vaccination; and the provision of costly urban infrastructure, especially sewerage and piped water, to be financed through taxation. The process led to what Jane Jenson has called a new citizenship regime, where good citizenship now came to be defined as generous public spending on building public works as an indication of dedication to achieving a higher civilization[27]. The process also opened the way for professional and scientific experts to take charge of the planning and implementation of these measures. In the colonies, however, the urban reform measures were far more drastic, as we shall discuss in the following section and in chapter 6.

 

Notes: 
10. Polanyi, The Great Transformation; Friedrich Engels, The Condition of the Working Class in England (New York: Oxford University Press, 2009); Eric Hobsbawm, The Age of Capital: 1848-1875 (New York: Vintage, 1996); Asa Briggs, Victorian Cities (Berkeley: University of California Press, 1993); Peter Geoffrey Hall, Cities in Civilization: Culture, Innovation, and Urban Order (London: Orion, 1999); David Harvey, Paris, Capital of Modernity (New York: Routledge, 2003).

11. Richard Sennett, The Fall of Public Man (New York: W.W. Norton, 1976), 130–149; Briggs,
Victorian Cities; Harvey, Paris, Capital of Modernity; Gareth Stedman Jones, Outcast London (New York: Pantheon, 1984).

12. As inflected, for example, in the novelistic depictions of Balzac, Dickens, or Zola. See for example Emile Zola, Le Ventre de Paris (Paris: Livre de Poche, 1997).

13. This statement is to highlight the rather a-historical approach of some the social historiography of public health in Iran during the Qajar period, which tend to frame the material state of the population’s hygiene and living conditions as an unchanging product of its “Islamic” as well as “pre-Islamic” cultural practices and forms of knowledge, rather than as an integral aspect of its larger and changing historical and geopolitical context. The informative and encyclopedic, but un-analytical and uncomparative, work of Willem Floor is an example of this trend. See Willem M Floor, Public Health in Qajar Iran (Washington, DC: Mage Publishers, 2004). For a comparison of the living conditions of the working people in the largest European capitals of the late 19th century see Steven Johnson, The Ghost Map: The Story of London’s Most Terrifying Epidemic–and How It Changed Science, Cities, and the Modern World (New York: Riverhead Books, 2006); Louis Chevalier, Laboring Classes and Dangerous Classes (New York: Howard Fertig, 1973). For a novelistic depiction of Chicago in the same period see Upton Sinclair, The Jungle (New York: Bantam Books, 1981).

14. There were major differences in response to epidemics and managing the dangers of contagion in different cities. For example, Birmingham had a far more successful track record in curtailing the 1832 cholera pandemic due to a combination of fortuitous location away from seaports, uncontaminated sources of water (deep artesian wells), and an urban elite willing to take energetic measures to isolate and curtail the disease. See Ian Cawood and Chris Upton, “‘Divine Providence’ Birmingham and the Cholera Pandemic of 1832,” Journal of Urban History 39, no. 6 (November 1, 2013): 1106–24.

15. Chevalier, Laboring Classes and Dangerous Classes, 11–14.

16. Richard J. Evans, “Epidemics and Revolutions: Cholera in Nineteenth-Century Europe,” Past & Present, no. 120 (1988): 128.

17. Peter Baldwin, Contagion and the State in Europe, 1830-1930 (Cambridge University Press, 2005), 37–122.

18. Robert Home, Of Planting and Planning: The Making of British Colonial Cities (London: E & FN Spon, 1997), 64–65. Birmingham was spared the devastation of the 1832 cholera pandemic in part because it had not yet been linked through railroads. See Cawood and Upton, “Divine Providence” Birmingham and the Cholera Pandemic of 1832”.

19. William Beinart and Lotte Hughes, Environment and Empire (Oxford: Oxford University Press, 2007), 153; William Cronon, Nature’s Metropolis: Chicago and the Great West (New York: Norton, 1992).

20. Baldwin, Contagion and the State in Europe, 1830-1930, 524–563; Jane Jenson, “Getting to Sewers and Sanitation: Doing Public Health within Nineteenth-Century Britain’s Citizenship Regimes,”
Politics & Society 36, no. 4 (2008): 532–56; Barrie Ratcliffe, “Cities and Environmental Decline: Elites and the Sewage Problem in Paris from the Mideighteenth to the Midnineteenth Century,”
Planning Perspectives 5, no. 2 (1990): 189–222; Anne Hardy, “Public Health and the Expert: The London Medical Officers of Health,” in Government and Expertise: Specialists, Administrators, and Professionals, 1860-1919, ed. Roy MacLeod (Cambridge: Cambridge University Press, 1988), 128–44; Somers and Block, “From Poverty to Perversity: Ideas, Markets, and Institutions over 200 Years of Welfare Debate”; Block and Somers, “In the Shadow of Speenhamland”; Evans, “Epidemics and Revolutions”; Johnson, The Ghost Map; Judith Walkowitz, Prostitution and Victorian Society: Women, Class, and the State (Cambridge: Cambridge University Press, 1980); Julia Ann Laite, “Historical Perspectives on Industrial Development, Mining, and Prostitution,” The Historical Journal 52, no. 3 (2009): 739–61.

21. Henry Mayhew, London Labour and the London Poor, ed. David England and Rosemary O’Day (Ware, Hertfordshire: Wordsworth Editions Ltd., 2008). See the fascinating critical discursive analysis of Chadwyck’s parliamentary report as the basis of reform of the Old Poor Laws in Somers and Block, “From Poverty to Perversity: Ideas, Markets, and Institutions over 200 Years of Welfare Debate”; Margaret Somers and Fred Block, “Reply to Hicks: Poverty and Piety,” American Sociological Review 71, no. 3 (2006): 511–13. Marx used these reports extensively in composing the important chapters 10 and 15 of volume one of Capital on absolute and relative surplus value. On Dr. John Snow and mapping the sources of cholera in London see Johnson, The Ghost Map.

22. Jenson, “Getting to Sewers and Sanitation.”

23. Mary Poovey, Making a Social Body (Chicago: University of Chicago Press, 1995).

24. Cowen and Shenton, Doctrines of Development, 2–57; Randall Packard, “Visions of Postwar Health and Development and Their Impact on Public Health Interventions in the Developing World,” in
International Development and the Social Sciences, ed. Frederick Cooper and Randall Packard (Berkeley: University of California Press, 1996), 93–118; Frederique Apffel Marglin, “Smallpox in Two Systems of Knowledge,” in Dominating Knowledge, ed. Stephen Marglin and Frederique Apffel Marglin (Oxford: Clarendon, 1990), 102–44; Michel Foucault, Discipline and Punish; Procacci, “Social Economy and the Government of Poverty”; Donzelot, L’Invention Du Social: Essai Sur Le Declin Des Passions Politiques.

25. Chevalier, Laboring Classes and Dangerous Classes, 13–14.

26. Ibid., 30–32, 161–162, 262; David Sunderland, “‘Disgusting to the Imagination and Destructive of Health’? The Metropolitan Supply of Water, 1820-52,” Urban History 30, no. 3 (2 03): 359–80; Procacci, “Social Economy and the Government of Poverty.”

27. Jenson, “Getting to Sewers and Sanitation”; Marshall and Bottomore, Citizenship and Social Class.

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