Jane McCredie: History repeats

IN 1881, the young son of a Chinese merchant in Sydney fell ill with the much-feared disease of smallpox.

The succeeding outbreak caused widespread panic well out of proportion to its actual impact, as historian Garry Wotherspoon has documented. In 1881‒82, there were 163 cases of smallpox in Sydney and 41 people died — hardly a huge toll in the context of 19th century public health.

But infectious disease and racial politics have always created a potent mix. In 1881, anti-Chinese feeling spread more quickly than the virus, leading to fiery letters to the newspapers, attacks in the street and government moves to stop all ships and immigration from China.

A ship carrying 450 perfectly healthy immigrants from China was compulsorily quarantined under conditions described as “unnecessarily vexatious”, a move the colonial government admitted was intended to warn off other intending immigrants.

All this despite the fact that the disease was most likely imported from Europe, as urologist turned medical historian Dr Greg Watters has written.

But who cares about evidence when there’s a big nasty disease out there and it might be coming from somewhere foreign?

Not our Australian Government apparently, nor some others around the world, whose response to the current Ebola crisis seems motivated more by fear than reason.

The head of the WHO, Dr Margaret Chan, was unusually outspoken last week in criticising Australia’s announcement of restrictions on travel from West African countries, including suspension of visa processing even in humanitarian cases.

“We have learned from past experience managing many, many outbreaks that travel bans will not stop cases coming to your borders”, Dr Chan said.

Rather than trying to restrict movements, countries should be upping their surveillance and preparedness to deal with any cases that did occur, she said.

“People are sometimes under pressure, governments are under pressure, to just follow suit. We need to do our utmost to curtail unnecessary actions that will cause further damage.”

Some fear travel bans and unreasonable quarantine requirements will impede efforts to contain the outbreak.

“Anything that will dissuade foreign-trained personnel from coming here to West Africa and joining us on the frontline to fight the fight would be very, very unfortunate”, the head of the UN’s emergency response mission said last week from the Ghanaian capital, Accra.

Australian microbiologist Professor Tim Inglis is not alone in arguing the best way for developed nations such as Australia to protect themselves from Ebola is not to attempt to isolate themselves but to contribute to those containment efforts on the ground.

“The real issue is that the threat to Australia, the United States and other developed countries will be much higher in six months”, he wrote in Nature last week. “The best defence is to act now and in Africa.”

We can only hope.

Sadly, there is a long history of isolationism in the Australian response to infectious disease, as illustrated by the 1881 panic over smallpox.

That outbreak has been credited with helping to inspire the appalling White Australia Policy.

It is also thought to have marked the beginnings of a coordinated public health system in this country, with doctors employed to combat the crisis at a rate of 3.5 guineas a day, plus buggy, horse and forage.

Let’s hope something equally positive comes out of the tragedy that is Ebola.
 

Jane McCredie is a Sydney-based science and medicine writer.