Dying in the City?

Hi, all. I agree with Lauren's earlier post about the parallels to other stories we've read in this class: in many ways, the story of African Americans and sickle cell anemia reflects many of the same issues as we encountered in our discussion of Filipinos. I think that these types of stories (that tie together public health/disease/hygiene/marginalized community) are great test cases for showing the very complicated way that disease works in America. As we see in Dying in the City of the Blues, the 'story' of sickle cell anemia is about much, much more than an illness. We can see the ways that this disease provided a center for the already existing discourses of race, gender, class, and region. At a certain point, though, it seems that a discussion that is based on sickness or disease should deal perhaps more with the actual disease. As one reviewer that I read pointed out, the book is called "Dying in the City of the Blues," but the book is more about living with or dealing with or talking about disease than it was about dying. Additionally, the book is more about the discourse surrounding sickle cell anemia than it really is about the experience of the disease. However, I appreciated the diversity of sources - particularly his interesting addition of blues lyrics - and I felt that they really helped to give a feeling of the pervasiveness of the issue of sickle cell.

FROM BRIENNE

Like another student, I too discovered that chapter six provided much food for thought. We see in it how politics, race, and disease interacted, sometimes in unscrupulous ways, in national and local politics. Overall, this book is interesting and enjoyable to read. However, I take issue with a couple of minor subjects in chapter six.

The last paragraph on page 183 oversimplifies and idealizes the controversy surrounding the disease, claiming that even conservatives could appreciate its implications for reducing drug abuse in patients. This paragraph seems to go against the grain of the book, which says that the disease caused disputes even among members within a constituency. I question how much the idea of funding the disease really appealed to conservatives, especially when one of the main arguments that was used to appeal to them was that funding research on the disease could help reduce drug addiction in the small number of patients directly suffering with the disease. In the same vein, today I could say that government funding for alternative energy research would appeal to Republican Congress members because it could help reduce our dependence on foreign oil, and also help provide more jobs to the economy, but ultimately when such a bill came up for voting, it would probably be accepted by many Democrats and few Republicans, because those issues I just mentioned pale in comparison, at least in the minds of most people, to the issue of protecting the environment, which is more heavily advocated by Democrats. In other words, almost any issue can be made to look like it will appeal to people with diverse political views, but in practice it only appeals to a certain segment of people.

Wailoo also seemed to dismiss too readily the problem of Italian and Greeks saying that Cooley’s anemia should be given the same deference by political leaders as sickle cell anemia (p. 194). The books contains only one paragraph on the subject, and essentially dismisses it as “me too politics,” instead of giving the issue due regard.

The Politics of Disease

I found the connection Wailoo made between sickle cell anemia and the political culture of the 1970's fascinating. Chapter six focuses on how the disease became "a crucial part of national health care politics and of the southern politics of racial realignment" (22). It seems at one level there were individuals truly concerned about the suffering of the African American population afflicted with the disease and, and on another, it appeared to be a political agenda line item utilized to gain voters. Or, maybe there were individuals floating somewhere in the middle. It was also interesting to see the statistics quoted with regard to funding allocated for certain disease research efforts. What became problematic was the shift of funds from one directive to another; who is qualified to make the call that says funding for sickle cell research should be drawn from, say, cancer research? The ramifications of this debate are quite serious. I think this brings to light contemporary issues of fundraising on a private level and research fund allocating within the federal government. The author is right on when he notes that in the 1970's, sickle cell anemia had to bear the burden of many political agendas. At some point during this time frame, the focus shifted from the actual disease and the patients striving to cope with it's affects, to a racial and political arena.

Dying in the City of the Blues

I think it is really interesting how Wailoo uses the visibility of one disease in one city as a case study to reflect the wider social challenges for African Americans in America. I think this book nicely accompanies many of the other books we have been reading this semester. Wailoo writes that “These questions of disease visibility point us toward the wide range of processes by which illness, syndromes, disease, poor health, and symptoms like pain have become the sites of negotiations about power, governance, justice, and social order” (24). In many ways, I think this is similar to Americans views and treatment of Filipinos in the Philippians, or Mexican immigrants crossing the border. Wailoo mentions that the higher infant mortality rate among blacks was perceived as a result of “negro ignorance” (56), and African Americans were in general viewed as unclean, even to the point separating black and white donated blood, this is similar to the way many white Americans viewed other races. I find it interesting and disappointing that white Americans used these views maintain social order. Wailoo makes an interesting point when he states that “pathologies among blacks… have been used similarly to moralize about African American status, sexuality, intelligence, education, or economic condition” (1).

New Eugenics?

I was really interested in how Stern kind of 'exploded' the idea of eugenics so that it was more than our early 20th c, Progressive Era preconceptions (or, at least mine!)

I find myself thinking about what forms 'eugenics' might take in our society today, beyond the more obvious issues like prenatal testing, etc. I'm particularly interested in the IQ testing that was used to separate 'gifted' children from 'morons,' used to justify school segregation. Are there still iterations of this form of 'eugenics' being used today? Children go through an enormous amount of testing to determine what 'groups' they should be placed in - Advanced Math, AP English, or on the opposite end, remedial classes. Some schools place children on different 'tracks,' separating the 'gifted' chidlren from others. In a slightly different form, we have special education programs - not all of which practice inclusion, essentially separating children with disabilties from 'normal' children. Teachers and administrators categorize children even if unofficially by deciding which children will succeed and which will not based on their behavior and performance in the classroom. These labels are applied to children in countless meetings and in evaluations, and affect what direction a child's education can take. Are these forms of 'eugenics,' even if they do not necessarily relate to reproduction, per se?

Eugenics Everywhere!

Although the ideas of ultra-nationalists are not new and are even studied in high school, making the jump and tying that into eugenics is a somewhat small step or at least that's what the author wants you to believe.  So far I'm somewhat doubtful and like last weeks post I find myself questioning the content/main premise of the book.  Is it really a small step from saying Americans in the late 1800's viewed Mexicans as lazy and dirty, and then saying this is proof that these same Americans wanted to create a master race?  Although Stern's evidence seems consistent and numerous, I still find myself having doubts.

Furthermore although these books separate the science from the history purposefully, I feel that more science would be helpful in understanding many of the issues investigated in the book.  One part I find myself confused over is when on pg. 67 El Paso's Chief inspector Tappan states the differences between working the Canadian border and the Mexican border by stating that on the Mexican border they have to "contend with an alien race: one with a different language, different customs, different moral standards and different diseases."  At first this seems like direct proof of racial foundations of his work, but more information on the science of diseases in differing climates would be helpful.  From experience I know that when traveling to many tropical areas certain vaccines are needed leading me to believe that heat and climate do play an important part, but how much I'm really unsure of.  In the end one can take away the fact that by including "different moral standards" in with his observations" that racial tensions has obviously played a large part in our immigrant policies.   Without a doubt Stern's arguments are clear and compelling, my only concern is are they as strong as she would have us believe?

Late again! Sorry!

Hi everyone - sorry this is extremely late, but I just can never remember this thing!

I was interested in the use of hygiene as a way of marking difference in race between white and Filipino people during early 20th century seemed to me to have some parallels to the first contact between the Spanish and native people in the 16th century. An article by Rebecca Earle, entitled "If You Eat Their Food...:" Diets and Bodies in Early Colonial Spanish America," deals with a similar issue, where Spanish colonialists feared that they would 'become' native - get darker skin, coarser hair, different behavior - if they ate the same food as the native people. This same concern is reflected in Colonial Pathologies, through food, but also early on through the environment, then through the 'dirtiness' of the peoples themselves. It is interesting to see that the same fears existed over hundreds of years: white people were healthy, from healthful climates, with healthy habits; whereas 'others' were sick, from dangerous climes, with non-hygenic habits.

Have to run - time for class! :)

imperialist medicine

Warwick Anderson deftly captures the additional narrative of the colonization of the Philipines by the U.S. military at the turn of the twentieth century; that of medical imperialism. Catagorizing the colonized as "other" while stratifying the population along arbitrary lines are basic imperialist strategies. However, in the Philipines in addition to these stategies "physicians extended their power to inspect and regulate the personal cleanliness and the social life of naturally erring Filipinos" (106). Thus hygiene worked to define Filipinos as "other" (unhealty and unclean), while while establishing a hierarchy of health (for example: the "health index" set up for each child in a particular class.

The fludity of race is also once again demonstrated through the U.S. military and medical establishment's belief that through proper training natives could attain proper citizenship. However, Anderson is carefull to point out the self-fulfilling prophecy of imperialist ideology. Even though many believed Filipinos could be so trained, few believed that their inherent character would allow them to.

Also, how about that 1908 float on page 126.

Science in the Context of Social Prejudices

Chapter 3 demonstrates how science and disease were framed by the Americans residing in the Philippines. Originally the Americans blamed their illnesses on the hot environment in the islands, which they believed they were not accustomed to physically, since they originated from a different climate. The need to stay in one's climate of origin was termed, "ethnic moral topography."

Later it was thought that the natives had acquired immunity to the local diseases, and when it was discovered that some natives did suffer from certain diseases, most Americans blamed the illness on the Filipino's depravity and moral failings, instead of looking for outside causes, such as socioeconomic factors. Filipinos were later blamed as being infected disease carriers, even if they were healthy. Eventually, the Americans turned to improving the personal habits of the Filipinos, by teaching them to replace traditional lifestyle choices with the "spirit of hygienic thoughtfulness."

While the Americans hoped to improve their own health, and also understand and treat the maladies of the Filipinos, they viewed things through a different scope than we use today. They thought it legitimate to blame the issues on not only the perceived biological differences, but also the moral differences between the races. Today we view disease as something that happens to someone due to physical causes, rather than moral failings, and most people would agree that morality does not directly impact one's health. The people at this time had a heightened sense of racial differences, and today racial differences, if considered at all in disease treatment, are (in theory at least) based on purely physiological differences.

The book provides some intriguing insight into how cultural upbringing and perceptions can influence scientific thinking in society.

The Progression of Medicine in Battle

I found the progression of medicine and how the army dealt with it very interesting. The fact that the people who were sent with the army to care for them according to Anderson "after a few weeks in the military "we found our ignorance was sublime"" is amazing due to the fact that these people were trained medically, but obviously not specifically enough as Anderson goes on to point out. It was interesting to see how the surgeons and medical personnel learned as time went on. The way that hygiene was taught and how people such as Lieutenant Kemp taught the other soldiers how to keep wounds clean and to keep the hospital corps out of the way is important. It shows that no one was really prepared for what they found on the battlefield. The conditions were obviously not the best to deal with so to see how things progressed grabbed my interest. This is also important due to the fact that every war is different and no conditions were ever the same.

Colonial Pathologies

I found it odd how Americans in the Philippines tried to use hygiene, or lack of hygiene as justification for the inferiority of the natives. Then how because of the Americans tried to civilize the Filipino’s mainly by reforming Filipinos’ personal hygiene habits and by implementing other measure that would improve hygiene, specifically through the “sanitary pail” and latrines. I find this interesting for two reasons. First of all, it’s odd that by modifying hygiene practices, the Filipinos were being colonized in a very personal matter. But I also find it interesting, that as Filipinos began to practice these habits and welcome hookworm treatment and the building of latrines, people began to lament the extent to which Filipinos were just imitating the colonizers. It just seemed that no matter what Filipinos did or how they reacted, they had immense difficulty coming out father ahead. And health just became on mechanism which Americans could just to justify their prejudices, first by denouncing Filipinos hygiene and then by claiming all Filipinos are healthy carriers.

Colonial Pathologies

I was really intrigued about the concept in Chapter 2 regarding the concept of laboratory. To quote Anderson, the laboratory began to stand for, "a symbol of control, purity, and precision..." in colonial times. I imagine a spotless room with various activities taking place under scientific examinations by men in white lab coats. Andreson then goes on to explain the nature of the Philippines as a tropical laboratory and my picturesque image of the lab is skewed. The meaning of this term at the time, in essence, stood for a 'hygenic space for experimental practice.'
Personally, I have a difficult time reconciling the two meanings. As we are lead to believe, the Philippines was not exactly the poster child for purity or precision and the element of control certainly depends on the controlling body. The idea that Filipinos were subject to experiments essentially for their own good is unsettling. Again, we see the stigmatizing of an entire group (or race as the case may be).