Urška Bratož

This chapter examines control over the movement of goods and people in epidemic circumstances, focusing on the case of nineteenth-century Trieste, and on the detention of individuals suspected of being disease carriers (of cholera in particular, as the city experienced several epidemic outbreaks at the time). Besides the key role the city played as a major Austrian trade port in the context of the Habsburg monarchy’s economy, its geopolitical position – situated close to both maritime and terrestrial political borders – enabled the observation of control mechanisms during the emergence of cholera. Quarantine (meaning detention of cargo and people as potential carriers of infection) was used almost exclusively in maritime transport, while control for overland transport was more lax. While the latter was mostly the domain of local (municipal) authorities, who could autonomously make decisions on the execution of health measures, the control over sea routes was more the purview of provincial authorities and was also subject to international sanitary rules. The connection between political, sanitary and economic authorities within the city, who were cooperating in these matters, also requires an interpretation of the contemporary theories as to the spread of infectious diseases and the role of these perceptions in the justification of economic interests.

in Medicalising borders
Outbreak anxieties in the United States from the colonies to COVID-19
Amy Lauren Fairchild, Constance A. Nathanson, and Cullen Conway

The aim of this chapter is to use the history of infectious disease epidemics in the United States to show both continuities – in the construction of social boundaries between the sick and the not-yet-sick, in the uses of epidemic crises for institutional capacity building –and change. More or less fear and panic are constant companions of epidemic disease, but the meanings attributed to these emotions–rational or irrational, random or the result of bad management, the province of ignorant masses or sensible elites – shift in response to larger contextual factors: the state of scientific knowledge and the infrastructure for disease treatment, control and prevention; how, when, by whom, and with what constraints the public is kept informed as the epidemic plays out; and the authority and legitimacy of the media and of those charged with crisis management by virtue of their public health and/or political positions. As we write in the era of COVID-19, each of these elements is playing out in real time. We offer this chapter in the spirit of George Santayana’s immortal words: ‘Those who cannot remember the past are condemned to repeat it’.

in Medicalising borders
An epidemiological 'iron curtain'?
Sabine Jesner

Sanitary innovations implemented during the eighteenth century made it possible for the Viennese court to expel bubonic plague outbreaks from the Habsburg Empire. The foundation for this development was laid through the establishment of an effective sanitary cordon at the south-eastern margins of the Habsburg Monarchy. The Habsburg Military Border, which was initially installed to protect the Monarchy from Ottoman invasions during the sixteenth century, expanded its preventive role through a sanitary function. Consequently, the most important element of these sanitary innovations was the establishment of specific quarantine facilities as permanent institutions in the Habsburg Military Border. Contemporaneously known as ‘Contumaz’, these facilities became the focal point of medical control. Border closures and mandatory quarantine became the predominant instruments used by the Viennese court to contain the plague. This chapter provides insights into the nexus of human movement and plague prevention at the external border of the Habsburg composite state. The method of quarantine is investigated by contextualizing the quarantine procedure in practice, the contemporaneous medical views and the perception of quarantine. Examining the functioning of quarantine as a tool to control epidemics in an early modern setting contributes to the research on the historical development of medicalized borders.

in Medicalising borders
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Medicalising borders
Sevasti Trubeta, Christian Promitzer, and Paul Weindling

The coronavirus emergency has highlighted the sanitary significance of borders, and therefore reinforced the need for turning the spotlight on the medical dimension as essential to border studies. A critical perspective emerges from the synthesis between the interdisciplinary field of border studies and longer-term historical studies of quarantine, contagion and sanitary controls on migrants and those who cross borders. The introductory part of this volume specifies the overall concept of the volume and the questions addressed in the chapters as being situated at the point of intersection of approaches to medicalisation and borders. The focus on interstitial borders represents a shift from policy in a single country to an interactive approach that may bring to the light transnational, regional and local dynamics. A demarcating border becomes an interactive location of cultural intersections, and transformative processes of cleansing and disinfection. What factors differing from, or complementary to, public health concerns (including economic and professional interests) do health control techniques at borders depend on? In which ways are such factors interwoven with a goal of constantly increasing scientific knowledge? How do (designed or implemented) medical controls at the borders connect or disconnect places by means of the containment, quarantine, detention and selection of migrants, refugees and border-crossers?

in Medicalising borders
Expurgating bodies, commodities and ideas, 1800–1870s
John Chircop

Quarantines were intended as prophylactic institutions: detaining, regulating and sanitising the movement of individuals and merchandise crossing the boundaries of a state. This chapter investigates these quarantine practices and other more complex multifunctional operations by focusing on the foremost quarantine institutions – the lazarettos – in southern Europe. Lazarettos are taken as filtering instruments which selected, separated, disinfected and disciplined ‘alien’ or returning embodied subjects before entering the country. They are analysed as inbuilt edifices, as an integral part of the state border itself. Their internal arrangements – spatial structures, physical divisions and social organisation – strictly conformed to and assisted the disinfection of persons, merchandise, animals and the expurgation of mail. Set against these permanent quarantine structures, this study then shifts attention to the actual protagonists – from the physicians to the health guardians to the expurgators – who were indispensable for quarantine to function. This helps us to examine quarantine disinfection and expurgation, not only as crucial sanitary procedures, but also as purifying cross-border rituals. While critically employing Giorgio Agamben’s idea of ‘apparatus’ to explore the basic functions of the lazaretto – to constrain, regulate and govern the movement and influx of persons, goods and animals – this study also brings to the fore other practices of filtering and expurgation which rendered the lazaretto more of a multifunctional site, serving as a crossover between detention centre, infective hospital, asylum, sanitary and social behavioural laboratory, postal-censor office and ritual purifying site on a country’s sea border.

in Medicalising borders
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On the coexistence of diverse concepts of territory and the spread of disease
Sarah Green

Quarantine is one expression of a particular relationship between infectious disease, governance, people and the territories across which both people and diseases travel. There are other ways to express that relationship as well. This chapter focuses on diverse and historically changing ways that the space across which disease spreads is understood and defined, particularly for the Mediterranean region. This begins from the obvious point that if a territory is understood in nationalist terms, attempts to control the spread of disease across its borders will differ from responses of territories that are understood, for example, as networks. In addition, medical and other epistemological understandings of the way that infectious diseases spread, including the metaphors used to understand these processes and vectors, can have a significant effect on responses (for example, total eradication and exclusion or learning to coexist with it). The chapter takes a brief historical look at how different political regimes responded to outbreaks of infectious disease – most particularly plague – in the Mediterranean region, and focuses on both the political and scientific logic drawn upon to guide the responses, as well as looking at critiques of the various accusations made as to who was to blame for epidemics in the past. It argues that the contemporary moment is at a crossroads, in which historical precedent could provide some indication of the implications of different paths.

in Medicalising borders
Sevasti Trubeta

Perceptions and representations of refugees and migrants as dangerous carriers of infectious diseases have been discussed in the scholarly debate as long-standing racialised prejudices and racist attitudes. This essay explores the operating force of such prejudices in the period during and immediately after the summer of 2015. This was a period in which what was called the ‘welcome culture’ shaped in Europe a framework of political correctness that conformed with humanitarianism and anti-racism. Given this framework and in view of the rescue operations at the European borders, how is racialisation and racism possible and operative? In dealing with these questions the author revisits the scholarly debates on ‘race’, ‘post-racial’ ideology and ‘colour-blind racism’ and makes the following arguments. In the treatment and representations of refugees and immigrants as potential vectors of infectious diseases (including the ritualised visual inspection of rescued border-crossers), there are codified global inequalities and a racial logic that draws on an ambivalence inherent to border regimes: humanitarian aid and securitisation. Both the metaphorical and literal signification of disease as a biological threat emerging from the global South (from ‘elsewhere’) mediates between biological warfare and migration; racism absolutises the biomedical perception of disease. Moreover, the racial logic translates the endemicity of disease in a geographical location into an endemicity of the pathogens in the bodies of the inhabitants. In this way, the risk of disease appears to be ascribed to the collective heredity of those who originate in the global South.

in Medicalising borders
Selection, containment and quarantine since 1800

The subject of this volume is situated at the point of intersection of the studies of medicalisation and border studies. The authors discuss borders as sites where human mobility has been and is being controlled by biomedical means, both historically and in the present. Three types of border control technologies for preventing the spread of disease are considered: quarantine, containment and the biomedical selection of migrants and refugees. These different types of border control technologies are not exclusive of one another, nor do they necessarily lead to total restrictions on movement. Instead of a simplifying logic of exclusion–inclusion, this volume turns the focus towards the multilayered entanglement of medical regimes in attempts at managing the porosity of the borders. State and institutional responses to the COVID-19 pandemic provide evidence for the topicality of such attempts. Using interdisciplinary approaches, the chapters scrutinise ways in which concerns and policies of disease prevention shift or multiply borders, as well as connecting or disconnecting places. The authors address several questions: to what degree has containment for medical reasons operated as a bordering process in different historical periods including the classical quarantine in the Mediterranean and south-eastern Europe, in the Nazi-era, and in postcolonial UK? Moreover, do understandings of disease and the policies for selecting migrants and refugees draw on both border regimes and humanitarianism, and what factors put limits on the technologies of selection?

Exclusion and non-Jewish labour migrants, refugees and asylum seekers in Israel, 2006–2017
Robin A. Harper and Hani Zubida

In this chapter, we probe the relationship between discourses of hygiene norms, polity inclusion and nationality in Israel. For the first time in Israel’s short history, it is experiencing non-Jewish immigration – labour migrants, refugees and asylum seekers which has provoked heated debate over the inclusion of non-Jewish migrants in the Israeli polity. One mode of social exclusion is the use of hygiene and cleanliness discourses. Claims of difference and inferiority based on hygiene practices and tropes of cleanliness to exclude, subjugate or disenfranchise outgroups have appeared throughout history around the world; Israel is no different. In concentrating on contemporary Israel, we analyse how hygiene and cleanliness discourses have been used since the founding of the state to reify the social hierarchy among Ashkenazi and Mizrachi Jews, Arabs and others. The prevalence of these discourses primed the public to the idea of hygiene and cleanliness as rationales for exclusion from the polity and for the state only offering negligible institutional and social accommodation for labour migrants, refugees and asylum seekers. Further, expansion of these discourses connected hygiene and cleanliness practices with criminalization, infection and social deviance, vilifying labour migrants, refugees and asylum seekers, and sealing their destinies to be outside of Israeli society and the Israeli national story. We show that hygiene and cleanliness discourses are not necessarily about health norms; they may also be about social hierarchy, inclusion and exclusion, accommodation and assimilation.

in Medicalising borders
From free movement of migrants to containment in concentration camps
Paul Weindling

This chapter explores the transition in migrant processing from the mass migration of the 1890s to the Holocaust and the containment procedures in concentration and extermination camps. Instead of making sure that migrants were free from pathogens, the Nazi procedures meant the migrants effectively became pathogens to be eradicated. Many aspects remain insufficiently appreciated, such as barriers to migrants claiming welfare, medical controls in the 1930s, and the extent to which the Germans exploited prisoners for medical research, turning people into reservoirs of pathogens.

in Medicalising borders