Reverby, Examining Tuskegee Part I

In Part I of Reverby's Examining Tuskegee, topic that struck me the most was how African American people with syphilis were handled. When syphilis began to have more of a presence in the 1920s, people would be treated with the use of mercury and other metals, which didn't actually help to treat the bacterial infection. Once people showed the first sign of syphilis, skin lesions, it was taken as primary and secondary syphilis (p. 25). And once the lesions healed, it was believed that the body's immune system was the best way to fight of the disease (p.26). Today, the best way to fight off the disease is to get treatment and not get to the stage of lesions healing. In Examining Tuskegee, patients in University Hospital in Oslo, Norway were hospitalized. Fifteen years later, some of the patients were followed up. Only 309 of the 2,000 patients were found, and 309 men and women were still alive, but 164 people had died. Out of the 309 still alive 40% were symptom free, but roughly half had presence of the disease in their blood. Another 18.1% had cardio or neurological problems (p. 26). To me this is evidence that some people who are untreated, can die or develop major problems later in life. Later on, penicillin (the cure for the disease) was discovered and was used on syphilitic people across the country (p. 63). However, there were some cases in which people would not be treated, such as on page 77 of Examining Tuskegee, and ended up having medical problems caused by syphilis. Overall, it is shown that not being treated for syphilis highly increases the possibility of medical problems or death.

Please post your responses to Molina, Fit To Be Citizens Chs. 3-5 here!

Thanks,

DK

Race, Medicine, and Society Notes - February 22, 2018

Race, Medicine, and Society Notes - February 22, 2018

Time frame: Aftermath of Civil War - 1920

Different racial groups not quite full citizens because of their racial categorization and matters of health

Discussion Questions:

• How do discourses of race, racialization, and health intersect and define Las Angeles at the turn of the century and Las Angeles culture?
• How does health and discourses of public health contribute to the radicalization (and chance of being considered a citizen) of certain populations?

Discursive Formation - the way discourses form, matrix of information

Discourse- allowable speech, stories that make sense

Historicize - put something in its historical context

Las Angeles was a new city at the time

• Marketed as an oasis to white workers
• High expectations of a city
• Problem for Whites: Different racial groups within the proximity such as the Chinese

- Typhoid Outbreak in the United States

- Changes in immigration (Influx of Eastern Europeans, Southern Europeans, Mexican, Chinese, Japanese)

- Labor Market

- Urbanization / Industrialization… Eastern cities had begun to become polluted from factories. Las Angeles promised a cleaner area and was advertised as an oasis

Questions at the time about immigration:

• Are new immigration groups safe (healthy from illnesses)?
• Will they steal jobs from white workers?
• Will they assimilate?
• Will they become Americanized?

Mexicans were thought to hold diseases such as Typhus Fever and Smallpox

• ‘Smallpox originated from Mexicans’

Disease played a role in defining who you are a citizen

• Led to isolation of those populations (China Town)
• Seen in the construction of Las Angeles
• People thought Mexicans would bring Fleas that would lead to Typhus, however clean hair is needed for fleas to cling to which goes against the controlled imagine as Mexicans being dirty people

Instead of admitting that railroad camps were unclean; workers were blamed and considered the be unclean

Diseases associated with particular groups

• Placed blame on people instead of controlled factors such as unsanitary living conditions

Chinese Exclusion Act (1882) - Barred Chinese laborers

Chinese Restriction Bill (1885) - Exclude all Chinese from the United States

Discursive Production - Certain groups shown a certain way for the whole population

• Led to policy outcomes (policies above)

Typhoid -> racialized disease

Comparable to AIDS in the 1980s which was thought to only affect homosexuals even though they were just disproportionally affected by the virus

Cracking down on minorities gave the public health workers more power

Sudden competition for jobs scared white workers

• Labor competition

“Stereotype” = Controlling Image

Chinese fruit pedlers

• Fruit being sold by a Chinese person was thought to be dirty
• Less people bought from them (therefore the Chinese could not participate in economy = not citizen)
• Symbolic: exclusion of groups, not able to contribute to society

Racial hierarchies constructed

• Mexicans aren’t white but they also aren’t non-white

Did medical discourse hold more weight than other fears and anxieties held during the time towards immigrants?

• Sexual danger
• Economic threat

Fit to be Citizens? Blog Post

The first portion of Fit to be Citizens? solidifies the argument even that Jim Downs asserts in his text Sick from Freedom. They both look at the root of widespread disease amongst the black community in the United States, however they explore different time periods. Also Natalia Molina’s primary focus is on how these healthcare issues impacted minorities’ “social membership” within American society. The early assertions made in Molina’s text resonate with the discussions we have had as a class: it recognizes the experience for people of color with healthcare, illustrates how policy failed to aid the problem (i.e. clean water or making a sanitary sewage system), and shows why such failed policy had existed (entrenched racial assumptions). [1]

            Many of these issues stemmed from the stigmas associated with each minority, and as the job market began to dwindle as the population grew, the false stigmas grew. Economic pressures increased the hostility from those in “power” (whites) toward minority groups. I find it interesting how Molina connects how this type of hostility reinforced the racialization of these groups, which in turn impacts their quality of healthcare, no matter their “ranking” in the societal hierarchy. Going off of this, her explanation of the new portrayal of the Californian Mexicans as Spanish, created a way to falsely morph these people into “European”. By doing this, they were closer to making them “white” which is, historically, the ultimate goal of assimilation here in the US, because citizenship is equated to whiteness. [2] It is also interesting to see the deep history behind this sort of discourse—that minorities are associated with uncleanliness, crime, and disease. Leaders capable of making improvements to minorities’ living conditions continuously pushed the agenda that racialized them and portrayed them as inferior.[3]

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[1] Natalia Molina, Fit to be Citizens? (Los Angeles: University of California Press), 4.

[2] Natalia Molina, Fit to be Citizens? 20

[3] Natalia Molina, Fit to be Citizens? 47-48

Hi Everyone,

Please post your thoughts on the Introduction and Chs. 1-2 of Molina, Fit to Be Citizens here!

DK

Response for 2/22/18

In Jim Downs Sick from Freedom, he begins his explanation of widespread epidemics and mass death tolls that resulted in freedpeople after emancipation by first, the treatment of free blacks and slaves during the Civil War and later, showing how this treatment followed post-emancipation. Using a man named Joseph Miller and his family as an example of the horrendous conditions black families had been left to survive in, Downs illustrates the beginning of the negligent treatment of the black community in America, even those who were serving their country. Like so many other black families during the war, “The Miller family had neither a place to live nor a reliable source of food” because even though “the Emancipation Proclamation officially freed the slaves… it contained no provisions for how they would survive in the midst of the war.”[1] This example allows a clear understanding of the main argument of the entire book: freedom meant that freedpeople were left to fend for themselves, with little support from the federal legislation in place, causing health issues to spread like wildfire.

After the war, once emancipation had officially set in, migration of freed people to the North exposed them to a new environment, and because of their “status” most were stuck in densely populated, and unsanitary living conditions. This, in turn, caused the widespread infection of the smallpox virus, which eventually became an epidemic. Several factors allowed this virus to continuously infect people including a failure by the federal government to act by funding scientific research, an embedded belief in black inferiority, and a historic maltreatment of black people seeking medical treatment.[2] In fact, the Medical Society reported that since this epidemic was only infecting freedpeople, that eventually they would become extinct, and therefore it was not worth the research.[3] This sort of negligent mindset fathered the current social climate relating to healthcare for minorities that has historically disadvantaged the well-being of people of color.

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[1] Jim Downs, Sick from Freedom (New York: Oxford University Press, 2012), 18-21.

[2] Downs, Sick from Freedom, 163.

[3] Downs, Sick from Freedom, 102-111.

Race, Medicine, & Society - February 20, 2018

Race, Medicine, & Society - February 20, 2018

Discussion Questions:

1. What were the competing ideas about Reconstruction?
2. What cultural and political factors shaped African American health after the Civil War?
3. Who/What was most responsible for African American suffering?

Quotes:

“Reconstruction witnessed the birth of the Modern Black Community.” - Eric Foner

“At last, The Black Man is free.” - Frederick Douglass

Reconstruction (1865-1877)

• How to rebuild country after the Civil War?
• Significant physical destruction of the South; economy destroyed because no more slave labor
• 4 million people freed, nearly ¼ die next 10 years during the Smallpox epidemic
• Sectional Divide after war (North and South aren’t instantly friends after the war)
• What’s the relationship between the North and the South going to be?
• North as conqueror of South or try to restore relationship of pre-civil war United States

Radical Republicanism - party in control after Civil War.

Main Views: South needed to be turned into a Democracy, the South needed to be punished (military occupation of the South) , free people educational benefits

Free Labor - Not enslaved. African American protections (laws)

Wade Davis Bill - What a state needs to do to come back to Union.

• Majority of free white men in state must swear oath to US and declare they had never aided the war effort in the South

10% Plan (Lincoln) - only 10% had to have been people that hadn’t participated in the Confederacy

Ex-States had to ratify 14th amendment to come back into the Union

African Americans suddenly free

Issues:

1. Migration - Nowhere to go. When enslaved they didn’t have the ability to move freely. People moved to reunite families, find jobs, move from rural to urban areas
2. Families - disruption of African American families by slavery
3. Education - 90% of freed population was illiterate
4. Free Labor - How do African Americans approach labor? Economic autonomy is what African American males seeked. Pushed back into agriculture.
5. Participation in politics - manhood suffrage

Reconstruction ends in 1877 with the withdrawal of federal troops from the South

• White Supremacist Regime rises as equality isn’t enforced in the South

No force to enforce medical relief for non-whites

Belief that Smallpox would make emancipated slaves go extinct

Smallpox vs Cholera (response was different)

More response for Cholera because whites thought Cholera affected the whole population

Physiological differences and result from emancipation = smallpox

• God’s disapproval of emancipation
• Smallpox symbolic meaning - inherent inferiority
• White “Emancipation has led to Smallpox and punishment”

Discourse = ways of thinking

Smallpox moves from biological epidemic to a way of thinking

Smallpox compared to Native Americans because of disease

Race, Discourse, Cure

Disease mechanism to get rid of unwanted populations, Natives infected on purpose

Dependency

Are Freed People able bodied or not?

- White debate

- Free Labor

- Are African Americans citizens?

Vaccines for non-whites:

-Inadequate dosage

-Shared needles

-Wrong ingredients

-Not packaged correctly

Federal Government lax on smallpox

-Members of Congress believed that African Americans would die off so therefore they didn’t require medical care or effort to provide medical care would go to waste

Survival of the fittest idea of the time (Darwin’s Natural Selection)

Government tried to solve Smallpox, but when it started to hit African Americans disproportionately they began to lax

Reasons for Smallpox?

-God

-Racial Inferiority

-Bad sheltering of soldiers in Civil War

-Inadequate treatment by healthcare system

-Lack of action by government

-Physicians would only quarantine area, not treat

Cholera = “Co-lera”

Cholera affected both, gov knew what to do and acted

Smallpox mainly non-whites, gov didn’t act

“Wasn’t what we did, it what was not done”

• Government didn’t do much to fight against Smallpox
• Willingness to be indifferent to their suffering. Disease, go extinct. Chose not to treat them.
• Various racist thoughts shaping the public health response.

Race, Medicine, & Society Notes - February 15, 2018

Race, Medicine, & Society Notes - February 15, 2018

Discussion Questions:

1. In what ways does Downs challenge conventional narratives about the Civil War, Emancipation, etc? Why is this important?
2. Why, exactly. Did the Civil War produce a major public health crisis?
3. What were the major factors that shaped freed people’s health?

- Americans had to deal with mass deaths

- Americas had to confront death (650,000 military deaths) (50,000 civilian deaths)

- With the use of photography, Americans were being exposed to images of
death from the war

Frames of War by Judith Butler

“Precariousness and precarity are intersecting concepts.
Lives are by definition precarious; they can be expunged at will or by accident;
their persistence is in no sense guaranteed. In some sense, this is a feature of all life,
and there is no thinking of life that is not precarious - except, of course, in fantasy, and
in military fantasies in particular. Political orders, including economic and social
instructions, are designed to address those very needs without which the risk of mortality
is heightened. Precarity designates that politically induced condition in which certain
populations suffer from failing social and economic networks of support and become
deferentially exposed to injury, violence, and death.” (Butler 25)

- Life is precarious

- Failing social and economic networks of support expose the populous to injury,
violence, and death. In other words, when the government is preoccupied (war) or
slacking (holding a potential bias towards a cause or population) they are not actively
supporting citizens.

- Lives can be taken on purpose or by accident (precarious = unstable)

Are all lives equally precarious? (how likely are you to die?)

- People tend to think of themselves as invulnerable to precarity. Otherwise, people wouldn’t sign up for wars.

- This same way of thinking is found in the medical profession.
For my intersession class (Doctors as Writers), I wrote my final paper on the perspective
of doctors that had become patients. Many doctors hold the idea that because they treat
a certain illness; they themselves are immune to it. When doctors contract a sickness or
are found to have cancer; they are very shocked, and quickly turn into patients themselves.

- “Despite this plan, however, Butler did not employ all the poor people who were
within the Union lines. He gave preference to “white men,” leaving hundreds of
starving former slaves on the outskirts of New Orleans.” (Downs 57)

- Ex-slave’s lives were more precarious than white lives. White lives were
prioritized when receiving resources and opportunities to join the military.

- Once slaves were free, they were met with diseases and large distances to travel

-Emancipation kind’ve left the slaves on a doorstep

- No support after Emancipation Proclamation for non-whites, not considered citizens still

- Non-whites wanting medical care was one of the first forms of fighting for rights after slavery

- Emancipation in United States compared to Caribbean nations

- This point was brought up in the book (I forget the page number), but the rate that
freedom was given may play an important role in how events played out. American
slaves were freed in one, sudden decree. In contrast, in the Caribbean, the freedom
process was more gradual. This could have possibly allowed for newly freed individuals
to receive government support. However, due to the rapid freedom process in the
United States, and the ongoing Civil War, the government didn’t have the time or resources
to support the newly freed slaves. Perhaps emancipation should’ve been more thought out
and planned. Also, the sudden Emancipation may have been brought about because of the
Union’s sudden desperation to turn the war to an issue of slavery. This was done to drive off
the pro-freedom British from further aiding the Confederacy. This also improved the image of
the Union’s cause; instead of it being simply to forcibly reclaim it’s rebelling land. The Cause
and Effect of emancipation should've been considered; instead of hastily throwing a
population into poverty with no support. Ex-slaves couldn't just 'make a living on their own
because they were in a position that required aid.

Freed slaves needed support such as:

• Clothing
• Food
• Clean Water
• Methods of Transportation
• Work/Form of Income
• Citizenship (Rights)
• Access to Healthcare
• Sanitation
• Shelter

Spread of sickness:

- Exposure to corpses and feces

- Drinking water not clean

- Sickness spread from people that were susceptible to sickness
(those who had wounds or were in close quarters with a sick person)

- Use of unsanitary medical equipment

Medical Knowledge

• No knowledge of microbiology
• Dangerous medical practices

Military Doctors:

• Some didn’t want to work with non-white bodies such as the physician from Arkansas (employed by the federal government) that refused to put his ear on the chest of a black patient if he had pneumonia. (Downs 35)
• Not always profession (lack of training) (also mentioned on Page 35)

- Civil War was not initially set out to get rid of slavery

- Lincoln was neither pro-slavery or abolitionist

- John Eaton - “Some among us, and some in England, have considered this
emancipation a farce, because it was proclaimed by President Lincoln as a military
necessity, and not on the ground of humanity and justice.” (Downs 38)

1860s - Newly freed slaves did not have citizenship

- Emancipation Proclamation freed slaves in only the rebelling territories

How much of suffering of freed African Americans was preventable?

• Racist ideals of biology (doctors refusing to help black patients)
• Context in history, during Civil War, nation busy with war

Involuntary service in Union camps

Plantation Owners - economic interests in keeping slaves healthy

Union camps didn’t care about health or the wellbeing of the individuals

Union Army cared about non-whites as long as they were military

• Food couldn’t be free, had to be bought with military service
• Union and Confederacy couldn’t afford to help non-soldiers

Belief that ex-slaves would rely on government if given help (argument against freedom for slaves)

• This view would consist (ex: Reagan-era ideas on Medicaid, that the poor would abuse the program and live off of food stamps)
• “...many federal officials feared that providing ample support would encourage freedpeople to become dependent on the government for food, shelter, and clothing; as a result, many federal administrators limited the amount of support that hospitals received.” (Downs 9)
• “Underlying this fear was the long-held belief that black people required white supervision to work or they would be indolent and unproductive.” (Downs 56)

- The Union and the Confederacy ignored the health of ex-slaves and focused on
economic and political gain (Just like when plantation owners were providing healthcare
to slaves. There is the initial period of investment, and then a hopeful payoff. In this case,
the payoff would be the use of black soldiers)

Downs (Sick from Freedom) challenged the common view of the Civil War
(everything didn't go as smoothly)

• Lens of health
• Perspective of newly freed slaves and the lack of support from the government

General Note for making blog posts:

-Make references to readings in blog posts

Quote of the Day: “At least there were maggots” - Jamie

Works Cited:

Butler, Judith. “Introduction/Precarious Life, Grievable Life.” Frames of War: When Is Life Grievable? Verso, 2009, pp. 25–25.
Downs, Jim. Sick from Freedom: African-American Illness and Suffering during the Civil War and Reconstruction. Oxford University Press, 2015.