Ghosts of pandemics past

Foreign Bodies takes us on a sweeping journey through time and empires, detailing the history of mass vaccination and the intrusive imperial approaches to public sanitation

Foreign Bodies: Pandemics, Vaccines and the Health of Nations

Author: Simon Schama

Publisher: Simon & Schuster

Pages: 465

Price:  Rs 899

Covid-19 was the first pandemic of the post-war era that demonstrated how globalisation could be a potent vector of disease. The medical community offered established common-sense ways to tackle the disease, but it was political ideology that drove national responses — from Donald Trump’s indifference to Jacinda Adern’s brisk vigilance to Xi Jinping’s “zero-Covid” obsession. Interestingly, the political-medical controversies that flared between 2019 and 2022 — lockdowns, vaccine nationalism, anti-vaxxers, anti-maskers, super-spreader events, all paranoid terms that have entered the public lexicon — had precedents dating back to the 17th century, as Simon Schama tells us in  Foreign Bodies: Pandemics, Vaccines and the Health of Nations.

The book takes us on a sweeping and sometimes unexpected journey from the Ottoman and Russian Empires, Europe and, most of all, India, battleground of the emerging science of mass vaccination and intrusive imperial approaches to public sanitation and hygiene. 

Dr Schama is a respected and prolific popular historian, best known for his authoritative Story of the Jews  (later a TV series) and  Citizens, a social and cultural narrative of the French Revolution. Big history has not been his only enterprise. Books such as Rough Crossings recounts a lesser-known history of Black American slaves, the abolition movement and a fascinating programme called the Sierra Leone Settlement scheme to create a self-governing colony of free blacks.

Foreign Bodies is in the same vein. You won’t find a close analysis of the 1919 Spanish Flu, the Black Death or references to Albert Camus’ famous work — the latter finds no mention at all — or a chronological account of the history of vaccinations. Instead, this sprawling, fascinating book will tell you how Europe came to adopt vaccination techniques via the Ottoman Empire (though he omits to mention that the concept was adapted from African tribal practices).

One fervent early user and advocate of the smallpox vaccine was French  philosophe Voltaire, who challenged “long ingrained assumptions that Christian Europe had nothing to learn from the barbaric orient”.  Almost half a century later, we meet Adrien Proust, father of the great French writer Marcel Proust, epidemiologist and tireless (some considered him tiresome) public health advocate.

Proust’s observations in his early medical career of the terrifying diseases that afflicted Europe at the time — typhus, cholera, yellow fever, bubonic plague — led him to conclude they were not the result of local conditions, the received wisdom of the time. Instead, such diseases “had legs” and could be transmitted across geographies through trade and tourist routes, through insanitary urban environments (open garbage pits, dirty drinking water, open defecation) and human contact (shaking hands, kissing, etc).  At serial International Health Conferences, he presciently spoke of the absolute necessity of a permanent international public health agency to cope with such emergencies on a global scale.

Most fascinating for an Indian reader is the story of the bacteriologist Waldemar Mordechai Wolff Haffkine, a Ukrainian Jew from Odessa, revolutionary refugee from Tsarist Russia, and pioneer of the cholera vaccine. Almost 100 years later, Indians will recall his eponymous (now government-owned) institute in Parel, which played a controversial role in the development of an indigenous Covid vaccine.

Haffkine is a genuine unsung hero. How a foreign Jew of Russian origin, a discreet homosexual at that, who developed his vaccine in a French institution (Pasteur’s) came to be made Companion of the Order of the Indian Empire in Queen Victoria’s Diamond Jubilee is the story that Dr Schama tells here over six chapters. This is a story of more than secluded toil in a lab and of enlightened patronage — though there was plenty of that. Dr Schama also chronicles Haffkine’s two decade-long grind in such squalid backwaters as Chaibasa in Bengal, Parel and Mahim in Maharashtra, immunising Indians in their thousands against cholera  — there are invaluable photographs showing Haffkine at work among India’s poor.

This is also a story that records an all-too-familiar clash between political ideology and science. In Haffkine’s case, the runaway success of his vaccination was at odds with imperial dogma and motives. His immunisation programme, grudgingly supported by the local bureaucracy, united Hindus and Muslims in their enthusiasm for inoculation, weakening British divide-and-rule policies. His voluntary programme —voluntarism was an article of faith for him — inadvertently highlighted the spectacular inefficacy of the colonial masters’ competing and intrusive sanitation theories that mandated forced entry and destruction of people’s homes and imprisoning populations in local quarantine centres.

Eventually, Haffkine was a victim of sabotage. Discredited, he left India to become involved in the Zionist movement. Dr Schama veers off into a detailed exposition of Haffkine’s Zionist obsessions.  Haffkine certainly deserves a full-length biography in his own right but in this context, his post-India political life detracted from the focus of the book. 

Though Foreign Bodies  reinforces Dr Schama’s talent for revealing history under the radar, it is an uneven work that seeks to be both evangelical and instructive. His big idea is to highlight the consequences of subverting nature “The matter filling million upon millions of pages of recorded history — wars and revolutions, the rise and fall of cities and empires, fevers of faith and the heaping up and emptying of faith — has been circumscribed by what we have done to nature and what it has done to us,” he writes in the prologue. But the subtext here appears to be the intersection between politics and medical science. That, as much as man’s destruction of the natural world, was the catastrophe of 2020.