Spectacular medicine: Plague control in French Indochina and West Africa, 18901914

Aro Velmet

In 1908, the Bubonic plague broke out in Phnom Penh, the capital of Cambodia, a
colony of the French Third Republic. The standard public health response of French authorities
was a three-pronged attack, focused on vaccination with the Haffkine lymph, disinfection of
contaminated housing with hydrochloric acid spray, and the destruction of rats, which carried
the disease. These measures were supposed to replace violent quarantine, forced hospitalization
and the wholesale destruction of housing, which bacteriologists working for the Pasteur Institute
had deemed counterproductive and sometimes even actively harmful.
In actual fact, however, deratisation and disinfection turned out to be prohibitively
expensive and the Haffkine vaccine was often unavailable. Faced with a shortage of the vaccine,
French authorities in Camodia began to use the only available anti-plague serum as a
preventative measure, injecting the khmer population, starting with the emperor Norodom and
his entourage. This was a problem: The anti-plague serum was difficult to produce, and
manufactured only in the Pasteur Institute in Paris. In a circular sent out from Hanoi, the seat of
French power in colonial Indochina, the doctor-general of the colony strongly prohibited local
administrators from using the anti-plague serum as a vaccine. This would further reduce the
supply of an already scarce product, meaning that when people actually contracted the plague,
there might not be enough serum to go around for treating them.1 And since the serum was
effectively useless as a preventative measure, why waste it, the doctor-general asked? Well this
makes sense, right?
1

Governor-general par interim circular, no 83, 1 juin 1908, GGI 2526, ANOM.

But what's interesting here, is the response of local officials. Administrators in Phnom
Penh replied to this circular with the most strongly voiced protests. To them it did not matter that
the serum did not actually prevent the plague, what it did, was to reinforce the trust and
credibility that French authorities had spent a long time building with their Cambodian
intermediaries. When the emperor Norodom and his entourage came to the French resident
asking for a vaccine, the French resident had to deliver something. One response to the circular
read:
If we consider the persistent efforts that we had to deploy to overcome the
instinctive, and still imperfectly won, resistance of the indigenous population,
if we consider the importance that this may have to first of all, hygiene, and
for securing our moral influence [] it seems clear that the local Health
Service could not have received more frustrating orders.2
This case flies in the face of many standard narratives about colonial public health. We
tend to think of colonial powers as aggressively forcing a racialized system of disease control on
subject populations, without much concern for the efficacy of Western measures or for the
interests of the subjects themselves. In these interpretations, Western public health functioned
primarily as a form of governmentality, a mechanism for justifying the differential treatment of
healthy Europeans and unhygienic natives, for categorizing and labeling the subjects, as a
way of creating the colonial order of things.
Yet the Phnom Penh epidemic shows how the colonial state was not only constantly
anxious about the success or failure of their containment measures, it was deeply conflicted about
what success or failure even meant. For bacteriologists, advising the governor-general in
Hanoi, success meant, in a very basic sense, eradicating the plague epidemic. For some
administrators, success might indeed have meant justifying their racialized policies on the
grounds of hygiene, as governmentalist interpretations of colonial public health suggest. But for
2

Resident-Superior to Governor General, 19 june 1908, GGI 2526, ANOM.

the French Resident in Phnom Penh, success meant demonstrating visibly to the Cambodian
intermediaries that the French state was present, that it had a solution to the plague epidemic,
that it could be trusted in a moment of crisis. It is this performative, spectacular aspect of
colonial public health campaigns that I want to focus on today.
I am going to look at responses to two plague outbreaks - Indochina in 1903-1908 and
West Africa in 1914. I argue that epidemic control in French colonies is best read as a form of
spectacular politics taking place in a context where uncertain state authority met overpowering
disease. As Guillaume Lachnal has pointed out, few historians have properly taken stock of the
role failure played in the colonial history of medicine. French power in the colonies was thin
and relied on the recruitment and management of local notables. In the space of medicine, the
state was particularly thin. Not only did French doctors not have effective solutions to many of
the common tropical diseases until the mid-twentieth century typhus, typhoid fever, the
bubonic plague, cholera, malaria, and particularly yellow fever they also lacked the means to
implement what few solutions they did have.
And yet, civilizational superiority, the power of science, bureaucracy and expertise, the
strength of state intervention were precisely the claims on which the French based their right to
rule. Epidemic disease rendered this imaginative gap particularly salient, and created a need for
the state to publicly demonstrate its power. The French, I claim, were constrained by their own
performances of power: once they had turned vaccination into a symbol of French scientific
superiority, they had to use it even when health authorities deemed it unnecessary or even
harmful. What mattered in these epidemics, I contend, was the performative power of
vaccination as a political symbol, rather than its medical effectiveness or potency for cataloguing
the bodies of colonial subjects.
The Haffkine vaccine emerged as a display of French competence in imperial

administration and the superiority of Pastorian bacteriology when the bubonic plague spread
across South-East Asia in the 1890s. The disease first broke out in China, and thanks to
unprecedented intensification of trade, quickly made its way around the world, from Hong Kong
to Hanoi, Bombay, Rio de Janeiro, San Francisco, Porto and even Liverpool. As the plague
crossed imperial borders, from mainland China to British Hong Kong and then to French
Indochina, plague containment became a way for competing empires to demonstrate their ability
to manage epidemic disease. British public health officials used then standard containment
measures quarantine, hospitalization and destruction of contaminated housing to little avail.
This provided an opportunity for French bacteriologists following the work of Louis Pasteur.
They claimed to be in the forefront of a public health revolution, substituting outmoded methods
of disease control with methods grounded in laboratory science, the identification of harmful
microbes and the development of protective vaccines and curative sera.
From 1894 to 1898, the Alexandre Yersin, Waldermar Haffkine and Paul-Louis Simond
worked in the British colonies, identifying the plague microbe, its transmission mechanims
through fleas inhabiting on rats and developing experimental vaccine and sera. However, the
efficacy of these treatments was highly debated variable at best and negligible at worst. [Yersin
and Simond loved to cite trials in Amoy, China, which resulted in seemingly spectacular success:
out of 24 treated patients, 22 were cured, and only 2 died.3 This sort of success, however, could
not be repeated, not even by Yersin himself. In Bombay in 1897, Yersin's serum gave mixed
results: one batch, shipped from Paris, delivered good results. The second batch, from Yersin's
own laboratory in Nha-Trang, failed 13 out of 19 treated patients died, a 73% mortality rate.
The third batch, again from Paris, showed improvement with a 38% mortality rate but still
nowhere near the promising results seen in Canton. The Haffkine vaccine showed better results,
3

Alexandre Yersin, Sur La Peste Bubonique (Sro-Thrapie), Annales de lInstitut Pasteur, Janvier 1897, 81-93

but it was difficult to produce en masse.] British, German, and Japanese researchers remained
highly sceptical of the Pastorian treatments, while Yersin and others remained convinced that
these proved the best weapons against the deadly disease.
In order to convince colonial officials of the promise of the new treatments,
bacteriologists tied them to the reputation of Louis Pasteur - basically a saint in France by that
point - and the superiority of French governance over that of British authorities. If the French
invested in vaccination over quarantine or the destruction of housing, Yersin argued in his
reports to the Indochinese government-general, they could avoid the kind of public disorder that
could be observed in Hong Kong, where thousands of Chinese migrant workers were fleeing
from the city, taking the plague with them to the surrounding provinces.
Moreover, vaccination was the method of Pasteur, which itself provided a guarantee of
future success and this was a powerful argument indeed. When the funding of Yersin's
laboratory in Nha-Trang came up for debate in the Indochinese Colonial Council, some
administrators questioned the wisdom of funding a vaccine whose efficacy had not been
satisfactorily proved. To this, one councillor responded: If M. Yersin is not appreciated by some
foreign doctors, he is certainly appreciated by French ones, who have followed the methods and
and teachings of the illustrious Pasteur. Pasteur too had his detractors who, jealous of his genius,
called him a charlatan for some time. This is all I have to say about Yersin's critics.4 From the
beginning, vaccination against the plague carried a symbolic weight which trumped actual
evidence of efficacy. The Haffkine vaccine represented Pasteur, which in turn represented the
superiority of French science, which in turn would lead to better governance in the colonies.
Indeed, the behavior of the Indochinese government-general during later outbreaks
demonstrated that whatever public health officials thought of the effectiveness of vaccination,
4

M. Mougeout, Sance du Conseil Colonial, 10 Feb 1896, GGI 2510, ANOM.

they realized it could communicate French scientific prowess to a variety of actors. The Pasteur
Institute in Nha-Trang regularly received demands from the government-general to deliver small
quantities of the Haffkine vaccine as diplomatic gestures, when the scourge broke out in
surrounding regions: Bangkok, Manila, Singapore, Macau, Quang-Tchou, the Chinese province
of Canton, and various locations in Japan.5 Because of the small quantities involved, the function
of these deliveries was clearly symbolic, designed to highlight the power of French science in
addressing the medical emergency, while rival powers Britain, the Netherlands, and China
struggled to respond to the effort.
Similarly, local Vietnamese and Khmer notables quickly learned that appealing to the
symbolic power of vaccination could improve their relations with French administrators and
avoid other, more violent measures. During the plague epidemic in Hanoi in 1903, French
administrators received both individual and collective complaints from the Vietnamese.
Protestors objected to the destruction of housing and the isolation of corpses by French sanitary
authorities, which made it impossible to follow burial rituals. Adopting the language French
administrators had proffered in public health campaigns, the letter-writers encouraged
vaccination, as a method of incontestable utility, such the construction of roads and sewers.
When the doctor comes to visit [the patient], and has him transported to the lazaret to be
inoculated and to prevent the spread of the disease, we welcome this good measure.6 Whether
this tells us anything of the disposition of the Vietnamese towards vaccination a practice is
debatable, but it certainly shows that the citizens of Hanoi and Saigon had understood the
symbolic connection between vaccination and progress, in contrast to disinfecton by fire which
bacteriologists had labeled barbaric.
5

Epidmie de peste et de cholra. Etat sanitaire en Indochine et dans les pays voisins 1889-1905, GGI 66345,
ANOM.
Citizens of Hanoi to Governor-General, 31 mars, 1906, GGI 6739, ANOM.

French bacteriologists seeking to establish themselves in the colonial world invested antiplague vaccination with particular symbolic meaning, separate from its actual medical efficacy. It
became a symbol of Pastorization, a distinctly French science, and a symbol of good governance
guided by French scientific expertise. Local elites seized on this symbolism, not necessarily
because they believed it, but because it offered a way of resisting other, more intrusive and violent
containment measures. As the Phnom Penh case from the beginning of this talk shows, colonial
officials on the ground were actually quite attuned to the mood of local elites. They recognized
the limits of the means at their disposal, and argued if they could not produce a response that
was actually medically effective, they could at least respond with a symbol that appeased the
anxious population and retained some amount of trust by responding to an expectation of state
action. I will now turn to the 1914 epidemic in Dakar, to illustrate the importance of medical
failure in producing this cycle of symbolic performance.
Dakar, the capital of French West Africa, and one of the Four Communes of Senegal had
both a large European population made up of entrepreneurs and colonial officials, as well as a
large and active African political scene, since the Dakarois were technically French citizens, and
could send a deputy to the National Assembly in Paris. Usually, this meant electing a French or
mixed-race deputy. In 1914, when the plague hit, however, Dakar had just elected its first
African deputy, Blaise Diagne, creating a particularly tense political climate. The response of the
Dakar sanitary committee therefore has to be situated in the context of a public health crisis
unfolding during a political struggle between French and African elites.
The French were mainly anxious about the very visible failures of the state's containment
efforts. The sanitary committee had instituted mandatory vaccination, sanitary cordons, and
forced hospitalization, yet it lacked the manpower to enforce these rules. Swindlers were peddling
fake vaccination cards, there was not enough manpower to vaccinate the population, and

quarantine was barely enforced. At the same time, death rates continued to climb. This led to
sense of palpable impotence at the meetings of the sanitary committee. The further the epidemic
spread, the more members called for immediate action, to put an end to the disastrous
situation as soon as possible. Although bacteriologists such as Alexandre Kermorgant warned
the sanitary committee that more violent actions, such as the incineration of housing, would not
in any way contain the disease, other members of committee argued that this would, at a
minimum, destroy disease reservoirs diverting the threat of a dangerous return of the disease.7 In
the absence of effective measures against the plague, and under pressure from anxious French
elites, the sanitary committee opted for measures that were both visible and fast.
Africans, however, saw the French medical response as proof of French opposition to
African political representation. Activists seeking to build support for Blaise Diagne spread
rumors that the coercive containment measures of the French were in fact retributions for the
election of the African deputy. 8 These suspicions were entirely rational: during the election
campaign, French merchants had refused credit to African customers known for supporting
Diagne, and the mayor of Dakar had threatened to cut off water and electricity to Africans
campaigning for the future deputy. Finally, as Blaise Diagne himself mysteriously disappeared for
several weeks following the declaration of medical emergency, rumors circulated among dakarois
that the French were trying to assassinate the newly elected deputy by infecting him with Yersin's
microbe. 9 In the minds of Senegalese voters, the election of Diagne and the medical response to
the plague outbreak became two parts of the same puzzle.
The protests quickly escalated. While the French saw the destruction of insalubrious
housing as an enactment of state power against an overwhelming disease, Africans saw it as an
7
8
9

My emphasis, Dr. Huot, Rapport sur l'pidmie de peste a Dakar, 2 June 1914, 2-3, Sngal H 73, ANS.
This argument is forcefully made by Myron Echenberg, Black Death, White Medicine, 60-68.
Echenberg, Black Death, White Medicine, 66.

expropriation of wealth, emotional trauma and blatantly racist injustice:

[The destruction of housing] has forced us to abandon the places where we were
born, where our parents lived and died [] for all who, with much difficulty, have
realized sufficient savings to allow them to construct a small house or a shack
where they and their families have taken shelter, it was ruination.10
The protests culminated in a face-off on November 9th, between a French sanitation
squad backed up by a reserve group of tirailleurs and a crowd of about 3,000 dakarois determined
to protect their houses. The orders of the sanitation squad were to destroy the Parc Fourrages
district, and relocate its residents to the Mdina, but were ultimately withdraw. It was only the
return of Blaise Diagne to the Dakar, and his cooperation with governor-general Ponty combined
with the retreat of the plague and relaxation of containment measures that restored order to the
city.11
The 1914 epidemic politicized disease containment for Africans and French alike. Blaise
Diagne realized that he exercised considerable power in such situations, as his name could both
fire up African protests and calm them down when needed. Dakarois activists saw that they had
more agency over the medical response than they initially thought. They may not have been able
to convince the French to call off the forced destruction of housing, but they were able to extract
important concessions such as greater indemnities and ownership over the makeshift housing in
segregation villages.12
The plague epidemics of the Great War thus created a kind semiotic equilibrium around
disease control. For the French, the failures of vaccination and vector control and the variety of
protests and riots reinforced the need for quick, decisive, and highly visible action, leaving no
room to question the reach of state authority in moments of crisis. For Africans, epidemics were
10
11

12

Petition to the Gov. Gen. of AOF, cited in Echenberg, Black Death, White Medicine, 73.
Echenberg, Black Death, White Medicine, 79-81; Haut-Comissaire de Dakar to Lt. Gov. of Senegal, 13 Nov
1914, Senegal H 55, ANS.
Rapport sur lpidemie de peste qui a svi dans la Ville de Dakar pendant lanne 1919, undated, Sngal H 49
(1), ANS.

moments of political possibility, opportunities to build support for their deputy in the National
Assembly, to extract concessions from the colonial government, and to protest against
increasingly visible discrimination. This was a mutually beneficial, if unintended, arrangement.
It enabled the French to demonstrate resolve in the face of calamity, and Blaise Diagne to
demonstrate his ability to stand up for African interests. The political symbolism of plague
containment measures was important to all parties: administrators, local elites, and
bacteriologists alike.
Guillaume Lachnal has argued that we have not adequately theorized the importance of
medical failure in the colonial world.13 Here, I have provided one attempt to show how the
collision of medical hubris and practical failure produced a particular politics of spectacle.
Unable to actually contain the plague, colonial officials in Indochina and West Africa responded
with measures that carried symbolic weight. Vaccination and serotherapy signaled bacteriological
expertise and French civilizational superiority, and while the French considered the destruction of
housing barbaric, they nevertheless fell back on this method, when political pressure forced them
to visibly demonstrate the presence of the state, in what appeared as a near-anarchic situation.
Crucial here is that this symbolism was acknowledged by French and local actors alike:
Vietnamese and Khmer activists demanded inoculation not necessarily because they believed it
worked, but because they hoped this would prevent other, more destructive measures. In Dakar,
violent containment measures became a symbol of state control for the French, and a means for
extracting concession and thereby proving their political capital for African elites. The spectacle
of containment became a game of politics and symbols. Alas, the biggest winner in this game
was the plague.
13

Guillaume Lachenal, Lessons in Medical Nihilism: Virus Hunters, Neoliberalism, and the AIDS Pandemic in
Cameroon, Para-states and medical Science: Making African Global Health, ed. P. Wenzel Geisller (Durham:
Duke University Press, 2015), 103-135.