The Response to Sars: Governments Are Following an Old Pattern

Linda Vergnani, in the Australian (June 30, 2004):

FOR Australian Alison Bashford, the drastic measures taken to control the recent SARS scare and the frightening imagery of people quarantined away were all too familiar.

A senior history lecturer at the University of Sydney, she is at the forefront of research into medical quarantine and border control....

"When it comes to infectious diseases, governments still grapple with the question: Under what powers can states compulsorily detain people so they can't move from one place to another, and what is the difference between that and imprisonment?" Some of these issues will be examined from tomorrow at an international conference on Medicine at the Border, which Bashford has organised at Sydney University. With the toll taken by modern diseases such as HIV and the emergence of illnesses such as multi-drug resistant tuberculosis, the response to her web-based call for papers was impressive. Sixty speakers from across the globe will deal with topics ranging from mad cow disease to the threats of smallpox bio-terrorism.

Bashford says the gathering is unique in that it will bring historians together with commentators on migration, global movement and health. Among the speakers will be epidemiologists, anthropologists and political scientists. Experts will examine the effect of medico-legal control measures, not only on citizens and travellers but also on asylum-seekers and migrants. For example, former Woomera detention centre nurse Glenda Koutroulis will examine how the Australian Government has associated political asylum-seekers with contagion.

According to Bashford, Australia still has the strictest quarantine policies in the world. But other countries, including the UK, are considering adopting some of our medical border-control policies such as compulsory TB testing of migrants.

Conference keynote speaker Richard Coker, senior lecturer at the London School of Hygiene and Tropical Medicine, recently came out strongly against the British Government's plan, arguing that such coercive policies contravened the European Convention, were not effective and should be rejected.

Bashford, whose book Imperial Hygiene was released in January, began her research for the tome -- examining quarantine and disease control in Australia until the 1950s -- at the historic Sydney quarantine station at North Head, just minutes from where she lives.

Situated alongside a crescent of golden beach, the complex looks like a disused brick factory with workers' housing. Yet for 521 people, landing at this beach was the last journey they made. Walking through the quarantine station grounds, Bashford points out the memorial tributes carved into the soft sandstone by ships' crews. On a ridge overlooking the bay is the hospital, now a museum, complete with iron bedsteads, bedpans and the rather ghostly suspended uniform of a nurse.

Quarantining began at North Head in 1828, when the smallpox-infected passengers of a convict ship were detained in the cove. As the station grew and the crew and passengers of passing ships were interned, procedures became more institutionalised. On arrival the healthy were separated from the sick, who were immediately hospitalised. Belongings were sterilised in giant autoclaves and inmates forced to shower in the caustic disinfectant phenol. The station had a mortuary and graveyards.

Bashford's book describes the 1881 smallpox epidemic, during which infected Sydney residents and their contacts were first confined to their homes but later forcibly removed to the quarantine station. One case that particularly moved her was of Sydney resident John Hughes who, with other affected men, was confined to a hulk in the bay while his wife and children were detained onshore at the quarantine station.

"He kept escaping from the ship and swimming to shore to see his dying child," she says. "They ended up putting him in leg irons to stop him escaping." In between writing chapters of her book, Bashford explored the dense bushland near her home and stumbled on a neglected cemetery, dating back to the 1881 epidemic. She was amazed to find the headstone of Hughes's daughter and other smallpox victims whose poignant stories she had just read in the archives....